The URL can be used to link to this page

Home My WebLink About5019-zFORM NO. ~ B~G DEPARTMENT Town Clerk's Office $outhold, N. y. Certificate Of Occupancy THIS CERTIFIES that the building located at .B..~y..A.v..e~..u.e. ............... Street Map No... ~ ........ Block No;[~. ........ Lot No..1~....~.ll.~..~.h.o.~. e .................. conforms substantially to the Appli?9,Zt~on for Building Permit heretofore filed in this office .dated ....... 0. C.t.o.b..e~'..2.1. t.' 19.7.0., pursuant to which Building Permit No..~.O.]..9.Z.,, dated ....... O.c.~.qlie..r~ .2.2.~..., 19.7..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 ~.ivate one famil~r ~welling, addition and deck' ~.(attached) The certificate is issued to . .A.t..S.,...1~. 9.~' .......................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .N.~.R., ................ UNDERWRITERS CERTIFICATE No.~ ......................................... HOUSE NUMBER.. 8~.1% ...... S,r=et .... .~.ax..A..v.e~..u.e. ........ i ........................ gutehague ....................... Building Inspector TOWN OF SOUTHOLD , BUILDING DEPARTk~Ei~T TOWN CLERK'S OFFICE ' SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5019 Z ot premlsos' I~:oted ot ............................................ ,, .................. ..~ .................................... ........................................................... uu~m~,s....,,,..;~ ~m ~-..~ ........ · ............................................... pursuit to applicatio, d~ed' ,...-, ............................. Building Inspector ~ , ~ 19..'..'~ and approved by the ........... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at.....~....~ .... ~ .... Street Map No. ~..?~...~lock No ........... ,,or No.~.~..e0?. ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... --...~......o~. ! ....... , 19.?0. pursuant to which Building Permit No..~.0./..~..~'' dated ..... 'I .......'~...'~.. ..... , 19 .?.~., was issued, and conforms to all of the require- ' ~ents of the applicable provisions of the law. The occup, ancy for which this certificate is ~ssuec ~s ................. 2~ fl'~' :~' -- £~' -¥' -: ............... ~ .............. ~ -~he certificate is issued to..~' """ . .)~..../.~~y. ..... ~ ........ f- ~ ~ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ................................... Building Inspector TOW. o; sou'moLD town CLm'S omc. SOUTHOLD, N, y. A- ~ ' ~ ..... 5-~ I?~- .~- ........................................ ,,. ........ ~.~,, .o-~_2'"'"'"'"'" .................... Disapproved ale ....................................................... ;~. .................. APPLICATION FOR BUILDING PERMIT 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 prem!ses~ relationship to adjoining premle# or public streets or .areas, and giving a detailed description of layout of property must be drown on the diagram whlch II part of ~hle application. c.. The work covered by this application may not be commenced before iuuance of Building Permit. d. Upon app .reval'of this application, the Building Inspector will Issue a Building Permit to the pppllcant. Such permit shall be kept on the premises available for I~pectlon throughout the p.~re~ of the work. "e. No bu!ldl~g shalli be occupied or used in whole or In part for any purpole whatever until a Certificate at Occupancy shall .hava~b~#n gtante~ by the Building Inspector. APPLI.C~TIoN IS I~EREBY MADE to the Building Deportment for. the issuance 'of a Building Permit pu_mtaant to the Building ,'onq O~l~nee of the Town of Southald, Suffolk Cmmty, New Yark, al~d other agpIIcab e Lav~ O~dlnonces or TR~geulatlons, f~r the construction of buildings, additions or alterotlonl, ar far removal ar demo Itlan, as here ~ d~cr bed · pppllcant agrees to comply with oil applicable law0 ordlnancel, building code, hauslng code, and maulat Ms. ..............: ............ '~.JL,~-~ ~ ' ( g ure~ appllcont, otname,.tfa~qae, mtlon) State whether applicant Is owner, lc##, agent, amhltect, engineer, general contractor, elKtrlclan, plumber o~ builder. (Name and title 'of corporate officer) I.ocatl~of land on wh~h propped work wll be done Map Na .............. Lot No.: ............... ~ / - oo y / .¢- ,-~ .../ .e , n ......... Street and Number ........e/.~.~-~../.~.. ........................ ~/.~~....,.~.. ............................ . State existing u# a,nd occupancy of premls# and Intended use and occupancy of proposed ¢onltmctlon: a. Existing u~e and occupancy .., ............ ~~, .............................................................................. ~f b. Intended use and occupan¢,' ..~ ....r~r~,~,,,m~.. .................................................................. 3. Nature of wink (check which applicable): New Building .................. Addition .. Alteration Repair ................. .-.Removal ........: ......... Demolit on.. Other Work (Describe) (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 e~ach type of use ........ .~......;.. ........... 7. Dimensions of,existingstructures, if any: Front ...... ~...~:.. ............... Rear ...... .~... .................. Depth .....'~..~.. .......... Height ..../..~'.~.,. ......... Number of Stories .............. Z ........................................................ : ..................................... Dimensions of same structure with alterations or additions: Front ..... .~J..:. ..................... Rear ....~.~.. ................. I Depth .......~.~. ................... Height ...../.~.. ................. Number of Stories ......... ../. .................... 8. Dimensions of entire new construction: Front ..... ~..~. ........................ Rear ...~.....~. ................. Depth .....~....~. ............. Height .../.~...~. ......... Nu.r?er of Stories ............... i ............................................... ~'[-': .......................................... 9. Size of lot: Front ...~...O.:.~ ~..~ ...... Rear ....~..~ .~.. ................ Depth ..... ./.Z.~ ........ 10. Date of Purchase ........ ./.i..-~.~..~'/~ .................................... Nome of Former Owner~~ 11.~ Zone or use district in which premises are situated ................................................. ~'~ ................................................ 1~2; ~',,Does proposed constr~ct~n.,vio ~.te ar~v zoning law, ordinance or regulation.> ........ ~ ............................................ 13. Name of Owner of premise~...~ .~......~.....~.~...Address ~'~'('7 ........ Phone N .~.~..~'.;~...~/..~.. Name of Architect ................... ~--r.....,~ ..................... Address ..........~ ......................... Phone No ..................... Name of Contractor ~...~ ............ Address ..~.~.y ..... Phone No~.~..~..~'~....2~. 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 d~escription according to deed, and show street names and indicate whether interior or corner lot. ¥~'% ~A~ 0~/~ .... ~ ~ / / / I STATE OF N~ YORK, lee COUN~ OF ................................ ~' ................. ~/~'.~....~!..'~.~ ........................ being duly sworn, d~es rand says ,~, he is the applicant (Name of individual sig~ing application) a~ve named. He is the ................................................................................................................... (Contractor, ag~t, co,orate officer, etc.) of said owner or owners, and is duly authorized to pe~orm, or have perfo~ed the said work and to ~ke ~d file this applicotion; that all statements contained in thi~ 'o~li~fi~ ate tree to the ~st of his knowledge and belief; and that the work will be performed in the manner set fo~h in the applicati~ filed ther~ith. .... .......... ' ...... ...... No. 52-8125850, S~olk Coup. ~e~m ~pires March ~, ~9~