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Home My WebLink About7308-zFORM NO. 4 TOWN OF SOUTHOLD BUN,DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. Zg~8~ ...... Date ........... THIS CERTIFIES that the building located at Bayeho~,e. Road ............ Street Map NoPee,..Bay. ~l~ No ........... Lot No..~O8 ..... Gl'eenimr. t.. N,.~, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Juice .. ?.., 19.~1~. pursuant to which Building Permit No..?30a~ · dated ........... ,T~... V"', 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 issued is .. PrSvate .aeaellol'y · (m~orage..)..b~ail~li~g ......................... The certificate is issued to ... lg~.tliam .M,-~lt~ ... 0~nel, ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .. Il. aR. ............................ UNDERWRITERS CERTIFICATE No..N....R.. ....................................... HOUSE NUMBER . .¶.970 ........ Street ... ~ays~l~. Road ....................... I~OB~ NO. ~ TOWN Olr SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7308 Z Permission is hereby granted to: ...... G~ee~po~t .................................................... to .,~u-'Ll~..~ev..&G~e&Ba~r...~),z&ge..~,t3,&jbM~ .................................................................... at premises located at &et...l~)8 ...... ,A~r..~ee~.,~e~..~d .......................................................... .............................................. ~.~..e.... ~o~....d. ......... .~.~.e~.~ ........... , ....................................... pursuant to application dated .................. ,T~ ....... .~. .................. , 19..~.., and approved by the Building Inspector. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS I o. This qpp!ication must be completely filled in by t~pewriter oe. in ink and subm tted ntr nspecto.r, with 3 set~ of plans, accurate plot plan to ~cale. Fee according to schedu e ....... '- ................. ~-[~ b. Plot plan showing location of lot and of buildings on premises, relatlonsh p to adjoining premises or public streets areas, a_~nd g~wng a detailed description of layout ofproperty must be drawn on the diagram which is Part of this appfication. c. I ne 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 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 Deportment 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, Osdinances or Legeual~t;~i~Sa~[OargtrheeesC~on~c~m~oi:nw~[hb~ildc:ngTi,ca~leltlons or a.!tera~.ti~,a.r~:~j0r,for removal or. demolition, as herein described. admit authorized ~n P y pp aws, ora ~ es, Iding code, hous ng code, and regulatiomi, and to inspections. (Signeture of applicant, or name, if a corporation) ....... .., .Y., .... .,. . .¢. .,,. .. . (Address of applicant) ~ (Name and title of corporate officer) Builder'S License No ..................................................... State whether applicant is ow~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... .... Name of owner of premises ..... ...~...L.'.L...~./i.~..n'J.... ,~... ~ ' If applicant is a corporate, signature of duly authorized officer. Plumber's License Ida Electricion's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: ............ ./-./--.~. ~.. .....Lot No...../...~..~f' Street and Number ..~.~...~..~,~..__~.. . ... ' .................. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy b. Intended use and occuPancy 3. Nature of work (check which applicable): New Building .................. Addition ........ ;Z.. ..... ~lter~ion ................. Repair .................. Removal .................. Demo ton Other Work .~.~..~. ........................ ... 4. Estimated Cost ..~I~.~..~..~.4~Z~ ........... ;.,..~ .............. 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, 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 olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ '~ Dimensions of entire new construction: Front ....i ............ J..(~.../. ......... Rear ....... ~..'~..../. .......... Depth ..... '.~.~)' ............ / · Height .......~.. ........... Number of_ Stories ....... ./. ........................................................................................................... ~Size of lot: Front ........ ~.v.'~ '.~..~..~.. ............................. Rear ............ .'7/....~.... ......... .~..%.. Depth ..... ~/~ .............. 10. Date of Purchase ....... .J./.~.L~.Z..~.J. ...................... : ...... Nc~;n;n~ of Former Owner 11 Zone or use d str ct n wh ch prem ses are s tuated /~...~....S..~ ..~.~ ~ T~,~-/_ 12 Does proposed construct on v o ate any zon ng aw, '~)'id nonce 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...~..~ ....................................... i.....[ Address'. ............................... Phone No. ...................... 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~OP~., / COUN ................................................................................................. being duly sworn, d~oses and says that he is the applicam (Name of individ~l signing contrac~ above name. He is the ................................................................................................................................................................................. (Contractor, agent, corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ond file this application; that all statements contoined in this application ore tree to the best of his knowledge and belief; and tha~ the work-will be performed in the manner set fo~h in the application filed therewith. Sworn t~be~m me this ......... .............. (Signa~re of applicant) JUDITH T. BOKEN Notary Pubfic, State of New York No. 52-0344963 Suffolk CounP/ (;ornrni$~ioll EXpires March 30, Io-X~