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Home My WebLink About8686-zNO. ~ TOWN OF SOUTHOLD BU~.DI~G DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~.7.6.!? ...... Date ............ .il~.l'.i.l...~. ..... , 19..77 THIS CERTIFIES that the building located at ... T. cwn. ltarbor..Lana ..... Street Map No. ~ ......... Block No.. X~ ...... Lot No...XX ...$o.uthol,d.. 1~,.~, ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .J~l.. 2.8...., 19.2./~ pursuant to which Building Permit No.. dated ............ .J..a~....2.8..., 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.~..l.v.~t.e.. ~.~i! .~At4a..g .po.o.1 .Wi.th. fence..t. &c. cesz.cl'ys ................. The certificate is issued to . ~.."-.B1.1~1~11~ ..... .t~eF ................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ]~.,1~, ............................. UNDERWRITERS CERTIFICATE No. ~[9.~.118 ...... 0'~. 28.. 19.7.6 .............. HOUSE NUMBER .............. Street .......................................... Building Inspector !~,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEfA~TMENT TOWN CLERK'S OFFIGE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8686 Z Permission is hereby gmntedto: .................. i~t,~t,~ml~ ....................................... m...J~:l~,..z~e~..~.~..~v~Ln~..~oo~...~.t~..feuee..&..eeeee~o~ ..................... at premises located at .~.~ ...~.(~'J~..HA~.~I:~...Z~II~ ........................................................................ .................... i ............................ I~1~].~....!!,~* ............................................................................... pursuant to application dated ....................... ~l~l~e....~ ............. , 19~ .....and approved by the Building In~ector. ~; ',,i,:: THE N W YORK BOARD'!OF FIRE UNDERWRITERS ~ i "; te July 28,'i' 1976,_ "~- Pau . Burns,..Town.Harbor. Lane, .Southo d,. L~I.' .. '. _ ~!.,,:'it-~i~''', ~ ' ' ' ' ' '"'~'"::' ~out's ' ' ' ~ ' ' ': ,o ', t ~ and~ound to be ~n eontpliance w~th the requirements Of ~hi~ Board, FIXTURE ~ I RANGES ;OOKING DECKS OUTLETS' ,V only~Because of ] ~ ' SouthoId, L.I.', 11971%' ', ': Lie 282 ' This certificate most not be altered in any manner, ,ofurn t6 the office of the Board if incorrect. Inspectors may be identif~.y/~helr Approved ........................................ , TOWH OF $OUTHOLD -~(~'~ 7~, .UILDING DEPARTMEHT ~/ / TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App,cot an ~/ ' (Building Inspector) / / APPLICATION FOR BUILDING PERMIT/ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate .plot p~lan 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 i~,~m-Cc~of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New~f~ork. ~r~J other appl~cgble Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations,/<~r for r~r~vol or de~l~,~on, as~ein described. The applicant agrees to comply with all applicable.laws, ordinances, 5uilding~c~le, housin~;~/f~o,d'e, and ,~e'gulations and to admit authonzed respecters on premises and in, buildings for nece ry in · ti0ns. ... ' ................ .............................. State whether applicant is owner, lessee, agent, architect, enginee lectrician, plumber or builder. Name of owner of premises ..~.....(~.~.~.....,Z~. ~~ ........................................................................................ 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 whic~grgposed work wi~ be~ done. ,~op No.:~ ....................................... bot,lt~ ............... . ......... Street and Number ..... -~.....~,-~...~.~.....~~. ..................... ............. Municipality State existing use and occupancy of pret~es and intende~i use and occupancy of proposed construction: a. Exisiting use and occupancy .......... ,, , ~-..~......,~..,~...~)..~.......~...h,' ......... /...~ ....................... J. ............................................. -- .... b. Intended use and occupancy .................................... ~..,~./..(~A..~ ........ ....q.(.,.J/. ................................ . ........ / . 3. Nature of work (check which applicable): New Building'. ................. Addition .......~,~ ....... Alter~,t~on .] ............ Repair .................. Removal .................. Demolitior. ................... Other Work ...~J.~/~ ............................ [~, ~_..~_ (Description) 4. Estimated Cost ............... ..l.x..~ .................... Fee .......................................................................................... ,f (to be paid on filing this application) 5. If dwelling, nurnber of dwelling units ............................ Number of dwelling units on each floor ........................... If garage, number of cars ...~i ...................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf 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 .................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ..................... .; ........ ~ ..................... Name of Former Owner ...................................................... 11. Zone or use district in which premises are situated ....................................................... .,~.~ .................... ~ .............. 12. Does proposed construction iolate any zoning law, ordinance or regulation: ...................... - '-~ ..~...ii ....... i;~ .............. 13. Will lot be regraded .......~.~'~-~. ..... Will exc~..ss fill be removed fl;~Vn premise, s:( ) Yes ~No 14. Name of qwner of premise~.....~..~...~..... Address~..O../~.. .......... Phone No.7~...'..Z..~ Name of Architect ....~ ................... ~..i ................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and slnow street names and indicate, ~vhether interior or corner lot. x STATE OF NEW YORK, ~ ¢ c COUNTY OF ....~.~£~(~]~ ........... ........................ ~t,~',;~'~gt~,.,~,e..z':ll~z?~bJ.~:t~ ............................ being duly sworn, deposes and soys that he is the applicant (Name of individual signing contract) , above nome& Fie is the ....................................................... OOg'g~,9,C~O~, .............. ,,-c,,v ......... ~ ................................................................... (Contractor, agent, corporate/o~ .~cer' etc.) oF said owner or owners, and is duly authorized to aerform or ha~e )~rformed t~e~ s:id ~ork and to make and file tbis application; that all statements contained in tt~is application ~re tlrue to the I~e~t of h~ knowledge and belief; and that the work will be performed in the manner set forth in the appli,l:at ~ filed therc~it ~. / \ Sworn to before me this ~ J /~ / ......... ~.1~..~ ...... day of ..................... .dT.~..e. ............. , 19.,.~..~... i ,~1 ~, ~ Notary Public,. ........ ~-, .............. ~1.£~0]~: ........County ...'~.......~..~ I~......U.... ~ ........ ~ ................... '/