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Home My WebLink About6384-zIvOB~ NO. ~ TOWN OF $OUTHOLD B~ffLnlNO DEPARTMENT Town Clerk's Office $outhold, lq. Y. Certificate Of Occupancy No..Z.~.~.2.2. ..... Date ...~...tl~,y..2.7 ................. , 197.~. THIS CERTIFIES that the building located at .... .6.1~..1~..I.~.'.l~..~...A.v.e..n.~e... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....i~..?.h..2. ........... , 19.~.~.. pursuant to which Building Permit No~ ..~ dated llal*eh 6 19. ?.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is Oarage for C&~' issued is ........................................................ ~ ............... The certificate is issUed to .... .D?..1~...~..~.i..l.~.e.r.a..1.e.e.v..e ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... .~.,.R.., .......................... ilolL UNDERWRITERS CERTIFICATE No ............................................. HOUSe. ~.R.., .~..S ........ Street..~?...~?...~?..*:. ~.~.~.i.~: .~.'!'. ....... FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6384 Z Permission is hereby granted to: ,J ~'-~ 7::/4 Z) (/ Al ~/ /F ...... .~...~.. ~,'~ ~ ~ ~) L ~ I ). D IZ1 .'~ l ............................... ~ ......................... '.~.....z. E~ ~t- at premises located ~' ~ L/~' ~t//C/T~ ~/A/~ ~ ~Z- pursuant to application doted ............................ 2 ....... ~.~.., 19Z~, and opproved by the Building Inspector. Building Inspector IU ~IU)IN~ DEPARTMENT ~ ~.~/n ~ ~ SOU~'HOLD, N.Y. -'/~"~ App c(]t~on_ Nc~ ............ ~..~... ........... .... , ......... ;.....~ ........ ~..../~.~~ .. APPLICATION FOR BUILDING PERMIT ~ Date '~- ~' 19.7....~...~ · . . , ,~' ,~,~.,.:i.NSTRUCTiONS : , ~ -' ~ a. This ~li~tion must ~ ~mpl~ly fiJl~ in by W~writer or in ink and submi~ed in tripli~te to the Buildi~ Ins~or. wi 3 ~:~ ~, ~r~W plot plan m I~. F~ ~di~ to ~ed~e. . . ./ ..... ~. - ~ b.~ot~ ~i~ion.~r lot and of ~i~i~ on pmm~s,.rrel.att~p~ ~(~;~ o~ ~O,c st~ or are~, a~ giving a ~ d~cription of I~t of ~ m~ ~ drMn on m~ram ~1~ is ~ eT m? ~tMtlon. ~ c. T~ ~ ~vered by this a~t~ ~ not ~ ~mmen~ ~re ~uu~ of Building ~emtt... ' .... II ~ k ~ ~ d. U~n a~mval of this a~liMtion, ~ Buildi~ Ins~or will i~ue a Building Per~t to t~ appnMn~ ~ wrm~t ~a ~ the p~mi~ available for ins~i~ ~r~out t~ wo~: e. No ~ildi~ s~l ~ ~p~ M ~ in w~ or in ~n for an~ ~r~ whKe~r until a ~tfi~.of ~n~ shall h~e ~n ~ by t~ Building Ins~or. · ~,/~'~ ~ ' :)N IS HEREBY MADE to the Building I of Southold, ~uff.~ County, New York, and other alterations, o~ for, removal or demoll.taion, as I housing .cOde, and regulations, end~o admit s ~tw~i~e~'~'~'L"r~?'~'-' · ' Building Zor~ Builu,,~ r,rmit pursuant to the construction bf appli( t is owner, les.e, agent, of ilcler's · No. ' °' ! No ................................................ 1. No ............ ..~,.~..,~ ........,~. ~ ... ,. ....... Lot N~/ ........................... ......... · -~.....'.°'."" :":'" °;:: FORM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. ~/h~.'~ Examined ......................................... Approved ...................... /......(.!?'...:.., 1~.._~... Pemit No. (~ ~) ,¢i i/ ~ Disapproved o/c ..................... ... .................................................................... (Building inspector) / / APPLICATION FOR BUILDING PERMIT Date ~ '- Z 197 1 NSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi'~T 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, ar~ giving a detailed description of layout of property must be drawn on 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 permit,shall be kept o the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have beet granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zo. Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or r the construction 0 buildings, ~ddil~on.s or alterations, or for removal or demolition, as herein described, The applicant agrees to comply all applicable laws, ordinancei ~ buil~ cod~ housing code and regulations and to admit authorized inspectors on premises and in buildings f inspections. State wh~ther applica, nt is owner, lessee, agent, corporation) rchitect, engineer, general Contrac~r builder Nan~f J ~)wner of premises If applicarjt is a corporate, signature of duly authorized officer. BiJ der s L ce S~ Nb: ......................................................... P~mber's Lic nsc No ......................................................... E~ectrician s License No ..................................................... Other ~jle's License No ....................................... 1. Location ~[,~nd (n which propos~cl j/york wdl be done. Map No ............ z.~.-! ......... ,' ............... Lot No ......................... 2. State existing use and occupancy of premises and intended use and_occupanjcy of proposed construction: a. Existing use and occupancy o~.-,~../~..~ ................................................................. b. Intended use and occupancy ~~..~'...~~ ............................ ~ ..................... 3. ~lature of work (check which applicable): New Building ....................... Addition .....~ ........ Alteration ............... Repair ......................... Removal Demolition ........................ Other Work .................................... ......................... (Description) 4. Estimated Cost .~/f&:....~.~...o. ................. Fee ................................................................................................. (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 commercia or m xed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ./.~'.:...~. ........ Rear../.fi.....:/. ............. Depth ,.~?. ............................. Height ~ ~/ ......... Number of Stor es ........................................................................ - · ........................... / ~ /1 ~,.,~ Dimensions ~ s~/me structure with alterations or additions: Front ...../.~....Z ......... Rear ....~...~....~. ......................... ri,nth t7{ ............. Hek]ht .....O~. ................................. Number of Stories ...../, .................................. B. ...... ........ ................... Hei ht ' .., Number of Stories ..................................................................................... g ........................... ' Z; '- 9. Size of lot: Front ..... ~.:.~'... ........................ Rear ....... ~.....: ........................... Depth ./.~.~ ...... ...-~.~......{. .......... .~..~. ..... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .....~..'....O. ............................................... 13. Will lot be regraded ................................... Will .excess fill be removed from premises: [ ] Yes.~ j. ] No 14. Name of Owner of premises ..~..~.~J~..)~ ...... ~..l.J-.~.~.-,[:~..e..~,..~..~-~. ........................... ~.-~.. -~...-'..-~.'":~'"'~'~'~' ......... (Address) (Phone No.) Name of Architect ............................................................................................... ~ , -~ '" (~,'~ ~ ~'~'~ i ........ (Phone~,N. o.),~ ,_ Name of Contractor '" ~"f2~L~' ')'/~'''''j'~'''h~d~/~'''~"-- --' -- ..................... i~,~J~l'~;~', .......................... .~.....~..~.l~;~.~:~:iC.=:..~..~-~_ ~ L/~; ~, ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. ~ ~ S3ATE OF NEW~._YOI:t ~K~ COUNTY OF ....-~,::.~:.~..~-~ ........................... ) ............... ~:~/:i.~.....?~s~:~.xS~2'.~ .................................. bein§ duly sworn, deposes and says that he h he app~antI ~o~e named. / (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 all ;tatements 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 therewith. TERRI L~E Et, AK j j- ' P~IBLIC; State oi l;e,v York' Notary ....... Co, tv ............... ........ ......................... t.~l (Signature of applicant)