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Home My WebLink About4609-zFORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificale Of Occupancy No..~9~. ..... Date ............ Dec ..... ~ ...... , lg. 72 THIS cERTIFIES that the building located at ...Tuthi.~'l. L~ne ........... Street Map No..XX ........ Block No. ~X ....... Lot No. x~x... C.utehogue. R,Y. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Jan...27...,' 19.70. pursuant to which Building Permit No. ~09Z' ' dated .......... .Jan...28 .... , 19. ?0., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. Private .one. £am~,~ .dwelling ...................................... The certificate is issued to ...James. Rason ...... 0vn®r ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N,I~, ............................ UNDERWRITERS CERTIFICATE No... N.e~R, .......................................... HOUSE NUMBER.. ~1.~0 ....... Street ...... .~thl_~. · .La~o ............................ Building Inspector /. NO. ~- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK, AUTHORIZED) N? 4609 Z .... Bbilding Inspector. r~'$.~.t~...,.: ......... Permission is hereby granted to: ................. ~..~.~..~..~ .................................... ~ to ................. ]~I~tL .~II. ~A~al~.,~,,..e~..e~~.~~ ............................... : ...... a, premises located Ot ............... ~ ...... ...~.....-.---~..~-.--~-.. ................................................................ .......................... : ....................................... .~~...Jl~. ......................................................... pursuan¢ to qpplication doted ............................ 4~'JJl~ ...... J~J~J ............ , 19...~J, and approved by the Bui ding nspector ) ' ~ TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥o Al~ro~ed ........................................ ~ 1~ ........ Permit No ............... Disapproved a/c ~.......~_ APPLICATION FOR BUILDING PERMIT ~ · Date ................... ,.......~..(~..~. ,~..~ ......... , 19...~. INSTRUCTIONS a. This application must be completely filled 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, relat onsh p to adjo n ng 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 ~his 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 Bui d ng 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 have been granted by the Building Inspector. B APPLICATION IS HEREBY MADE to the Build ng Department for the issuance of a Building Permit pursuant to the uilding 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, housing code, and regulations. ~o gnature of~applicant, or name, if a corporation) ...... (Address of a~blicant)ti ' ' State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ........................................................................................... If applicant is a corporate, ~qgnature of duly authorized officer. (Name and title of corporate officer) Location of land on vLhich~,,~ ~pr°p°sed work will be done. J~Aap No.: ................... ~. ................... Lot No.: ..................... Street and Number ~~ ......... ~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................... b. Intended use and occupancy &~ .................................................. ; ........................................ · 3. Nature of work (check which applicable): New ~uilding .................. Addition . ..J~... .......... Alteration .................. Repair ............ ._.~.. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ~i~.~...*..{~.~.. ....................................... Fee ....~... ................................................................................... (to be paid on filing 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 .................... Number of Stories ...~,/:~. .................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ............................... ',. _ 10. Date of Purchase /...~.~....~. ........................................... Name of Former Owne .......... 11. Zone or use district, in which premises are situated ............................................................................... r 12. Does p~:pposed~const_rjdc, tJort viola~_~c~lgJaw, ordinance qr regulation? ..... 13. Name of Owner of premises~.~ress .~.~....~..~i....i.... Phone No. ~.,L~.....~...~.?~ Name of Architect ........ ~ ~ ....... Address .~.~.E.~..E.~ ........... Phone No.7.,;3..~...-.~.~.~.~/ 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 block number or description according to deed, and show street names and indicate whether interior or corner lot. I I '--/--~ 'TN LC,/',/E .... STATE OF NEW YORK, lee COUNTY Of ................................ ...... .............................. ing du y swam, deposes and sa ,s he ~ (Name o~ indivi~~appiication) above named. He is the .~~~~ ............................................................................................................. (Contractor, ag~t, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~ffo~ the said work a~ to ~e ~d file this application; that all statements contained in this application are tree to ~e best of his knowledge and belief; and that the work will be performed in the manner ~t fo~h in the application filed ther~ith. Swam to before me this