The URL can be used to link to this page

Home My WebLink About7165-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~836 Date 19. L:S.I~o THIS CERTIFIES that the building located at ............................ Street Map No.~&.~.~.:...~.~... Block No ........... Lot No. Pal't 10~ C~ltehog~ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... l~a~..? ..... , 19. ~ pursuant to which Building Permit No. 716~Z dated ........... &P.~.t.!.. ?.., 19 .... ~1~ , was issued, and conforms to all of the ~quire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is l~t~ate aeeessory (storag® - tool)shed The certificate is issued to Wi!liana & Margaret Phelo~ Jr (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER .............. Street .......................................... (THIS PERMIT MUST BE KEPT ON THE PP, EMI~ES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7165 Z at premi~e~ located at /~03 L,.I LAC~. Building Imi~'. F.~ $! BUll. DINe ~.fARTMINT TOWN GLIRK'$ SOUTHOLD, N. Y. ..................... Approved / 'r 19......; Permit No. Application No....i:/:;~..~..~..~ ....... i.....~'~ Disapproved a/c ............................................................................................. (Building Inspector) APPMCATION FOR BUILDING PEIt~AIT ~ · / Dat ............................ ~....d ............. , INSTi~UCTIONS o. This aPplication must be completely filled in by typewriter DC in ink and submitted in triplicate to the Building Inspector, with 3 .sets ~f plans, accurate plot plan to Kale. Fee according to schedule. b. Plot plan sh6Wing location bf 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 Cou.n. ty, New York, and other applicable LAWS, Ordinances or Regulations, for the construction of buildings, additions or alterahons, or for removal or. de~o!!tion, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, houstng code, and regulations, and to admit authorized inspectors on premises and ir) buildings for necessary inspections. (Signature of.applicant, or name, if a corporation) .............................. ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner of premises ......~ -- -- ...~..~....~...L..~..~..~...:.....~...~....C...'.~..~ ............... Name of 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 Trude's License No ............................................... ~A~tT 0 F Il. Location of land on which proposed work will be done. Map No.:'..~..).l.~.~, ........................... Lot NO ........ /...~, .......... Street and Number ...... ~. .................. .~,..~:....../= ........................................................ .~ ........................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy .. V A c A ~/ .~. L A tV.D b. Intended use and occupancy ...... ..-~...?..?...L. ...... .5....~....E...~.. ......................................................................................... 3. ~Jqature work (check,which applicable):, New Building,,;.;:...-~.-.. Addition Alteration I ' Repair .................. Removal .................. ' Demoht~an..:.~....: .......... ,,~Other Work .................................................... (Description) ., ,~ 4. ,Estimated Cost ~7,0-~. i..'.'... '..~' ~ ~Pee ...; ...... (to'be paid on filing this application) 5,.' If dwelling, number o~ dwell)pg units ...... ..-Z .................. Number of dwelling units on, each floor ............................ ,, If garage, number of cars .......... ..-:T.. ........... :.....;,.: ......................................................................................................... 6: If business, commercial ~ or mixed 0~cuPancy, Speci~ nature and extenfof'each' t~l~e of use ....--. ........................ 7. :,.Dimensions Of existing structures, if any: Front .....-:T ...................... Rear ....... -'T ........................ Depth ..-~. ................ Height ........ ~ ............. Number of Stories .......~ ......................................................................................................... Dimensions of same structure with alterations or additions: Front ...=- ...............................Rear .....-~. ..................... '." .......-~:.. ....................... Height .....~ ................... Number of Stories ..~ ....................... ~. Dimens~oqs' of entire new construction: Frorff ....... I..0. ......................... Rear ....... L.~. ................ Depth ....~.(A ................ Height .....~ .............. Number of Stories ....J. ................................................................................................................ 9. Size of lot: Front ............. .~..{). ..................................... Rear ............ ~.(P. ........................ Depth ......... ~...~. ............... 1D. Dateof Purchase ............~.~..'**.'7.~:.1..~.~....~. ............ Nome of Former Owner .......... I~.~¢~.¥...~,.~.~.~/.~..~. ............... 1 ]. Zone or use district in which premises are situated ....... ~,~£ .............. I~.Li~......o..~....(?...~..~../s.~..~J~.~D.~. ..................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ..J~.~ ................................................ Will lot b~,regmded ...,~,..1~. :.~. ....... .,..... Will excess fill be removed, from premises: ( ) Yes ( ~ No . ~,m~ oLC~,r of nremises ...~..¢....~,~ ..... Address :.~.e~,N.C,~.~/~. Phone No..8.~.;.~=~.0....~' Name of AKhitect ...... ..~...~..~ ............................................. Address .........--'. ...................... Phone No ....................... Name of Contractor ...,~..A.~I..¢~ ............................................ Address ......; ......................... Phor~ No........~ .............. PLOT DIAGRAM · Locate, ¢leorly'.'an~istlnctly all buildings, whether existing or proposed, and indicate all set-back dimensions frolm property lines, Gf~ ~ and block number or description according to deed, and ~how street names and indicate .13; 14. O0 ',V No.'T'eS b STATE OF NEW'YORK, ~ c c : (~0UNTY OF :':'"":';"':';'"'"'~'::ml:::?'" ,. '~' .................... ~ ........ ; ........... ~ .......................... ; .......................... being duly sworn, deposes and says that he is the applicant - - :(Name.~of · ndividua! ~ighing contract) ' above nem~d;' He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer· etc.) of sbid owr~er 6r owners, and is' duly authorized to 'perform or hove 'l~erformed the said work and to make and file this aDolication; that all statements Contained in this application are. true to the best of his knowledge and belief; and tP, ar' ~'fi~"~9~tk*9/~lt'be 'perfotmeld in the manner set forth .i~ the applicat[olq filed therewith. *~ Swam to be ~{qre me this , . ........................ day of ........................................... ~, 19.....!.. Notary Public, . ................................................... County .................................................................... : ............................ ~ITH T. BO~ (Signature of applicant) -j ?g&? OF ~/As~gAU FAR/9..9 IN TH~ $1~FFOL~ COU~JTY C~F~t.e. R~ fgAP ~V-e I1'~