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Home My WebLink About4079-z~O~M ~0.4 TOW~ OF SOI~I'HOLD BUILDING D£PABTMEN~ ~I'OWN CLERK'S OFFICE' SOUTHOLD, N. Y. IDEI~TIFIOAT£ OP OI~I]~I~ANI]¥ TttlS CERTIFIES that the building located at .. ~.~...lt~,llll~l~ ........... Street Map No... ~ ....... Block No...lg~ ....... Lot No. ~ .... 80~. ~,~ .......... eonforms substantially to the Applieati,on for Building Permit heretofore filed in this office dated .......... .~%...9 ........ 19~. pursuant to which Building Permit No. ~.. dated ....... .0¢~ ..... 9 ........ 19.6.~, was issued, and conforms to all of the require- xnents ,of the applicable provisions of the law. The occupancy f.or which this certificate is The certificate is issued t,o . .~%. 8acco ....... ~. ............................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appvoval ~.. ~..~...~y. ~. ~ ..... Building Inspector TO~N OF $OUTHOLD BUILDIN~ DEPARTMENT! TOWN CLERK'S OFFI{~E SOUTHOLD. N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4079 Z D~'e ........... i ............................................ , 19 ........ at premises pursuant to application dated ............................................................. , 19 ........ nd approved by the Building Inspector, Fee $ ...... A...L. .......... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OFf HEALTH Date ~ TO WHOM IT MAY CONCERN: The sewage at s/s Hill Road, Southold Bldg. Pe!rmit No. 4079Z disposal facilitiels for a structure located (Give deed location) Calves Neck have been inspected by this department and found to be satisfactory. Builder - George Ahlers C~mer - Sacco Di itrict Engineer FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMEI~IT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ ~ ]9. pproved ................... . Perm,t No. ~isapproved o/c ........... 5'..~..T.~..~..'~ ·. · · .~ ................................... (Building Inspector) Application No, ....../7Z....~.....7....~.. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in i~k and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relati?nship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust be drawn c~n 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 applieation, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used Jn whole or in pa rt 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Ybrk, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or {or removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, builcl.'ing code and regulatilons. ......... '('~i'~tu~e-o~'a~li~;~t, or name, 'i'~;'~'~)';l~';~;i;;i ......... ......... .......... ..... i ....... ..................... State whether applicant is owner, lessee, agent, ar~cl~tect, engineer, gener~al contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work ~ill be d~og~e. Map No: ......... ;~ ........... ,~...~..,,} ........... Lot No: .................... Street and Number ..................... :..~..;..%~..~.. ....... ..~'....~... .......................... ~.'.o~..~ ............................................... Municipality State existing use and occupancy of premises and intended use ahd occupancy of proposed construction: a. Existing use and occupancy .......................................................... ,¢/?">v] .................................................................... b. Intended use and occupancy ...................................... ~...;..'ff6..~ ..........~ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition ........... ..~.... Othe~9,~ (Describe) ...................................... 4. Estimated Cost .................~..~..,~.q.~.:..~..~ .................... Fee ....Z...../...d{.....~.... ............................................................... (fo be paid on filing this application) 5. if dwelling, number of dwelling units .............. ~. ............ Number of dwelling units on each floor ...~...~2./..~.~ ............. If garage, number of cars ................. ~,, ....................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................. ; ............. 7, Dimensions of existing structures, if any: Front ..... ~ ...... Rear ....,~..~....;..~, ........ Depth ......~ .......... Height ......... ,z~.; .......... Number of Stories ............ ~ ........................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...... .2..~,.%.~..~ .......... Rear ....... ~..~..~.7...~. ........ Depth ....~/.?,,,o,,.'.' .......... Height ....... ~...2, ................ Number of Stories ....... ,/,./,/.~,,, .............. 9. Size of lot: Front ............... .~. .......... ear ............... ~ ........... Depth ................................ 10. Date of Purchase ....... ,,¢..".~r.~..:.. ............................... Name of Former Owner ...~..~.~.r...: .................................. 1 1. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .... ~ ............................................. 13. Name of Owner of pram.sas ...~../.~¢! ............................. Address ~ ........ ..~.~...~.....~ .............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~..~:¢........~..~./~.../~..r.~ .................... Address ....~.~.u..~.~.q..e.?......~...~.....~..~....~.., Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly ell buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. J STATE OF NEW YORK, ~ ~ ~ COUNTY OF ................................ ~ .... ......... ~ .......... -/~/)~ ................................. being duly,~sworn, deposes and says that he is the applicant (Name of ~dividual signing application) ~ , 7,44"~//~,~ above named. He is the ............................................. ~,.m'..~C~.,,m..r.~., ............................................................................. (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 this application; that oil statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to/l~efore me this (~0r/ .......... ........... day ..................... ,,, ........ ~ ¢ -~ ................... .-~.- ~, ,~.~.. ........ ~'* ..k?~..*~.~ ............................ Notary Public,~/.~..~'.,.J(~ ........... County~uml/~,~ A~ il, (~, m' ........ (~noture of applicant) ......