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Home My WebLink About4934-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte O[ Occupnncy No..Z~..!~ ...... Date ............. ~Tall....~.~ ..... , 19.7.~. THIS CERTIFIES that the building located at . Deep. hole. D~ ............ Street Map No. ~ ....... Block No .... ~ ...Lot No. ~:ll~[X.. P~tt~LtllCk .... N. ,¥... ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. l~®l~t .2.., 19.70. pursuant to which Building Permit No.. ~93~Z' dated .......... Sept...2 .... , 19 ?0., 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 ... PrSvate · ~e .fa~ly. dYelling ..................................... The certificate is issued to . .J,. F-ol~t...0wnel, ..................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . -. l~.,.R, ............................ ou,o # 2 oo ..... :..5 . ....... Building Inspector / ~Ol~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 934 z Permission is hereby granted to: ...... J~..aeLl~...&..aea~.~.&.~eat~ ....... to ......... atd3A .~z~..a~,1,t,Sa~..ea..ez~t,a~..4~ ..................................................... at promises I~ed at ....................~..~ ...................................................................... ....................................................................... ~t~ ................................................................... pursu~e to application d~ed ........................... ~. ......... ~ .......... , 19..'...~ and appr~ by the Building I~pector. Fee $..,~aflO ............ Disapproved o/¢ .............................................................................................. '~ APPLIGATION FOR BUILDING PIRMrT ~te .............. i ....... ~......~.... ......... , ,~....)...~..~ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink und submitted in ckJpllcate to the Bullding~'~ Im, peator. ~ b. PI.at ~lan ~howian~l location of lot and of bu.ilding~ on premises, mlatlor~hlp to adjoining premiere or publi~ Itmet, or~' areal, aha g vlng a ciera ed description of layout of progeny must be drawn on th~ diagram whloh I~ I~rt o~ ~ie Ol~dlcation. c. The work covered by this al~llcation may not be commenced before iseum~e of Bulldln~Pemdt. d.. Upon ap~r.~ol of this application, the Building Impector will Iseue a Building Permit to the al~lloont. Such permit shall De Kept on the premJles available for inr~oection throughout the pragre~ of the work. e. No building shall be occupied or used In whole or in part for any purpaee whatever until a C~rtlflcote of O~cupanoy shall have been granted by the Building Inspector. APPLI_CATION IS HEREBY MADE to the Building Department for the issuance of · Building Pmmlt pumuant to the ~uiludlng/.one Ordinance of the Town of Southoid, Suffolk Count, New York, and .c~ner al~lloebJe ~ Oedinances or egu ations, for the construction of buildings, addltion~ or alterations, or ,for removal or demolltlofl, o~-hereln d~crlbed. The applicant agrees to comply with oil al~olicoble law~, ordinances, buUdmg code, housing code, and regulotlom. State whether applicant i. owner, I.~c~engln.r. .ne,al contractor, oioctrlcI¢~. ,hal~r or builder. ...... ..:g...: .......... ....................................................................... : ........ : .................... If applicant I$ a coq~orate, signature of duly authorized officer. ~_ '~,,~1~- ................................................... and .,t,"of ................... 1. Location of land on which propaeed work will b~ done. Map 1~4e..: ....................................... ~1,~' No.: ..~,....: .......... = na re m . u.~..~ ..la..= ........ ~ .......................... ., .......... .. ....................................... MUnicipality 2. State existing use and occupancy offended use and occupancy of propmed comtm~lon: a. E~i~tlng USe and occupancy ..... r. ............................. ,~ ............. u .............................................................................. 3. Nature of wink (check which applicable): New Building .................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelllng, number of dwelling units ............................ Number of dwelling units on each flodr ............................ 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 ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construct;on violate any zomng law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No .................. Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor' ;: ..................................................Address ............................................ Phone No .................... ~,:~!., ~ PLOT DIAGRAM Locate clearly~/dJstinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give S~'reet and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~:)P~./~ tee COUNTY OF ...~ ........... J'~'~' ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................................................................................... .'~ ....................................................... (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 and 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 ........................ day of .................. ,, ...................... , 19 ........ Notary Public,(~~..~~.... Coun~~ .......... i~'~;l~'~'~'~'~;ji~'~'~ ............................. ELIZABETH ANN NEVILLE NOTARY PUBLIC, State of New York N~o. 52-8125850, gulf01k County