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Home My WebLink About4930-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 . E~S ;..t~/eSlv.i~,. DX* ........ Street Map No. ~ ......... Block No. ~ ....... Lot No.. conforms substantially to the Application for Building permit heretofore filed in this office dated ........ A~g ...... 28. , 19 .~0. pursuant to which Building Permit No.~... dated .......... A~g...~.. · , 19 ~0', was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occUPancy for which this certificate is issued is . .. ~iva~ - (aCcessory). Zw~ .pool :~ ............................. The certificate is issued to He~y .&. Et~za~h. Zeg~a ...... ~ers ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....... ~,~, ......................... FORM NO. 2 TOWN OF SOUTHOLD BUILDING Di~PARTMEN? TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4930 Z Permission is hereby granted to: .............. ~a~9'..~,..~m~l~.~..~e .......... .............. ~e~..~ ........ : ........... : .................. .............. 1~t¢.$~ ....... N-,.~.,. ......... ~ .................. to ......... ~m~.t,e~J...~.~r~s:e...s~,~..;~oel....(ae~.,~..~~) .......... ot premises located at .......... mJ~....~l~r~l~.-]~.: .............. :..-.*; ........... : ........................................ ............................................................. ~t~.~,~ .:: .. · :]l.~,~Z-~. ·: .......................................................... pursuan4' tO application dated ........................... ~,~j: ......:" '~":'i'"'"' 19,~., and approved by the Building Inspector. Fee $.-~,00 ............ Building Inspector FOBS' NO, 1 TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ..................................... , ]c~ ........ Approved ........................................ , 19 ........ Permit No ............................. .......... ....................... APPLICATION FOR BUILDING PERMrI' INSTRUCTIONS a. This application must be completely filled in by typewriter or in i~nk und 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 ~n the diagram which is port of this applicatior~. c. The work covered by this application may not be commenced befor, e issuance cf Building Permit. d. Upon approval of this application, the Building Inspector will issuC.-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 ptirpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLiCATiON IS HEREBY MADE to the Building Department for the i~suance 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 bui dings, additions or alterations, or for removal or demolition, as herein described, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. '~ o~"~~'~i'i'f'~"~'~';~'~';~'fi~'~,'~' ........ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generdJ contractor, electrician, plumber or builder. Nome of owner of premises Jt'C'~Z::~/~tJ~.')/ D 2EG:ZuL4 ~ 8LIz~'T/¢ ~Z¢5:Z~ 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.: ....~ ...... ~Z ......................... Lot No.: ...................... Street and Number .~'!L:..~...~......*:.~..?...~...~..!..!.?.?..!~.~..../~.....~.. ................. /(:, P 2. State existing use and occupancy of premises and intended use an~ occupancy of proposed construction: a. Existing use and occupancy [~ ~;::S I D 1~/~ (~ ~ b. Intended use and occupant:, ................................................... ~. .................................................... 3. Nature of walk (check which applicable): New Building .................. Addition .................. Alteration .................. Repair ............. ~ ....Remg¥4]l .................. Demolition ...................Other,Work (Describe) ...................... ..~... ~........C...., (to be paid on fi!lng 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, Jf any: Front, ........................... Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of sorne structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...................... ;. ............ Rear ............................ Death ........................ 11. Zone or use district in ~hich premises are situated ............................................... '~'r~' ............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.? ...... .~.~ .................................................. 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 indicflte all set-back dimensions from property lines, Give ~treet and block number or description according to deed, and show street names and indicate whether interior or corner Jot. STA'¥E OF NEWcYOI~/7', (! CO[JHTY OF ...,)..q..~..k?..)...~., ...... ..... .J~[..~..~....J~.......~;.:.~...~.....~....v...!....~. ........................................... being duly sworn deposes and says that he s the app cant u~ame at indiviaua~ signing applica,.tion) above named. He is the ......... .~.,.~....~....,.i~....~.....,.~ ........ ~ ...................................... (Contractor, agent, corporate officer, etc.) cf ~;'~ ..... er-'~r 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 true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. ..... ....... of ..... .............. , , Nato r'/ Public,. ................... .~....~..~...~..~.L I,...~:~. _ ............. County ' : ..................................... SCALE. VAN TUYL ,~ SOIl L ~I~,ID ~U D. VI~YOt~. $