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Home My WebLink About6910-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No...~.6.1.0. .... Date ......... 0. c..t0.b.e..r' ?.6.~. ...... , 19 .7.3.. THIS CERTIFIES that the building located at ...~..~..n..R.o.a.d. ............... Street Map No...'.~. ........ Block No .... .XX. ..... Lot No..~. .... C..u.t.c.h. gg.u.e. ................ conforms substantially to the Application for Building Pemit heretofore fried in this office dated ....... 0¢~;,..2! ....... , 19 ~. pursuant to which Building Permit No...6.~.]...0.Z. dated ....... Oct.,..2~ ........ , 19.7.3, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is . .Pr~.v. ate. Acce~.aory..($1;o~.~ge~l~],dge ................................ The certificate is issued to .... ~To~.ef. ~WI~ ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval NoRo UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER 3606~; Street ~aln Road Cutchogu® Bmlding Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Fl,. Y. N°. BUILDIN~ PERMIT (THIS PERMIT MUST BE KEPT ON T~IE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) 6910 Z Date ', ................... ...~..~..~.~.~..... ~, ........... , Permission is hereby granted to: ......... ~..~.~.o..~.... ................................................ ~o ..]0.ti;~d..z~e~z..a~s~a~e~e...C/u~ca~A~:.~..~rt~! et.tn~ ....................... ' .................................... at premises located at .~r4,~fi...~gB. fJ ..................................................................................................... ..................................................................... m~t¢.hel~e ..... 1I..¥.~ ....................................................... pursuant to application dated ...........................0..~ ....... .~.. ............ , 19~..~...., and approved by the Building Inspector. ~OB~ NO. 1 TOWN OF ,~OUTHOLD BUILDING DEPAItTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ~ ~' 19.~.,~.,. Permit No. Disapproved a ...................................................................... ~ ~- APPLICATION FOR BUILDING PEP. MIT Date ...~ .................... ,19...?...~..... INSTRUCTIONS ng~ a. This application must be completely filled in by typewriter or, in ink and submitted in triplicate to the Buildi 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 or areas, and 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 a Building 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 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the cor~truction 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, and to admit authorized inspectors on premises and in buildings for necessary inspections. ....... ~* ................ *~ .............................. .// ........... .,,~,. ,,.,..T~_ eth~er~d ~ (Address of applicant)~/ f State wh app icant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber o~; builder. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Locat on of and on wh ch~oroposed w9~rk w~ be done. Ma~ No ......... Lot N= Municipai~ty, State existing use and occupancy of premises and intended use and occupancy of prop0~ed construction: b. Intended use and occupancy .................................................................. 3. Nature of work (check which applicable): New Building ...:~i ............. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition..; ................. Other Work ...................................................... (Description) 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelJing, 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 .,...~.-..~...~..~eight ...................... ~,....Number. of Stories ................................ __ 8. ~-' .-.~._...?~.~ , .--~'~"°~'~-~- ~nnst~*~-. .... Front ........ /....~ .... ~. Rear ............................ Depth ........ i.~...,~.... Height ......../:..~....~.. Number of Stories ................................... ; ..................................................... ; ........................... 9. Size of lot: Front ........ ~ .............................................. Rear .......................................... Depth ................................ 101 Date of Purchase ...~.....~: ....... : ..................................... Name of Former Owner ........................................................ 1 I. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will Jet. be regraded, '.~.;;.~...~...'.......~....r.. Will excess fill.be removed from~premises: ( ) Yes ( ) No 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contracter ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM L0~ate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner 10t. STATE OF NEW YORK, COUNTY OF ................................ ~'~'~ ............. ~ ................................................................................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing contracf) above named. He is the ................................................................................................................................................................................. (Cgntroctor, agent, corporate officer, etc.) of said owner or owners, and i~; duly authorized to perform or hove 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Swam to before me this Notary Public, . .