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Home My WebLink About7525-zFORM NO. 4 TOWN OF SOUTHOLD BU~DIN(~ DEPARTMENT Town Clerk's Office $outhold, lq. Y. Certificate Of Occupancy No..7.609b, ..... Date ...........8~pt.. '9 ........ , 19.~. THIS CERTIFIE~ that the building located at 8mal~ .Vie# .Ave ........... Street Map No.. m ....... i Block No..~ ..... Lot No.v,r~.. 8o~tholtl.. 1~,¥, ........... conforms substantially' ~ the Application for Building Permit heretofore ~ed in *his office dated ...........&~ i' 13' ' ', 19. ?.~ pursuant to which Building Permit No..?~Z. dated .......~pt$' '9i ......, 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 . pl':l.va~e · ae~ sso~J', boAldZug...(apl~ovod .by Bd. Al~pe&l~:t ........ The certificate ~s i~ssued, to. Jolm. F., .Ke&.t~ ...... ovnez. of the aforesaid ~uilding. (owner, lessee or tenant) Suffolk County Department of Health Approval . I~oB, .............................. UNDERWRITERS CERTIFICATE No ......... lt,R, ............................... HOUSE NUMBER.. ~ ...... Street...Som~d. ¥~l,ew. ~1 ...................... Inspector FOu-M' NO. ~ TOWN OF $OUTNOLD BUILDING D~PARTMIJNT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE'rlON OF THE WORK AUTHORIZED) N? 7525 Z Permission is hereby granted to: ..~.~ ..~.,...ll~.t~.~.~ .......................................... ....... $959.~.... ao~n~..3;~o~..~vo ....................... 8outhold at premises located at ...... ~.~,..~IIJ~...T. III~..Alr~ ........................................................................... ........................................ '. ................ Jt~.u.tll~,~.... 11,~..~ ................................................ pur~uont to application doled .................................................... . ~9 ........ . end opproved by the Building Inspector. FOE ~TO. 1 TOWN OF SOUTHOLD BUILDIN?G. DEPARTMENT TOWN cLERK'S OFFICE SOUTHOLD, N. Y. Ex°mined . ......... , ....... , ..... Oi~pproYed o/c ......................... Application No.....~....~....~.,,,~.,. .............. ' : ~!':: Date .~,lt~;U~.~...'J.'~. ....................... , 19..~'.~ ..... a. This appli~tion must ~ ~mple~ely filled in by ty~writer or in ink and submi~:;~~ triplicate to the Building Ins~or, with 3 ~ts of plans, ~urite plot plan to s~le. Fee a~rding to schedule. b. Plot plan showing location of lot and of ~ildin~ on premiss, relationship to '~di~ing premises or public st~ or areas, and giving a dctail~ description of layout of pro~rty must ~ drawn on diagram which is pa~ of this application. c. T~ wo~ covered by this appli~tion may not ~ ~mmen~d ~fore issuan~ of Buildi~ p~mit. d. U~n approval of this application, the Building Ins~or will i~ue a Building Permit t~li~nt. Su~ ~rmit ,shall ~ kept on the premi~ available for ins~ion throughout the work, e. No ~ilding shell ~ o~pi~ or u~d in whole or in ~rt for any pur~ whatever until a ~ifi~te of ~upenw shell have ~n gran~ by the Building Ins~or. ~ ~. 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 all applicable laws. ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .'[9....c,}9~...~"J~em.. Alrmml. e ......................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Buiider's License No .......... ,~,,/..~. ......................................... Plumber's License No ...... '.~../.~.. .......................................... Electrician's License No....][/,L ......................................... Other Trade,s,License No ...... ,~.~ ..................................... 1. Location of land on which proposed work will be done. Map No .............. ~ .......................... Lot No ........... ~ ......... Street and N-mber ........... .fl.~....~....~.~.~...~.,~....~......~.,?.~.e. .......................... ...1~....~.~. .......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~stmg use and occupancy ................................. ~ ....... ~.__~ ....................... ~..,~ ........................................... 3. Nature of work (check which applicable) ~lw Building ....... ~ ......... ~ldition "0 ............. Alteration ............... Repair ......................... Removal ......................... Demolition ........................ OtlILW' Work ............. ;..;......, ........... (Description) $ 5.oe Fee ..... Z. ........................................................................................ 4. Estimated Cost .......................... (to be paid on filing this application) S. If dwelling, number of dwelling units ..... ~/~,.... Number of dwelling units on each floor ......... J~/~,,.... ................... ' If garage, number of cars ....................................................................... ~ ......................................... ; .......................... 6. If business, commercial or mixed occuoanc¥, specify nature and extent of each type of use ..... ~[~.~ ...................... 7. Dimensions of existing structures, if any: Front ....... ~.~.~. ....... Rear ..... .,'7~.~, ............... Depth ....,~,~.~. ........................ Hmght ...................... ~ ........................ Number of Stories ................ .'1 ........................................................... Dimensions of same structure with alterations or additions: Front ....... ~.~. ............ Rear ..~.~..~. ................................ Depth ................. ,~...~. ..................... Height ......... ..'l..~.~. ................. ~ ....... Number of Stories .....~ .................................. .8.~ Dimensions of entire new construction: Front ....... fid ............. Rear .......... .~0. ............ Depth ........... .'1t3 ................. - - . ,~, 8s . Mmgnt' · ........................................... Number of Stones ......................................................................................... 9. Size of lot: FrCalt ..............~..'IDOI ..... Rear ............ .c~ ......................... Depth .......... ~,~.! ............................... 10. Date of pur~~le ....... ~-~.~ff.~ ............. Name of Former Owner ........ ~/~"~1]~.~...~.3~1.<).~ ................................ 11. Zone or use district in which premises am situated ................ ,~e~;l~ll.t~La]. .......................................................... ' ' ' ~ ~l'o~ attic . ...................... 12; ' Does proposed constructiOn'wolate any zoning law, ordinance or regulation: ..................................... ~.. 13. Will lot be regraded ~O~ .~JE~.~B.~II~. ...... Will excess fill be removed from premises: [ ] Yes Iii: ] No N~. ...... _~-~_ ~ F. Xeat:L~ ~9 c)9~ 8eu~tev Ave. i~me .... 14. marne or uwner OT pre~..; .............................................................................................. ~ ........................ 1~ '~l~r~ (Address) ~.m~.~hone NO.) Name of Architt~t~ ........... ...--;~l~l~.(~ ......................................................................................................................... (Address) (Phone No.) Name of Cont,~ior ...........L..a ................................................................................................................................. , - --:~ , ~ (Address) (Phone No.) ~ '~.. PLOT DIAGRAM Locate~ cleil~y and distin~tly, all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines."Give~tmet and blocl~umber or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK. COUNTY OF ...................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of indivicFual.gigning ~ontract ) - ' _. . 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 statements containe~his applica,~n are tr~ue to the best of his khowledge and bel~f; .~nd that the work will be performed in the manner set forth in the aDze. cation filed tlVa~ewith. .................................... · U~.BA~:)~701~ ............ ~., 19 ...~. .... · ~ No. 24-5208400 7 Notary Public ......... , ....... ........... Coun ................................. ........ ........ Commission Expire~ Marc. .