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Home My WebLink About8586-zNO. 4 TOWN OF SOUTHOLD BUTLBING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..Z~..'1.6'..... Date .............. Dee...13 ...... , 19..~.6 THIS CERTIFIES that the building located at ...... A,l, be~S0~. ~alle ..... Street Map No.. ~ ........ Block No..z~x ....... Lot No.. ;~IZ.....01'~.e~p0r.tl..li,.Y, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. liay...1.1~ 19.76. pursuant to ,which :Building Permit No..8~86Z. dated ............ l~a~....~.lt.., 19. ?.6, 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!'..! .ga. ~e..(a.ag.e.s..s.o~'~.).. g.a.~&g.e ........................................ The certificate is issued to ... Jo. seph,..Barizcze~zski ..... 0vnet. .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval I~ ;R~ ................................ UNDERWRITERS CERTIFICATE No..N.*R~ ....................................... HOUSE NUMBER ...1760. ...... Street.. A ber on. lane ....................... TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTNOLD, N. Y. proved .................. C/.. ....... f......., erm,t ........ Disapproved o/c ............................................................................................ ................... i~u[Iding Inspector) APPLICATION FOR BUILDING PERMIT Date ...... ......... , , .... INSTRUCTIONS a. This application must be completely filled in by typewriter ac in ink and submitted in triplicate to the Building Inspector, with 3 sets 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 streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit 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 Occupancy 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 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 ar o~terotions, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, end regulations, and to admit authorized inspectors oN premises and irt buildings for necessary inspections. ............................. /'/(Sigg/ature of applicont~/~r..~ome, if o corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, sig~f~ture of ~July authorized of 'c . ~ (Name and title of corporate officer) Electrician's License No ........ ~ .................... Other Trade's License No ............................................... 1. Location of land on which prgposed war-k, will be done. M~p No.: .:~ ................ J,~bNo .............. ~. Street and Number ,.Z~..X',~,',....,,.~~.../~..-'~'~ ........ ........... ~.~ ..... State e×ist,ng use and occupancy of premises and~.n]:d..~ and acc.pon? of proposed canst~ructian: 3, Nature of work (check which applicable): New Building', .......... ilion .................. Alteration .............. Repair .................. Removal .,~. .............. Demolitio~ .................... Other Work ................................................. .,. ?/ . (Description) ----.- /...; (to be paid on filing this application) .5. If dwelling, number of dwellmg~uni~ ............... Number of dwelling umts on each floor ..... , ...................... If garage, aumber of cars ............ .,,~.,<:'3~.(~r..? ............................................................................................................... 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 ~ - , s. D~mens~e,',s of e,~t~re new construct~oa: Front ....... .~...~.::.....--.. ......... Rear....~.~.:.....Z. ...... Depth..~..a...7.: ...... Height .../...~.. ..... Number of S~orie~ ............ ~-....~. ................................................................. .~ ............. ,. ,ze o, ,at: Front ............ .... ................... Rear .................. Depth ¢ 10, Date of Purchase ........................................................ Name of Former Owner ..... ~ ...................................... 11, Zone or use district in which premises ore situated ....................,<?/...t', ........ ~ .................................................. 12 Does proposed construction violate any zoning law, o~dinance or regulation: ........... ~/.C_~. ................................. 13, Will lot be regraded ..... ,.'~..~ ....... Will excess fill be removed J:rom premises: ( ) Yes '~ No .......... Phone~ _. . ,~r---'~ ' ~ '~' ~:1 'i~'.~,, ]4. Name of Owner of premises .~..~..,~..~.~.2~.,t~.,.,~..~.......~..~,.~.~...~_ ~ddress ..... ~ Na~, ............... Name of Architect .............................................................. Address ................................ Phene,~ Marne of Contractor .................... ~.~ .........................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 ar description according to deed, and show street names and indicate ~vhether interior or corner lot STATE OF NEW YORK, ~ c S COUNTY OF ...... Su~ffalk .........f~' .......................... ./~8~pl~..]~,s,~,~.zc.~.e~k,£ ........................ being duly sworn, deposes and says that he is the applic~n~ (Name of individual signing contract) above named, Fie is the ................................................... O.~e~ .................................................................................................................. (Contractor, agent, corporate officer, etc.) of s~id owner or owners, and is duly authorized to perform or have performed the said work and to make end file this application; that all statements contained in this application are true to the best of his knowledge and belief; that the work wilt be performed in the manner set fo~h in the application filed therewith, Sworn to before me this ~ day of ~ , 19 Z6 ~ / . ~ ~ / (Signature of ELIZA~H ~NN N~VtLLE / 514.~ / -1. AL / / / kX,,qp or Pc~o~sr,'r'y'