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Home My WebLink About6715-z~0~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupancy No~j~6 ....... Date ........... Aug...8 .......... , 1973. · THIS CERTIFIES that the building located at 8/8 .Pt.i~ .]leek .Road ...... Street Map No ............. Block No ........... Lot No.. x~ ... ~uth~]~.. BoY. ......... confoms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~T~].~r .... 9" 19"73 pursuant to which Building Permit No.. 6?¶ ~Z dated ........... Ju.].y ....9'" 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 '' 'P~"~'g&t,~' 'aO~'dg6~y 'l~OA~[d~lig' (' 'Storage' e~ce) .................... The certificate is issued to . F~%~' l~a~.~.~ff~'6 ' "0~' ' '~ ........ ~ ..... .~ ......... Lowner, lessee or ~enant) of the aforesaid building. Suffolk County Department of Health Approval ...N,R, ............................ UNDERWRITERS CERTIFICATE No ...... N-,lq, .................................. HOUSE NUMBER .... ~0 ..... Street ... P~ne' I~eck' Roa~ ...................... Building Inspector ( IP~W.M' NO. ~8 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING FEP~IT (THIS PEPu~AIT/MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 67~.5 Z Date ............. ...~......."~" ............, 19.?.....~... is hereby granted to: Building Inspector. ......... TOWN CLERK'S OFFIGE ^pp,,catlon .o. ................. Perm,, ,o. ...... Disapproved a/c ~;.~ ............... ~ ............... ..~ ............... ~.~c~ ....... ~ ~ _. I APPLIC:ATION FOR BUILDIN~ PERMIT ~F~, INSTRUCTIONS L./ ' a. This application must be completely filled in by i~Pewriter o~, in ink and submitted in triplicate to the Building Inspector, with 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 o~ '~' areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of this application. L c. The work co~ered 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 on 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 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 or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatlons,'and to admit authorized inspectors on premises and in buildings for necessary inspections. . ............ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. app 'ca 's corpo a , s'g a u e o du y authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. 1. Location of land on which~_~ ~-.,- ~-<°r°°°sed-~°rk .will be done. Map I~.: .................... Municipality 2. State existing use and occupancy of p/~ises an~L)~J:~te, nded use and occupancy of proposed construction: ha' Exisitingntended uSeuse andond occupancyoccu nc ..............~~ ~'~m ................ ~ '~ ............................................................................ t'~, .~~~ ~ ~~ ~% .... 3. Nature of work (check which applicable): New Building ~ Addition .................. Alteration Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ...........: ................................................ Fee ....~...~....~ ........ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... O.. ............. Number of dwelling units on each floor ............................ If garage, number of cars ......................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent 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 ............... ~.. ................. Rear .~. Depth ~ O Height Number of Stories ~ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date.of Purchase ........................................................ Nominal ~Former Own#r .............. 11. Zone or use dstrct n wh ch prem sas are s tuated ............. :~. ........ ...~..~ .............................................. iiiiiiiiiiii 12. Does proposed construction)~c,t)e any zoning law, ordinance or regulation: .......... ~ .................................. ]3. Will lot be regraded . ......... ~...v..~,,~ ...... .]/j.~j,vw~ e?ess t~Will ex ess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ......~..~..../...v..L?~ .......... Address ................................ Phone No ....................... Name of Architect ................. ~~'v" ..................... 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-back dimensions from 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 NE'W~.4)R~,~..,,~iJ.~r' J¢ c (Nl'nm~ /-~lindJ'vidual/~J~,~'~g contracf) swgrn, deposes and soys that he is the opplicanl above 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 ond file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perforrj~'d-J?~the manner set forth in the application' filed therewith. ......................Swam to bef~ me this ~~1~,, of (~o7(-.~~'~ ' ( / (Slgno~ ~(';l~l~hcant) TERRt"~[ ELAK ~ ~ j~ NOTARY PUBLIC, State at ,.;aw York ion Expires March 30, 19'7~