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Home My WebLink About7321-zTOWN OF SOUTHOLD BUn.I~I~IG DEPARTm~'T Town Cle~k', Office Southold, N. Y. Certificate Of Occupancy No. ~6~6..Q ...... Date .............14a~oh...%3 .... ,19. THIS CERTIFIES that the bui]dlng located at .W/~ .Va~sten. A~l ..........Street Map No. ~.a$~....P.t.. Block No ........... Lot No..32.7..&. 328....Q~t0~ogu~...1~,~.o conforms substantially to the Application for Building Permit heretofore ~ed in ,hi, office dated ..........Sept...12.., 19~.~. pursuant to which Building Permit No. 61~59Z. · ~une 12 .~ dated ..........8~p%. · .1.$..., 19__ ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi~ ceriiflcato is is-,ued is ...P. rl.v~te, m~. 1'~t1~..d~el~.tn[.. ~tt, h. s,,. &d~titio~ ............... The certificate is issued to $,~,tt0~1~I1~ ....... ~ ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Depa~-tment of Health Approval . II,R, .............................. UNDERWRITERS CERTIFICATE No. p~o~lllxi ................................... HOUSE I~UMBER . .. ~.~90 ...... Street..~lan~,ton. ttoad .......................... ........... Bui]dlng Insp~r /rOB~ NO. :g TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT O1'4 THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7321 Z Permission is hereby granted to: ·.tT.;;.,...g.eer~;.~.....AZ.~......;.t.~.,..~.e~.L~ ......... ...~.~..t.~$~ ................................................. to ..~.~,~...e~..~J,U,Q~..Q~..~z~,~I;~..~,wO~,~ .............................................................. at premises located at ...... .V. IU~I~...~g~. ...... ]{~9&lL~.O.~l~t, .................................................... .. .......................................................... o-~,ta~zo~ ......... zaoZ, ............................................................ pursuant to application dated ............................. ,T~,~. ....... .12....., 19...~..~., and approved by the Building Inspector. Fee $.t ~.~.00~ ........... · d g spector ~ Disapproved a/~' APPLICATIOH ~ lUll,DINg FBRMrt INSTRUCTIONS a. This application must be completely filled in by typewriter oK in ink and submitted in triplicate to the Buildings1 Inspector, with 3 sm of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationsh p 'to odjo ning premises or .,p~. lic streets or oreas, and giving a detailed description of layout ofproperty must be drawn on the diagmm which is part of th~s application. c. The work covered by this application may not be commenced before issuance of. Bu Idlng 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~.i shall have been granted by the Building Inspector. i~ .A,~P. PLI .,CATION !S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the U,,ualntgi :on.e C~d_. mance, of ..the '"1". ,o~'n..o,f. Southold, Suffolk Cou.n. ty, New York, and ..other al~licabl. Law~, Ordinanc~ or .~ ar ,.OHS, .mr me c.onstruct~.on o..~. ou~?ln~.., ,ac.~l. It!ons or alterations, or for removal or demolition, a~ herein described. _je i~ppl~a_n,~ ?g~ .r?s m.comp,y wire au app?.cao, m.! ..a?, ordinances, building code, housing code, and reguloticm, and to uum ~ auTnonzea in~oecr~l's on prom ses aha in IDUlIOIrI~ Tar' rl~ce~ary Jr~.'tions. · Tee. Deerkoskt (Signature of applicant, or name, if a corporation) ~attituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder Nome of owner of premises ...~.e~:.e~g,~,~B,~J. ....................... ~f applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ......... ..~......~:..~ ............................. Electrician's Llcen. No..~...~...~,..~.r.~.: .................... Other Tmde's License No ............................................... 1. Location of land on which p~ work will be done. Map No.: ...~..~..~.:.....~g..~...~.. ........... lot No .................... Street and Number ...... .~.~....~11J.~;.~l..~J~.....~[&~i~.~..,~;.~......f~l~,g~ .................................................. /V~lntCil~lllty 2. State existi~ use a~ ~cu~y of pmmis~ a~ intended use and ~cu~ncy of p~ c~: a. ~isiting u~ a~ ~cupan~ ...~.e.~ .......................................................................................................... s~e vl~ ~ a~dttlo~ ~ b. lntend~ u~ ~ ~u~ .......................................................................... '3. Nature of work (check which applicable): New Building.. ................. Addition ......,r,z.z, .... Alteration ............. '7' Repair .................. Removal Demolition .................... Other Work ~ . (Description) 4. Estimated Cost .................... ~.~..~.(~.......+ ................... Fee 11~o00 (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 alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... .c,:,) ............................ Rear ....~) ...................... Depth ....1~, ................ Height .................... Number of Stories ...... .~.:1~ ......................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10~ Date of Pgrchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... ."A"....rlt II.t, ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~ ............................................... 13. Will lot be regraded ..... 3~1 ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .RA][.,~I].]A]~ ........................ Address ................................ Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....nT.~..~.eZ'lro~lr;L .......................... Address ................................ ~ 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 ..... /__ COUNTY OF ...~~'~'~ /, ............................................................................................. ,..being duly sworn, deposes and says that he is the applicam (Name of individual signing controc¢~ above named.. 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 make and file this application; that all statement~ contained tri: this eppficetC0n 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 flied therewith. Swam to before me this ....... Notary Pu blic,~ ../~f~..... Z~c&~..~-~c~D.~Jnty ...... .~..~.~.~ .................................... F! V (,,g.at. re o, opp,i o.,, · ' JUDITH T. BOKEN Notary public, Slate ot New York No. 52-0344963 Suffoll~ Coun~ Commission ~xpire~ March 30, 19.~.-/