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Home My WebLink About5216-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z ,b302 .. Date THIS CERTIFIES that the building located at Map No. xx Block No. ~. Lot No. ~u~.st. 3 , ts 71 S/$ 8o~_na Ave @ Walnut Street ~ Nattituck N.Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated April 6 , 19 71 pursuant to which Building Permit No. ~216Z dated A.~r.tl 6~ 19 71, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private. one family .dwelld~g w£th attached garage .. The certificate is issued to Edgar CQrl~el.~ ...... ~r~e~ .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... N..,R, ................ House ~ 11080 .... / ' Building Inspector / FORNI NO. 2 TOVv'N OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5216 Z Permission is hereby granted to: ................... F~I~a~,,..~j~.~! ........................... ........................ l~t~tuck .................................. to .,...llu$~..~j..~t~,,a~...~e~,ej:e..~,~..e~t~f,~l..4~t.]:tjj; ......................................... at premises located at ............. J~J~--4~'{~e.~3~.-i~riB..~i~.-~.- .~l;~¢~..p~Mjljj ............................... i.. ............................................ l!~t.t ~.~u~ .............................................................................................. pursuan¢ to application dated .............................. ~J:~[ .........~ ...... , 19....~.I, and approved by the Building Inspector. .Fee $. 5x*.~J~l~I ............. Building Inspector FOB, M NO. I 'T~OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved '' 19..~.~... Perm,t No. Disapproved a/c ........................................................... ...... (Building Insp§ctor) APPLICATION FOR BUILDING PERMIT Date ..... ...~....~......*. ................................... , 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Buildi Inspector. b. Plot plan showing location of lot and of buildings on premises, relohonship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicati, c The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant. Such per, shall be kept on the premises available for inspechon throughout the progress of the s~ork. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa, 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 , Building Zone Ordinance o! the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additmns or alterahons, or for removal or demolition, as herein describ The applicant agrees to comply with all apl3licable laws, ordinances, building code, ~:~'~ik c~dr~s. (~ig~ure cf ~p~j,cant, or name, if a, corporation_) .... (Address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil~ If applicant is a corporate, s!gnatufe' of duly authorized officer. (Name and title 'of corporate officer) ~'~l (~j.,a 1. Location of land on which proposed work will b/e done Map No~ .. ....................... , ............... Lot No.: ................... Street and Number ./.../..~...~......~.~..'~....~..~...'T ......... ~./~ ................................................ Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed consfruction' a. Existing use an~ occupancy .......... /~....~.~.4... ,,~ ................................................................................................. b Intended use and occu~:an,, .......... ~..~......~..~..~ 3, Nature of woik (check whicl~ a~plicabJe): New Budd,ng -..~ ......... Addition ................ Alteration Repair ................. ,r Removal .................. Demolition .................. Other Work (Describe) ....................... ,. ......................... ..................................................................... (to be pa,d on f,'4ng this apphcotmn) 5 If dwelling, number of dwelling umts ........................... Number of dwelling umts 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. D~mens,ons of existing structures, if any: Fron! ...... ..~....O...~....~...~f.... Rear .~.~.~..~..~...f../ ............ Depth ...~ Height ...../~ f. ........Number of Stories ............Z.....~-- ................................................................ D~mensions of same structure with alterations ar add~tfons' Front ................................... Rear .................... Depth ................................ Hetght ........................... Number of Stories .............................. / , - , 8. D~mensions of entfre new construct,on' Front .................~ ............... Rear ..... /...~. ................. Depth . Height ................... Number of Stories ...... ./...,~q~ ................................................................ 9. Size of lot' Front '~"~'~/r Rear .~..~/./~.~ Depth ~'.3...~..'~L'-~ '~?' ,', ~ ·//1 ~'~ ' '', 10. Date of Purchose ...... ~.~1~.., ........ /.~..~.....~.~/ ............. Narn4~%ofF,~or~rOw/ner~9..'~..7/~I~.....':'~/~.~.~.~.~,,~,, 1 1 Zone or use district in which premises are sttuated ......... ~.-..6.;~..~ .................................................... 12 Does proposed construct,on ~,oJ.L~t,e any zj:~rpg la~wx~ ordinance or regulation? .... :..~....' ...... ............................ Name of Archttect ................ ~--~--~,,.....-'...~.%...L; ............... Address ~//~~ Phone No, Name of Contractor ........................ ~ .............. Address ........................................... Phone No ............ PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dtmensions p,operty hnes. Gwe street and block num~b, er ar descript*on according to deed, and show street names and in, whether interior or corner lot. STATE OF NEW YORK, COUNt. ........ ............................................................................................ being duly sworn, deposes and says that he ~s the (Name of individual signing aj~/cc~jo~)T-~ above named He ts 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 this application; that all statements contained m th~s appl,cation are true to the best of his knowledge and b thor the work will be performed m the manner set forth in the application ~ therewith. ~,x~t ~OT~Y PUBL~G, St~e of Ne~ ~or~ No. 52-3233120 $utiol~ Term ~p[res ~arch 38,