The URL can be used to link to this page

Home My WebLink About4843-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~ .~.......~.~...~.....~.~.~...~.~...~.....~.~...~....~.~...~ Street Map No....Jl~ .............. Block No..~J~ ............... Lot No. ~ ....... JJfll&t~o~,lJ.....J~.~[., .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~IZ~JI .......... ~ ......... , 19....~.0 pursuant to which Building Permit No...J~...~...~.. doted .......................... ¢,1'~ ....... ~, ........... , 19...~(~, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ The certificate is issued to ....... R.t, clT~..D, oz'~IilC:L ................~ ................................................. (owner, lessee or terlaot) of the aforesaid building. FORM NO. ~' TOWN OF $OUTHOLD 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.o 4843 Z Dote ............... ~'~ ............... ~t. ............. , 19.....~.0 Permission is hereby granted to: .......... ~.~ ~.~e=..d~,.7,.C ~ ...... ................... · c,z~,~tl~q~ ...................................... at premises located at ..................... ~ll~'"'~I/"JlOr~l~'"/lll~ ......................................................... ................................................................... ~h~tt~tl~ .......... l~e~',' ...................................................... pursuor~t to application dated .......................... ~:11~ ......~ .............. , 19...t~0, and approved by the Building Inspector. Fee $'"i;,~ ........... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI¢:! SOUI'HOLD, N. Y. APPLI~,ATION FOR BUILDING PERMI'T 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 and of buildings on premises, relationship ,to adjoining premise~ or p~lic streets or~ areas, and giving a detailed description of layout of property must be drown on the d,agram which is part of Jhle 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 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 o Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, 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. ....... g. ....................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. Conl;~'~cl~or Name of owner of premlse~ ...... S.te=~..l'soz'.o,.~l~:L ............................................................................................. ; ................ If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on whlch proposed work will be done. Map No.: ........... ~ ........................ Lot No.: ..... ~ ........... ...~r' street and Number ........ ~/~..D.],c~.~e~,,h..~,oe41, .............. ~ ~ ..~-'.~'-'~ ~ Municipality 2. State existing use a,nd occupancy of premises and intended use and occupancy of propoeed comtmctlon: ,~ ~ ~ ~ .......................... a. Existing use and occupancy ............ ~).~1~.,~.~1 ..........~ ................................................... b. Intended use and occupancy'. .............. ~.~q...~.~.t;~..~l,~..'(;~1.g~ ...................................................................... 3. Nature of wink (check whici~ applicable): New Building .................. Addition ........ ~... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 5. If dwelllng, number of dwelling units ....~..o.~.e. ................ 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 ....hl,~l~.s~ .... 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 ........ [2. ....................... Rear ......... 1~ ............... Depth ...1~%,,6. ........... Height .................... Nurnber of Stories ..................... ~ ....................... . ......... 9. Size of lot: Frc,nt ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated e~t 12. Does proposed construction violate any zoning law, ordinance or regulation~ ................... llO, ................................... 13. Name of Ow~,er of premises ..S.t.e.~a..Doz'.oa~:L ...... Address ........... ~xotl.~chct],~l ............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM ~: J~ocl~te clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-b~ck dimensions from p ~peJ~.~dmes. Gwe,street and block number or description according to deed, and show street names and indico~'e whether interior or corner iot~ STATE OF NEW YORK, ! S.$ COUNTY OF ....~,1~£O.1~ ........... $ ' "':'"~"'"":'";"'; ............. A~'~13~..~:LP--~:~:~ .......................... being duly sworn, deposes and says that he is the applicant (Name of individual s. ign. ing application) above named. He is the ....................... (~1~:~1.~(~1~ .......................................................................................................... (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 thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Natal/ ................. Public,'~'"" day of~~'~.~ ............... ~t,~l~ ................ .... , 1~::~ v~'~' ...... ,5'~ (Si ~'~ ~" ................... ELIZABETH ANN NE~LLE NOTARY PUBLIC, State of New York Count No. 52-8125850, Suffolk 1~ ~erm Expires March