HomeMy WebLinkAbout3886-z FORM NO. 4
TOWN OF SOUTHOLD ~
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Occupancy
No. Z. 366.4 ..... Date .Nov, e~oer.... 12, .......... , 19.69.
THIS CERTIFIES that the building located atH~lr~aters. &..C,q~r.t~goab~ns . Street
Map NoZCassau .Pt.. Block No ........... Lot No407.i.408,40g,. Cutchogue.,..N. ¥,
~rop. Map No. 806 ~
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ....... l~Iay.. 3-5, ....., 19 6/~. pursuant to whic~ Building Permit No.. 3~6. ~..
dated ........ May...16, ...... , 19.68., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for Which this certificate is
issued is ...private. ond. famil.y..dwelling ........ ~ .............................
The certificate is issued to . Louis. Ramunni .......... .............................
(oWner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ....................................
House ~ 2895 Hay~&ater Road
485 Carzington Road
FORM NO. 2
TOWN OF sOUTHOLD r
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) :
N? 3886 Z
Permission is hereby granted to: ~ ~
......... ~.1. · .w~,~..t~..~t.taan,. 1i~t- ...... ~ .................
.................... ll~.m..&,~.~.~t~,~..lld~, ....... ~ ...... ,lJ.~, ...............................
pursuan¢ to application dated ..; ...................... '"~" ...... ]~[.~ ....... !...., 19..~., and approved by the
Building Inspector.
'TOW)4 OF SOUTHOLD /~'
TOWN CLERK'S OFFICE
........... .......
^~ ........................................ ,~ ........ pe~,t ~o..~..--.~ ~0/~
&PPLI~TION FOR BUILDING PE~
. . ..... .......
INS~U~IONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showin.g, location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which is port 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 progress of the work.
e. No building shall be occupied or used in whole or in part for any purpOSe whatever until a Certificate of Occupancy
sholl 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
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, aS herein described.
The applicant ag~es to comply with all applicable laws, ordinance, 'b~d~ing code,/l~ousing code, and regulations.
, 'J ~ , (Signature of ~'ppl. icant, or name, if a corporation)
.......
- ' (Address of applicant~'~'~ '~:~
State whether applicant is owner, lessee, agent, architect, engineer, general coniractor, electrician, plumber or builder.
Na~ of owner of premises .. .~....~.!.-.-:.. ..........................................................................................
/
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
2. State exi~ing u~ and ~cupancy o~mmi~s an~~ and ~cu~ncy of p~ con~tl~:
a. ~isting ~e ond ~cuponcy ...~..~u. ,~ · ~'~ ...............................................................
/ /~
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ........... :~ .....
Repair .................. Removal .................. Demolition ........ L~.....' Other Work (Describe) ........................................
4. Estimated Cost ....~...~....~...e.....~ ............. ~..i ............... Fee ..... . ....................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .~ ............ iNumber of dwelling un'its on each floor
garage, number of cars ........ ~ -- ...o~.....~...~ ............. ;;;.; ...............................................................
If
6. If business, commercial or mixed ocoJpancy, specify_natUre and extent of each,~type of use ~... .....
7. Dimensio~ns of exLsting structures, if any: Front .......~...~...~ .... Rear ..; ....... ~...~..~... Depth -~.~..~.....~.....
Dimensions of--some structure with alterations 9r additions: Front/...4.~../..~...~....LT ........... Rea~..~..S..~...J~.
Depth ; ...... ~..~..!. ............... Height ....... [..,c..~x........Number of Stories ................................
8. Dimensions of entire new construction: Front ................................... ~ Rear ............................ Depth ........................
Height .................... Number of Stories .....................................................................................................................
9. Size of lot: Front ....,..¥...~..~,..'..: ....... Rear ................. .~.....,~..,..:.... Depth .......... ~...m.,e...,....:..._
10. Date of Purchase ...~....~...~.~.(~.~. .......................~.,~ll.[l'.,~,,r~cN"l..."-N(me of Former Owne~r ..A./.~.~.~......~..?..L~.~..I.&,~..~.. ........
11. Zone or use district in which premises are situated ...~.~.?...~,I.~..I....I..L~.~.2...~.......L.I...: .........................................
12. Does proposed construction violate any,,c, oning law, ordinance or regulation? ,......./~....~'.. .......... ~....~..~.,~ ...................
13. Name of Owner of premise~./~ ...... Add ress ~ .~... ~~~o...~.T.~.~
Name of Architect~~t~,~.~......Addres~~.~one No.~,__~..-~,4~
Name of Contractor .~/~.' ........ Address .~//....~.~~bne No. ~.t..~)...~/f
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property 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, ~. c e
COUNTY OF ......... : ...................... $~'~'
................. .'~...Z..C..!..~.. ...... 1.~.~....~%.. ~....I'~LL .................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ...................i"..0. L~...~.~...~..~.. ..........................................................................................................
(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 all statements Conto:ined 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 applicati, o~' filed therewith.
Sworn/~_to before me this ...~ 19...'..~..
..... ....... : ...................
Notary Public, .~ ....... '.~_./.....~....~'..~. ....................... County ' (SJgl~ature of applicant)
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