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Home My WebLink About2806-zFORM NO. 4 TOWN OF $OUTHOLD BUr~DING DEpARTM~,NT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No.. ~,~+~ ..... Date .........8eptea~er. ;tl~e..., 19. ?.~ THIS CERTIFIES that the building located at .N/l; .Lee.to~. il~iv~ ....... Street Map No ....)~X ....... Block No.. fY, ...... Lot No ....XX ........................... conforms substantially to the Application for Building Permit heretofore fried in this office dated ..........Jlkly.6~ .... , 196~. pursuant to which Building Permit No... 2806Z dated ..........~'t~J.y. 69 ..... , 19..6~, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...Pri.v~te. one. i'a~il~ .dweZlllag ..................................... The certificate is issued to .... James .W,. iiert,~ch ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Heaith Approvai ...N.., .R., ............................. UNDERWRITERS CERTIFICATE No...P.e.n..d.i.n.g. .................................. HOUSE NUMBER 8~0 Street Leeton I)l'ive Sou~hold Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1~.O 2806 Z Date ......................... ~1~1.)' ............ 6 .......... ' 19"65 Permission is hereby granted to: · Jmses...l~e~tsoh ............................................... .......... · B~u'bh~d .................................................. to ~tcr ..bu.t.~:d.. ne~.. ~,lt~...f,~l~I?...~.. ] ~.~.~ ............................................................................... ct premises located at ...]~i/~.,,..~l~tT.~. ......................................................................................... ................................................ Sottt~o.l~ ............................................................................................. pursuant to application dated ......................... ~Ytt~.~' ....... 6 .................. 19.~..., and approved by the Building Inspector Fee $" '~"&'O~ ........... -- ~ v BUILDING~DEPARTMENT ~/~ ~ed ....... ~ ............ ~., , 19. Permit No ........................... ....................................................... ~.. ...~~ ............. _q ....... .......... .................. -- V ~ /6 '"STRU~IONS o. T~is application must be completely fiJle~ in by In~ectot. b. Plot plan sMowing I~ation of Jot and of ~uiJdings on premises, miationsMip to a~joini~ premiss or areas, a~ givi~ o ~°il~ ~riptim of layout of ptope~ must c. ~e *ark covered by t~is application may not ~e ~ommenced d. Upon ~proval of t~is application, t~ Building Ins~ctor will issue shall be kept on tMe promises available fat i~tion tMrougMout t~e pr~ of the work. e. No ~OiJ~g s~ll ~ ~cupi~ o~ u~d in w~oJe or in port fo~ any pu~ose wMotever until a Ce~ific~e of ~ncy s~oll Move been granted by tMe Building Insp~tor. 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 Regulations, 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, ordlnanc~--~ code an~ulations. ~ _.~Z'~,C.~_~_7 ~' ~ ~r~ (~' ~/' ~f~' ~:'~"<~'"~'"iX~;~ss~=~L~ ~ ~,~) ............... of applicant+ ~' ...... ""~": .............. State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builJ:ler~ ...... ...................................................................................................................................................................... Name of owner of prem ses .................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. LOCation of land on which proposed work will be done. Map No.: ........................................ Lot No.: Street and Number ........................................................................................... ~i;:'il~'li~' ........ : ............................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ,.~..../.~.~../~..~ - / ..~..'~,~../.J. y Intended use and occupancy .....~.......~..~,.~...~,......Z..~.~./.~... ................................................................... _3. ~Nature of work (check which applicable): New BUilding .................. Addition ................. Alteration ............. Repair ................. :ARemoval .................. Demolition .................. Other Work (Describe) ........................................ t 4. Es mated Cost ....... ~ ......................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........ .~. ............................ ;. ...... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~.~. .................. ..... , / 7. Dmensonsofex~§tngstructures, fany'Front ~. ~ Rear .~. Del~th Height ...... .~...'~....~.(~....~ Number of Stories ..... ~.Z~.... ...................... ~ ............. Dimensions of same structure with alterations or additions: Front ..... ,~.~..~.....~ .......... Rear ....,~-...~.~'.~.. ........... ! Depth ....~'~.~.7~...f. ......... Height ..'./...~......~.. ........... Number of Stories ............ ..~..~...~.. .......... · / ! 8. Dimensions o,f entire new construction: Front ..t.~..~..~... ................ Rear ....~-~.,.~.. ........ Depth ..~...~... ....... Height ./..~...,~.......~ Number of Stories .........~.~.~... ...................................................................................................... Size of lot: Front ......7.....'~../. ...... Rear ...,~....~..~..../. ......... Depth ....... ~./.../...z. ........ Dote of Purchase ...........(/~.../.'. ................................. Name of Former Owner ................. ;..~...'~...~.~.......~ ............... Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation> Name of Owner of premises~.~...~'d~(...~...~.~..Address ..~..~...~.~X/.~..~..T...~..~phone No.-~..-..~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... 10. 11. 12. 13. PLOT DIAGRAM ~ · Locate clearlY and distinctly all buildings, whether existing or proposed, and indicate all set-lx~:k dimensions from :prOperty lineS. Give street and block number or description according to deed and show street names and indicate whether i~ter or or cornerkot. COUNTY OF '' - .............................. (Name aividu l signing lication) above named· H~ the .............. ~..~......:~.~ .......................................... ~ ................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~erformed the said work and to ~ke ~d file this application; that ~11 statements contoined in this application ere t~e to the best of his knowledge and belief; and that tbe work will ~ performed in the manner set fo~h in the applic~reWith.~ Swam to before me this ~ ~ Permit requested to build a new room 2'4'6"" x 12' with a 10' ro'of overhang on the water side of h~use. Construction will be masonry an~-wood with gable roof all materials to match existing house.,