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Home My WebLink About7094-zFOw'~' NO. 4 TOWN OF SOUTHOLD BUH.BING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificete Of Occupency THIS CERTIFIES that the building located at .. 8/.8..~.~.d.1..e....R~....(.C..~. ~.)Street Map No. ~;~ ........ Block No~ ....... Lot No.....~.....C~...t~..~. ~.....N.i .~, ....... conforms substantially to the Application for Building Permit heretofore filed in thiR office dated .........F~l~..~'~...., 19~.. pursuant to which Building Permit No. ~j~Z.. dated ........... .F.e.b....~.~..., 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 ~,~,va.te. ~.e.e~.o.~..(~.t..o.m. Z,e. )..b..~..l~..mi ............................. The certificate is issued to ~:l~'.~...H/e~.....b~.. ........ .0~.. e.l'. .......................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) ...1,~, ............................. UNDEBWRITEI~ CERTIFICATE NO. X~R, ....................................... HOUSE NUMBER .~.S.~.00 Street Mlddl® ~a4 (C~?) Building In.~pector / I~O~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 709 Z Permission is hereby granted to: Robert Rubbard .......... .C:A~C~e g~e ........................................ .. ....... Build new accessor bu.i..1..d...i, ng (c~.~ck~.D..C~.~). . ot premises Iocoted ot ..~.,/...~....¥..~..~.,.~.,~.,,~...~...0..~...~. ................................................ Cutcho gue N.Y. pursuaht to application dated .........................~b ....... 2~7. ........... , 19.~..br..., and approved by the Building Inspector. BUILDING DI~pARTMENT TOWN CLERK'S OFFICE ~ , ~U~D, N. Y. 19~ ~proved .............. ~ ......................... , 19.....~ Permit No. ~.~..L.~.~ ....... Disappr~ed a/c .~ ............... o. Thi* o~lic~tion m~ b~ eompl~t~l~ fill~ in b~ ~writ~r o~ in ink ~ inspector, with 3 ~ of pl~s, accurate p~ plan ~ ~ale. P~ acco~i~ to ~h~ule. b. Plot plan showing I~ation of lot and of buildings on premises, relationship to ~joining premises or public streets areas, and giving o detoil~ description of layout ofp~e~ must be drawn on the diogram which c. ~e work covered by this application may n~ be comme~ed before issuance of Building Permit. d. Upon appeal of t~is application, ~e Building Ins~tor w~ll issue a Building Permit shall be kept on the premises ~ailable ~r inaction th~gh~t tbe ~rk. e. No building shall be ~cupied or u~ in whole or in pa~ for any pu~ose whoever until o Ce~ificote of ~cuponcy shall have ~en gmnt~ by the Building Ink,tar. APPLICATION IS HEEEBY ~DE to the Building Depadment for the issuance of Building Zone O~inance of the Town of ~uthold, Suffolk Count, New York, and other applicable ~s, O~inances or Regulations, for the constru~ion of buildi~s, additions or alterations, or for ~movol or demollti~, os heroin d~ri~d~ ~e opplicont agrees to comply with oil o~licable laws, o~inonces, buildi~ c~e, housi~ c~e, edmit aut~oriz~ insp~to~ ~ p~mi~s ~ i~ buildings ~r n~es~ i~tions. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~...~. ,~..~ ~ ...~...~....~.....~.....~.. ~' O .................. / .............. If 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 License No ............................................. ~ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. AAap No.: ........................................ Lot No ......................... Street and Number ..................................................................................... ~ ........................................................ Munlcip~lity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......................./.~./..L...T'.. ....... ..~.....J~..........~........~..~.:..~'.. ........................................ b. Intended use and occupancy ..~...~...¥...E]....~Z /V_Fh/ ~C..~t .~. ~ Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (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. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height ...... --~'~.... ....... Number of Stories .............../. ...................................................................................................... 10. Date of Purchase ........................................................ Name of Former Owner ................ , ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... z..-_...,c. ................................... 13. Will lot be regraded. ........................... Will excess fill be removed from premises: ( ) Yes 14. Name of Owner of premises '~o]~-r /dr~/~'JB~qT~J) 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 indicat, all set-back dimensions from property lines. Give street and block number or description according to deed, and ~ow street names and indicate whether interior or corner lot. STATE OF NE'~,~YCIR, K, ~ ~.. I-~ COUNTY OF-~/,t...I'~':> /,J JJ.~ O.~ · ............................. ...... £~..'..;.../~.~:.....f.. ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing contraCf) above named., He is the ............................................................................................................................................................................... {Contractor, ogent, corporate officer, etc.) of said owner or owners, ond is duiy authorized to per{otto or have performed the soid work and to nmke ond thi* ~pplicotion; that oll ,t~t~m*nt* contoined in this ppplicotion ~r~ tru~ to th~ best o{ hi~ knowledO~ ond b~lief; ond th~ th~ wo~ will ~ p~rformed in the m~nn~r *~t {o~h in the opplicotion fil~ thor*with. Swomtobefom methis ~ a ................ ~oto~ ~ublic,~.~..(~n~ .... &....~.~..r......; ....... ~. ........................................................... (Si~notur~ o{ opplic~nt) ~D~ T. BOKEN Nolaw Public, State 0~ New Yo~ No. 52-0344963 Suffolk Coun~ ~m~ ~es March 30,