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Home My WebLink About4598-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Rio. Z..3~6 ............ Date ............................. ~TI;ll3a ....... ~J~....., 19....~.0 THIS CERTIFIES that the building located at l~ld.:te...l~.-&..l~.~okha~..A~e .............. Street Map No...~1[ ............... Block No ............ 31~ ...... Lot No...3E~ ......... ~t~.4~e~l[ ....... ~'~,¥.er ............. conforms substantially to the Application for Building Permit heretofore filed Jn this office dated ................................ ~)e~' ......... ~) ............ , 19~.. pursuant to which Building Permit No. dated .................. ~ .........'$r .................. , 19..~,{)., 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 ........ ........ ~ s~ ..bu~.:l~4.~ ..,,....&~se~.~j~e...e®z.e:Ee® ..eta4~ ~en ............................................... The certificate is issued to S~t3')..~)~1. C~O · ~;~'~'~[ e~l~o~..~¥i .............................. of the aforesaid building. Souse ~ ~77~ Niddle Rd building ~nspeltor FORM 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) 4598 Z Permission is hereby granted to: ..... ,~l~.L..~.~......*.~...~.l,.x....~.~.. ~ .e.. ...... .......... ~,O~r,..-~J ........................................... ....... · 1~t~"~ ..... lt,~.o ...................................... to ..... ~-.aa..a~,~.. oa..ea~, e~,t~t,~atl..~m~l.x~s~...~d,l,a~al~ ........................... at premises locoted at .............. ~3~..~oa~L..(C~.~..&..l~,teirJaaai..A1eJ ................................ .................................................. ltj, tt&~ ...... i1,~,,, ....................................................................... pursuOr~t to application dated ............................... ~tJ~l[ ....... ~ ......... , lg,,.J~, and approved by the Building Inspector. .Fee $.....~.J,.~ .......... NO.! BUILDING DEPARTMENT ~) ~ TOWN CLERK'S OFFICE , SOUTHOLD, N.y. ~'~'~ /~(-~ ~/ ~ Examined ...~.~ ¢~ 19.~.....~ Application No.~'~ *~ '~ '' ~ Approved ........................................ , 19 ........ Permit No ............................. ~, Disapproved a/c ................................................. ~... ................................................................... ", ,. . ................... j ..............?-~.,~ L.~--"'L..., ......... ,, ...... ~L .......................... (Building Inspector) APPLICATION FOR BUILDING FERMI'I' INSTRuCT'IONS a. This application must be completely ~illed in by typewriter or in ink and 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 port 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 ir~pectic~n 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 Occupanc¥~'~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a BuiJding 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 demo t on, as herein described. The applicant agrees to comply with all applicable laws, ordinances, b~'ldin, gj,.~,~ ~'~/"~""'~"~"~'/"~'/'~'~'c°de' housing code, and regulations. (Signature of ap~'ant, or name, if a corporation) (Address of applicanf~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corpprote, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ....... ~ ....................... Lot No.: ~ Street and ~.~mb~er .~':~'~'.~d~}'2*"ii~lil~'"(~"~'""~' ')'"~~'''~''q~''''A'''~'''''''t'''''~' ~''~''~'~. Municipality,_ / ~',.~ ,~- 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E~ist~ng ,s. and occupa,¢y ..... ~.e..,...,...~...~....1.~...~...-.....e..e.e...e..1.....~......,...e.~.e...e...I.~.t..S....m... .................. b. Intended use and occupancy .......... .~lMl~...l(;Lt~..~..~i[c[~,.t~,~ .............................. ~ ..... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (~e) ..... ,~..~ .............................. 4. Estimated Cost ............................................................ Fee ........................................................ + ................................ (to be paid on filing this a~pplication) ,, ~ §. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................ ~1~1~ ...................................................................................... ..................... 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 oddition~. Front ....................................Rear ....................... ~ .... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordilll~lle n? ......................................................... ~.. . 13. Name of Owner of premises ........................................ Address .............................. ~1~ ......... Phone No ..................... Name of Architect .............~]~,~,~'"0'J~"O~' ........... Address'~!X~'~l~t~' '].'~snll'"~¢l~' P~'IL~'~'""~"9~'q.. Name of Contractor .................................................... Address ............................................ 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 b~ock number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YOR~, ~ ~,~/ ~i ~' COUNTY OF~..,.,.~'..~...~.~....~,,<~..~/' ..... '' '"'"'"~' "'"' "~,,.~, ., ......... .....~..F~......: ....... ~ ...... ~. ....................... being duly sworn deposes and sa~s that he is the applicant . . (Name of individfsigning application__~--~_ above named. He is the ....i .......................... .~,. .................................................... .~ .............................. (Contractor, agent, corporate officer, etc.) ' of said owner or owners, and is duly~ aqthorized to perform or have performed the said work and~to make and file this application; that all statements coh"?Oined in this application are true to the best of his knOWledge and belief; and thar the work will be performed in the manner set forth in the application filed therewith. Swam to before me this -~) # A/,,,~ / '~ ' /.//////' ~'"~ ~'--' .......... ..................... V JA~':S WIESMAN~I NOTARY PUBLIC, Sfafe of 14~1~]~I~ No. 30-4264073 ~uehflad In Nassau Cea~z_ ' '