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Home My WebLink About3946-z· O~'tt~ NO. 4 TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office $outhold, lq. Y. Certificete Of Occupancy z6o9) s, ept 9 ., No .... ~. ...... Date ........................... TI-IlS CERTIFIES~ that the bmldmg located at ..0~k.. D.r..t.?.e.. ................ SMut Map H~..~*.. '.Blo~ No.. ~. ...... . Lot No.~.t~,?6 ..... co~9~ subst~tia,y ~o the App~cafion for B~g Pemit heretofore ffl~ ~ th~s office ........... ~...~.., 19~. p~su~t to w~ch B~g Pe~t N~ ~at~ ......... ~.. ~ ...... , 19 ~0., was ~u~, ~d confoms men~ ~ of ~e applicable pro~io~ of ~e law. ~e occup~cy for w~ch issued is ~Y~. 9~. ~. ~.~.~ ....................................... ~he Certificate ~ ~sued to ~T.q~qT$~. 9~qll~} ....... ~t.~ ..................... (o~er, lessee or ten,t) / bf ~e Mores~d b~g. S~o~ Co~ty Dep~ent of He~ Approv~ N~t ................................ UNDERWRITERS CERTIFICATE No.I~.e..1~..t~. S ..................................... HOUSE NUMBER ....7.3.0 ....... Street...~ .D..1'.~..~? ............................ Building Inspector / l~OJl~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPuV~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3946 Z Permission is hereby granted to: 80~hO~Ld to b ~1~ ..~..~ t~=..~..~.~ s.~,~ ...dye..~.~1~ ......................................................... at premises located at ....:[..~.O.~..~,~,1...~,~..~ ...... ~,~il~ ........... ~J~J~I~"JlIJII~IIIFI~ .................. ................................. ee~..~.ve .......... Gout:~4 ....... It~ ........................................................... pursucu~t to application dated ............................... ~'~ ....... ~ ......... , 19...~8, and approved by the Building Inspector. ~'"~I- w~ ~w. o, ~OUT.O'D['~-,/;'~ h~,,,,- a~.-,- - ~ ~/ / ~ o BUILDING DEPARTMEN~ - ~ ~ · -/~' · ~ ~U~LEOV,e~Fl~~',, ~r~.~ c~ ~t~ v~,'~ ~ souTHOLD, a.Y. . ~T-~ ~' ~"~ e ~ g . > h 7 Approved ........................................ , 19 ........ Permit No. ~..~. .................... Di~pproved o/c ............... ~ ............. ~ ......... ~ ...... ~ . ' , .................... ~ ....................... ~ ................. /~ ~ --. / ............... c~~.}~-.~;;;;;~ ...7~-~.~.~~ ~, .~~....~. ............................... , ~.~..~ .... ,N~,ON~ ~. lhi~ application mu~t b~ complet*ly filled in by ~pewrit~r or in ink ond ~ubmiffed in duplic~ to th~ Buildino~ In,peter. b. Plot plan ~howin~ I~otion o{ lot ~nd o{ buildiag~ on premix*, ~lotion~hip to od~oinin~ pr*mi~ or public *tr~t~ or ~re~s, ~nd oivin~ ~ detailed d~scription o{ I~yout o{ propa~ mu*t b~ drown on th~ dM~mm which i~ ~ of thi~ c. Th~ work covered by thi~ ~pplicotion may not b~ commenced be{ore issuonce o{ Buildiag Pormit. d. ~pon ~prowl of thi~ applicotion, th~ Buildin~ In~ctor will }ssu* ~ Buildino ~rmit to th~ ~pplic~nt. Such permi~ ~h~ll b* k,pt on ~he pr*mi~ ~v~ilobl* {or inspection thmuohout ~h* profess o{ ~h~ work. e. ~o buildiag ~11 ~ occupied or u~od in whol~ or in po~ {or ony pu~o~ wh*tewr until ~ C~ffic~t~ o{ ~holl h~w been ~mnted by th* 8uildiag In*p~tor. APPLIC_a~TION IS HEREBY Jv~ADE to the Building Deportment for the issuonce of o Building Permit pursuont to the Building Zone Ordinonce of the Town of Southold, Suffolk County, New York, ond other opplicoble Lows, Ordinonces or Regulotions, for the construction of buildings, odditions or olterotions, or for removol or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nor~e of owner of premises ....,~.....~.<d~---"'T~~ ..........~: .................................................................. If applicant is a corporate, signature of duly authorized officer. [/, ................................................................................................ (Name and title of corporate officer) ,~ ~"/- 1~ (e 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ....,~.~...~..~....; Street and Number ....7...-~...~.. ........... ~ ............ ~' Municipality 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~ .......... ~.> ........................................................................................ b. Intended use and occupancy ...~.......~/../........~.~..~......~.. ...................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal ..................Demolition .................. Other Work (Describe) ........................................ # , 4. Estimated Cost ........~..~:?...~......~RI~. ................ : ........... 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. Dimensions of existing structures, if any: Front ...... ~...~. ............. Rear ...... ~....~... ............... Depth ...~..~. ...... Height ~ ~ .. ....................... Numar of Stories ...... Z ............................................................ Dimensions of same structure with a.],terations or additions: Front .......... ~..~ ............... Rear .... ~.~. ............. Depth ........ ~.~ ................ Height ........ · ................. Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~.~ .................. Rear ....... ~..~ ............ D~th ....~..~ .......... Height ........ ~ ........ Number of Stories ....... ~ ............................................................................................................. 9. Size of lot Front ........ ~.~.~ ........ Rear ....... ~...~ .................... Depth .....~..~.~ ............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premis~ are situated ..................................................................................................... 12. Does proposed construction violate any zoning I~w, ordinance or regu at on? ~ - o, o, ...... Name of Archit~t ...................................................... Address ............................................ P~ne No ..................... Name of Contractor .~..~..~....Address' ' ~'....~ ....... P~ne N~Z~.~.~. ~ ~ ~ PLOT DIAG~M p rop~;a~n~a r~n~r~:ti?tl ~ ~u i~ ~ i~ :~ Wchret~src ~ it~ t~o~t~;s~'~ :~, i :~ i~a~o:l Is ~J'e~ i~ :n~ °~d/~: whether interior or carrier lot. ~~ ~ - ~'~ ~,~ ~. ................. ................................................................................................. being duly sworn, d~oses and says t~¢ he is the applicant (Name of individual signing application) above named. He is the ......................................................................................................................................... ~ ............... (Contractor, agent, corporate officer~ etc.) of said owner or ~ners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contoined in this application are true to the best of his knowledge and belief; and that the work will b® performed in the manner set fo~h in the application filed therewith. Sworn to bef~e me thie ~ . ............. o, ...... ........ ...... .................. ] MARION A. REGENT ? ~TARY PUBLIC, State of Ne~v~-' ~o. 52-~233120 Suffolk ~ ~p~es ~rch 30, 19~