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Home My WebLink About4891-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED u~ucfIFICATE OF O(~umANCY No Z-2302B Date THIS CERTIFIES that the buildin~ Location of Propert~ 400 SU~ERLANE House No. County Tax Map No. 1000 Section 78 Subdivision JUNE 2, 1994 ETRD u-r u~ES N.Y. Street Block 9 Lot Filed Map No. Lot No. Hamlet 22 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEE NOTE BELOW pursuant to which Building Permit No. SEE n~x~W dated SEE NOTE R~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is OEE F~MILY DIe~r~-TNG WITH ADDITION & ACCESSORY BUILDINC. S * The certificate is issued to of the aforesaid building. JOHN S. RAOSDALE & SUSAN NEVE~S (owners) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R. VILLA- JULY 1969 UNDERWRITERS CERTIFICATE NO. N-748719 - JULY 30~ 1969 PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS CO UPDATES CO Z-7141 DATED JULY 28, 1976 FOR BP ~ 4244Z -- (DW~LT.ING & ACCY BUILDING) BP ~4891Z - (ACHY BUILDING) - BP ~6991Z - TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~. SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE! UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 4891 Z D~ ............. ......... ,,~,~ ...... .7 ......... , '~9.....?.~ Permission is hereby granted to: ............. ~.~ .~.,,... L~ ~;~.~,.. ~;1,~ .......................... ............... ~.~...~.e,. .......................................... .................... ~ta~4.. -...'.i~,~.,,, ...... ~ ................ to ........ jj~..l~:.:t~e~.~...a~aj~..~,.. ........................ · ~..~e~e~..l~t~.....: ..................... ~ ........................................................ at premises located at ........j~...~. ...... ~a~.J~...t~&~t~? ........................................................ .................................... ~t~l~e;~.. ]~. ~o~ii~l~....~,~.~ ..... ,'. ...... ........ .................... pursuan¢ to application dated ........................... ,~1~k~ ......... .~ ........ i...., 19....~J and approved by the Building Inspector. Building Inspector I lrOBM NO. I TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ......... ............ , ....... ^~roved ........................ !~ ............. ,1" ........Permit No .... ...~.~...~.. / ~ ............................ '? ...................... APPLICATION FOR BUILDINO FERMI'I' Date ................................... .A...'.'.'.'.'.'.'.'.'~.~.~. ...... , 19....~.0 ..... INSTRUCTIONS This application must be completely filled in by typewriter or in ink und submitted irt duplicate to the Building~ o. 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 wMch is part of thte appllcatio~ 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 port 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 punluant to the Building Zone Ordinance of' the Town of Southold Suffolk County, New York, and other applicable I.awl, Ordinances or Regulations, for the construction of bui dings, additions or a terotions, or for removal or darnel t on, os here n descr bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing,G'~de, and regulations. (Signature of 4t'pplicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... ~.~..~...~....s~..d.T~...~.~.~..~...~....a~..~.c1.~.?~.e..~.~..1..~.~..e..e.~.~...~..~.~.~.~.~ ......................................................... 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.: ..... P'~.-~..~. ....................... Lot No.: ...'.~,~ ........... Street and Number ..... 6,.,.0...0...~....u~.~..e..~...~.e. ..................................................... ~.o...'~..~o.];.~ ............................................. Municll~llty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.e.~.i..d.....e~.,c..e. ............................................................................................................ b. Intended use and occupan:, ..s.~.°.~g.e....s.~.e.~....e~....d..Y..°~...s~gD ............................................................................ 3 Nature of walk {check which applicable): New Building ...... ~ ......... Addition ................ Alteration ............. Repair ................. Remove! .................Demolition .................. Other Work (Describe) ................................. 4. Estimated Cost ...~..2.~...'..,O..,~. ...................................... Fee ...$..5..:.0...0. ...................................................................... (to be paid on fi!lng this application) 5. IF dwelling, number of dwelling umts ........................... 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 exist!ag structures, if any: Front ,....J~ .................. Rear ........ ]~ ................... Depth ....;~Q ........... Height Number of Stories 1 Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ......................... Number of Stories ................................ 8. Dimensions of entire new construction: Front .............. ,?~.. ............... Rear ....... ::......~... ........... Depth ....-.~....~.....~..~ ....... Height ~ ? Number of Stories 1 9. Size of lot: Front l(10 Rear :1~0 Depth ~ ~(~ 10. Date of Purchase ..... ,A..l~g~..,s.t..,A~....1.~..0. ...................... Nome of Former Owner ..... .,L.e.r. gy....H..u..t.g..h..'.z~,.~.9.n. ................. 1 1. Zone or use district in which premises are situated ...... A..r.O,~,i,c~OD,%~ .................................... 12. Does proposed constructlon ~iolate any zoning law, ordinance or regulation? ........... ,n.o. ............................................ 13. Name of Owner of premises Thomas J. Elak Address Southold Phone No. 765-2326 Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and blo~;k number or description according to deed, and show street names and indicate whether nter or or corner iot. Lob #23 on Map of Bayside Terrace, w~ch map was filed in Suffolk County Clerk's office on March ll, 1953 as Map #203~o, ~00 S~mmer Lane, Southold, N.Y. STATE OF NEW YORK. COUNTY OF ...S...U~'..O...L~.. ............... / ~'~' .................................. .T..h...o..n~....s....J......,E..,l~.k. .................................. being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the .................o~'~er. .................................................................... ......................................................... (Contractor, agent, corporate officer, etc.) ~ 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 true to the best of his knowledge and belief; th. ar the work wffl be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... ~5.t...h ......... day of ....~,l,~m~.t ............................ , 19.~..7.0 .~/ ,/~ Notor'! P~blic, . .................. ~N~TAR~.,~t~-~.t.e.,9.f..N..e..TM ~l~t~, .~_.~rm Expires March 30, 19...../