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Home My WebLink About6043-zTOWN OF SOUTHOJLD BUI.DING [ EPARTMENT Town Clerk's Office Sonthol& N. Y. Certificate Of Occupancy No. Z.~ll+.~ ...... Date .............. ~ .... !5., 19.73. THIS CERTIFIES that the building located at .. ~OllgVieW .La..&.ldatlerssd~rd~ty Map No. ~e.!'t'~ .W~rtS.,Block No ........... Lot No.. ~9 ........ ft~tl!;l!o!d .... I~ ~i ~.. conforms substantially to the Application for Building Permit heretofore .filed in this office dated ............. All§ .....~, 19 .~.~. pursuant to which Building Permit No. 60~3Z . dated ........... Al,lg .... 7..., 19.~., was issued, ahd conforms to all of the require- merits of the applicable provisions of the law. The oc¢~apancy for which this certificate is issued is . .&ocasso~..l~ilai~g.. (,s.t.~vat~. ~,~). .............................. The certificate is issued to Ii. arty..~ .tglala. J.o1~2~oI¥ ..... 01~lor8 .................. (iowner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval If.R, UNDERWRITERS CERTIFICATE No. ,l~ ,.R.* .............. ' .............................. ItOUSE NUMBER... lfig~ ..... Street .... Lo~l'i~lr. Lal~ .............................. 1+70 Waters Edge way Building Inspeclor [ FOI~ NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UT~-tORIZED) N°. 6043 Z Oa~e Permission is hereby granted to: to .......... ~Z~..-r,r,.~. .~'.~.,,~..., ~..:.../~..x./~. .......... : ................... at premises I~cated a,~ pursuant to ~pp~icotlon ~uild~n~ Inspector. ..... Inspector FOlt~ NO. 1 TOWN OF SOUTHOLD : BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ 19 ........ Pemit No .... Disapproved o/c ............................................................................................ {Build~n~ ~ns~ector) Application No, .,,,.~',.~...~'..~/....?.. ....... APPLICATION FOR BUILDING PERMIT ................... , :.......... INSTRUCTIONS a. This application must be completely filled in by typewriter or In in~< and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, and g~ving a detailed description of layout of property must be drawn on diagram which is part of this application. c, The work covered by this application may not be commenced before i~uance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a'Buiiding Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. ' e, No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector, APPLICATION tS HEREBY MADE to the Budding Department for t~e issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sauthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, add~tions or alterations, or for removal or demolition, as harem described, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections, ............. ....................... (Signature of~app)icant', or name.~,,~J~ a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, If applicant is a corporate, signature of duly authorized officer; (Name and title of corporate officer) ~, Location of Sand on which proposed work will be done. Map No.: .,~.~.,~'...~'~..'..,(-?.[~, ..~'.~,. ,~_.-~ ......... Lot No..~.~.. .......... w ......................................... · . - ..~..~,~,,,.,~.¢.~.,~,,.t ....... : ............. ~ ~unicipahty 2. State existing use and occupancy of premises and inteq'ded use and occupancy of proposed construction: ,. .......... ................................................................................ ....... u ....................... Addition ..................... Alteration ............... ..... .~ .. Remove ....... D~nolition ....... Other Work .................................... (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 ........................... Depth ................................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ............................................. Height ......................................... Number of Stories ........................................ Height ........... ~,..z. ................................ Number of Stories ........ .~.. ............................................................................. 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..... ~ ......................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~,..~. ........................... .../ ................. 13. Will lot. be regraded ' ........ ......// ~/ .'"~ ~/v~_Will~/~,excess~o~/fill be removed from premises: [ ] Yes~j.._~..~[;o] ~No.~.,~ (Address) (Phone No.) Name of ~rcmtec~ ................................................................................... (Address) (Phone No.) {Address) (Phone No,) PLOT DIAGRAM I'ocate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF N~EW Y/J~RK~, ~/ ~' ) CO U N Ty O ~ .~.~..~..~,... ................ )SS .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named, (Name o£ indi~dual si~fing contract) He is the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, of sad owner or owners and is duly auth~{)~a'y~ ~m or have performed the said work and to make and file this application; that all statements co3ta ned n th s app cat ~;~'~¢;?J~r'~*~{~°~"~ knowedge and ~ ief and that the work will be performed in the manner set forth in the ap~cation filed ther~r,n Fxplros ~m~1¥30, .............. ................ ............... ....... .......... Notary Publi~:Z~ ~ .............. L .~..: .............. Y ......................... ~];.. ~-.~:~-t? ................................. ~ ~S~amre o1 appn~nu