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Home My WebLink About7854-zTOW~ OF SOUTHOLD BUU~. O DEPARTMENT Tm Cl~k', O~iee ~a,N. ¥. Certificate Of Occupancy THIS CERTIFI~ that the ]:.,t]dt'ng ]LO~ated at .. ,WOOde. l:{~.f,f.-~E ........... Street Map No..~::~ ....... Block No. zx~ ..... Lot No, x~... )[att:Ltu~..]l,~[a ....... conforms substant~lly to the Applicatkm ~or B~llc~tng Pea-mit heretofore ff~led in rids o~[tce dated .............~lar.... ~1~ 19.?~. pur~-nt to which B~din_e P~-~t No..~,. dated ..............~.~....2.0.., 19.?~., was issued, and conform~ to all of the requir~ ments of the appBcable provisio~s of the law. The occupancy for which this certificate is issued Ls .. Pl'~vat~ .one. ~m~LN. d~l~ul. ~th. ~n. addit~ ................. The certificate is issued to )~tCh~l. ~l~ke ..... 0~nel' ............................. (ow,,ef, lessee or tenant) of the aforesaid bui~a~. Suffolk County Depar~,..ent of Health Approval . .N oRo ............................. UNDEEWRITERS CEETIFICATE No..l~nd~,ug ................................... HOUSE ]~rM~ER ...~.~Y ........ Street ....W..o~.....~f..~..D.~ ........................ FOR~ NO. ~ TO~N OF $OUT~OLD BUILDING DEPARTMENT 'TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7854 Z Permission is hereby granted to: tz, i. ehe ¢*~....bu~e ................................................ ...... '1'~'"'¥;U'~L'~"rITr"~' .............................. ......................... ',':~'~tT~ck' .............................. ~ ~i.~.~r`~a~Z~.i~.i~n~.`~:ak~;~.a.~%~`~ ~ ~?n~q~x~n.g~:e.:.~.in~ ................. ............... ~s.. apty~eve~ ..~y-..zT~l.-.A? ,~ ea.l.~--..-Ap~'~"t...'~ C)-.~ 9~ ................................................ at premises located at -.-~/~,.-~)~.-~.~'-i-~'.-$)~ ............................................................................... ........................................................ ~,at~ ±~u~k" "~'~Y'¥ .................................................................... pursuant to application dated ..................... ]:,~;~.....L~O .................. , 1%~...., and approved by the Building Inspector. Fee $].~.,.QQ. ............ -- Building Inspectlr Disapproved a~.....~ ..... ~ FOKM NO, ! TOWN OF $OUTHOLD /'/?~,- ~' BUILDING DEPARTMEN~(~ TOWN CLERK'S OFF:C ~UTHOLD, N.Y. - A~plication No..~.~ .................. Permit No...< ................................. ~/~ ~ '"('~ ~[' v(~ ' (Buil~l'lng Inspector) APPLIGATION FOR BUILDING PERMIT Date ................................................... INSTRUCTIONS a This application must be completely filled m by typewriter or in ink and submitted in triplicate to the Buildin~ 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 o~ 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 permil 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 Occupanc~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o. Regulahons, for the construction of buildings, additions or alterations, 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 t, admit authorized inspectors on premises and ir~ buildings for necessa~Q~'in~jpections. ~'/~S~g~turo of.opj;)lican, tnor name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises. ~~~.- ~.~.: ..... ~ ........................................................................... If apphcant is a corporate, s~nature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's k~cense No ............................................. Other Trade's License No ............................................... 1 Location of land on which proposed work will be don~ ~Aap,~qo~z?..~/f~ .~...~.. ................ Lot ~Io...~....~'..'~..~. Street and Number ........... ~..~..~. ......... ~...~./~.~..~'~..~.411rf-~...~.. .................. .'~.~~ ........ Municipality 2. State existing use and occupancy of premzses and m~,~nded us~e and occupancy of proposed construction: b. Intended use and occupancy .... ~.....~/¢4t~. ....... ..~...4~........~ ..................................................... 3 Nature of work (check which licable). New Building .............. A on ..... Alteration .... Repair ................. Removal ............... Demoht~or. ............ Other Work ............................................. (Description) ?, ...../...../.J:.. 4 Estimated Cost ..................................................... ee ....................... (to be po~d on fihng th~s apphcat~on) 5 If dwelhng, number of dwelhng umts ........ /.. ................ Number of dwelhng umts on each floor ......................... If garage, number of cars .................................. 6 If business, commercial or m~xed occupancy, specie nature and extent of each type of use .......................... 7 Dimens,ons of ex,st,rig structures, if any' Front ...... ~..~. ....... Rear ..... ~.~.. .................. Depth .4~.Z~/. ......... Height ...../.....~. ........... Number of Stories ..... ~.. .................................................................................................... Dimens,ons of same structure w~th alterat,ons or add,tions' Front .......... ~....~.. ................. Rear ..... -~.'~.. ...... Depth ......]_~ .................. He,ght ..... ~/' ~l/ ........ Number of Star,es ...... ~.. ................... 8 D,menstons of ent,re new construct,on. Front ......... ./..~ ............... Rear ...... /....~.. ............... Depth ..... ~.. ......... Height ........ ./...~/. ...... Number of Stones ............. ./. ............................................ 9. Size of lot' Front ............ l~.~. .............................. Rear ........ ./.~J.O. ...................... Depth ...'."/."~...~...'""""' 10 Date of Purchase ............~..~.. Z..~'...-:....."~.....(~.. ........ Name of Former Owner ............ ...~....~...'~....~.../'...~... .................... 11. Zone or use district in which premises are situated .... /~...~.....S'.4..~..~..7'./.~.f. ......... ~ ................................... 12 Does proposed construchon wolate any zoning law, ordinance or regulation' 13. Well lot be regraded ...... ./[J.F.J ........... Wdl excess fill be removed from premises: ( ) Yes .~,C~No 14. Name of Owner of prem,ses~'~/.K~Y~.&...]../.:...~...~. .~...~...~.J -" -- .......... Address ~'~'~:~' Phone No. Name of Architect .......................... Address ................................ Phone No ...................... Name of Contractor ......................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and d~st~nctly all buildings, whether ex~sting or proposed, and red,cate all set-back dimensions fron property hnes Gwe street_.qD_~d_bl~ock number or description according to deed, and show street names and ind~cat, whether inter,or or corner lot ........... '(N~m~ 6f mdw~dua[ signing contract) above named He ,s the ..................................... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and thru applicahon; that all statements contained ~n th~s opphcetion are true to the best of his knowledge and behef; an thor the work wdl be performed in the manner set fo~h m the apphcation filed therewith. Sworn to before me this n~/~RY~PURLIC Stnte of~,,,~ 'Kook ~ rm Axp~Fc~ A~FCt) 30, l~