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Home My WebLink About6774-zl~O~ NO. 4 TOWN OF SOUTHOLD BI~.~ING DEPARTSel~ Town Clerk'~ O~iee Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .. ]//.8.. I/&te~lev. D~ ..... Street Map No. XxX ........ Block No. ~x ...... Lot No. Xxx..$~tholA..$,Xe .......... conforms substantially to the Application for Bui]dlng Permit heretofore filed in ,ht~ office dated ..........Jtlll~... ~0., 19 ~. pur~,s~t to which Building Permit No. dated ...........AW ....3..., 19.~3., was issued, and conforms to all of the require- ments of the applicable previsions of the law. The occupancy for which this certificate is issued is . .Pl~ltv~. ~. f~atl~', dwt. l~ .with-~ .&dd.$tiol~ ................. The certificate is issued to. J. oseph .C,..Co~II~]~ ..... 0~1'. ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ioR= .............................. UNDERWRITERS CERTIFICATE No. l).q=4~l~ ................................... HOUSE NUMBER.. ~ ........ Street ... l~&te~,vt~¥, lh'.tv~ ..................... Building In~ctor I FORM NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMEN? TOWN CLERK'S OFFICE $OUTHOLD, N~ ¥. BUILDING PERMIT ('rillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 677~ Z Permission is hereby granted to: .... ...................................... 8o~t, ho3.d ]l'.~. pursuant to application dated ............................ ..~...~:.~....~0. ........ , 19..~.'~., and approved by the Buil~Jing Inspector. Fee $...41.ff+00. ......... Building Inspector / BUILDING DEPARTMENT ~ ,,~,x ~WN ~LERK'S OFFI~ ~ ~-~ ~omined ........... ~ ......., 19 Application No ..................... .............. ............. ........ . ........... ..... DJ~ppr~ a/c .. (Building ~tor) APPLICATION FO~ BUILDING PE~IT . INSTRU~IONS ~. Thi* ~lication mu~t be compl~t~l~ fill~ in b~ ~writ~r o~ in i~k and ~mi~ in b. ~lot plan ~hB~i~ I~ti~ of lot and o{ buildi~ ~ premiss, r~lat on~h p to ~djo nin~ premise~ or public ~tr~t~ o~ ~r~*,~nd Oivi~ ~ d~t~il~ d~riPti~ o{ I~out ofpr~ mu*t ~ dm~n on th~ die, mm which ~ ~ork c~r~ by thi~ ~lic~tion m~ n~ be comm~m~ before ~u~nc~ d. U~ ~pmwl of t~, a~li~ti~, th~ 8uildi~ I~tor will is~u~ ~ Buildino ~r~it to th~ ~pplic~n/. Such p~rmi~ e. ~o buildi~ ~11 be ~cupi~ or u~ in whol~ or in pa ~ for ~n~ pu~se whoever until ~h~ll h~w be~n ~mnt~ ~ ~h. 8uildi~ In~*~or. ~P~klCAIIO~ IS ~[RfiBY ~D[ to th~ Buildi~ D~rtm~nt for ~o issuance o{ ~ Buildinfl ~rmit pu~u~nt ~o th~ 8uildln~ Z~ Ordin~ o{ tbe T~n o~ ~ut~ld, Su~olk Count, ~*w York, ~nd ~h~r opplic~bl~ R~ul~tion~ for th~ co~tructi~ o{ bulldi~, ~iti~ or ~t~mti~, or {or mmowl or (Signature of applicant, or name, if a corporation) Southold N.Y~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ : ............................................................................................... .........................................Name of ~ner of p;~mis~......~ ......................... : .............. :....: ................................................ If applicant is a corporat ,~gnature of duly authorized officer. Builder's kic~se No ..................................................... Plumber's License No ................................................. Electrician's License No. ~:.QI'~,~,, ............................ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ......... ~ ....................... 4. Lot No.......X~... ............... Street and Number .... ..W../..S.......W..a...t..e...r.~.i...e..~.....D...r..i.?...e. .............. ..S..o...u..t..h...o..1...d: ............................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ..cl:..~...e..]r...]..~..~.K ...................................................................................................... b. Intended use and occupancy .............. .s....8~...e.....~...~..~..~......8~......a...d;~..~..~..~.o..~.. ............................................................... 3. Nature of work (check which applicable): New Building .................. Addition .....~ ..... Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ....~1.~.~,..0..0.. .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... .o...~..e. ........... 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 ........... ~.'J,~. .................. Rear ........... ~., ............ Depth ...Lg. ................ Height .................... Number of Stories ....Q~ .................. : ....................................................................................... 9. Size of lot: Front 1 O0 Rear 1 O0 Depth 28L1' ~ 10. Date of Purchase ........................................................ Name of Former Owner .....~..:....G...r..o.~..o.~..~.~ .......................... 1 I. Zone or use district in which premises are situated ....... A.....d.~.$~ ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..n...o. .................................................. 13. Will lot be regraded~ ........ ~.o. ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor J. Cornell Constr Cor A"r Southold ....................................................... P... aa ess ................................ 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 corner lot. Bee attached plan STATE OF NL:W YORK. ~ ¢ ¢ COUNTY OF ....... lit. J '.Ql ........ ................................................................................................. being duly sworn, deposes and says that he is the opplicanl (Name of individual signing contracf) above named. He is the .............................. ~13~J~l,el~'. ................................................................................................................................. (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 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 therewith. Swam to be~l~rne this ~.~.~-I/~ ................ Nato ry Pub, ic~.. r-~..., ~ountYNoi,, ,l~,~'Hl~ublic, ,ate1'' ~o,~,~, New V~k ~~';; .................. No. 52-034496~ Suffolk Count~ CommisslSh Elqb~l March 30, 19.~.~ L~AYVI ~/ WATi;~ViEw AT L:~AY VI [W TOwN or $OUTHOLD, N.