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Home My WebLink About4814-zFOI~M NO. 4 TOWN OF ~OUTHOLD '~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Na,?' ~000 Date Se~.t 28 ]9?0 THIS CERTIFIES that the building located at ~.~LI~.~O~I,..~CIB.~ ...................................... Street Mop No. ~ ................ Block No..;~CI~ ............... Lot No. :tOI;..,i.....Ou.t~JlOg.1~ ......... .~,.~, ............. conforms substantially to the Application for Building Permit heretofore 'filed in this office dated ........................................ ~.~1J~0......22 ....... , ]9..~.C[. pursuant to which Building Permit No..~.~.~... dated ............................ ~T.1.1~....~- ......... , 19...~.0., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wJ~ich this certificate is issued is ......... P~.~.v~t~.. ~e oe s~o~'.~...(.s .t~ ~'~ t~..bu~ld.$.n{~ ) ...... ~ ........................................................... The certificate is issued to .....~W~,~..~.~I~,U .............. g.~ ...................................................... (owner, lessee or tenant) of the aforesaid building. ~ouse # 670 ...... 1...; .......... ~ .................................... ./. .................... Building Inspector / FO~,~ NO. ~ TOWN OF $OOTHOLD BUILDING DEPARTNI£NT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N? Z Permission is hereby granted to: at premises located at ........................ ~.;gil~.~ga~ .................................................................... ................................................................. .~~ ........... .#.,.~.~ .................................................... pursuant to application dated .................................. ~ ...... 2...., 19,...~, and approved by the Building Inspector. Building Inspector/ TOWN OF soUTHOLD ~BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..~ .~...--/ ........... .r...~ ................ , 19..:..I,, Permit No....~..~,'.~.,.!...~.,.~..-~.,: Disapproved a/c .................. ~:;~ .......... ,.,,,.;:~;~ .~......: ,.,~:;~9 .~..~:~,.~..~.. (Builaing Imp~ APPLICATION FOR BUILDING PERMIT -~ Date ,J-)tztle 2~' 19. 70 INSTRUCTIONS ~-, a. This application must be completeJy filled in by typewriter or in ihk and submitted in duplicate to the Building~,~ inspector. ~, b. Plot plan showing location of lot and of buildings on premises, relationship to od oining premises or public streets or ~ areas, and giving o detailed description of layout of property must be drawn ~n the diagram which is p~rt of this application. ~/ c. The work covered by this application may nat be commenced b~fore issuance of Building Permit. d. Upon approwl 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 port for any pdrpose whatever until a Certificate of Occupancy ~ shell hove been granted by the Building Inspector. APPLICATION IS HEREBY ~ADE 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 ¥or~, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein.described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulohons. Edw..M.o~eau (Signature cf applicant, or name, if a corporation) Pinewood Road Cutchogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................ ~1~3,~ 1'. .............................................................. ~ .......................................................................... Nome of owner of premises ...Ectwa~.d...lVi~=e~u, ..................................... .......................................................................... if applicant is a corporate, s!gnature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done, Map No,: ~ xx · .... ~ ................................... Lot No.: ........................ Street and Number ~,~ .qg.~ .~.il .9,~.g.{l~.~ Nt..~..~ ................ ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ cl~e.'l.'[ZLl~ ........................ ; ............................................................... b. Intended use and occupan:;y . ......... ~a~e...~.'i.~-t..~,~.¢e,~s~:x~...B~,d~ ............................................................ 3. Nature of wo~k (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............. ,~.0..._,+ .................................. Fee ..........~..~..0..0. ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling umts ...... ,t3.Q~ ............Number of dwelling units on each floor ............................ If garage, namber of cars ............................................................................................................................................. 6. If business, commercial or mixed OCCLIpOncy, specify nature and extent of each type of use 7. Dimensions of exist!rig structures, if any: Front. ........................... Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of saree structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of enHre new construction: Front .......... 1.0 ...................... Rear ...........1.0 ............. Depth ....... .1~ ............ Height .................... Number of Stories ............. ~1.~ ................................................................................................. 9. Size of lot: Front ............................ [),ear ................................... Depth ................................ 10. Date of Purchose ........................................................Name of Former Owner ........................................................ 11. Zone or use district in ~hich premises are situated "" ............................... st ..................................................... 12. Does proposed constructlon dolote any zoning Iow, ordinance or regulation? ....... ~O ................................................ 13. Name of Owner of premises ....]~.....~oJt~&~ ......... Address ...... g.~l.1;.O]~p.j~g,~ ................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ......... ~..~.~.e. .................................. Address ............................................ Phone No ..................... PLOT DIAGraM Locate clearly ond distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. GNe street and block number or description according to deed, and show street names and indicate whether ~nterior or corner Jot. STATE OF NEW YORK, COUNTY OF ..~..~].~ ............ ,( · · .......................... ~,~.l~.~.,~/IO;l'.ea,~ ............................................ being duly sworn, deposes and says that he is the applicant (Name of individugl signing application) above named. He is the ........... .Owr~e~. ................................................................................................................................. (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 ali statements contained in this application are true to the best of his knowledge and belief; and lhor the work will be performed in the manner set forth in the application filed there)~;b.. Sworn to before me this ................ ......... ......... , Notary Publi~.~.~.:.~.~/2J,~,~,~.... Counh,'~~f~p~"t'i ............................. (-/ ELIZABETH Ab/N ~E~LLE NOTARY PUBLIC, State of Now York No. 52,8125850 Sutfdk Co~nt~ Term [xpres March 30,