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Home My WebLink About4988-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF' OCCUPANCY THIS CERTIFIES that the building located at ..... J~.J~...~,~J~...J[~.g~..~...o.~ ..................... Street Map No...31~ ..............Block No..31~ ............... Lot No:ll~[~l; ....... JJOli.~sh~l, JL...~Js~a .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................................... JJe~.,..6 ......... , 19.~O.. pursuanf to which Building Permit No......~.9.~JJ~... dated ............................ ~g.~ ....... .~. ........... , 19..~..O.., 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 ........ .... F_r~& ~ .. ~ ..£maS.l.j'...d~o3-1.~.~g ............................................................................................ The certificate is issued to ..TIOl~..T~Z'~tJr .......... g:tllJ~F .................................................................. (owner, lessee or tenant) of the aforesaid building. H,D,Approva~. Ja~ 13~ 1975 b7 l~°us' ' 11+2' ./~ ~ .~-----~____ Bui ding Inspector FOR¢~[ NO. ~ TOWN OF SOUTHOLD } BUILDING DEPARTMENT TOWN CLERK'S OFFICE . SOUTHOLD, FI. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE COMPLETION OF: THE WORK AUTHORIZED) 4988 Z UNTIL FULL Dote ~ 19 Permission is hereby granted to: ~ ~ ! ~.~ ~ at premises I~ated at ..................................................................s ............................... 4 ........................ pursuan¢ to application dated ~ ~C T f, 19.~.~, and approv~ by the Buildin~ Inspector. Fee $....[.. ................. Building 'InSpector S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OFfI HEALTH~.~ ~ Permit No ~ TO WHOM IT MAY CONCERN: at The sewage disposal ~acilities for a structure (Give deed location) located have been inspected by this department and found to be satisfactory. · row,,, oF sOU'r,.,OLD BUILDING DEPARTMENT TOWN CLERK'S OFFI(:E SOUTHOLD, No t'. AppliEation No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMI'r ~ Date ........................ ...~........~....~.... ................ , , 9.?.~......~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~ Inspector. b. Plot plan showin.~ location of lot and of buildings on premises, relationship to adjoining premlees or public streets or/~ areas, and giving a detai~ed description of layout of property must be drawn an the diagram which Is part of thJe 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 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 pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law1, 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. (Signature cf applicant, or name, If a corporation) ........... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of ~ner of premises ...........................,....~ .......................... /Z.....~ ........ ~ ..,.....~ ................ ~...~ ....... ~ ...... :.,. If applicant is a co~orote, signature of duly authorlze~ officer .... , / ~ _ .................. ................... Str,~ and Number ~. ~ ~ ~ 2. State existing uM and ~cu~ncy of pmmJ/~ and ~ntended use and ~cupancy of a. ~isting use a~ ~cupancy ................................................................................................................................... b. Intended use and ~cupan~', . ........................~ ................. ~ ........................................................................... / 3. Nature of work (check which applicable): New Building .................. Addition ................. Alteration ............. Repair ................... Removal .................. Demolition .................. Other Work (Describe) ................................... 4. Estimated Cost .....~..,'.~...~_.~...~. ...................................... Fee ...... ~.~.....'.'~.... ................................................................ (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, 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 ....~.. ............. Num,ber of Stories ...... ~ ................................................... 7 ...................................................... 9. Size of lot: Front ..... ./..~...~. ............... Rear ...... ./...~...~.~...x. ............... Depth .../..~...~. .................... 10. Date uf Purchase ....... ./..?...~.~ .................................... Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated .................................................................................................... 12. Does proposed construction ~ioIGte any zoning law, ordinance or regulation? ...... ../~'..~...: ............................................. ]3. Name of Owner of premises x~..~/:¥.~....Y'.....~,.~.~..~'.~...~..Address ././...~...~.....~......~..Z......~'..~..~.~../. p~one No.~..6.':..~..-...°...~.~..~' Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor . .x~..../?.,.~(.../~....~.../U...C...~-....../Z../..E.?.....~/...~....Address ~,./.~.E...~..~..~...~..~.~......~...~..T...~p...k.D Phone No. ~..~...~.:.~....~..~..~. PLOT DIAGRAM Locate clearly ond distinctly oil 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 indicm'e whether interior or corner Jot. STATE OF NEVVL~P~ I~c I COUNTY OF ..'I~Mi/F.~. ............ ,f"""' , / '~' ..................................... being duly sworn deposes ond says that he is the opplicant (Nar~e of individual signing applica~on) above named. He is the ........................ ~ ........................................... ,....i .................................................. (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 aH statements contained in this application are tn~,e to the best of his knowledge and belief; and thru the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ~ _ _ ...... ....... day o,' ..... .................. , / Notor/ Pubhc ....... County ~lgnature o'~plicant) Term ExpiTes March 30,