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Home My WebLink About4473-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupency No ............. Date ........... IIl~la ..... ~0 .... , 19. ~ THIS CERTIFIES that the building located at .. ~t~,l*$ek .~. ............. Street Map No .... x~ ....... Block No. ~ ....... Lot No. '~1~" 'F~l~e~'l~ 'ZS~' ' !14~' ' conforms substantially to the Application for Building Pemit heretofore filed in this office dated .......... Sept .... $4~" 19~. pursuant to which Building Permit No.. ~73' ~ dated ....... '~$ept "~' ..... , 19..~1~ 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 ..... l~vat~ 'ela~ 'fala~y' dwel~ ................ ' .................. The certificate is issued to ... -B,C'dl~tt~rsc~ ..... O~me~ ........ ~ ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Depa['tment of Health Approval ........... ~l,~e .................... ......... FOILM NO. :B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OIfFICE SOUTHOLD, g.~. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4473 Z Permission is hereby granted to: · ..& ,~.~ra~:~..../~u~g.....~., g., ?~.~.t,~.,~, ........ .......... ;..I';L~.~'.~..2,~ ............ :.., ........................... at premises located at ............................. ~...,~.~.~.~.;J,g~...~.~. ........................................................ .............. ~ ........................................ lE.~s..~I~J~d ............ ~o~,. ......... ........................................ pursuant to applicotion dated ........................ ~41~t,.....~ ................ , 19...~c~, ~ approved by the Building Inspector. I~WN O~ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... ........ ^pproved ........................................ , 19 ......Permit bio ............................ Disopproved a/c ...... ...........................-.................... · ............. APPLICATION FOR BUILDING PERMIT 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 ond of buildings on premises, relationship to adjoining premises or public st.r~ts or areas, and giving a de~ailed descriptian of layout of pmperb/must be drawn on the diagram which is port of thie appl,cation. 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 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 or in part for any purpnse whatever until a Certificate of C)~upancy shall hove 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 Count, New York, and other applicable Laws, .Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herren described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. E.C. Patterson Name of owner of premises .................................................................................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land an which proposed work will be done. Map No.: ....~t.,~;T~c~..-~;~e.~. Lot No.: ....... .................. Street and Number ........... ..~..c?..n..~. ........................................ .~...J...$.~..e..~..?....Z...s..];....c~...?.:.....~...e~.......~..o.~..~. Munlcipallt~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................. .~.4~.s...J..~..e..~g,.e. .......................................... i ............................ ~ .............. ~... b. Intended use and occupancy ................ ~8~L.C~Ce. ............................................................ ~,:....~ ............. .,, ..... 3. Nature of work (check which applicable): New BuiJdipg ..~ .......... ~ ....... Addition .......~ ........ Alteration .................. Repair .................. P, emovol .................. DemOlitior ................... Other Work (Describe) ........................................ ' 4. Estimated Cost ....... ~,J~.,.~).00.o. DD. ............... ~...~.:: ........ Fee '. ....... , .......... 5,..OD. ........................................... (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 structures, if any: Front ;.~.~'...~).~! ............ Rear ....~.0......~. ................ Depth .....~..0.....=.0. .... Height 25'-0" Number of Stories 2 ' Dimensions of same structure with alterations or additions: Front 45 ~-0" Rear 30~ 0" Depth ......6...6..'..~.0..? .............. Height ........2..5..'...-..0.~ ........ Number of Stories 2 8. Dimensions of entire new construction: Front ....... .1~8!.,~05 ............... Rear ..... /.8!.,,,0:! ......... Depth ....~..,,.0 .......... Height ]'0' -0" 1 - .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front 120 ~ .-..0'~ .......Rear 160 ' -0' Depth ...... ~1~....=~). ........... 10. Date of Purchase ...0.C.J;~);:~...,[.cJ. 5.~. ........................ Name of Former Owner ..... A.l.~e~t::~-..Da.1,/s~oP_ ................... 11. Zone or use district in which premises are situated ................ ..~..e..~.../..~...e.~.~...:J:..a...[. .......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~.~. .............................................. 13. Name of Owner of premises .~C.~..~.aY, t. ez::~oJm....Address .~i~st~e,,g&..Z~].az~cl./q...¥J>hone No. Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ....~.s...~.~...~.~.~ ........................ Address .~,~]3~'~...;T,~l~.~l~,[~...~'eOhone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensi°ns from property, lines· Give street and block number or description according to deed, and show street names and indicate whether k~terior or corner lot. STATE OF NEV~ Y~RI~;i ' ~ S S COUN'T~ OF ~J,~j,,J~'~ ....... :.....~' · · ...~~..~....:......~'.~....~ ................................. being duly sworn, deposes and says that he is the applicant ' ~/'(Name of indivi§ugl signing applicati0n) ~ above named. He is~the ..~..~~'~: ~'-' '~ ..................... , ....................... ' ..................................................... -- ''' ........ . : (Contractor, agent, corpOrate officer, etc.) of said owner or owners, and is duly auth~orized to perform or have performed the said work and to make a~d file this application;' that all'statei-fients canto~ned in thins 'application are true to the best Of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this D .... .......... ........................ ....... ................ · ~ ~':/.. ~ ~ I. A. JOHN C-,ADA ~. n-- Notary Publ~lg'f,~~b~tc:3t~t~V.lVew~Oo~ ty ~e' - (Signature of applicant)~e' ~k~Jn~ in Suffolk C0. Off. No. 52-6439000 Cemmi~ion F. xpi~. M~rch ~0, I q '~0 E.T T ~. ~Cw-- .I C > I b C. M~/H HAY, H.A IZ f~O D_ GOLF' CLU~ q :Z 'o