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Home My WebLink About4656-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMI~.NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. -Z~6~ ..... Date .......... 0at~b~ .189 ..... , 19.~. THIS CERTIFIES that the building located at ... Ig/J~ .PaF~II.e .~.e$.. Street Map No... 3[~ ....... Block No. XX ........ Lot No...Z][...~O~tt, hO3,~ ................ conforms substantially to the Apphcat~on for Building Permit heretofore filed in this office dated ........ ~-~t ' ', 19. ?13 pursuant to which Building Permit No...~. ~.6. Z. ed~ .21~ 19..7.0, issued, and conforms to all of the was require- ~ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Pl':l,v.&te. olle. fa~,l~..SWeI.XiILI .................................... The certificate is issued to .. J~l~a MoCa~.tl~ ..................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N*..R.* ............................. UNDERWRITERS CERTIFICATE No. PENDING HOUSE NUMBER ... ~330 ...... Street ..... Pal, ad, me. Sho~ea .~,~ ............ FOKM 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) N? 4656 Z Permission is hereby granted to: ........ !~..~~ ...................................... at premises located at ..................... ~J..~S~..~ll~1'4~...JJ~lt& ............................................ pursuant to application dated ............................... II~ZlIJJ ....... ~...., 19......~Oand approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE .~)UTHOLD, N. Y. ...... ApprOved ~ ~ 19 ........ Permit No. Disapproved a/c .......................................................... APPLICATION FOR BUILDING PERMI'~ Date l~rch ~ 19 ~0 INSTRUcTIONS a. This application must be completely filled in by typewriter or in ink and submitted in dup cate to the Bud ng Inspector. b. Plot plan showing location of lot and of buildings on premises; relationship to adjoining premises or public streets or areas: and gi¥ing ~, de, ailed description of layOUt of property must be drawn on the diagram which is part of this application. c. The wark covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building 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 o Certificate of Occupancy shall have bee. n 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 here n descr bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. r-~ _ ~. James McCarthy ~ '- (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner - builder Name of owner of orem ses Ja~.es McCart.h.y. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Locatig~.,o,f land on which proposed work will be done. Map No.: ......... ~ .......................... Lot No.: ...x~... ........... Tfl '- I 30 Street and Numb~r ........... ]~/.~.....~..P~.~..~.~,a~.~R ~..~9.r..~.~...~..o..a...d. ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~,~e'll.~t~ ~.~; ][~'.~, O.~.r~.g~. ......... b. Intended use and occupancy same w~th an adct~t~on on garage and attach to dwell~ 3. Nature of work (check which applicable): New Building .................. Addition .....~ ......... .Alteration ...~... ............ Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ............................................................ Fee ..... ~..e..0..0.. ........................................................................... (to be paid on filing this application) one 5. If dwelling, number of dwelling units ............................ Number of dwelling unit~ on each floor ............................ If garage, number of cars ........................ oz~e .............................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type6f 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 ......... .1.8 .......... Height Number of Stories oT~e 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................ !!A.!!..~;~bS~; .................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... ~) ............................................ 13. Name of Owner of premises .~..,..,~..(~.Z'.~l~. .......... Address ............... .~..O..~.~..~.9.~..~ .......... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ........ .s.?....~..e. ............................... ;...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. STATE OF NE'~. YORK COUNTY OF ..~.1~1~.~. ............ ........................................... ~T~III~.a..~C~.&~.[~. .................... being duly sworn, deposes and says thor he is the applicant (Name of individual signing application) above named. He is the ............................... ..(~....D..e..?....-....~..Q.~.~.~.~-. ..................................................................................... (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 thi~ application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . ~, . .................. day of .............. ........ ........ , ,4~n, ~ -~ [~ q~ ' ~ .................. .~:..~..JY~......C.~.~.....~... .................. Notary Public, ~..~4f,~t,~...l..~4~J/,~. Counfy -- ELIZABETR ANN NEVILLE NOTARY PUBLIC. State of New NO. 52-8125850, Sulf01k Coun~ Term Expires March 30, 19,..~_D