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Home My WebLink About4348-ZNO. 4 TOWN OF SOUTHOLD BUH.r~ING DEP~NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z~t6 ..... Date ............. I$.ep.t..~..~..~..~..~.% 19.7.~. THIS CERT~S ~at ~e b~d~g locat~ at .. ~ .8~.~. P~ ........ SMut Map No.. ~ ........ Block No... ~ .....Lot No. ~ .............................. confo~ subst~ti~y to the Application for B~g Pe~it heretofore ~ ~ ~ office ~ted ....... ~. ~a~ ..... , 19~.. p~su~t to whi~ B~d~g Pe~it No..~. /~ ....... J~ ~8s ...... , 19~., was issued, ~d confo~ to ~ of the req~ men~ of ~e applicable pro~sio~ ~ ~e law. The occup~cy for whi~ th~ ce~ffica~ ~ ~su~ ~. ~te. ~ .f~. ~ ...................................... ~e certificate is ~u~ to .....~. ~ ................................... (owner, less~ or ~n~t) of ~e ~ores~d b~g. S~olk Co~ty Dep~ment of He~ Approv~ ...~R~ ............................. ~ER~IT~S CERTIFICATE No .... ~.~ ................................. HOUSE NU~ER ..... ~ ...... S~eet ...~$~ ~ ...... [ ................... FORM NO. i~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV/N CLERK'S OFFICE SOUTHOLD, N. ¥. ~UILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLk-TION OF THE WORK AUTHORIZED) 4348 Z Permission is hereby granted to: ~..~.~.~,....~.~.....~a..bz~, ....... . ,~to ............. ~u~,...m~.~.t~-. ~..e,~.~..~L~ ................................................ at premises located at .................... ;~.~.....~1~1~.~..~/~]~ ....... g~.~..~e4~i~i~-.~& .......................... .... ~......'....~....~ .................... ~ ...... ZeXo .............................. i ................................................... pursua~ to.application dated .............................. ~V~l~ ....... ~..~....., 19..~.~., and approved by the Building Inspector. Fee $..~. ................... (Building Impector)/ APPLICATION FOR BUILDING PERMIT c)at, ,,Tune 18 ..... INSTRUCTIONS ~ This application must be completely filled in by typewriter or. in ink and submitted in duplicate to the Building ..~' Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, Qad giving a detailed description of layout of praperb/must be drawn on the diagram which is port of thie application. c. The work covered by this application may not be commenced before issuance of Building Permit. -d. Upon approval of this application, the Building Inspector will issue a Building Permit ~o the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used In whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Buildin.g. Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant egree$ to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) Southold ............................... ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Nome of owner of premises ..... .ThG-~.....~a:~z'.:i. EL ................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which propaeed work will be done. Map No.: ........ ZX. .......................... Lot No.: .,,7~ ............. , Street and Number .......... .,.~/.~.....~All2.e,~..~.~,f~..O;~.,~..~(~.'~D~,..,~,gt: ...... ~.~C~ ...... [ ................................ ~ / - L~'O ~ Municipality 2. State existing use and occupancy of premises and intended use and occupanCY of proposed construction: a.' F.~i~ting use and occupancy ...... .~M~,],3,~' ...... ~ ................................................................................... ~ ..... b. Intended use and occupancy same -with an addition 3. Nature of work (check which applicable): New Building .................. Addition ....~1~ ........ Alteration ...~1~, ......... Repair .................. Removal .................. Demolitior .................. Other Work (Describe) ........................................ 4. Estimated Cost ....~00...~. ................................ :J....:...Fee ....:...~..OO. ........................................................................ r (to be paid on filing this application) ............................ Number of dwelling units on each floor ............................ · 5. If dwelling, number of dwelling units o/~e 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 ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height · ...................... ~...., Number.of Stories ................................ 8. Dimensions of entire new construction: Front ............. ~ ................... Rear ............................ Depth .....~J.~. .............. Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............................ Rear ................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use di~strict in v~hich premises are situated ....... ?.~,.a...~.:j~ ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... ~ ........................................... 13. Nome of Owner of premises ......~....O.~.....~-...?.?..:~ ........ ~.Address ...... ~.O.~P,.~t~,~ ................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ......... ~.Q..[9/&S~eslr[ ........... Address ...~ ....... ~D.~Y.,~O].~ .............. Phone No ..................... Locate clearly and distinctly all buildings, property lines. Give street and blOCk number whether lnterior or comer lat. PLOT DIAGRAM whether existing or proposed, and indicate all set-back dimensi~f------~'"'-~~'~' or description according to deed, and show street names ancl~-~ STATE oF NEW Y,,OR[(, I c COUNTY OF ...... g.~'.z,~; ......... ..................................... ~.O....,[...W.~..S..~.~..S.~ ............................ being duly swam, deposes and says that he is the applicOnt (Name of individual signing application) above named. He is the ....................~.G~3~&~.~.Q:~. .................... t ....................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or' have performed the said work and to make ~ file this application; that all statements contained in this 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 Notary Public, NOTARY ' ' ....... ' .............................. Term Expires March 30, 19~/.f~