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Home My WebLink About7518-zFOR3~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Cerlificnte Of Occupnncy THIS CERTIFIES that the building located at .Co~®y. C~,eek. ~ .......... Street Map No. Kok®..0D&.. Block No ........... Lot No..~..8outholt4..N.][, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~t.i~. ~., ~. pursuant to which Building Permit No. dated ..............Ha~[~l~t;..--" .1~ ,'"~.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . ~iy&te. o~m .fairly. dwo] l~ln~ .wi~h .add~o~ ..................... The certificate is issued to . ~. ~haW .......... 0¥~F. ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . N.,H, .............................. UNDERWRITERS CERTIFICATE No.. p.$.~.5..l~. Iz .................................. HOUSE NUMBER ... 8.~0 ....... Street .... ¢o1'.$y. (]~esk. RoaS... (Pg~ .l~)..%l~).,. Building Inspector FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7518 Z Permission is hereby granted to: .............. ~.m~,t~.~.4, .............................................. to ~1,l,~ .. all.. &dcht t,:l. on .. c~.. ax.t ~ ~ ..d,~ ;i,~ ~ r,~ ................................................................. ~t pr~mis, located at .C. Dr~y...~r. eak..ltoa4 ....... /,sro~..~D,t,~ ..................................................... ...................................................... ~.g~,l~,~ ...... /~,~, ...................................................................... pursuant to application dated .......................... ~.~]).~ ...... ..if. .......... , 19..~f.., and approved by the Building Inspector. F, S.~.~,...m... ............ Buildmg Inspector a. This a~lication must be c~ple~ y f ~ in by ~wr ter ~ in i~ a~ s~mi~ in tripli~ b. Plot ~an ~lng I~at on of lot and of ~Jldi~s ~ nr~m ~ ~]afionsh]~*f~-~-~ .................. a ~s, and g,v ~ a detad~ de~r,pt~ of I~ut ~pr~ must be drawn ~ the diagram ~Jch is ~ of ~is ~licati~. .' c. T~ ~ c~ered ~ ~ a~lication ~y n~ ~ commenced ~fore isqupnc~ of ~.uJ ding Pe~it d. U~ a~al of ~is ~plic~ion, ~e Buildi~ In,tar will iss~ a 'B~ilding Permit to the ~li~: S~h permit ~_ shall ~ k~t on ~ premis~ ~ailable for in~i~ th~h~t the work. ~l[e' haveN° ~ildi~n grant,Shall ~ the~CUpi~Buildi~°r U~ln~or.in ~le or in pa~ for any pu~me w~er until a Ce~ific~ ~ ~c~ ~LI~TI~ IS HERE~Y ~DE to the BuJldi~ ~ment for the i~uance of a Bui~i~ Pe~it pu~ ~ui~ Z~i~nc~ at the T~;o~ ~, ~ffolk C~n~, New York, and other ~llc~ · (S~gnatu~ at applicant, or ~me, if a co~mtl~} State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ! ................................................... If applicant is o corporate, signature of duly authoriz~t officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No... Electrician's License No ..... B..~...L....~.....'~/...~.... ............... Other Trade's License No ............................................... /',,. ~ ~ ~ · 1. Location of land on whi,~h proposed wo. rk will be done. Map No.:~.~...O....~..~....0....~.....~...]..i.iljl Street and Number ....".~..~..~.....~....~......~...~......&....~.... ~...~ U ..~..~.O....(:...~.....,~I,_~ _ _ --:- ............. I-pt~Nol...j ......... ' i ..................... ........... 2.State existing use and occupancy of premises and intended u~e and occupan~.cy 9~l:N~oosed construction: a. xisi..g use and occupancy ..... ........... b. 'ntended ond o cupanc ............................ 3: Nature of work (check which applicable): New Building.. ................. Addition .......[~ .....Alteration ....~... .......... Repair .................. Removal .:; ............... Demolition .................... Other Work ..................................................... ,~. ~- 90 ~ l~...? (Description) 4. Estimated Cost ................. ~) ........................................ 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 alterations or additions: Front .................................... Rear ............................ Depth ............... .. ................ Height ............................ Number of Stories ................................ - -'~ _8~ .,_Oime~nsions of entire new construction: Front .............. L..,~. .............. Rear ........ ~....~ ............. Depth ...(....~. .............. Height .................... Number of Stories ............~ ......................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 1~. Date af Purchase ........................................................ Name of Former_Owner ........................................................ 11. Zone or use district in which premises are situated ..l~..I.t.....~...(.~..E. ............................................................... i .... 12. Does proposed construct on v o ate any zon ng aw, ordnance or regulation: ........ ...~....~ ....................................... 13. Will lot be regraded ..;...~ .............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..~.~....~fl~... ......... Address ................... , ............ ph°ne No ......... Name of Architect ..................................... I.~. .................. Address Phone No ....................... Name of COntractor ...... ~.; ...... ~' i ...... I.~~ . .~...-..crr:...... 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 corner lot. (~ ~. ~!~ ~ ' STATE OF o ...... .............. ......... ,,.., ............... (NomW ~ ~dividuol ~nlng contmcO the He is ............................. ~ ................................................................................................................................. (Contrector, ~g~t, corporate o{{~eB etc.) of soid owner or owners, end is duly aut~rized to perform or have performed the s~id work ond to rake ~nd file this opplication; t~t oil ~tements comined in t~ opplication ore tree to the best of his kn~ledge end belief; end th~ the work will be performed in the m~nner set fo~h in the epplication fil~ ther~ith. Sworn to ~{om me this .................. day of .. .............................. .......... ,, Notary F,~:,;c, State of New Yo~ ~mmh~ion ~xpire~ March 30, l~