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Home My WebLink About7855-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~?OObr .... Date ...........~Y . ~ ......... ,19..76 THIS CERTIFIES that the b, dlding located at .~/S..',~e~g. Creelc .Ave ...... Street Map No.. xx ........ Block No... x~x ..... Lot No...LX . · .Cu.tchogue.. ~I.,.X. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Apr..2~ 19. ?.5 pursuant to which Building Permit No.. 78.%%7, · dated .... Apr...28 .... , 19..~.%, 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 .. mcce~.~ory..storage, b.uilding .................................. The certificate is issued to .. Ect~mrd..& Crertructe .,~Fli~ -~.. '~,.?ms ............. [owner, Aessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N..H .............................. UNDERWRITERS CERTIFICATE No.. ~[..E(~ ...................................... HOUSE NUMBER ...... 1.~2.~. · Street .. :~est. (~'eck.-Ave...Cu.toh~g~ ......... ..... Bui]dfng Inspector [ FO]~I ~0. 2 TOWN OF $OUTHOLD BUILDING DEPARTA~4ENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COA4PLETION OF THE WORK AUTHORIZED) N? 7855 Z Permission is hereby granted to: ~ad.~.a:c.d...C.~...,~;Le., , · .......................................... ..... · ~t...C~k...Ay~ ................. gn~ho~ ......... at premises located at ....... ~..~.....~.~.~ ..... w~.~..~,;...¢~V..~ ............... .(, ~. .1. .?. 3 ,~. ). ............................................ ............................................................. .q~.~.b..o.~.qe. .......... .~. :. :.13: .-. ........................................................... pursuant to application dated ..........................~.P.~..]:.~ .......... 2...8. ..... 19.?..~..., and approved by the Building Inspector. Fee $...1..C..:.:~..0. .......... ! Building Inspector FOILM NO. I TOWN OF SOUTHOLD BU[LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19.,Z~ Permit No..Z~,,..~,,.~,,...,,~-,...; ..... Applicotion No...3,,~,,.,-~',.,,-~',, ............ Disapproved a/c .................................. ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a This applicat,on must be completely filled ,n 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 buddings on premises, relationship to adjoining premises or public streets · areas, and g~ving a detailed descriphon of layout ofproperty must be drawn on the diagram which is part of this applicatiof c. The work covered by th~s apphcotion may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector w~ll issue a Budding Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e No bu,ldmg 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, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. · ............................ (Signature of applicant, or r~ime, if a corporation) (Address of applicant) 0 State whether apphcont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildei ...... ..~.....~.....%.....~,£ .............................................................................................................................................................. Name of owner of pram,sas .~t/~.l ..... /.~.o.~ ....... I .......................................................................................... If apphcant ~s a corporate, s~gnature of duly outhorize~5 officer. (Name and title of corporate officer) Budder's License No ..... ~~ .................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1 Locat,on of land on which propos, ed/work w_,ll be ~g_ ne._ Map No_."'..~ J./~.~_![.~. ...... "' ~' J.[.?..C.:..../~. at No Street and Number Municipality 2 State existing use and occupancy of premises and intended,use and occupancy of proposed construction: Ob Exisitmglntended use Onduse and occupancy '"/'"~"/~J'" "'~'"'(~" C' '~' 'J" ' ~'¥' ~'" "~;" "~'~':~';~.' ii~-Z- 0/c) y'c~ '~ '~-'O'---' t / '(4 /L~ 4(~ '*~ ........................................... 3 Nature of work (check which applicable) New Building .............. Addfflon ................. Alteration ........ Repair ................Removal ............. Demoht~or ......... Other Work .............................................. ~ (Description) (to be pa~d on filing th~s apphcat~on) 5 If dwelling, number of dwelhng units ........................ Number of dwelhng units on each floor ......................... If garage, number of cars 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 D, menslons at, ex,st,rig structures, If any Front .. ~',~,..O. ............... Rear ........ Depth .~.'..Z.?....x...~. Height ...../..~x ................ Number of Stories . ../.;.~'/ ....................................................................................... D~mensions of same structure with alterations or addmons: Front .................................... Rear ...................... Depth ................................ Height ....................... Number of Stones .............................. 8 Dimensions of fmtire new construct,on Front .... /...~ .......................... Rear ...... ............... Depth ......'~......~.. ........ Height ....../.?~.. ...... Number of Stories .... / .............................................................................................. S,ze of lot F/rant ....... ~/ .............................................. ear ..../.. ................... ~. ........ Deptkn .............. ~.../ ......... 9. 11. Zone or use district in v?h~ch premises are situated ./.~ ....................................... (/. .................. " ......................... i2 Does proposed construction violate any zoning law, ordinance or regulation ........................................................ 13 WHI lot be regraded .... .~....~.. .......... .... Will e,xcess fill be removed from .~jzemises: ( ) Yes (~"~No C Name of Architect ............................. ~. ............ Address ................................ Phone No ...................... ~ Name o{ Contractor .................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex~stmg or proposed, and indicate all set-bock dimensions fron property hnes Gwe street and block number or descnpt~on according to deed, and show street names and indicah whether interior or corner lot COUNTY OF ..Q'~TTY~-,//~~,,.__F~.)// ~' ~. / ~/~ ..... (Narr(6/0f individual signing contrac~ above named He ~s the ...................................................................................... ctor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f~l~ this application, that all statements contained m this apphcehon are true to the best of his knowledge and belief, an, ti,at the work will be performed m the manner set forth in the apphcation filed therewith Sworn to before me th~s Notary Pubhc, . ............... ~ ..... County (S~gnoture of a~/Hicant)