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Home My WebLink About4956-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~ .~13~ .... Date ............. ~T~I ....15 ..... , 19.~.1. THIS CERTIFIES that the building located at ...14ar~oolm .Roe~ ........ Street Map No. ~ ........ Block No .... z~ .... Lot No. ~ .... 14a~;t~.~;uek, .1~,~, ....... confoms substantially to the Application for Building Permit heretofore filed in this office dated ........... l~ep~., li~., 19. ?O pursuant to which Building Permit No..!~9~6 .~ dated ........... ll®p~ · - ll~., 19. ?O, 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 . Pl'tv&t;~ .on~. £am~.~y. d~ll~t~ ....................................... The certificate is issued to . .AI~ .l~h~mell ...... 0~1~1'. ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... · N,R~ ........................... ..... ~.. . . ./.-:'~. ~ .......... Building Inspector ~ TOWN O~ BUILDING DEP~RT~E~4T! 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? 4956 Z Permission is hereby granted to: ............ ~,~!~.~e~'~ ..... ~... . at premises located at ........... ,., ,, :,~,..?...:., ........ , ............................................... ..................................................... : ..... J..~. ~.~ ~ ~, . pursua:n¢ to application dated ........................ ~.~-- ........ ,.~..A!i,~., 19~.ii., and approved by the Building Inspector. ' ' ',' ' ' : ~ ~: !~ BUiJdin~ I nspector "" ....... TOWN OF SOUTHOLD BUILDING DEPARTMENT ?OWN CLERK'S OFFICE SOUTHOLD, No 1'. Approved ........................................ , 19 ........ Permit No ........ Disapproved a/c .............................................................................................. .................. (Building ..... APPLICATION FOR BUILDING PERMI'r ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in ck~plicate to the Building Inspector b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premiee~ or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whlch c. The work covered by this application may not be commenced bsfore 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 part for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPL~ATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purmuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York ~nd other applicable Law~, Ordinances or Regulations, for the construction of buildings, 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. R~chard ][enar~' (Signature cf applicant, or name, if a corporation) (Address of applicant) State whethar applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. .................................................... cGn.~.act ~ ..................................................................................................................... Name of owner of premises ..... ~).13..~]3&I:~OD, .................................................................................................................... .~'~ If applicant is a corporate, signature of duly authorized officer. ~ 1. Location of land on which proposed work will be done. Map No.: ......... ~ ......................... Lot No.: ..i..~(~, ........... ..~ Street and Number .......... ~'~l,~&~;~.~l~..~ ........................ ~..~.:~.~.~.~ ........................................................... ~'1 --'-- ~. 77.~ Municipality 2. State existing use a~d occupancy of premises and intended use and occupancy of proposed conmtruction: a. Existing use and occupancy ...... I~,IKl~.l.].J.13~ ......................................................................................................... Intended use and occupant, . ........ seme..vitb..edd.~e4.ol~..&..&.l.te~a.,o~e]~ ............................................. 3, Nature of walk (check which applicable): New Building .................. Addition ....... 31~ ...... Alteration Z~. .... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated Cost .................. .1. t.Ll~)O...,~ ........................ Fee ..... ~.t.~ ......................................................................... (to be paid on f'~'ng this application) 5. If dwelling, number of dwelling units ....... O~et .............. 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 s~'ructures, if any: Front. ........................... Rear ................................ Depth .......... Height ....................... Number of S~ories ............................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ........................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ .1~) ................... Rear ...... 'J.0. ................. Depth ...~.~i .............. Height .................... Number of Stories ........ ~e ....................................................................................................... 9. Size o~: lot: Front ............................ Rear ................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated .......... ~J[..~...l~.i~t; ........................................................................ 12. Does proposed construction violate any zoning Iow, ordinance or regulation? .......... nO ............................................. 13. Name of Owner of premises .~kl:LI~.~J~,~:;LQ~, ........... Address ....]~IL~.~.~,.~.~.. .................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~..e....~..e.~9~.:~t~. ............................ Address .....~....:~...e.o.~.~..a: ....................... Phone No .................... PLOT DIAGEAM 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 indicat'e whether interior or corner Jot. I STATE OF NE'~Z Y. CI~I~, t ~ ¢ COUNTY OF ..~..1~..:.[.-..O.~ .............. )'~.~. ............................... · l~L~-he~l ..~/'~ ................................ being duly sworn, deposes and says t~t he is the applicant (Name of individual signing application) above named. He is the ........................ ~e~ ...... ~ ................................................ ~ ........................................................ (~ntractor, agar, 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; t~ot alt statements contained in this application are tree 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 ............... ~..... d~y Of .................. "'~. ................ , 19.~..~~