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HomeMy WebLinkAbout7327-zFO~'~ NO. 4 TOWN OF SOUTHOLD BUIi.t~I'G DEPARTMENT Town Clerk's Office Sou,hold, lq. Y. Certificate Of Occupency No. Z~.. ...... Date ..............J..l~.. .... 19 .... , 19..~. THIS CERTIFIES that the building located at . ~ .~0qtl~ ............. Street Map No. 8.,....H~..l~..]~SBlock No ........... Lot No.. ~. .... ~.qql~h.o.J,d...~.e .Y.~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........J..l~.q...~.~...., 19..~.. pursuant to which Building Permit No..~.~.F~... dated ..........J..u~.....1.? .... , 19.7~.., 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~.v~te. ~e. fm~tly..~ell~g. ~th. ~ddit~m ...................... The certificate is issued toDaSd L~li~ & ¥~A~ 0W~'8 (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~. ?R.~. ............................. UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ..... ~ ...... Street .... .~.~e..8~ ........................... 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°. 7327 Z Permission is hereby granted to: at premises located at ~.t,...~.....~IUIXI~K..~.....(.iIg~,..~RZ~...~.~II~ ............................ pursuant to application dated ........................... e~......1.~! ......... , 19.~.., and approved by the Building Im~ector. ...... Building I~ " " TOWN OF SOUTHOLD ~/..~.5,/:,y' ,,~,~ ~..,'~. BUILDING DE.P,~.RTMENT ~ p-'~'/, ~ TOWN CLERK S OFFICE . / -~o- .,~/*c~ ' ~~ Ii ti ....... ............ . ........ Dimpproved ~/c ................... ~ .............. ~.. ~ ~ ~ ......................... ........ L '//~ p~ ~ ~ &F~IC&TIOH FOR BUlLDI~6 FE~MIT ~.~ ~- .~-' ~ ~ .~...L~ ................... , ~.~.~.... .~ ~_ - /~ I ~ ~ ~ ~ ~ ...... ~. Thi~ ~¢~lie~tion ~U~t ~ ~l*t~l~ {iliad in b~ W~writ~r or in ink ~nd ~ubmi~d in triplimt~ to the 8uildin~ 3 ~ of pl~n~, ~eeur~t~ plot plan t~ *Ca~.~ a~ordin~ to *cbedule. b. ~lot plan *howin~ Ioc~tion of lot and of buildin~ on pr~mi*e*, rel~tion~hi~ to ~d~oinin~ ~r~mi~* or ~ublie ~i~in~ ~ d~t*i~d d~criotion of I~out of pro~rW mu~t ~ dr~n on di~r*m ~hich i* ~ of thi~ o. T~ ~o~k ~r~d b~ thi* ip~licetion m~ not ~ eomm*nmd ~for~ issu~n~ of Buildin~ ~rmit. d. H~n ~pro~l of thi~ ~licetion, the Buildin~ In*pector ~ill i~u~ a Buildin~ ~*rmit to tbe ~li~nt. Such ~rmit *hell he tbe premix* ~il~b~ for in~ction throughout the work. e. No buildi~ shall ~ occupied or used in whole or in part for any purpose whatever until a Ce~ifi~te of ~cu~n~ shall have gran~d by the Building Ins~ctor. 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 ell applicable laws, ordinances, building code, housing code, and regula,tions, and to admit authorized inspectors on premises and in buildings for necessary inspections. . E ~ . 7 ,~ .~ -- -- ~' ~' {Signature of applicant, or name, if a corporation) /' ........... ~ ~ /, . (Addre~ of a~licant) ~tate whether applicant is owner, I~, a~nt, archit~t, engin~r, ~neral eontr~tor, el~trician, plum~r or builder. Name of owner of premi~~...~.~..~[ ...... ~[~.~ ....... ~.~.~..~ .................................................................... If applicant is a corporate, si~a~re of duly authorized officer. ~ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map NO,: .....~..~.. ..................................... :~.. Lot Noz .-~...f. .... Street and Number .....~...o....r~.... ....... ..~../...~..d.~. ......... ..¥_~...~.....~ .................................... '..~..~..J..~.... .... ' -Municipality 2. State existing use and occupancy of pre. milles/%,, !and intended us~ and occupancy of proposed construction: a. Existing use alx:l occupancy ....... ~. ~t~'.'.~...~[. ~.~.. b. Intended use and occupancy . .p....¢? ................................................... ¥ 3. Nature of work,., (check which applicable): New Building ....................... Addition...~....... .......... Altera~tion..:,.....,,,...,, Repair ............. · ............ RemoVal ..................... ... Demohtmon~ ........................ Other Work .............. :.....,: ...... / ~--(~---- { DescrjpUon) ~ t~.oo, oo .. Fee ..../.. .................................................................................. · ....... 4. Estimated Cost ............................................. (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 ....'7..~ ...........Rear ....'~..?..'. ................. Depth ....~... ............... " ......... Height ..../. ................................................ Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front ..... .~.. ................. Rear ..... ..?...b..'. ........................... 'at / Dapth ............................................. Height ......................................... Number of Stories ....................................... · S. Dimansions of entire new construction: Front ..~ ............ Raer ....~.~. ............. Dapth ............. Height ................................................. Number of Stories ...........L ............................................................................ Rear .......................................... Depth ........~..~.. .................................. 9. Size of lot: Front ....l....O...o. .......................... ( o o ~- ' ' 10. Date of Purchase ..................................... Name of Former Owner .............................. ....... ... ..... · .....- .-.... .- 1 I. 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 -fl?---0 ............................ Will excess fill be removed from premises: [ ] Yes DO No 14. Name of Owner Of premises ....~...fi~.[..o.....~....~...ID... ...... .)=.¥..~...o.~.¥. .................................................................................... (Address) (Phone No.) Name of Architect ...................................................................... r:..=.....,.-...r..;-rt ..................... ;~'r;,~q'~i ............... Name of Contractor .................. {~dre~''''~''''''''~'''''d' .................... ........ , . (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-baCk dimensions from and block number or description according to deed, and show street names and indicate wheth- property I nec G~ve stree erLinterior or corner lot. STATE OF NEW Y~RK~ ~ ~_/., ) COUNTY OF ..~ ................. ) ~......~.~ ~,**~.....~...:.:...~ .................. be ng du y sworn, deposes and says that he is the applicant above named. .............. : ......... {~l~t'~"~'f indiv!d~al signing contract} He is the ...'..."...:.~-~~ ............................................... ............................................................................................................... (Contractor, agent, corporate officer, etc. ) of said owner or owners, and is duly authorized to p~rform or have p~rformzd tbe said work and to make and file this application; that all ~tatan~nt~ contained in this application are true to tiaa best of~Xk~l~ami, hailer; and that the work will be pzrform~t in th~ manner Notor~ Public, b{ote ot-~New ~orK mt forth in the application fil~:l ~r~with. No. ~2-034a963 ~ .--~ [ ..... Commission Exta~t~/~arch ~0, ....... ........................ day.of. : ' :"% mT' - , .... ............... .................................. 73¥.¥N O~:-S<..,', )TH© L?] bi,y,