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Home My WebLink About8887-zFOI~M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~?.~.6.~. ...... Date .......... .14~...l.0. ........ , 10.7.7. THIS CERTIFIES that the building located at ...}q!~ldIe.t~n. l~nad ........ Street Map No..F~,~e..t...1~..e.l~lock No ....... Lot No, . .8. .....0.r:~.e.r~t).o;~.t;.. N.o.~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept .25. , 19 7.0. pursuant to which Building Permit No... ~.7.~. dated . ...Sept .........28 , 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~'v:~ t.e. 9ne..f.r~..~i~,..d.~.-..I~ ing..wi. ~.h ..~...a.d.d..t.t.i. qrA. ................. The certificate is issued to M.r.s...L..C..a..~p..b~.l..~ .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.,R, ........................ UNDERWRITERS CERTIFICATE No. p.e...~.0~.n.g .................................... HOUSE NUMBER 8.~0 ... Street ....~!!d..d.l.~t..°.n. .Rd. ..... G.?.~p.n.p.o?.~ ........ Building Inspector FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULE COMPLETION OF THE WORK ^UTHORIZED) 8887 Z Permission is hereby granted to: c~.~..2 ~?~....A./..c...~!~..s.;....~,;....c.~.~..b..~. ,z..z. ...... .................. .~..~..e..n. ~..o.r..t. ........................................ ~...b..~..~.x..a......~.....~.~::.~.~.:~.~.~.~.~n...~.~..~.~.~.n~:..~w.~.~iag ............................................................... premises located at ...... ~.~....~...~.~.~...~.~.~ ..... Fl~.t£J. ei~ .......................................................... ~ '~ Niddleton Hoad Green~ort pursuant 't~' al:~pJi[oti~n ~'ecJ ~. ..................... :.....~.~r.~ ..... ~. ........ , lb..~.., and approved by the B~ilding Ins~e~or. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... ........................................ 10 ........ ermit No ..................................... D,sapproved a/c ..~ ...... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No ............................. a. Th~s application must be completely filled in by typewriter o~' in ink and submitted in triplicate to the Buildir Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locahon of lot and of buildings on premises, relationship to adjmning premises or pubhc streets, areas, and giving a detailed descriphon of layout ofproperty must be drawn on the diagram which is part of th~s applicotiof c. The work covered by this application may not be commenced before issuance of Building Permit d Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and i admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ....................... State whelher applicant ~s owner, lessee, agent, architect, engineer, general contractor, electricmn, plumber or budde If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... .~.~.., .,~.,.~.,,. ............... Plumber's License No ................................................. Elechician's License No ............................................. Location of land on which proposed work will b_e done. Ma Lot No ~.~...~.~-~./~ Street and Number ....~../~..~.. ....... ~.~.'.~...~ .............. ~~.'.~ ..................... Municipality Stale ex,sting use and occupancy of premises and intended use and occupancy of proposed construction' b intended' use and occupancy / / ~. ~ 3. Nalure of work (check which applicable). New Building ........... Addition ....... ~.... Alteration ......... Repa,r ................. Removal ................. Demolmor ............... Other Work .................................................. (Description) .~ Estimated Cost .... .K.~..~..~ ................................... Fee. .. (to be paid on filing thss opplicahon) 5 It al;welling, number uf dwelling umts ......................... Number of dwelhng umts on each floor ........................ If garage, number of cars ................................................................................................................................ 6 If bus,ness, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 Dimensions of ex~stmg structures, ff any' Front ....... ~..~... .......... Rear ................................Depth ....ff'..~'.? ......... He,ght ..... ~....~.. .......... Number of Stones ............. ?. ......................................................................................... Dm~ens~ons of same structure with alterations or addmons Front ...... ~ ................... Rear ................ Depth ..... .~...~... ........... Hetght ..... ../.~.. ......... Number of Stories ...... ./.. .................. 8 Dm~enstons of entire new construction. Front ................................... Rear ....... . ./~.... ............... Depth ...~..'~. ....... Height .................... Number of Stories ...... ../. ................................................................................ 9. S,ze of lot' Front ......... .~....~. .................................... Rear ........'.~...~.. ........................ Depth/..~;__ ..,~ ..2.,..~'. ~..C'~.__ ........... 10 Dale of Purchase ................................................. Name of Former Ownerx~......~....(~.~~... 11 Zone or use district in which premtses are s~tuated ......................................................................................... 12 Does proposed construction violate any Tatung law, ordinance or regulation' . ........... ~ ............................... 13 WHI lot be regraded ....... ~ ........ ~Will excess fill be removed from premises: (>d:) Yes ( ) No 14 Narne of Owner of prem,ses~......~...~~...~..... Addressx~f'.~.'~..Z.'~JPhone No.~..ZZ.?...~..~..~.' Name of Architect .. ~, ......................................... Address ................................ Phone No ..................... Na ne of Contractor ~..~,.~.-~.~ .............. Addres .. Phone No~.~ .~...~...~...~..~ PLOT DIAGRAM Locale clearty and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back d~mens~ons fror property hnes (~we street and block number or descript~on according to deed, and show street names and indicat whether inter,or or corner lot STATE OF NEW Y/~RK,~ ~, /-~ / ~ S S COUNTY OF ~~e~.~f ....................................................................................... being duly sworn, deposes ond s~ys th.t ho ~s the ~pphc~r (Name of ind~wdual signing contract) above ~ ~ . named He ,s the ................ ~;~,"~r~;~; ;~'~'~ ;;~'~ of sa,d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and f~ this apphcat~on; that all statements contained m th~s apphcahon are true to the best of h~s knowledge and behef; ar that the work will be performe~ Jn the manner set fo~h m the apphcation filed therewith. Sworn to,afore me th~s ,~ / / _ . ...... ~.~',. ...... ~ay ~f,~...~~, 19~ ~; ~ ~.~ Noto~ Pub~~/~....~~.-~ .........................