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Home My WebLink About4940-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~o~,~l...~.!~.ew...R~ .............................. Street Map No.OZ','te~t..J~,..~l~k No ..... ~ ............... Lot No....2~[ ............ Or. iezl~.....l(~Y.,. ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~e:p~. .......... If .......... 19..~.0.. pursuant to which Building Permit No....~'9.~.0~,.. dated ............................ ~ep.t, ......... ..l~ ....... 19...~.0., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... P.~.:tv~te... ~e...f. a~.i.l.~.. ~e i.t..ifig .......................................................................................... The certificote is issued to ....G.~..o..Z'..g~...i..)~.~.~..~.. ............ .O.~.~,..e...~. ............................................................. (owner, lessee or tenant) of the aforesaid building. Itouse FOI~I 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) 4940 Z Permission is hereby granted ..~e=~:.,~==..,.~_....¢,.,o..~z ............ ................... ~;~.~, .............................................. at premises located at ........... ~L~.~'...~3 ....... 0~.~.~...1~..~..~ .................................................. .......................................... ~.~m.¢...Tk~...~.~ ........... .o~e~ ....... ~.~..~. ...................................... pursuan,t to application dated .............................. ~a~,...,J~'. ....... ...-, 19..~.0., and approved by the Building InSpector. ~ Building Inspect~;f TO~N Of sOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIG! SOUTHOLD, N. Y. ^ , tion .................... Disapproved a/c ............................................................ _ (Building Inspector)/ APPLICATION FOR BUILDING FERMrT ~ Date ...................... ,.....~g.~.e~Ll~.~ X'......~...., 19..2.CI ..... INSTRUCTIONS ~. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining promises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which Il part of ~hle 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 to the pppllcQnt. Such permit shall be kept on the premises available for ir~oection throughout the progress of the work. ' e. No building shall be occupied or used in whole or in port for any purpoee 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 pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other pppll~ble Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, If a ~oq)oratlon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contrQetor, electrician, plumber or builder. ..... ~ ................................... ~'a.t3.~ez ....................................................................................................................................... Name of owner of premises .~I~.4~JeL..~Gt, I[ ..................................................................................................................... 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.: ........... 0~I,~X),~;..,I~r...B~.iLOt No.: ....~-,'~ ........ Street and Number ........ ao~_..YJ.e~..~c~&~, ......... GtLe~t, ......... ~,7~, ............................................................. Municipality 2. State existing use a.nd occupancy of premises and Intended use and occupancy of pmpaeed comtru~tlon: a. Existing use and occupancy ..... C1.1~3.~.:L1~ ........................................................................................................... b. Intended use and occupon:', . ....... SILIlI4L.~:Lt,~..~0...ILCI, C~:Lo~ ...................................................................... Nature of work (check which applicable): New Building .................. Addition ...... ~ .......Alteration ~ ..... Repair ............ ~. Remova~ ................. Demolition .................. Other Work (D~scribe) ..................................... Est mated Cost ..~/~...~..'..~='~ Fee ~..?.00 . (to be paid on filing this application) If dwelling, number of dwelling units ....O~e. ................. 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, if any: Front ............................ Rear ................................ Depth ............ Height ........................ Number of S[ories ................................................................................................. Dimensions of sarr. e structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~ .................... Rear .............. 114, ......... Depth -..-16 ................ Height .................... Number of Stories ............O%3~ ................................................................................................... 9. Size of lot: Front ........ .1.00 ............ Rear ....... 300 ...................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ......... .~ ........................................ 11. Zone or use district in which premises are situated ...... ~.A.~...~.&~ ............................................................................ 12~ Does proposed construction violate any zoning law, ordinance or regulation? ..... 3%~ ................................................. 13. Name of Owner of premises ..~O%'&e..]~e~,~ ........ Address .....0%'~Le%%~, ......................... Phone No ..................... Name of Architect .................................. : ................... Address ............................................ Phone No ..................... Name of Contractor ...~%L~...I~o;LdI~. ...................... Address ....... ~,I~;Le%~'& ...................... Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~ YORK, IS~' COUNTY Of ...S~l~r,4~lr, ............ ........................................... TI'~...~I~ ........................... being duly sworn, deposes and says thot he is the applicant (Name of individual signind al~plication) above named. He is the ............................. ~.~"].~eD .................................................. "~ ....................................................... (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. Sworn to before me this Public,'l~"'""e~.~~~/. '/~ ~-v, ..,~..°f ~-'~i'~"~'P~' ......... :....., 19.Cou~h,..~.0...~....._,~ ........ ' ~"~'"'~(Signa6Jre of applicant)' ........................... hlotort NO~(RY PUBLIC, State of New Vail( No. 52-8125850, Suffolk Count~ Term Expires March 30,