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Home My WebLink About6844-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ZI~023 ..... Date ........... THIS CERTIFIES that the building located at . 0~.ehard Si; ............ Street Map No. .. Icc .... Block No .... :r.x. Lot No. xx~.. O~ien¢ .. · I~,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~pt . ~ , 19.73. pursuant to which Building Permit No.6~[~¢Z. & 681+~Z dated ' 'Sept~' · · 6 · ", 19,73 ' was issued, and conforms to all of the require- ments o£ the applicable provisions of the law. The occupancy for which this certificate is issued is 'FTiva~e' one family- 4wet. t~-~g wi.th, ad4ition .& ~ew. A~es~o~y. building_ The certificate is issued to 141~ &. Mrs. Dona.ld S~,. Saint .... Owners .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.,R., ...................... UNDERWRITERS CERTIFICATE iNTo. lXe~il~ .................................... HOUSE NUMBER 1+30 ..... Street ....0x:ghar. cl. Sl;;r. eet; ...................... FORM NO. 2 TOWN OF SOUTHOLD 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? 6844 Z Date ............................ ~le]).~ ....... & ........ , 19.~3.. Permission is hereby granted to: .... · 1.~2~....~.....~.~.~wa~ .................................... ................ ~.~tb~p. ton ................................... to...................build ~.n........~.~.~. . ..~ .. ezia~JJ~g., dw' ,~a~]Ax~ ........................ : .................................. at premises located at ..-'q/~.-..~ ,J~.~-.~t~ .............. ~ ..................................................................... ............................................ g~e~t....~ ................................. ~ ..................................................... pursuant to application dated ........................... ~j~Ji ....... ~ ........ , 19..~j.., and approved by the Building Inspector. ~ Fe~ ~...! .P.:.~ .......... INSTRUCTIONS a. This application must be completely filled in by typewriter off in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship.to adjoining premises or public streets of areas, end giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this 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 o Building Permit to the app cant Such perm t shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa rt 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 a Bu Iding Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suff01k County, New York, ~and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or,demolition, o~ herein 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 neces.sa~7,_inspecti~ns. · ' , , ° fpo 'o ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................ ............................................................. Nome of owner o' premises ...... .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ................................................. ~.. Plumber's License No ........ ....~.......!..~.~. ...................... Electrician's License No ...... ~.....~.?.....~... ..... Other Trode's License No ............................................... 1. Location of land on which proposed w~ork w~ll be done. Map No.: ...................... Lot No ~ . . Street and Number ....~..~....O.........~....~.~..,~k?......,.~...~.:....~..,.~..~.~/;.~a/3~::° ' .............. ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of prOPosed construction: o. Exisiting use and occupancy .../........~..~,~...,...~..~.~...~'..~.., ..................................................................................... N..~'~. ~-...z:., ~r~' e.. ..................................... .~.. .,e.,e..,,,.,.~ .~.=.~.~ ./-z'..~ Z, ~ ,,,..~ b. Intended use and occupancy .......................... .~.. ! RepaJr~j ....... ~. .... Removal .................. Demolition .................... Other Work ....................................... . . (to be paid on filin~ this application) S. If dwelling, number of dwelling units ............................ Number of dwelling units on ~zch floor ............................ ~ If garage, number of cars ............................................................................... ~, ............................................. 61 If business, commercial or mixecl °cc~/pan~y, specify nature and each type of use ..~...:...~.,.: ........... 7. Dimensions of'existin~'structures, i~y: Front ...~,'..~..... ....... . ........ Recur ................................ Dept~..... ............. .. ....... ...................~.~.~.....T.~ ....................................... ~ .................. Dimensions of same structure with alterations or additions: Front .~...~... ....................... Rear .~. .......... Depth ................................ Height~."...../..~. ............. Number of Stories ..... ..~...~'..~. .................... 8. Dimension,s~f entire new construction~. Front .~.....J~.....~..~...;:.:..~;L....;'.:: Rear .../~......~...~'. ............ Depth ...~.. ................... 9. Size Of lot: F~ont ...~....~...~.~. ................ ~......~ .............. Rear ..'..7.~..~..~,.....~...~ ................ Depth ../..~:.*...~... .......... 10. Date of. Purchase ..................................................... Name of Former Owner ........................................................ 1 1. - Zone or use"~strict in which premises are situated ..................................................................................................... 12. Does-i~r0jdo~ed constructio~ violate any zoning law, ordinance or regulation: ........................................................ ]-3. Will lot be.~egrad~'d~..,. ......................... Will excess fill be removed from premises:~ Yes ( ) No 14. NomeofOwn ro premiSes,._..~.~.. ........ ................... Address: Nome of Architect ...~ ......~ ........................................ ~ ........ Address ~ ............................. ~ Phone Ne, ...................... Name of L~ontrOcTor ....................................................... , ................................................................ PLOT DIAGRAM ' ~ and distinctly all buildings, and indicate oil set-back dimensions from ~l~ber or deed, and show street rmmes and indicate N ~*~'OF ¥OR~, ~SS ,~ ~'-*OU? ~.~V..* ........................ ~ ' ~'%~i:~.LLi:;..":%..~ ......... : ............................................................ being duly swam, d~oses, andsays t~t he is the applicam ~2,' : (Nam~ ~ ~vmdual smgm~contrac~ above name, He is the ................................................................................................................................................................................ (Contractor, ag~t, co~orate officer, etc.) of said owner or owners, and is duly authorized to per,tm or have performed the said work and to ~ke and file ~.this application;-that ~H'stotemeqts contained in this appli~tion am tree to-the best of his knowledge and belief; and ~thaz the wbrk will be performe~in the manner ~t fo'Hh in the application filed therewith. Swam t~-me this // , __ ~ ~ ~ ......... ....... ............... . Nota~ Public~,_-- -- ..- .......... ~ ~gun~. . .......... ~..~.=~ ................ t ............ ~ .................... ~_ ~ ~ (Signature of opplicont) ~ ~f New ~r~