The URL can be used to link to this page

Home My WebLink About4507-zFOl~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O]~ice Southold, N. Y. Certificate Of Occupnncy No. ~.i~601 ...... Date ......... ~.e~ .... ~ ....., 19.6~.. THIS CERTIFIES that the building located at Qakl&%va. & .;Jockey. Ck. DF Street Map No. ~ ...... Block No .... ;~;X...Lot No. .:x~:x .... ~o~tho.~d · · · I~,Y, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... 0Or ' '10' ' 19 69' pursuant to which Building Permit No...~0.? .Z dated ......... 0ct' lk~" , 19 69' was issued, and confoms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .. A~ce~sor~' ~ild~g. {.%oo.1. ~;o~tse, {~. s'torag~ etc.) ............. The certificate is issued to D~. Joh~ .F~ose~ .... of the aforesaid building. Suffolk County Department of Health Approval . . (owner, lessee or tenant) l~Ol~.,~i NO. ~ 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) N.o ~1507 Z Permission is hereby granted to: ................................................ ~....aautao;l~t ......... ll.~ ..................................................................... pursuan( to application dated ............................. {~t~ .......... ~Q ........., 19...i1~9, and approved by the' Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. m,ned Approved ........................................ , 19....~.~... Permit No ........ Application No...,,~,,..'~,,.,~..2 ........... ~:~ Disapproved a/c ... ..................................................................... APPLICATION FOR BUILDING PERMIT ..---- ~ ~1 ...... ................................. ,, ... a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing 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 whmh is port of this application INSTRUCTIONS 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 o 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 part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY 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 derrtdition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building i~~and regulatlons. (Signature of 9l~licaht, or name, if a corporation) Name of owner of prom ses . .~..~ _ ~ ................ .~...~...~.....~....a. ~' -- .~ 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 Nq.: ........................................ Lot N~o.: ........................ ., . Street and mumDer .............. / .................................... ; ........ :.~ .................. ~ ....... ,/..~:.,,.,;,T ........................ Municl'pality 2. State existing use and occupancy of premises and intend~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 ....................~...../...~?... ..................... Fee. ............... ~ .............................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units --I ....... ~ .......J~nber 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ....... J~ ................... Number of Stories ................. /. ............. / /ntire ! "~ ~ 8. Height ...~./xl, ........... Number of Stories ..".." ............. ~ J .............................. ~.".." .......................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ......... : .............................................. 1 I. Zone or use dJstrlct in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~..~). ............................................. 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DI~GPu~u~ 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 comer lot. STATE OF NEW YORK, tee COUNTY OF ................................ $~'~' ,, ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~ work and to moke and file this application; that all statements contoined in this application are.,t~m~o the best.,~J~ his knowledge and belief; and that the work will be performed in the manner set forth in the applica~ion file¥ therein'. Swom to before me this .~ \ L~ ~-'"~ 19..~...~ . - _ ................. ...... ....................... ........................ Notary ~'ublic, .~..[./~7.,J.,~,,~:~.......~'.....~ County (Signature of applicant) MARION~ A REGENT k NOTARY PUBLIC, ~tate of New Yor ~/ ~1o. 52-3233120 SuffoLk County 7erin ~pires A,~arch 30, 19_.~