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Home My WebLink About4532-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z..3896 ..... Date ............JU~... 21~ ....., 19.?0 THIS CERTIFIES that the building located at l~t .Road. (l~o~J, olt .P&).. Street Map No..Id,- gay .... Block No. l~O~. ~u~ot No ..... ¢~ae. area.)...Ft, ahera conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... 0ot. · - ~3' · ', 19..~J~ pursuant to which Building Permit No. ~+.~32Z.. dated ........... ~)ct' ' '30' '" 19,69., 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 .Privete. one. fam~.ly' <lwe.l.~.~mg ....................................... The certificate is issued to ...Ke~t .t~odea ...... 0m~er ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .P. encl~ng ........................... ..... .... ,. .... /.. Building InspectOr NeY, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, FI. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~1532 Z Permission is hereby granted to: ..~,~1~.~,:~..~,.~.... J~..x~..~ .... ................. tEt~.r~...~L~ ............................. to ............ ~....a.~...~....t.~...~~. ....................................................................... at premises located at ..................... ~..~...~...~l~.~t~...~l~ll~ .............................. ; .............. ........................................ ~.~t~;t,.....~.e.r...e~l~.....;~e.t~..J~ ......... ~t~I~.~...~ ............. pursuc~t to application dated ............................ Jl~t~ ......... .~ ......... , 19..J~1~, and approved by the 13uilding Inspector. Building Inspector ~FORM ,NO. I TOWN OF S~u-,rdOLD BUILDING I~PA~T TOWN C~-~w"S OFFICE SOOTHOLD. N. Y. Approved .................... ,19 .... Permit No ............ APPLICATIO~N FOR BO~LDING Date ................................ 10 .... INSTRU C'riONS 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 o n premises, relatkmship 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 part of this application. c. The work covered by this applicatkm may not b e commenced before issuance of B~ild/ng Permit. d. Upon apprOval of this application, the Building In spector 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 o~ in part fbr any purpose whatever until a Certificate .of Occupancy shall have been granted by the Building Inspecf~e.~ APPLICATION IS 1-~l~l~y MADE to the Building Department for the issuance of a Building Permit pursuant to the ~uflding Zone Ordinance of the Town of Sauthold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction ~f build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, building code, housing code, and regulations. ~ ....... ............. .... (Signature of applicant, of name if a corpo a ' ) ................ (Address of app State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .... ~ .~ .................................................................... Name of owner of premises .~..~(...-~...~..~ ............................................... 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 No ................. .Lot No ............. 2. State existing use and occupancy of premises and intend.ed user'-arid 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 ~ O~ O o o .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 ears .... .~.. ~ ........................................................ 6. If business, commercial or mixed occupancy, spec ify nature and extent of each t~pe of use .............. 7. Dimensions of existing structures, if any: Front .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions of same structure with alterations o.r additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories ..................... / 8. Dimensions of entire new construction: Front ...7..~. '...C.'.~ ...... Rear . .7.2 ./. (...~.... Depth ~...~. ?...~.. · Height . ..~q ~....cl... Number of Stories .......................................................... 9. Sizeof ~ot:Front .../..?..~.! ....... Rear .,~,.c~.o.t... Depth ~ ~'o' ;tO. Date of Purchase ...... .... ./.~..~. ¢ ...............Name of Former Owner ~..'~...~ ..........~..~. -~'. :~. ........... ~ 11. Zone or use district in which premises are si. tuated .................................................... 12. Does proposed construction v[olate an_~ ~w, ordin~,an~oe or regulation~ ..: ......................... 13. Name of Owner.of pretl~es .~...-r~.... ! .~.~ddress~l~t~' ~ .~ .'~: Phone No ............ Name of Architect · .-~..-..~/-~-.. .~;L~.. .. · ...~-.-.. ~2ddress .~~ ...W~...~.... Phone No ............ Contractor .~...~.~4-.~..~-~ .... Address ~.~.~ Phone No.~.~.['..].~..~.~ Name of PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give s~eet and block number or de scription according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, )S.S. C OUNT_Y_.Q~ .............. ) .___ ~ being duly sworn, deposes and says that he is the appli- (Name of individual signing application)/-~ p/.~..~ cant above named. He is the ............................ . .-~.O ..... .Pl..~....~ ........................... · (Oontractor, 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 thi~ application; that all statements contained in this application are true to the best of his knowledge and belief; .and that the work will be p~ed in the manner set fortl~ in the application filed therewith. Sworn to before me this api)iica~) of I I DECK HOUSE; INC