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Home My WebLink About6979-zTOWN OF SOUTHOLD BU1LDI~G DEPARTmO~ Tovm Clerk', O~iee Southold, N. Y. Certificate Of Occupancy ................ ."/% ~ '..l' ~ '[' ~ ....... ' '~ .... THIS .O~..~.~. ~t the building located at ..~~.~ .~..~.~/~Street Map No.. .~. 'Block No ........... Lot No. . ........ conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ....................... , I ., was issued, and eonform~ to all of the z~luh'~ The certificate is issued to ........................................................ (owner, lessee or tenant) o! the aforesaid building. Suffolk County Del~-i~ent of Health Approval ~ous~. ~ ..... /5~;,~: ..... '" .................... ....... ~... ~-~ ~.~;~.~ ....... FOF, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6979 Z Permission is hereby granted to: .~b..~........~..~.d....~.... ............................................. ...... .~.e~atm~..~l .................................................. ~o. ~.....~.......a~...d. ~.~ ~..o.~...g~.. ~ta~..~c c.e ~oz~.. hut3AJ~ ....................................... at premises located at ...~..~.. ...........II~l~u..P.a;Lnt..~p ........................................................ ......................................... .T.e,=.a.~.~..~ad, ......... C'~d~ho~ue ....... ]L.:~,, .......................................... pursuant to application doted .................... .~....g~-. ......... .8. ................ , 19.[/~.., and approved by the Building Inspector. Fee ~..0..~....0~.. ............. Nailing along rafters (all panel~,): 15t' on center For FilorI-Stripesand Sunguard: t~,~ ve~tlea~ lille, strr[~ on TOWN CLERK'S OFFICE ( ' ~' ~'/'; ¥ ~/~0. 2 ~ ........... , · Disapproved o/c .............~~ Date ................. ...... a. ~is a~licati~ must be completely fill~ in by ~ewriter o~ n nk a~ s~mi~ ntr p i~te Ink,tar, with 3 ~ of pl~, accurate plot pl~ ~ ~le. F~ acco~ing to ~h~ule. b. Plat plan ~ing I~ation of lot a~ of b~i~s ~ premises, relationship to ~jo n ng prem areas, and givi~ a detail~ de~ripti~ of iayo~ ofp~ must be dr~n on the diagram which is c. ~e wo~ c~er~ by this a~lication ~y n~ ~ comme~ed before i~uance of Building Pe~it. . U~n oppmv~l o{ ~i~ opplic~fi~, ~h~ ~uildi~ In~or will i~u* ~ 8uildin~ ~rmit to th~ ~pp c~nt. Such p~rm t *hall ~. ~o build~ ~h~ll be ~cupi~ or u~ in ~o1~ or in ~ {or ~n~ pu~ose ~h~t~r until ~ ~{1~ ~h~ll h~w ~n flmnt~ by th~ 8uildin~ In~tor. A~LICATIO~ IS HfiRSBY ~Dfi to th~ Buildin~ ~p~m~nt {or ~ i~u~nc~ o{ ~ 8uildin~ 8uildin0 Zon~ O~inanc~ of th, To~n of ~ld, Suffolk ~n~, ~ Yo~, ~nd ~h~r ~lie~l~ ¢~oul~fi~,, {or th~ co~truction of buildin~ ~dd~fi~ or ~l~ration~, or for mm~l or ~lfi~, ~, h~l~ ~rl~. n~ ~ppllcont o~r~ to comply with ~11 ~lic~b~* I~, o~i~, buildin~ c~, h~ ~, ................. ......... .......................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of 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. ~ ........................................... 1. Location of and on wh ch prgpased we~k w be done Map No · e , At kt- ~ ~'/ Street and Number ....... .~..~ ~ ...................................... ~/"'~/'v ,~u ......................... ~'"' Municipality 2. State existing use and occupancy of,~l~.is.e~)~n.d/~tended use and occupancy of~[oposed construction: b ntended use and occupancy ..~ ~ ~~ ~.~f~ 3. Nature of work (check which applicable): New Building Addition .....~..~...... Alteration ....... .- .......... Repair .................. Removal .................. Demolition .................... Other Work ' o ,D.c,,pt,on) 4. Estimated Cost ............................................................ Fee ............................................................... (to be paid on filing this application) ~' 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garagq, 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 ............................ R~ar ................................ Deptl~'~ ...... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... /..~ ................... Rear ..... /..~ ............. Depth .~ .............. Height .................... Number of Stories ........ ~ ........ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ....................................................... c?Aa~e .<~C. or~n~ Owner ........................................................ ! 1. Zone or use district in which premises are situated .....4~.........~ ................................................................. 12. Does proposed construction V~Av~any zoning law, ordinance or regulation: ........... i~ ................................. ']3. Will lot be regraded ............~.~/~'"' ~1 ~ejess fill be removed fr°/9) P~m' .~es: (_)Yes ( )No 14. Name of Owner of premises ..b~.~.../~...~ Address ~ ....... Phone No .........~[.i .......... Name of Architect ................. ~ ...................... Address ................................ Phone No ....................... Name of Contractor ........................................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposeo, and indicate all set-beck dimensions from property lines. Give street aqd block number or descriphon according to deed, and show street names and indicate whether interior or corner lot. ~ t~, JUDITH T. BOKEN Public, Slate al~ New York 82-0344963 Suffolk Count~/ Cemmlulon Expires March 30, STATE OF NE~~ [S$ OF ........................ /-,~X .z4~...'o~;....~....'.~:.7. .............................. being duly sworn, deposes ond soys thot he is t~ ~pplic~nt (N~of i~ivid~l signing controc~ above name. ~_ ~~ He is the ............................................................................ (Contractor, agar, co~orate officer, etc.) of said owner or ownem, and is duly authorized to perform or have performed the said work ~d ~o ~ke and file this application; that all state~nts contained in this application are true to the best of his kn~ledge and belief; and that the work will ~ ~rformed in the manner set fo~h in the application filed therewith. .S...~..~..t..~..b.~.f.~,/~., ..... ~~....~....., 19.~ .. '~..., ' ~ ..... ................ (Signature of applicant)