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Home My WebLink About5225-zFORM NO. 4 TOWN OF SOUTIIOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~1+222 .. Date April ' 27 , 19 21, THIS CERTIFIES that the building located at E/$ Birch La Street Map NOBireh Hills Block No. l~x Lot No. 8 C~tcheg~e ~ N.Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated Ear,ch 17, 19 71 pursuant to which Building Permit No. dated ~,pril t2 , 19 7t , 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 Accessory building (storage etc) The certificate is issued to Bridget P, Lark. -, of the aforesaid building. Suffolk County Department of Health Approval . (owner, lessee or tenant) Building Inspector FOIL~ NO. ~- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. N? BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) 5225 Z Dote ........... : ................ ~L..JJ ....... , 19.~.~.. Permission is hereby granted to: .............. ~.~t~.e.~...L ~ ...~, ...................... ~ ...... to bb~l. cL ... ~e~r...~t,~..u~;~e~...,l~t;L~ ......................................................... ~ ..... pursuant' to application dated ................................ ~ ....... :~.~..., 19..~$., and approved by the Building Inspector. ~ ~..~,~ ............ l~m NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No............................. Disapproved a/c .~.~..,~ Application No. ,--~',,...~.,,,~,.. ~ ........ APPLICATION FOR BUILDING PERMI'J' Date ........... .H..~ ~P.h....Z.Z ............................. , 19.?.~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in mk und subrnitted in duphcate to the Bu~ldm Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoimng prem,ses or public streets, areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicahor c The work covered by this applicahon may not be commenced before ~ssuance of Building Permit d. Upon approval of this application, the Building Inspe. ctor will issue a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the progress of the s~ork. e. No building shall be occupied or used in whole or in part for any purpose whatever unhl a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to tk Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with oil apphcable laws, ordinances, building code, houmng code, and regulations ........... .................... (Signature ~f 6pplicant, or nome, if a corporation) .... .............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde Name of owner of premises .... ~.g~'~...~..,...~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done Map No ...... ,LI'.~.O.~ ...................... Lot No: ...... ~ ........... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....?..A.~:~.?. ............................................................................................................ b. Intended use and occupant,' ..?..Q...~.~,~.~...r~..~.~.O~A.,~..~,~...~..O~..~k~...&~..~.~. ................... E~UIPMEN~. 3. Nature of wo~k (check which applicable). New Building .....N../...~. ....... Addition .... .N./..A. ...... Alternhon ...N/A ... ..... h..?. ........... Repair .....N/.A ...... Removal ...]~{/.~, ........ Demohtian......N./..A. ..... Other Work (Describe) ~T0~A,.z~ SHRD 4 Estimated Cost ...... .$..~.0..,..0..0....f..9.?.....m...a.~.e..?..i...a..1...s. ..... Fee ............ .~.~.~.....0..0. ............................................................... (to be pa~d on fi'ag this application) 5 If dwelling, number of dwelhng umts .... ..N../~, ................ Number of dwelling umts on each floor .... .N./..A. ................ 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: Front .... ~,~./.,.~. ................ Rear ...... .~.~../..A.. ................. Depth ..~.~/...A. ........... Height ...~/..~ .............. Number of Stories ........ ~/.~, ............................................................................................. r. N/A O:mensions of same structure with alterations or additions' Front ..... [~/.~¢ ........................ Rear ........................ Depth .....N../..A. ..................... Height ............. ~[/.~, ....... Number of Stories ........ .N/...% ................ 8' 8 Dimensions of entire new construction: Front ..... .1..2. J ......................... Rear ..... ..1.~J. ............. Depth .............. Height ...... ~. ............ Number of Stories .......... .3~. .................................................................................... 9 S~ze of lot: Front ....... .1..1..Q ............. Rear ........ ~.Q ..................... Depth .... ~..0..0. ............... 10 Date of Purchase .....J. ul,y...!6.,...1.c).7.~ ................... Name of Former Owner 11. Zone or use district in which premises are situated .................... 12 Does proposed construction ~iol~te any zoning law, ordmance or regulation> ....... .[.~..o. ........................................ 13 Name of Owner of premises .~.~./,cl, F~..t,...P. .... .L.~,t?~..Address~P~...,1...~.C~X...!~!~ ........... Phone No ?. ].~. .-. .6. .2. .2. ..5 Name of Architect ........ .N./...A. ..................................... Address .................................Phone No ............... Nome of Contractor ...... .[.~../..A.. .................................... Address ....................................... Phone No ................ PLOT DIAGRAM Locate clearly and d~st~nctly all buildings, whether existing or proposed, and ind,cate all set-back dimensions fro~ property hnes. Give street and block number or description accordmg to,deed, and show street names and indica, whether ~nterior or corner Jot. ~ -/~ !/CC/-/ £,4/V~ ~ ) 3.4 STATE OF NEW~YORK~ 1¢¢ (: -~ - COUNTY OF ..Qh~..f.Q~k ............. J' ~'~' ........... ~.i~e.~..2.....~a~k .......................................... bemg duly sworn, d~oses and says thaShe is the apphcc (Name of individual signing apphcation) above n~med. · ~7~~; that all statements contained ~n this application are true to the best of~owledge and behef; tha~ the work w~ll be performed ,n the manner set fo~h in the application filed therewith, neF Swam to before me this ~/~ day of FIarcb 19 ~1 ..................... ]'"] ..................................... ' ....... . ............ ......................... Natal/~b~i~, . .............. ~.O~k .............................. Coun~ / ~ (Signature of applicant) ~' ~ / ~~ . ~ ~IOHARD F, LARK z/~¢~ //~ ~ARY PUBLIC State ef N' w Y~r~ ~ w ~ Ne, 52-7432500 - Suff~IR ': Oommissmn Expires ~"