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Home My WebLink About7352-ZFO~M lq~ & TOWN OF SOUTHOLD BUILDING DEI)~ Tovm Clerk's Of Bce Southold, N. Y. Certificate Of Occupency THIS CERTIFIES that the build~,~S located at -~-bb~t.La~e .............. Street Map No.. auc~ .......Block No... xax ....Lot No..r. ar, c .... l~a~.~ .~a~ .... N~Y.,. · · conform.~ substantially to the Application for Building Permit heretofore filed in th~_~ or, ce dated .~.$3/'~.¶.,&/L~/,~,e/~I~... pursuant to wk~h Bui~di-~ Permit No. dated ..... &Il..a, bc.~ ......... , 19 .... , was ~ssued, and conforms to all of the require- ments of the applicable provLsions of the law. The oceupane7 for which ,1~_~ certificate Js issued Js . ~:'_,va~m .cn~ .ff~,~ '.:r. d~e?~L~ng..~Ltl~ adctLt~.~n~ & .aL~era~,~,o~ & .Aeey. The certificate Ls issued to ... G2a~u~ey.;a'o~,ffe ..... 0~m~. r. .......................... (owuer, lessee or tenant) of the aforesaid building. Suffolk Couuty Department of Health Approval .~i..1~. ~ .............................. LTNDEBWRITE1L5 CEBTI~ICATE No.. l~er-~Lug ................................... HOUSE NUMBER .... 8.t~ ...... Street. ~h~bb£~ .Lane ...... F~t;. ~.~,~£ca ........ ..... ........ FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~.EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7352 Z Permission is hereby granted to: atanl~..~elf~. ............................................... ..... ~.....~e~t..~...~ .................................. ............ iee...Zmek ...... Z.~.......l~O~k ............... to ......l~..~..~4~l~te~..~..ax~..d~l~ .............................................................. at premises located at ....~.~..~4~b~l,:l;...L&lle ................................................................................... ·aRt ~o~ pursuant to application dated ..........................~.1~1~...,..~.~ ....... , 19...~., and approved by the Building Inspector. Fee $...t ~.e,O~ ......... ~uilding Inspector( BUILDING DEPARTMENT ,,,l~'~1_._ Application No ................. \ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS · This appl cat on must be completely filled in by typewriter or in ink and submitt,~ :- --:-': ...... -'--" .... Inspector, with 3 ~et~, of plans, accurate plat plan to ~cale. Fee according to schedu · b. Plot P ar~ Shdwmg location of lot and of buildings on premises, relationship to adjoining premises or public streets of areas, and giving a detailed description of layout ofpraperty must be drown 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 Occapancy~ 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 .~uloti.o. ns, for the cOnstruction of buildings, additions or alterations, o.r for removal or demolitiOn, as herein described. appncant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicar~or name, if~ cor~'~i~ ........ ................ ...... 0 .... 'l ddress of applicant) State whether applicant is o~ner, lessee, agent, a~hitect, engineer, general contractor, electrician, plu~er or builder. Name of ~ner of premises ................... ~ ............... ~ ................................................. r ............ If applicant is a co~orate, signature of duly authorized officer. .......... ..... Builder's License No ..................................................... 'Plumber's License No ................................................. :'Elecm~m's_&lcm=e~-- NQ.; ............................................ 1. Other Trade's License No ............................................... ...,--.<: --7 Location of land on whlc_h pr.ap.osed work will be done. ~p No.: ........................................ 'Lot No ......................... Mun~i~li~ Sta~ existing use and ~¢u~ncy of premises and intended use and ~cupancy of proposed const~tion: b. ~ntend~ use and ~cupanc~ ~ ~.~ ~ ~ ~ ~ "~l~l~Nature al v,e~k (check ~h~ct~ applicable): New Buddmg .................. Addition ..... ~ ..... Alterati, . "'~ ~ - R~ir .................. Removal .................. Demolition .................... Other Work ............................................ .. ~ (D~ription) ' 4. ~timated ~t ........... ~..~.~..: .............................. Fee ...~ ................................................................................. (to be paid on filing this application) 5. If dwelling, numar of dwelling units ....... .~ ...............Number of dwelling units ~ each flor ............................ If garage, number of ~rs ............................................................................................................................................ 6. If business, commercial or mix~ occupancy, speci~ nature and extent of each ~pe of use ..................... 7. Di~nsions of existing structures, if any: Front ....... ~..~.1. ............Rear .......... ~.~.f ................ Depth ~..~ I ' Height .........~ ............ Nu~er of Stories ........... ~ .................................................................................................. Dimensions of ~ame structure with alterations or additions: Front ......... ~..~.~ ................. Rear ....... ~..~.1. ........... Depth ....... ~ .............. Height .......... ~..~ ............. Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~ ...................... Rear ........J.~ ........ ~... D~th ...... ~.~. ............ Heigh~ ...~.~.~.. Nu~er of Stories ......... ~.~.~..d ....... ~.~.~.....~..~ ....... ~.~.~.(~. .......................... 9. Size'of lot: Front ............... ~.~.~. ............................ Rear .............~.~ ............ ~ ...... Depth ..... ~..~.~ ................. 10. Date of Purchase .......... ~..~..~.~ ................................ Name of Former ~ner ..... ~.~R.Z~.....~.~ .............. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ ~3. Will lot be regraded . ........ ~..~ .......... Will excess fill be remov~ from premises: ( ) Yes ( ) No 14. Name of ~ner of premises ~.~..~.~J.~.~ .................. A~re~s~.~7./~..~.~ No.~.~.~.~.~.~... Na~e of Architect .............................................................. ~ ....... ~..~ ............... Phone No ....................... ~ome of Contractor ~ Od ~ Address Phone No. PLOT DIAGRAM L~ate clearly and distinctly all buildings, whether existing or proposed, and indicate ~II set~ck dimensions from prope~ lines. Give street and block number or descriDti~.according to de~, a show names whether interior or corner lot. ~ ~ ~ ~ I ~ ~ ~ ~" ~ ~ street and indicate STATE OF NEW YORK, ! c ¢ COUNTY OF ................................ )'~'~ , .............................. ~....~.~.~.~..V....~)..0..L~. ......................... being duly sworn, deposes and soys ~hot he is the applJcanl (Name of individuc/I signing cdtntracf) above named. ~ -- He is the .................................... ~).~....~....~. ........................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and ti,az the work will be perforr/~in the manner set forth in the application filed therewith. Sword to bef, re m~this ( , 7...~. ,~-~ ....... of ..... .............. Notary Public,,~...~--~/~.~ ............. C u ty ....................... .~...~.;...:...:..=.| ...... ;'...I.'[.: .................................. ~AMUEE 3. GLICKI~Af~ ~ll~ar~ Public, State of New No. 52.6544580 iTer p' s Ma ~