The URL can be used to link to this page

Home My WebLink About4659-zFOB~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z3882 .Tu.I.~' 22 19.. ?.0. No. Date THIS CERTIFIES that the building located at ]~/~ 1~'ood Lal~e Street xz o~ No :aox Peeon~.e Map No ....................... Block N ................. Lot ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated 1970 pursuant to which Building Permit No. b*'6~9Z ~rch 70 . dated .................................................. , ~........, was issued, and conforms to a~ of the requirements af the a~ficab~e ~¥i$~ons o~ f~e ~w. ~e ~c~c~c~ ~o~ ~c~ th~s ce~ff~c~$e ~s ~ss~e~ ~s ........ T~ ~m~,, ~ ~,~ ,o ....~.~...~.t..~.~S.~ ............... ~.~ ....................................................... of the aforesaid building. ~Iouse ~ 925 FON. M NO. ~ TOWN OF $O~TSOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIC:E SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4659 Z Permission is hereby granted to: ...~.o..~...o. .............. .w..~m..~.~ .............. .... Z~. ........ ..e.~ ....... L..O..~..S..~.~ ............... ~ N ~; C~' to ................................................................ · ................................. .~ ............. .0.......~.I &J..../_ .~.... at premises located at ..................................................................... .~..~.: .~.. ......... ~.~..~..~?. ..................... ............................................................................... :..~.~..~.:.~ ......... ~./.~.~ ........ ~..a.o. ..... ........ '-~£ d'ONt~__ ^t 5' pUrsuon¢ to application dated ................. .,~,..,~. ............ ...~.,...~..?,.~...~/...., 19..Z.(/land approved by the Building Inspector. Fee $ ........................ Building Inspector lOBar NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Examined .............................. ,19 ........ Ii Aparaved ....................... Perm..o. ........ ............. · _ ................ ~~...~~ ................. · (Buildi~ Ihs~tor) APPLICATION FOR BUILDING PERMII I1 ~ _ ..... ................. , INSTRUCTIONS a. ~ This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat plan showing location of lot ond of buildings on premises, r~lotionship 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 opalication, the Budding Inspector will Issue a Bud ng Permit to the a~olicant Such oermit" shall be kept on the prem sas ava ab · 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. 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 I~n~s', Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descr bed The applicant cgrees to comply with oll applicable laws, ordinances, building cede, housing, cede, and regulations. (Signature of applicant, or name, if a corporation) ........ (Addres~ of ap'~licant) .................... State whether applicant is owner, lessee, agent, a~hitect, engineer, general contractor, electrician, plumber or builder..~.l Name of owner of premises C ~.,~.~ (~,'~ C- .~. , ~ If applicant is a corporate, signature of duly authorized officer. ~ (Nome and title of corporote officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street anti, Number .-~'....~..~.i..~ .~.......~....e._~..~......~/~....V::~. ................... ,~::~......~....C..o...~..i ..~.. ~'~- y~ ~Z~ z~- M.nic~po,ty ..................... 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~..~.!..~....~.~......~... ....................... b. Intended use and occupancy ......... ~....c~ ............................................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration Repair ................. .**Removal '"i .............. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .... .~......~...?..~....~...~. ............... ~ ......... 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 ~o ' Depth ..-.~..~.~. .......... Height ...j..~.t. ............... Number of Stories ...... [ .......................................................................................................... Dimensions of some structure with oltercrtions or additions: Front ....~,...c~.....~ ................... Rear ....~,...~. ................. Depth ..~../. ...................... Height ..... ~. .................... Number of Stories ...... ~. ....................... 8. Dimensions of entire new construction: Front ..... .~..~...r. ...................... Rear ..... ..~....Z:.....r. ........... Depth ../...~.. ............... Height ....~.~ ............ Number of Stories I r t ~[ 9. S,ze of lot: Front ..... . ...................... Rear ..-'/..~ .......................... Depth ................~.....: ....... w 10. Date of Purchase ...~ ...... .[...~..~...~.. ........................... Name of Former Owner .....l~..~...~.~...o....~.....~.....e~..)~.~;..~...~.. ....... 11. Zone or use district in which premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law. ordinance or regulation? .......~'.~../~....~.. ..................................... Nome of Owner of prem,ses ....................... Ph e ........ Name of Architect ..... :.... ....................... ~ ................... Address ............................................ Phone No ..................... ,ama of Contractor PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether exi.~ting 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 i~terior or comer lot. STATE OF NEW YORK, ( ¢ ¢ COUNTY OF ................................ ~ '~"~' r~° ......... ~.~1~ j~O ....... ~1~.~ .................................. being duly sworn, deposes and says that he is the applicant (Name of individual s~gnlng apphcatipn) - ., ". above named. He is the .C¢~..~.~..~...~......f~... ................................................................................................. i ........... (Contraator, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to n~ke and file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and that the work w_Jill be performecLin the.n~anner set forth in the ppplJcation filed therewith. Swam to b~fc~,t_hi~.~ /7~3_ ~._..~. . .................... ........ .............................. NOTARy ,P?BLIC, State of New 1~9f~ Count~/ (Signature of applicant) Notary Public, . .................... ~le..52 s~2585'o;'~Yf'01/~"(~:~'u'~ty ' Term Expires March 30.