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Home My WebLink About4093-zFOI~M NO. 4 TOWN Or 5OUTHOLD BUILDING DI~-PAI~TM£N~r 'I"OWN CLERK'S OFFIC~. SOUTItOLD, lq, Y. r:EF~TIF'IOATE OF' O00LIF~ANO¥ No. ~ .33~ .... Date ...... ~ .......... ID~ .... I~ ....... 19.68 THIS CERTIFIES that the building located at .PI~.f~ ,"P~Ed .................... Street ~ Cedar Beach Pa~l_ ap l~o ............. ~-iuc~ No ............. Lot No, . ...~ ......... ~O~O~d.. N,~., . conforms substantially to the Application for Building Permit heretolore filed in this office dated ............. Q~ .... 1~.., 19. ~ pursuant ~o which Building Permit No. ~.. dated .......... 0~.~ ..... ~ .... 19.6~, was issued, and confor~s to all of the require- merits .of the .applicable provisions of the law. The .occupancy ~or which this certificate is issued is .... Private. garage..(Ac.ac ~tor. y. ~d$)..; ............................... The certificate is issued ~o ~e.~o~ph. O~i~.~ ................. ~ ..... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department ef Health Approval ......... , ..... ~,~ ..................... .... ~i~' i~p;~[;;q'':'~ :~ ........ TOWN OF $OUTHOLD BUILDING DEPARTMEN'I~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~093 Z premises I~otod ot ................................................................ ~ ........................................................... pursuo:n, ,o opplicotion doted Ig' O~ r 19..~.~, and *pproved by the Building Inspector. Fee $..,..,~.'.~.. .............. · ..:..:..(:..:: ~:'..-:?. ....... .'..':'...:...,::~::,~. ~ Building Inspector TOWN 0~: SOUTHOLD BUILDING DEPARTMENT~ TOWN CLERK'S OFFICE ~, SOUTHOLD, N. Y. Examined ........................................ , ~9 ........ Application No ................. / r,.j~: ........... ......................... ................ ......... '... ............ ............ ...................... ::....::: .... ~ ............... ............................................................ , ~.~.: ..... INSTRUCTIONS o. This application must be completely filled in by typewriter or in i'nk and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot end of buildings on premises, relatlonship to adjoining premises or public streets or areas, and giving a detailed description of layout of property r¥ ust be drawn pn the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issuance 6f 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 througkout the Pr0gr~ss of the work e. No building shall be occupied or used in whole or in part for any pcjtpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the i~suonce 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 f;or removot or demolition, as herein described. The applicant agrees to comply with oil applicable lows, ordinance, build',ing code, hgusing code, ~nd regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, en~iqeer,, genera! contractor electrician, plumber or builder. ............ ....................... ......................... ......................................................................... Name of owner of prem~ises ...~....r~/.~.~:~A..~:,/~~> .................................................................... If applicant is a corporate, signotut~of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done Map No.:~. ~'.'..~.'-~.....~......~.~ ~ ....... Lot No.: ...~..~..~ ............ Street and Number .... ?..<..¢..~..~.?...:~.¢~.~.::...~...~...-~...~..~...--~ ........... ..~..~..~..:~...:~........~...~./.~....~.....~ Municipolffy 2. State existing use and occupancy of premises and inlended use and, occupancy of proposed construction: a Existing use and occupancy ......'..~.~r~.~ b. Intended use and occupancy ...:~¢?>,.,~?~...~.,.~..~ ............................................... 3. Nature of work (check which applicable): New Building .................. Addition .......... R pal ~ R ~J D lift Oth W k (D ib ) (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... m.~.~ ............ Number of dwelling units on each floor ............................ 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 ...... ~.:.~ ........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 ........ ~ ................... Rear ....... (.~.~ ........... Depth ....~.~.~ ........ / J Height ....... ~...~ .....Number of Stories .......... ~ .......................................................................................................... 10. Date of Purchase .................(.~ .............................. Name of Former Owner ....~,.....~~ ............... 11. Zone or use district in which premises are situated ............. ~ .......................................................... 12. ' Does propos~'d c~ns~ruction ~olate any z~ning law, ordinance or regulation? ........... ~ ......................................... 13. Name of Owner of promiser--S. Address .~.~..~ ..... Phone N~.~..~.~. Name of Architec~J~~..~.....Address .~.~.~.....~ ...... P~one N~.~..~.~.~.. Name of Contr~.~.~~..~,.Addres~~.~one N~.'.~.'.Z~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~SS CZa~ Yta~ COUNT~ OF ..................~ ............ ~ ' · .... ~~.~~...~....~.~ ........... being duly sworn, deposes and says that he is the applicant ~ ~med. 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 ~ke and file this application; that all 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 before me this No 52-0618100 Suffolk Cou~y ' / ~ ' / Comnuss~on Expires Marcl~ 30, 1~ /