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Home My WebLink About4440-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~[ice $outhold, N. Y. Certificate Of Occupancy No. ~:~8~ ..... Date ............. July .... 9 ....., 19. ?$ THIS CERTIFIES that the building located at Tl~e®,~mter~t .L~® ........ Street Map No. Orient. by .Sl~ck No ..... I .... Lot No. I+3 ...... 0r~,ent. ·. -N,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ AII. J · .~)., 19 69' pursuant to which Building Permit No. ~. dated ............ ~,~lg ' '29' ' ' 19'6~' 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. 'erie' f~ly 'dw~'ling ....................................... The certificate is issued to . .Wee~hell~w. Preperties' Ine ............ 0~er ...... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... N/,i~, ...... ................. ][.u.., 2~ /~ r.,/ ~ ~-'~/'~ ~.~ Building Inspector FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4440 Z Permission is hereby granted to: ..... ~..~ozX~m......~.....w~w..~ ................. O'z'~.~,~'t,, ................................................. at premises located at .................. ~t,..J~,~.....~..J~....$/J.:J~lljt..~Jr-..Ji~lJ..~ ............................ ............................................. ~..w~z.s...1s, ....... 0'z'~.tm~ ....... it~.~.~ ......................................... pursuan¢ to application dated ............................ AII~ ......... ~ .......... , 19..69., and approved by the Building Inspector. BUILDING DEPARTMENT - c~,~ · ' ' . -- -- Y__ SOUTHOLD. N.Y. ~ _ ~ ~ ~ E×amined ............ 19 .... ' Application No ................. Appv~ve,d ..................... 19 .... Permit No .................... Disapproved a/c ............................... ,,, · ........ ... ........ APPLICATIQN FOR BUILDING P,I~RMIT Date ................. INSTRUCTIONS a. This applicati.on must be completely filled in by typewriter or in ink and ~submitted in duplicate to the Building Inspector. b. Plot plan showing l.ocation of l~t and of buildings o n 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 part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval ,of this applicati, m% 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 o~ in part for any purpose whatever until a Certificate .of Occupancy shall have been granted by the Building Inspector. APPLICATION IS 14p.2e~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of S~athold, Suffolk 0aunty, New York, and other applicable Lawz, Ordinances or Regulations, for the construction cfi build ings, additions ay alterations, or for removal or demo- lition, as herein described. The applicant agrees to cam ply with all applicable laws, ordinances, building code, h.~using code, a~d regulations. ~..~ ..... ............. (Signatur~oi .applicant, or name if a eorpora~'o ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Name ,of er o emises ~ ' If applicant is a corporate, signature of duly authorized <ffficer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No...~...~-(,../ .... Lot No../~..'-~. ........ Street and Number '7~-~' .~c/..~ ..~-'.. ° ..~.~~ ''~''' ''~''''~'' ......... .................................. ~L,~i~ipality 2. State existing use and occupancy ,of premises an d intended use and .occupancy of proposed cormt~uction. a. Existing use and occupancy ~ , .................................................... ............... b. Intended use and 9ecupancy ~ * ...................................... 3. Nature of work (check which applicable): New Building . ..~..... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) .-.~..~../~.~..~.~--.~ ....... 4. Estimated Cost ...... ~:.,.~.?..~.,..~../). ............ Fee ................................................. (to be paid ~n filing this application) 5. If ,d~velling, number ~of dwelling units .......... Number ,of dwelling units on each floor .............. If garage, number of cars .... ./ ..................................................................... 6. If business, commercial ,~r mixed occupancy, specify nature and extent of each type of use .............. ~.! ~ ~ '~/~ D~n~h '~ ~ '~ '~ 7. Dimensions of existing structures, if any: Fr~ut . .~ ............................................. Height .... /..'~. ~ ........Number of Stories ../. ~.. ................................................ Dimensions ,of same structure with alterations .or additions: Front .............. Rear ............... Depth ................ Height ................ Number of S~ories ..................... 8. Dimensions ~of entire new construction: Front .... ].9. ~ ......... Rear ../..~. ~ ....... Depth . .~..2': .~ ..... Height . .]..~..'. ..... Number ,of Stories ............................................................. 9. Size of ~ot: Front .../~.~.: ...... Rear ..../?.3.! ...... Depth ...[.~.?'..~ ..... 10. Date of Purchase ............................... Na~ Former Owner ............................. 11. Zone or use district in which premises are situated~· .......................... 12. Does proposed construction violate any zaning law, ordinance or regulatkm? . .....'~..: .................. 13. Name of Owner.of premises Name of Architect ............... i ......... A'ddress Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or 'proposed, and indicate all set-back dimensions from p~:~perty lines. Give street and block number ~r description according to deed, and show street names and indicate wheiher interior ,or corner ~ot. STATE OF NEW YORK, ) S.S. COUNq~Y OF .ff..~.~.F.~.Z ff.... ) ....... T.~.~.~... ·///.~..~.~.~ ~/~. ...................... being duly s~orn, ,deposes and says that he is the appli- (Name ,of individual signing applicati.on) cant above named. He is the ....................... C.~..~..~. ff.~.C.~.~..~ ................................... (Contractor, agent, c~)orate officer, etc.) o~ said owner ~or ~)wners, and is duly authorized to perform or have performed the said work and to make and file this applicati, on; that all statemenls contained in th is applicati, on are true to the best of his knowledge and belief; and th'at the work will be pelffe~rned in the mann er set forth' in the application filed therewith. Sworn t,o before me this k