The URL can be used to link to this page

Home My WebLink About6516-zFO~,,M NO. 4 TOWN OF SOUTHOLD BUII.I~INC_. DEPARTI~ Town Clerk's Office Soutlmld, N. Y. Certificate Of Occupancy No. Z6~9 ...... Date .............l~z:oh .... 13..., 19.7~. THIS CERTIFIES that the building located at . Nase&u..Peir, t .Pal ......... Street Map No. Nasse..Pt,.. Block No ...........Lot No, . (~... ~ntchoin~e.. Ii,Y, ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........Ap:il...26., 19..73 pursuant to which Building Permit No..6.~1~.. dated .........&p~ll. a6 ...., 19.~., 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 P..riyat, o. one. fa~i. ly..dwel.l~g., witch. ,~ .edg. lt,~.o~ ................. The eertffic,~te i~ i~qued to ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk ~ounty Department o{ Health ,approval Ji.,ii.o ............................... UNDERWRITERS CERTIFICATE No. l~ q .n .d .i l ! ~ ................................... ~OUSE NUMBER ..... 8~ .~. .... Street ... ~ .P.~,~U~ .~, .................. · .:.:... ..... ?~ ............. B11i]alng Inspector FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6516 Z PermiSsion is hereby granted to: at premises located at ....L~t,..i~ ............... ~&l~'g...~&..]~"~'e~ ......................................................... ..................................... ~-~.~.~,S u~ ..~. ~t, .. ~d ............ ~u-t,o~'ee I~e ....................................... pursuant to application dated .................. ..~.p...~.~..1......~.~.. ............... , 19~..3...., and approved by the Building Inspector. Fee $.1. ~..*..0...0. ............ · ~Olg~ NO. I TOWN OF SOU'mOLD BUILDING DEPARTMENT TOW..CURK'S (%- 19 ........ Pemit No .............. Application No ................................. APPLICATION ,FOR BUILDING PERMIT INSTRUCTIONS e. This appliCation must be completely filled in by typewriter or in ink 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 lot and of buildings on premises, relationship to adjoining .premises or public streets or areas, and~ giving a detailed description of layout of property must be drawn on diagram which is pert 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 o 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 Zog~ Ordinance of the Town of Southold~ Suffolk County, New York, and other applicable Laws, Ordinencas or Regulations, for the cofl~truction~of-' buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ell al~icable ordinances, building code0 housing code, and regulations, and to admit authorized inspectors on premises and in buildinge for necessasy inagections. &Oaap~..De~koskl ............................................ {Signature of epplicant, or neme, if s corporation) ~attituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contrac tot Name of owner of premises .... .~.g,T...t;~.f~'....C.~IL~.~. ........................................................................................................... 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 Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No .............................................. Lot No..~ .............. E/8 Nassau Point Road Cute o ... Street and Number ........................................................................................ !~...~J~,,; ................................. , ........... ,; Municipalt~ 2. State existing use and occupancy of premises and intended use and occupancy of proP°Sed~construction: f use an nc dwellin · . a. Existing d occupa y ........................ ~ ....................................................................................... ~ ............... b. Intended use and occupancy ....... ~l. aJ~Le...~r~.~;h..a.~.~;e_~zt:~Lo~...&.Ac~l,:L~L:Lo~.....:.,. ............... : .......................... ~i ~J. :~lature of work (check which applicable): New Building, ....................... Addition ...3La. ............ Alteration.....AOCZ... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost 7.....~2.~OD......~. ......... ~.~ ......... Fee ....,.I[~,Q0 ................................................................................ . , (to be paid on filing this application) 5. If dwelling, num6er of dwelling units ...... ..o~...e...... Numar of dwelling units on each floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing ;~ructures, if any: Front .....................Rear ........................... Depth ................................... Height .................. , ....................................... Number of Stories ........................... Dimensions of same structure with alteration; 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 ..................................... Name of Former Owner ............................. 1 I. 'Zone or usa district in which premises are situated ....~,~..I;3J.$.1~ .............................................................................. 12. Does proposed con'ruction violate any zoning law, ordinance or regu at on ... ~ .................................................. 13. Willlot bere~'eded .~.9.., ...................... Will excass fill beremoved from premises: [ ] Yes [ .] No 14. Name ofiOwner of premises .....~tLme~'...ChtlJ;e. ................................................................................................. ~.: (Address) (Phone No.) Name of'~rchitect .............................. if'1~ (Address) (Phone No.) Name ~ntraCtor ........ ~.,...D.~.fl ~;~... ~ ..... .~..~.~ ~..~.g.o...Iii ............. ~ ........................................................... (Address) (Phone No.) PLOT DIAG RAM Locate clearly and dmt~nctly all 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 NEW YORK, I~tl/~fo~ ) COUNTY OF ...................................................... ) .............. · Tos.e.p.h Deerkoskl .............. ~']~;r~;';~;'i;gi'~,7~';~}g_~;4~;;j .................... being duly sworn, de~ses and says that he is the applicant above ne~. He is the B~lder (~n~ctor, a~nt, coyote o/fleer, etc.} ' of said owner or owners, and is duly authorized to ~rform or have ~rfor~d the said work and to make and file this appli~tion; that state~nts contained in this application are true to t~ ~st of his knowled~ and belief; and that tbe work will ~ ~Hormed in tbe ~n~r ~t forth in the ap~i~tion filed therewith. ~w.O~......day f ~Y ~R~te of New York o ...... : ........ ~.~ .............. lg f.~ ........ Nota~ Public, .~ ~-~i~ ~h ~, l~ ~ ~ {S~ of applic~t}