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Home My WebLink About9448-zFO~ NO. 4, TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Block No ~- Lot No conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ~;. ~.... 19 ?/. pursuant to which Building Pemit No. dated ....... f~:~ ~/~...~]., 197~, was issued, ~d conforms to ~1 of the req~e- merits of the applicable provisions of the law. The occup~cy for which this certificate is The certificate is issued to ,~2~,,~..~[, .~-6~,~z?~:... t. / (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval f?.( ................................ ..... ':. ......................... HOUSE NUMBER .... 'e :~'.~... Street .~..C~:~ .... Building Inspector TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9448 Z Date ............................... ~,~.: ..................... Permission is hereby granted to: .u~.~...?............. ~.. ......... :~ ......:~.-~...........~....f~.~?.c.~:: ........ ~!. ~-,- o ~ ~ pursuant to application dated ~f)~ ~ I ...... : and approved by the Building Inspector. Fee $ ........................ BO d ng tnsp~¢tOr ' : : ': '; ~i" TOW~ OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~ / 19....Z Approved ................. ~.,,.~/. ........ /.., 19.~.Z Permit No ..................................... Disapproved a/c ........... ~.~. ~T:~.~ ................................................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No. L~ a. This application must be completely filled in by typewriter oe 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 appl cat on, the Build ng nspector 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 o 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for D~ecessar%{nspections ~-, / ..... ~;:~;~ :t, or name, if a corporation)' ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................................. ......................................... ...................... Name of owner of prem ses ....... .~..9.~....A..,....~......~.?.,~.~q .e..~....~,...~..e.o.~..~.... ..... ............... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of co~orate officer) Builder's Lic~se No ..................................................... Plumber's License No ................................................. 3. ~,L' : ." :~:, A; ~F ANY KIN~ 4. Electrician's License No ............................................. Other Tmde's License No ............................................... 5. ALL CONS'F~UC~C.H MUST ~E~T 1. Location of land on which proposed work will be done. ~ap Ho.: ....:...~[~..~,.~ ~?.~A~6.~E. ........ Stre,t a,d Nu be, .... ...... Municipali~ 2. State existing use and occupancy of premises ~nd intended use and occupancy of proposed construction: ~. Exisiting use ~nd occupancy .................. ~ ............................................................................................... b. Intended use and occupancy .................. ~ ............................................................................................... 3. Nature of work (check which applicable): New Building,, ................. Addition .................. Alteration ................ · · T '-' >r , (Description) $3°800.00 $1o.oo 4. Estimated Cost .....................................:,.,.:.;~ ............. Fee .......................................................................................... , ,,¢ ' , , (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ 7/. ............. Number of dwelling units on each floor ............................ If garage, number of cars 2 / 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........... ,~...q.I. .......... Rear ........ .2.,.O.,.~. ................. Depth .... .~...0..~, ......... · 12' to 1 ' He,ght .....................'..br. Number of Stories ............................................. ~ .................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new constr6ction: Front . . ,~.~ ......... ., ............ Rear ......~.~. .................. Depth ....... ~..O..f ........... Height .A:.?.~.~...°..~....~.4~'lumber of Stories .................................................~. ................................................................... 9. Size of lot: Front ~)5.Jl.O '" 'i07.91 265.00 ......................................................... Rear .......................................... Depth ................................ 10. Dote of Purchase ........... .D.,~.,~..,....~..~,~.~. ....................... Name of Former Owner ....... .~..~..~.,.~.....~..:...,~.,~..~.?.. ............ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded .......~.~ .............. W excess fill be,removed fr~m~ramJses:J_ ) Yes , , (X) No · John/~ran Keogh . , . 298 ~263 14. F, ame of Owner of prem.ses ...................... ; ............................. Address ~g~.t~.~l~.¢l~ .......... Phone No ....................... ' . ........... Address ..........................:;.,...'.Phone No.- ...................... Nome of Contractor 0~e~ Address ......................~. ........ Phone No ....................... ' ~LOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or pr~.~osed, and i~M4~t~!~,~At~~sions from property lines. Give street and block number or description ac~r'df~g to~Jeed~, and shb-~s~et in?roes and indicate whether interior or corner lot. D¢~:~'~- , L STATE OF NEW YORK, ~ c c COUNTY OF .......... ....... ~.ob~..&..,..&..~.~ll,rt~.~S..~....K~O~ .......................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the ...................................... .~. ............................................................... : .............................................................. (Contractor, 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 file Sworn~ t is ' 9~ ..................... .......," ............ ALaN ~T~Y ~B~C, S~TE OF N~ YORK ~IFI~ IN ~F~K CO., NO, 52-6022275 [~I~ION ~IRES ~RCH 30, 19--