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Home My WebLink About6586-zFO~M NO. & TOWN OF SOUTHOLD BUH,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy THIS CERTIFIES that the building located at . I~..a~.,~...R.o.a.d. .............. Street Map No. 7~ ......... Block No.. r~ ..... Lot No, ~... 0rker~t.. I~ ,:~ ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~y . .%2., 19. ?~ pursuant to which Building Permit No. dated .......... ~.~Y . ~.~. , 19 ~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is ~sued is ...F.~.~..~;SX~.~ .b~l,c~ .......................................... ...... ~ The certificate is issued to Lloycl..~.e.~'~'y ...~r~,. b:~- ~.c~, ....................... (owner, lessee or tenant) ,of the aforesaid building. Suffolk County Department of Health Approval N,R, .................... UNDERWRITERS CERTIFICATE No. N,R, ........................................ HOUSE NUMBER . · · ~.~70.. · Street .... i~a.~ .~oad · ·. ~)r~r~.~ ................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERt~IT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6586 Z Permission is hereby granted to: .... LI~..~-_ r~-~ ................................................. ......... ~;Le~'t; ...................................................... ~o ..~:_~..a....~...~...~.a.. .......... .(..a..,...,.?..~.~?.~..~.?..). ........................................................... premises located at ......... ~'.~.:~tt..~.O~_~L.~ ................................................................................. .................................................... ~1._~.~ ........... ~*Y~ .................................... : .................................... pursuant to application dated ......................... ~ .......... ~....i.~., t'~j~.../ and approved by the Duilding Inspector. Fee $.jO.j~, O~ ........... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of building~ on premises, relationship to adjoining premises or public streets or areas, an giving a detailed description of layout of property must be drawn on diagram which ,is part of this al~lication. c. The work covered by this application may not be commenced before i~uance of Building Permit. ~. d. Upon approval of this application, the Building Inspector will i~sue a Building Permit to the applicant. Such permit ,shell be ke the premi.ses, e?ilable for inspection throughout the W°rk. e. No budding ~hall be occupied or used in whole or in part for any purpcee whatever until a Ce,rtificete of Occupancy shall have been~ granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pur~ulmt to the Building Zone Ordinance of the Town of Southold. &Jffotk County, New Yo~k, and other applicable Laws, Ordinances or Regulations, for ~te eenatructk~ buildings, additions or alterations, o~ for removal or demolition, a~ herein described. The applicant agrees to comph/wi~ all al~l~flcable lew~ ordinances, building code, housing code, end regulations, and to admit authorized inspectors on premises end in buildings for neoHle~ inspections. Lloyd Terz'y (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,' plumber or builder. .............................................. Otmar....~..b,~ ]_~ ez: ............................................................................................................... Name of owner of premises ..T.1 D~r~l...~,ti~,,"~ .................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No ........ ~ .............................. Lot No.~ .................. Street and Number .................Y~....i...D....~...o..a..~.. ....... ..O.r.~en.t' Municipality 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~..~TrTR ....................................................................................................................... b. Intended use and occupancy s.a~....e...,,~.~..h....ff.,,a.,,z~..$..t;...a:..,]~.. ................................... ~ ............... 3. Nature of work [check which applicable): New Building ...~ ........... Addition ..................... Alteration ............... Repair ......................... Remdval ......................... Demolition ........................ Other Work (Description) 4. Estimated Cost ...................................................................................................................................... .... ....... .. (to be paid on filin~ this application) 5. If dwelling, number of dwelling units ...... .0.. ........ Number of dwelling u~its on each .floor., ............... ....................... If garage, number of cars .......................................................................................................... .. .._ · .. · · .... .- · 6. If business, commercial or mixed occuoencv, specify nature and extent of eech,tVpa of use ..................................... 7. Dimensions of ex'~Sting~tructures, if an,/: Front ............... - ...... Rear ........................... Depth ................................... Height ........... ;: .................... ; ......... :: ......... :.. Number of Stories ............... : ............................................ -~ .............. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ...... l ...................................... Height ........ t...~:.,~......,,, .......... ,. NHmber of Stories ........................................ 8. Dimensions of entire new construction: Front ..~ ....... .lt~ .......... Rear ...:...l.J~ ................ Depth ..... ~2. ....................... Number of Stones ......................................................................................... Height .................. £ .......... :.:: ........... ' oZ:te 9. Size of lot: Front ........&cez~a~ ............. Rear .......................................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district' in which premises are situated ..... ~,~....i~3,~. ...................... , ....................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~¢i .............................................. 13. Will lot be regraded .... ~o ....................... Will exCeSS fjll be removed from premises: [ ] Yes [ ] No 14. Name of Or{ruer of premises .......T~q,.o]~..~e~'.~....; ................................................................................................. (Address) (Phone No.) Name of Architect ........................................................................ (Add~ess) (Phone No.) Name of Contractor .............. §.~....'. ....................................................................................................................... (Address) (Phone No,) PLOT DIAG RAM Locate clearly and distinctly all b~.ildings, Whether existing or proposed, and indicate all sat-back dim.e, nsions from property lines. Give street and block number or description according to deed;,and show street names and indtcate wheth- er interior or corner lot. STATE OF NEW YORK, I COUNTY OF ................. ~.~..0.~ ................. ~7. T.]...O,.¥..~. ~el,]~. ~eing duly sworn, deposes and says that he is the applicant above named. . {Name qf tndivtdual stgntng contract) {Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that afl statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed~'therew[th. ..................... .2...2..... day o¥~ ~r TERRI , 19 ~,3 '