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Home My WebLink About4338-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. ~..~7.¶.~ ...... Date ......... D.e. oe!b.e.~....~.~. .... , 19 ..~. THIS CERTIFIES that the building located at ... ~a~&.~el~l. D.~,~ ....... Street Map No...l~JO~.$.. Block No ........... Lot No...~ ..: .... t~l~l~ ... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .J..~..e...¶0 ......, 196.~.. pursuant to which Building Permit No. dated ...... .J.l~u~...lJ ......., 19..(~, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is isSued is ...P~.?a. tg. ja.~?&~e..?..~e.q$.s.~.o.~., b~l~. $4~g ........................... The certificate is issued to ....A..1'.~...t~.. ~.e..l~l~..1;.~. ..... .0~..e..l' ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...... .ll.,.B. ? ......................... Building Inspector FOF, M NO." TOWN OF $OUTHOLD 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? 4338 Z Permission is hereby granted at premises ocaTea aT ................................................................................................ ,~... / j A/. 'r'. Building Inspector. Fee $...-~. ................. ~FORM ~NO. 1 TOWN OF SODTHOLD BUILDING I~PARTM~T TOWN Ct-~ItK'S OFFIC~ SOUTHOLD, N, Y. · ' , e / ...~~~~~ .... ~.. ....................................... ....... .......... .... ...... : ......... (Build~g Inspect) Application No. ~/~ APPLICATI(~N FOR BUILDING PERMIT ate .... INSTRUCTIONS a. This applicat$on 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, relatimmhip to adjoining premises or public streets or areas, and giving a detailed description of layout of propexty must be drawn on the diagram which is part of this application. c. The work covered by this application may n~t 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 fo r inspection throughout the progress of the work· e. No building shall be .occupied or used in whole o9 in part for any purpose whatever until a Certificate .of Occupancy shall have been gra~ted by the Building Inspector. APPLICATION IS l-lJ~ ~:RY MADE to the Building Department for the issuance of a Building permit pursuant 4o the Building Zone Ordinance of the Town of Southold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to comply with all applicable laws, o~ building code, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................................................................................................... Name ,of owner of premises...4~...~...~..'~'.~..4~-..../~-..~' '~"~" '/"~'"" ~ ................................ If applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) ~\~ Location of land on which proposed work will b e done. Map No ................. Lot No .............. zrf- o ............ Street and Numar ............. Municip~iW 2. State exis~g use and ~p~cy of premises ~d iniend~ ~e ~d oc~p~ of p~ ~nst~ction. a. ~isting use ~d oeeup~cy . ~.~. f~~ ~ ~~' b. Int~ded ~ ~,d ~p~cy ~ff~ ~ ~ ~ ~~ / 3. Nature of work (check which applicable): New Building ........ Addition ........ Alteration ........ Repair ......... Removal .., ...... Demolition ........ Other y~prk (Describe) ...................... 4. Estimated Cost :.~. / (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, spec ify nature and extent of each type of use ....... ; ...... 7. Dimensions of existing: str~ctures, if any: Front ...... ..~.O...~.. Rear .... .~..~. /. ... Depth ..~. 2./ Height ......... ./.~. ....Number of Stories .../. ....... i .................................... Dimensions of same structure with alterat~ns.0.r additions: Front ... ~.Q..t. .... Rear ...~./. ....... Depth ....... ~..~. ..... Height ../..~. .......... Number of S~ries ..................... 8. Dimensions of entire new construction: F~ont ...,/.~. / ' Rear /~' ' Depth /~ ~ Height ............ Number of Sbories ............................................................. 9. Size of Lot: Front .... .~..~..~. ..... ~Rear '... ~../..~: .? .....Depth . ;~ .~..o ....... 10. Date of Purchase .../.~..~.~.~. ................... Name of Former Owner ~.../ffT~...e ..~. ................. 11. Zone or use district in which premises are situated .... A~..~. (.,q..'Y~..?../..~h~.. .............................. 12. Does proposed construction yiolaSe a_ny zoning law, ordinance or regulation? ........................... 13. Name of OWher of premise~.'~ .-..~..c~,~..~..~-...~...~ddres~ ...-~...~fi~/. ~ ........... Phone No~..~. .~..? .-~'../.°.~ Name of Architect ............................. Address ...................... Phone No. : .......... Name of Contractor ... Address Phone No. PLOT DI~GRAM 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, )S.S. COUNTY OF .............. ) _.L/?'', ti ................ ~..~...T~..~..~....~'...C.//...~.! .U-...~.. ..... being duly swo , and ~ys ~at he is ~e appli- (Name of ~dividual signing application) c~t a~ve n~ed. He ts the ............................... ~.~.C~.~ ................................. (~n~a~r; a~t, ~te ~icer, etc.) of ~id.own~ ow~e~ and ~ du~ au~.~ p~o~ or hav~ pe~ ~e ~d ~k ~d ~ m~e and file ~ application; ~at aH stateme~s ~nfain~ In ~is applicat~n ~ ~e to the best of h~ knowl~ge ~d belief; and that ~e ~k will be p~ ~ the mann er set fo~ in the applicat~n filed ~e~th. Sworn to befo~ me ~is ~~ ............ . · .............. i '* .......... ~ARY pUBLiC, Stat~ d New No 52.8125850, ~ulfol~ ~e~m Expires Ma~ch 30,