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Home My WebLink About5075-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .. Dogwood · Lane .. . Street Map No. 8~set l~O~lllrk No../~I ...... Lot No... 38 .... 14attituck N.,]/,... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... NoV 27- , 19 70. pursuant to which Building Permit No. dated .......... Noir. 27- , 19.70., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to · .M,~.,.~, Construc~;ion ~Ol'p ..... ~e:r ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...8epi..28...19~J... by It, .V. illa. Undox~riters Cort ~ N871661 Building InspectorI FORM NO. 2 TOWN O~ SOUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N, ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEI:q- ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5075 Z ' ..~7 D~,te Permission is hereby granted to: ........... ~:..~:...T.. ..... .¢.v.. ~:~.T. .~.~.~, ~: p. ..~ .... at premises located at- ............................................................................................................................ ................................................................ ~.v..~-...~ ...... ~.~...o.~.,...~ ........... .~.E..g~ ........... .................................................................................. .~..~..~..~.~.~., ......... ~.~Z ................. pu~u~ tO applic~ion d~ed ...... ; ........................... ~-~---..~.d 19.~, and apprbv~ by the Building Inspector. Building Inspector ~'~' °°''~' ~ ~1~ OF ~ C~NK O~ ~MFFO~K ~ ~448, YOUNG ~ YOUNG · 00 OSTRANDER ~V~NU~ ~ RIV~RH~AD, N, ~ L~N W YOUN~ HOW~HO · SURVKY ~ M ~ ~ CONSTHUCT/OR COR~ LOT ~8 "SUNSET KNOLLS, SECTION 2. MATT/TUCK ~ow~ o~ SOUTHO~ ' SUF~ CO, ~ ~ 70-34~ I AppLICATION FOR lUll,DINg PEIL~IT ~r,~ o, to ........................ 22 ...... Z/.~.~. ............. ~.Z.o. ..... INSTRUCTIONS b. Plot plon showing location of lot and of building~ on premix, mlatior4hip to odjMntng pmmiMI or _lwblic Itreets or% are~, and giving a detoped d~crlptlon of layaut of pmlle~/mu~t be drawn ~n th6 dlngram ~h It ~ M ~ ~~ c. Th. ~k conrad by mis appleton may not be c~mmenced before iuu~., of Bu~aq hrmit~ ,~. d. Upon c~roval of this application, the Building Impector will Issue o BUilding Permit to the alXt4ic~t. Such permlt~: shall be kept on the premises avolloble for IrKoectlon ~roughout the progrm~ of the work. e. No building shall be occupied or used in whole or In part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building De~rtment for the luu~nce of a Building Pelmlt _puN~.mlt_ to the Building Zone 'OKlinonce of ttm Tov~ of Suuthold, Suffolk County, New York, Grid ott~r ~ k~ ~ or Regulations, for the comtructlofl of buildings, odditlom or alterations, or for removol or ~itto~ 1O ~ dllcflbed. The applicant ngmes to comply with all applicable laws, ordino tiding code, housing code, Gnd ; (Signature cf applicant, or/4or~4, if ~ ~) (Addm. of oppllcont) //~ State whether applicant is owner, leMee, agent, architect, engineer, general contractor, electrlckln, plumber or builder. NarM of owrmr of pmm,. .......... ..~.~..~.'.~ ....... ....~..~..~.v...t..~...l~..~......~....'k'~, .~..:. ............................................................. If applicant I$ a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) ,, ,i ~ , ~.a,,~ of ,ond on whic, ~.~.d.o~.,,, be ~o.. ~.~ No.: ...... -.~.~ ...................... ~,~ ..................... .~ .~ ]',~--. ~--!, . . , ~.. ~,,,, ,nd no,be, ....... .~........ ..,~. ........................................................ ..q..~.'t.T.i]zo..:s~ ............................... , 2. store exlltlng use and ocCUl~n~/at p~ml~ ,,nd In~ln~ ~ ~ ~ ~ ~ ~: u~.~Z .................................................................................. ~. ~i~1~ m ~ ~ .................................. ,. .............. ....... ................................................. 3. Nature of walk (check which applicable): New Buitding .................. Addition .................. Alteration ........... ~ . Repair .................. Removal .................. Demolition .................. Other Work (Describe) ................................... 4. Estimated Cost .............. ~..~..~..~..a ............................ Fee ................. I...~.......°.~.~.. ......................................................... (to be paid on fi!lng this application) O' S. If dwelling, number of dwelling units ............. ~ ........ Number of dwelling units on each flor .......................... If garage, number of ca~ ............... ~ .................................................................................................................. 6. If business, commercial or mixed ~cupancy, specJ~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing s~ructures, Jf any: Front. ........................... Rear ................................Depth ............ Height ....... ~ ....... Number of S~ori~ ............ ~ ............................................................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ 8. Depth ................................ Height ...........................Nu~er~ of Stories ............ ~ .............. ~ ~l' ' Dimensions of entire new construction: Front ............. ~ ................... Rear .........~ ................ D~th .~ ................... Height ..... ~.~ ...... Number of Stories ........... .~ ..................................................................................................... 9. Size of lot: Front ........... J.~.g. ........Rear ............l~.g ............... Depth ........ ~.~,q~.~.~ ....... of ................ /92. ............................ of ..................... ................................ 1 1. Zone or use district in which premises are situated ...................... ~.~..~ ................................................................... 12. D~s proposed construction violate any zoning law, ordinance or regulation~ .......... ~..g. .......................................... 13. Name of ~ner of premises ..... ~.~:.C~/~..~.Address .............. ...... Pho,, No ..................... Name of Architect ....~~ ......................... A~ress ............ ~[~.~ ......... Phone No .................... Nome of Contractor .Z~..~..~ ................ A~ress ~..~~.~ ....... Phone No. PLOT DIAG~M L~ate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set~ck dimensions from prope~ lines. Give street and bilk. number or description according to de~, and show street nam~ amd indicate ~h~th~r interior or corner Jot. STATE Of NI~-~Yg~I~ COUN Of .............. ....................... :..._.~_ .~....~.~.~........~...~...~...X~...~...,~... .......................... being duly sworn, deposes and says t~t he is the applicant (Name of individual signing application) above named. He is the ............................. ~~ ............................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to ~ke and file this application; that all statements contained Jn this application are t~e to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed ther~ith. Swam to before me this ......... ........ day of .............. Noto~/ Public,~ ................... ~ ....... ~~.. COU,~LIZABETH ANN NEVILLE .......... (~ ~i~;~ of applic Yf ............................. ~ ~ · ~ ~ I J' ~ . n~ NOT~RY PUBLIC, State 0f New York ~ .... ~'~ Te~m Expires ~rch 30, 19~