The URL can be used to link to this page

Home My WebLink About4803-zFOKM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~lt:[~v~b~.~.~.4..&..~m ....................... Street Map No..j~l~r~ ......... Block No...3gE ............... Lot No. ~ ...... ~.1~14 ....... ~e~'e ................. conforms substantially to the Applicotion for Building Permit heretofore filed in this office doted ............................... i~llt~ ....... ¶;~ ............. , 19.~r. pursuant to which Building Permit No..~.. dated ............................... ~'~1~.....~....., 19...~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .... PI'&v&te · .ono...~.mn~.l.),.. 4vot.l.f,~ ............................................................................................ The certificate is issued to ..... J~Z, UdUF:L~.~.J~,:[a~i~.~W~,~;.;;..~;~FF~ ........................ of the aforesaid building. House dL 60 no~thfield La Building InspectOr FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENI~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4803 Z Permission is hereby granted to: ............ ~k....~e~t..&..~¢~fa ......... ................... .8c~u.t~o;~l ......................................... to Build an addition (deck) on an exts$1n~ dwell~g . . pursuan,t to application dated ............................... ~.~ ..........~.~*...., 19...7~, and approved by the Building Inspector. Examined Approved ....~.. .............. '....! ......... l~Olg~ ' NO. ! '/'OWN OF soUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. 1~ ........ Permit No ............................ APPLICATION FOR BUILDING PERMI'/ ~, Date ........... .~i.,4A,~t,~ ...... I ........................ , 19...?...~....e~' INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or Jn ink uod submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo n ng prem ses or pub c streets or areas, and giving a detailed description of layout of property must be drawn on the dlagram which is part of this application. c. The work covered by this application may nat 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 wark. 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 Southo d, Suffolk County, New York, and other applicoble 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. (Sig~tature cf applicant, or r~e, if a corporation) '" ( ddrd~s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~,/~.'/~:~.....~7..........~.....~~ ....... ....~...~ ......................... If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I' 1. Location of and on Which proposed work will be done. Map No.: ...~, ........................ ,, ........ Lot No.: ...................... Street and Number ......... ~:~.~) ......... J~~~.....~ ............ ~ ~ I Mun~ ................ ~' .............. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupanc,~ ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........ ...~.1..~.~,-~...~.. 4. Estimated Cost ................ .~)./) ................................... Fee .......................................................................................... (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 each type of use ............................ 7. Dimensions of existing st'ructures, 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 ................ 1.,.,~...'. .... 10. Dote of Purchase ............. )...~L~. .............................. Name of Former Owner .................... .~0..-¢1~ .......... )1. Zone or use district in which premises are situated ................. ././..4..~.~. ....................................................................... 12. Does proposed construction violate any.T,~oning law, ordinance or regulation? ............ /~..Z) ....................................... 13. Name of Owner of premises ...-~..~.y....1.~.~.~,~,~..~.......Address'~' ' ~~~ ............................................ Phone No Name of Architect ..................... ,,-I~ .B . t/' \ll'"~ ........ ;.~ ........... Address ............................................ Phone No ..................... y~/-,J~...J,~.~ ......... Address ............................................ Phone No ..................... Name of Contractor PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines: Give street and block number or description according to deed, and show street names and indicate ~hether interior or corner lot. STATE OF NEW YORK, .................. O.-~.¥~...~.c..~....n,,-r,~..~.~..: .......... being duly sworn, deposes and says that he is the applicant (Nam~e~of individual signing oppl a~94~n) above named. He is the ........................................ ~ ............................... ~[ ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, 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 ti,at the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ......... ............... , ' Notary Public, ¢.',';:~~.L~..~County~, '~/¢~'-'1 ......... i~i~'~'~-;';~'~l~)'~%~-"''"T'''~ ..........