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Home My WebLink About4997-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerli[icale O[ Occupancy THIS CERTIFIES that the building located at . .~ ,..L.~$gO~ ./~ ........... Street Map No... x~ ....... Block No .... x~ .... Lot No...xx .... t,;att:±tuek .. I~..~. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Oct.. 8 ...... , 19.70 pursuant to which Building Permit No. dated ........ .Oct...ll4 ..... , 1970., 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 ..... Private..one..i:aral.1.): .dwi] l.lng ................................... The certificate is issued to .. Jnseph .~ .. F. inora .... .(~wner ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval I~,~. ............................... ... .... ~ ~ , ~::..../ .............. Building InspeCtor l~OIt~I NO. ~ TOWN OF ~S~UTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE COMPLETION OI~ THE WORK AUTHORIZED) UNTIL FULL N? 4997 Z Building Inspector. Fee $.. ~.e i~.O ............ Permission is hereby granted to: pursuant to application dated ......................... ~{'""'""'~"~"~*":i' .... 19..:.~ and. approved by the f ~ i~l~uiJding /j~§pector' [ NO. I ~O~VN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. Approved ........................................ , 19....'.~. Permit No ........................... Disapproved o/c ....... ~._...~ ..... ~ (Building Inspector) 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 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 on the diagram which is part of this 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 sh~ll be occupied or used in whole or in part 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 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code housigg code, and regulations. · ......... /"/, _t,~nar. ur, el~r p_PP' , ,' p · ) ........... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of Ioj~ on Which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Num/be~...../...~...~.~:~:..~.....~...~T...~?,,.'~,....~...~...~..T,..,/~'~...~......~...~. ..................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~../~-. ! ..~.~..~. /..~...~:'.~...~/. ~ ~.../.:f(~..~../...~.(.~.. ................................. b. Intended use and occupanc,' ........................... .,~..~...,/~..~.... ................................................................................... 3 Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair ................. .~Removal .................. Demolition .................. Other Work (Describe) ........................................ (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each flor ............................ If garage, number of cars ................................................................................ 6. If business, commercial or mixed ~cupancy, specify nature and extent of each ~pe of use ............................ 7. Dimensions of existing s~ructures, if any: F~ont ..... ~.~.~. ............ Rear Height ........................ Number o~ Stori~ ........ D[mensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ D~th ........................ Height .................... Number of Stories ............................................. 9. Size of lot: Front /~o ~ Rear ........ ~.~,~...~ .............. Depth ..~.~.~ ................. 10. Date of Purchase ............. Nome of Former ~ner ........................................................ 11. Zone or use district in ~hich premises are situated ..................................... 12. Does proposed construction violate any zoning law, ordinance or regu at on~ ..... ~ v~t~ ~'~': ............................................. 13. Name of Owner of premJses~9.f.~.~...~..~&~....Address ~...~"Rg, M;~ ,49.~Phone No. ~.~..~Z}.~.9..~ Name of Architect ...................................................... A~ress ............................................ Phone No ..................... Name of Contractor ..................... Z ............................. A~ress ............................................ P~ne No ..................... PLOT DIAG~M Locate clearly end distinctly all buildings, whether existing or propose, and indicate all sotek dimensions from prope~ iines. Give street and block number or description accord~ to de~, and show street n indicate whether interior or corner Jot. t Of NEW YORK,. OF ...... lSSl ' ' .......... l ...... ~?.~..~.- .~.-~......~....~..~'..../~...?.~.....~.. ......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ..................................................... ~....~...~..~...~ .............................................................. ~ .7,g~,,;,~...,~.~,.~.~ ~,.,~ of ~a~ 0~,-,~,' ,., ~';;....rs, 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 therewLt, h, Swam to before me this ~ ~ e ~ ~ ......... Noton! P-b ............................. ~AR¥ PUBLIC.z,~o. ~2-~I?57tsStczte of l',ew ~ouc y ~, ~/'-'~ .......... ~'~' ...... i in ~u/iolk Count~