The URL can be used to link to this page

Home My WebLink About7152-z~ NO. 4 TOWN OF $OUTHOLD B~'T~.r~ING DEPAaTSf~ Town Cle~k'e Of[ice $outhold, N. Y. Certificate Of Occupancy No...z6~39 .... Date ........... ~me.. 20 ....... ,19.~. THIS CERTIFIES *.hat the bugdlng located at ~t,h .Dr. ]lc .& TII'F~..1~. Street Map NoGoos®. ll~ek. Block No ........... Lot No..~00 .....8a~athol~.. II,Z. ....... conforms substantially to the Application for Building Permit heretofore filed in th~s office dated .............. )far...1~ 19~.. pursuant to which Building Permit No..?~1~. dated ..........Apr~.... ~.., 19..~, was issued, and conforms to all of the require- me. nM of the applicable provisions of the law. The occupancy for which thJ~ certificate is ~ued is . F~.~Y~. e.e.~.o~-j~. ~.~o. reSe)..I~.~..~][ ........................... The certificate is issued to .~e~l~e. ~,o. A~lt~t .... ~ ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval II,R, ......................... UNDERWRITERS CERTIFICATE No.. ][,Re ...................................... HOUSE N-U-MBER... ~CK)0 ...... Street...8~tf~h .De. ~lox. th ...................... ....... l~lla,,,~ In~'" "~ .... BUILDING PERMrr (THIS PERMIT N~UST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N? 7152 Z Permission is hereby granted to: ~s~$e..-~.--~4~$~ ............................................ .... ~ ~y..4~;k..~..8~ t& ..l~.. ~z~t,~ ............... ...... ,~o~t,l~4....~];~ ........................................ to ~kl~..~w..&~-~ o~:~.....~or, ag~...~he,d. ............................................................................. et premises located otLe~.....$O0 ....... Goeee-.~':eek.,.:~e~a.~e~ ....................................................... ............. ~OItlT..~Am)G.~..~,$ &~..~ ~&v&..~ ~h. ...........~o~t~t~).l&.....~-~ ........................... pursuant to application dated ................ b~ .......... 1.8 .................. , 19~14...., and approved b~ the Building Inspector. B02~I J~l.,~i.;~ ~O be setback 3f~ f~oa no~'~h & ®~lt ~)~'olo®l'~ff Fee S1:~:~ ............ (nOt. ~ .:ldo yaZ~) ~L.~S t / [/ I '7~ BUILDING DEPARTMENT ~//~/// TOWN ~K'S ~FICE -- ~u~OLD, N. Y. ~c~, V ~prav~ " ~ .~..: ........................................ , 19 .. Permit No ....... Disapproved o/c ............................................................................................ ................... (Building Inspector) / ~'~ APPLICAT,O, FOR BUILDING PERMIT ~ ~ Date ................. ./...~.~.~., 19..~...~.'.....~ INSTRUCTIONS Bu~i Xd,~n~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the i Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public st.ree~'~pr areas, and giving a detailed description of layout ofprpperty must be drawn on the diagram which is part of this appl.ca~.;~ c. The work covered by this application may not be commenced before issuance of Building Permit d. Upon approval of this apphcation, the Budding Inspector wdl ~ssue a Budding Permit to the applicant. Such p~m~t~ 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 Occul~ancy shallUnave been granted by the Building Inspector. 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, add t ohs or a terations, 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. (S~'gnature of applicant, or frame, if a corporation) State whether applicant is~owner, lessee, agent, orchltect, engineer, general contractor, electrician, plumber or builder. Name o ner of aremJses ' If applicant is a Corporate, signature of. auly authorized officer. (Name and title of Cbrporete officer) Builder's License No. ~ ..... Plumber's License No ................................................. Electricion's License No. -~' --~5~~ /' Other Trades Lic,ense No ............................................... ~ ~,~" 1. Location of land on which propose~J, work will be done. Map.~Njp '~..~..~...:.~. ..... ...:'T...,~.:~.o~t No...../_..o.._.~. ............ Street and Number Municipality 2. State' ex~sting use and occupancy of premises and intended use and occupancy of proposed construction a. Exisiting use ar:~d occupancy ............. .~....:..............~l ............................................................................................ b. Intended use and occupancy ........................~.~ ...... ii ............... ".'..~;." ........... ; ........... Repair .................. Removal ............. Demolitioh..~ ...... ~.......,. Other Work ....~..~....:.....~,~...:....-c.~.-~.x~r-"-~'--~J -~'/~"-'~ ......... (Description) 4. Estimated Cost ......'~....~..~......'~... ................... i'...~ ........ Fee ../..O....-. .............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~....i.~ ......... 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 exi~sting structures, if any: Front .~ .......... .~ ...... Rear ....~ ..................... Depth ..5 ........... Height ........................ Number of Stories ...... ~ .......... ./.~ ........................................................................ Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ---- Height ............ ..-TT. ............ Number of Stories 7'~ . ~& ........................ 8. Dimensions of entire new construction: Front .................................... Near ............................ Depth I Height ....~. .............. Nurnl?er of Stories ......,~.....~ ................................... ; ................................................................... Size of lot: Front ...... ~..../.~...~ ........ Rear ..... ./....~..~. .......................... .Dep~th ./.~...~......~.......~...~.:..~.... Date of Purchase ........ ;../...~....~..~......-~.....~.~;;~; ......... -"4:~' .~.-~- ~r~mer Owner ........................................ Zone or use district in which premises J ed .................................................................................................... 10. 11. 12. 13. 14. ~ Does proposed construction violate any zoning law, ordinance or regulation: ...~......'~.. ................................ W, ill lot be regraded ............................ Will eXcess_fill be removed from premises: ( ) Yes'"~ ( Name of Owner of premises .................................. ~ Address .......'2Z.....~...'~. ............... Name of Architect ................,......~ .............. ~".....~. ............ Address ...~...~. ....... ~ ....... Phone No. Name of Contractor .............................................. Address ................................ Phone No ....................... PEOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock 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 NEV~YORK, L? i - ~ ...... ~ ............................................... being duly sworn, deposes and says that~he is the applicant (Name of individual signing contract0 above named. ~He is the .......~ ....................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true to th~ best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swom(.~.t/q/~,fore dayme this//..~;~ ~ 19.~..~. ~o ~ dl ~,o~ ~/0 ' '~'~~' Notary .~:;~,~-~../...vq. · · · County ............................................................................................... (Signature of applicant) r -- ' -- ''RUI)OLPH H' BRUER NO'I'ARY PUBLIC, $~are of .New Yore No. $2-0465530 - Suffolk Counh/ .CernmJssion Expires Me,ch 30, 1976