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Home My WebLink About6664-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Of[ice $outhold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . W.~.n~mbmh,~. Blv~ ......... Street Map No...XX ........ Block No....XX ...... Lot No..7.2. .............................. conforms s~bstantiaily to the Application for Building Permit heretofore filed in this office dated ........ J~Z~e. iL?,, ...., 19 .~.3. pursuant to which Building Permit No.~.~.~;~%... dated ........ .J.~i~.$. ~L~, ..... , 19.73.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pr.i. vat,- 'aee~sery -~u!.ldin~ ........................................ The certificate is issued to ... HeltVy. H,. Alclrich ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ...3.1~0.~. ...... Street ..... g.~n..n.c...1~.....I~.l.v.d.; ................... ..................... .. ........................ .~. .u. ~. .~.n.~. .~.a.t.~. r.,. .s. ~. .t.h.n. ~. .~, .N. ,~. ......... Building Inspector/ FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6664 Z Permission is hereby granted to: ....... ~e~...~.~.~lc~ ......................................... .......... ~.~ut~.~ .................................................. ~o ~..l~L],~. ~w..ac.ce ~s ~,--'y... ( at ozage.)...b~L]~ ................................................................ at premises located at ...... ~;J,121J~;li~..~vd ...................................................................................... .................................................. · outho;~....lt.~. ............................................................................. pursuant to application dated ........................~l'.t~J ........ 1.3 ........... 19~..~..., and approved by the Building Inspector. Fee $.tg.:...Og.. ........... BUIL~IN~ DEFAKTMINT TOWN CLERK S OFFICE '. , : . .... SOUT.OU~, .. Y. ~ - o~ %. E×am,n. ....... ........... p,,cat,o".o ....................... ........... ,:......,.., ........... . .... Disapproved a/c ............................................................................................ ·-',' ~ Date ............. :~.1~,.e.....1.~..~...~.~.~.., ~ ............ :~ INSTRUCTIONS .~ a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the Buildln~ Inspector, with 3 sets of plans, accurate plbt plan; t° sc~il~. Feeq,ccRsdi~g to schedule.. b. - ~i~t plan show.ng location ~f Jot and of bu.ldlngs on premises, relatlonsh p to adlom.ng premises or public streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application.~, c. The work covered by this aPPlication may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perrnit~ shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole orin part for any purpose whatever until a Certificate 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 pursuant to the Building Zone Ordinance of the Town of Southold,. Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal Or demolition, as herei.n descr bed.~,,~l The applicant agrees to comply with all applicable laws, ordinance~ building code, housing code, and regulations, and taXX ~.~mit authorized inspectors on premises and in buildings for nec~ss~ryAfnspectior~ ,~--,,,~.. - ~ ~ ..... ~..;;,.: ..~ ..... .... 1¥.. ,..../_..'......~,e: ...~.~..~.......-.~ .............................. · (Signature qlf applicant, or name~ if a .corporation) ..... .............. ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of o~Wler of premises ................. ~1;1~/....~.,t~..~..2...1~.~ ............................................................................................ If applicant is a corporate, signature of duly autl~orized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot No...~..~. .................. Street and Number ..... x~....m~]~.~....~..~.~..~.~.~'...~..~..~..~.~.~.~..~.'~.~.~.~...~.~t~.~t~t .............................. , Municipality State existing use and occupancy of promises and intended Hse and occupancy of proposed construction: a. Exisiting use and occupancy ....... ..~..~.~..~.....~.?.~. ................................................................................................ b. Intended use and occupancy ....... .V.e.e~t~..~,e~...w;I,l~lL~.~.e~e...~.~ ..................................................... Nature of work (check which opplk:oble): I~~ ..Z...(..~...~..O..Z:....~lc~l~l~t~J~. ............. i.. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) 4. Estimated Cost ........... .1~,,0.,0,.',.,0,'0' ................................ Fee ...1.,,0,..~.....; ................................................................ ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................. If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and'exteat of each type of use ............................ 7. ~ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....],{)..~.IL...; ............... Rear ..].0...;~.~. ............. Depth .:~.<l...~'.~. .......... Height ...~.,..~.~'. ....... Number of Stories ..,(.~.~.~...~..~.ll~...{~..,~ .............................................................................. 9. Size of lot: Front ..... ~..~...~'.~. ....................................... Rear ...... ~.0.....~..,~. ........................ Depth ..... ,]..~..0.....~..~. ............. 10. Date °f)~L~rchase .i.~,~.~..~...0. ....................................... Nome of Former Owner ]J~ee3.111 11. Zone or use district in which premises are situated ................ .~..e.~..J..J'....~...~...[..l.~. ................................................ ~ .......... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ]J~. ......................................... 13. Wilt lot be regraded .......~..e. ........ ; ....... Will excess fill b~ remQved from i~remises: ( ) Yes ( ) No 14. Name of Owner of premises ....~..l.~...~.~.:..J~....l~....[...I..~. ........... Address Pho.e Name of Architect .............................................................. Address .................. ; ............. Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions frail3 property lines. Give :street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF N E'~V YO~,K, , , t S S COUNTY OsF,~,..,',',',',',',',','~,.'.,~..'~..'.~..'.~..~'... ...... )' ' ;.: .................. . ,~.'~, .~.~ .~,,~...... ,~ .,X,; ..,,~ ,,~. ,~.,w~L~ ,~;, ,X~. ................ being'duly (Name df ~dividual si{;lning corffractO above framed. sworn, deposes end says that he is the applicant (Contractor, agent, co~pemte ef~er, etc.) of said owner or owners, and is duly authorized to perform or ha~/e performed the said work and to make and file this application; that all statements contained imthis ~3[~plic~etid~l~¥t~ to the best of his knowledge and belief; end tha~ the work will be performed in the manner set fo~h in'the'ap~lJ~o~ fi'led the~with. Swam to b~ore me this , ~ ~ ~ ~ ~ ~ , (S~naturd of applicant) -~ NOTARY P~~[,L~a~ New ~or~ ~