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Home My WebLink About4647-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWFl CLERK'S OFFICE SOUTHOLD, FI. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..[g.'l.&~...¥i~'4'..~, ..................................Street Map No ..... ~ ............. Block No. ~ ................. Lot No. ,llZJC~....G.tt.e~l~J:~'.t ......... ~l .............. conforms substantially to the Apphcahon for Building Permit heretofore filed in th,s office dated ................................ J~J'~'*t3h ....... ~J'6 ........ , 19..~.0.. pursuant to which Building Permit No. ~.~..~.~.. .... dated ...................... ..-~a.~'~,~ .......... ~,6 ....... , 19....~.0, was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for wh,ch th~s cerhficate is issued ~s ........ .... ~.~$v~te..~)~..~m~l.~..~we.ll~ng. ........................................................................................... The certificate is issued to ........'A'~'beT~"'"[~i~)~'~tg .............. I~l~t~' ........................................... (owner, lessee or terra.t) of the aforesaid build~ng House ~ ?~ Building Inspelor FO~ NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ' COMPLETION OF THE WORK AUTHORIZED) N°.. 4647 Z Permission is hereby granted to: jJlltl~t~ ~l,~l[e~1~ ~J~ljJ~j JJ~tJ~JJ~j to ............... ~...atL~,,~ttt,~m...ma..m~..~U..~t..tr~..~e;~Z~l~ ....................................... ................................................ ~~.t,'. ........ s,:,'., ....................................................................... pursua~¢ to application dated ................................. J.;~3~ ........~.., 19...~, and approved by the Building Inspector. F- Approved ........................................ , 19...~.!... Permit No ..... ,.:... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING FERMI'I' .... 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, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ot 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 fo.r 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. 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 ogrees to comply with all applicable laws, ~ ~ ~,.~ _~ ordinances, build' g code, housin code, and regulations. ........ i~i~noture U'~'~'~'li~i'~;'~'~"r~i'i'~'~'~:~'r~'~i~'r~')' ........ ............................... ....... ................ -Stotewheth. er a:licant is owner, lessee, agent, a.~t~c~r,.'general contractor, electrician, plumber or builder. Name of owner of premises ...... ............. ..~...~....: ......................................................................... . ....... If appliconca~,,isa co~ignature~.~duly authorized officer. ................... 1. ~ati~ of land on ~ich pm~ed wo~ will ~ done. Map No.: ........................................ Lot No.: .. ...................... Str~ and Numar ........................... ~.,~.~.....~Z~T.~. ~...~.~.~:~.....'./.~-'[~.T.~..~ 2. State existing u, and ~cu~nc, of premises and intended :, ~;~u~nc, of pr~ const,ct,~: a. ~i~n'e u~ a nd ~c uPa~Yn "' ........ ~ ............. ~ ............... ~~' .................................................................. b. I t ~usea d~c ~ cy ....................................... ~.~ ................................................................. 3. Nature of work (check which applicable): New;Building .................. Addition ........ ~... Alteration .~ .......... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ................i... ......... 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 ....... .~.~..::...Z. ....... Rear ...... ,.~..~...~, ............... ~Dep. th Z&~ 9' Height /6/ 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 Owner ........................................................ 11. Zone or use district in which premises are situated ................................... ~.. ............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~ ............................................. 13. Name of Owner of premises ...~/./~.e..~...i..~.Le.~/./.~,~ .......... Address ..S~././..."~./:~..~.///......~?,S~/.~49.~ Phone No..~../..~.....~..~..L.~..oz7 Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~'..~.°......./~.../~../.~..~.......~.~././..~/.e.c.r.."~:'"'/"~"Address ....~v.~..~....~..°..~....~..%..~':'~r.~...:.. Phone No....~..~.~...~./.O 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. STATE OF N~ YORK, lee COUN~ OF .............................. ~*'~' ................... ~ ........... ~'f~ ................................... being duly sworn, d~oses ond s~ys t~t he is the opplicant (Nome ~ individuol signing opplication) ebove nomed. He is the ................. : ............................... ~;~~ ................................................................................................. (Contractor, ogent, co.orate officer, etc.) of soid owner or owners, ond is duly outhorized to perform or hove performed the soid work ond to ~ke ~d file this opplic~tion; thor ~11 stotements contained in this opplic~tion ore true to the best of his ~owledge ond belief; ~nd tho~ the work will be performed in the monner set fo~h in the applic~ti~ filed ther~ith. ~ ~ ~~ ~NN NEV LLE ~ARY PUBL C, State of New York No. 52-8Z~850, Suffolk Coun~ Term Expires March 30,