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Home My WebLink About4464-zNO. 4 TOWN OF $OUTHOLD BUIL1)ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. $. 377~ ..... Date ...........&l~X'l~ .... ~ .... , 19 .?0. THIS CERTIFIES that the building located at ... II. er-~d~t..ATe .............. Street Map No ....U ....... Block No.. mi ......Lot No.~... M~t.ti~a~k..][~:~, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........8eFt .... 1~ 19. ~ pursuant to which Building Permit No.. dated ............ I~el~t .... 1~, 19~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...~i~le .l~l~...~.. foo~ .10l~ls~ .......................... The certificate is issued to ..... I~'a~k. 1~. ~]~J~l~al$ ...... 0~m~ ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... ][~][, .......................... Building I~/e~tor · mle ~11170 I~OB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOt,D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4464 Z Permission is hereby granted at premises located at .............................................................. ........................................................................................ l.z..z~~ ................................. /7 ~/.. ....~., pursuonf to application dated ............................................... .,~; ...... , 19. and approved by the Building Inspector. Building Inspector IPO~ai NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. /7 ..................... Disapproved o/c ~ .................... i ............ ..........----V',,,z,~.4....,~.........Z...~ ....~.... (Building Inspector) Application No ............. APPLICATION FOR BUILDING PERMrr /7 INSTRUCTIONS 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 which is part of thie application. c.. The work covered by this application may not be commenced before issuance of Building Permit. d.. Upon approval of this application, t~e Building Inspector will issue a Building Permit to the applicant. Such permit shall De Kept on the premises available for in~oectJon throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY 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 demolition, as here n descr bed The applicant ~grees to comply with all applicable laws, ordinance~ building code, housing code, and regulations. ....... ........................ (Signature of applicant, or name, if a corporation) Ga, ddress of applicant) ..... State whether applicant is owner, lessee, agent, architect., engineer, general contractor, electrician, plumber or builder. 0~ Name of owner o 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.: ........................ .......... /.../..,/.7~- Sou,v.~ ~w-- , ~,,,-rr,-r-uc ................ Street and Number ....................................................................... .7.,~i~i.l~.li~,. .................. 2. State existing use and occupancy of premises and intended use a~d occupancy of proposed construction: a. Ex stn~ use ondoccu,~,~, b. ntendeduseondoccupancy . ~..~.:.~.~...~,~.~..;'~....~..~ f.. 3. Nature of work (check which applicable): New Building .................. Addition /'/ .................. Alteration ..~ ......... Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ~. ................. ~. ..................................... 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 structure, if any: Front ........ ~....0..~. ............ Rear ...~...0.../. ..................... Depth ...~...0...0..~ ..... Height .l.-~...~../~l~. Number of Stories -.-.1 .......................................................................................................... Dimensions of same structure with alterations or additions: Front .................... ..~.~....s. ...... Rear .......... ~ ................. Depth .................... ~ ........... Height ............... ~ ........ Number of Stories ....... ~ ................... 8. Dimensions of entire new construction: Front ....... ~...~..~.....~. .......... Rear ...... ~..,~.~.~...Depth ..~.~.~. Height ........ ~ ...... Number of Stories ....~ ........................................................................................................... 9. Size of lot: Front ..... ,.~./.~.J ............ Rear ..//.~.i...~.~.?..S....~.~.~....~..~.....~/~)eC~pth ....... .~....0.~.~.i...~ ........ 10. Date of Purchase ...~..~..~..~.~.....J~..0~...~.~...~- ..................... Name of Former Owner ....'~...~..~..~. ....... ..~..."...~...~.~ ..................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law ordinance or regulation.;> ............................................................ ame of Owner of premises ............. ........... No ..................... · Name of Architect ...................... ~ ........................ Address ............................................ Phone No ......... "--. ........... Name. of Contractor y~.,.,....~.~..~.~:~ ........... ress ...~..~<.~.....~..: ...... Pho~ No.~..~....~.~ .~..~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, ond indicate all set-lx~k dimensions from property lines. Give street and block number or description according to deed, and show street n~ lines and indicate whether Iht .,riot or comer lot. STATE OF ~IEW YORK, ·" ~ = ~ ~/' ~' cou,~ ~:~ ................. ~. ...... s°i~' ~ ,,~ , ,,, ~.y.. .... ,.. be, ..................... .~.Z~/~..~........~.....*~/~.~ ........................... 'rig duly swam, deposes and says that is the applicant Name of individual signing application) above named. He is the .......... ./~..~...~....'~...?~.. ................................................. ~ ............................................................................ (Contmotor, 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 this application; that all statements contained in this application are~z~o the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applica~on file~ therewith. Swom to before me this _ O,~.~,v' L~ /~ ,/~,//,,~ / .... ........ .......... ~o , .;~-~f~ ,y~ · .n~,, ,~v~_..~~'..~./~.~ ......................................... Notary Public~..~../..~/~l~J~tt~l~ r~,/~ (Signot~re o~bpplicant)