The URL can be used to link to this page

Home My WebLink About7431-zFORM NO. 4 TOW3~ OF $OUTHOLD BI.~.r~ING DEPARTn~k~'T Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~,6~1.h- ...... Date ............J..ul~.....2,~ ...... ,197.~.. THIS CERTIFIES that the building located at . ~edar..P. oirtt .~'~es.t .Dr .... Street Pk Map No. Ce~ta~..I~eachBlock No ........... Lot No. ~5 .....~ou.thQld...I~,[.'. ....... conforms substantially to the Application for Building Permit heretofore fried in this office dated ............July.... 23 19.71+. pursuant to which Building Permit No..~1+~17.. dated ..........,~u1¥ .... 23.., 19. ?.l+., 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.r.~.v. ate. one. £amiZ.y..dwe~lling. wi. th. an .adcl~tt~on .................. The certificate is issued to . .Ph:[~,p..GJ,(~I'~i~ ..... 0wlae~'. ......................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .N.P~, .............................. UNDERWRITERS CERTIFICATE No. N., .H.. ........................................ HOUSE NUMBER ...1165. ...... Street .. C.edar. P. oin.l; .~/es.t .. D.~;tve ............ IUI~ ~MiHT 'TOWN CLERK'S, oFIqc~ SOUTHOLD, 19. Y. BUILDING PE~J~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FUI~L COMPLETION Of: THE WORK AUTHORIZED) N? 7t31 Z Permission is.hereby granted to: ..~I~,;L~...§},..~,~....~.. ......................................... ............... .~.l~ ...?.~:~D...t.. Ld.]~,~.v.e v.e.,s...t. ..... ~outhold pursuant to application dated .......................... .G;~,~. ....... 2.~ ....... , 19.~......, and ~ by '~he Building Inlpector. IFOBaf NO. 1 BUILDING DEPARTMENT TOWN CLERK'S OFFICE .~ SOUTHOLD, N. Y. Examined ...... ~......~......, 19..~....~. ,,pprovad ....... ! ................. . rm,, Na. ......... Disapproved a/c: .......................................................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................................................ , ........ o. This application must be completely filled in by typewr ter or in ink and submitted in triplicate to the Building nspector, with 3 sete 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 ox areas, and giving a detailed description of layout ofpraperty 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 construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .... ~.6.~,tt. McDonald ..A.,.v..e., ]~rpo]cl~n 11230 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O,mer Name of owner of premises ..P~lil~,~...~,.~.~.no 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 -q-e-.d...a-r.....B..?.~achw.P.k~ Lot No 13~ Street and Number 116~ Cedar. Point Dr West Southo-~'""~;z;' ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..d. wellin$ b. Intended use and occupancy .... .s. ame with an addition 3. Nature i p licable): New Building.. ................. Addition .....~[....~.Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ...~.~...?..0..0. ........................................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ....... .O...~..e. .............. Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................... r 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 ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: FrOnt ............ .1~ ................... ...... ............... Depth .J,.0. .............. Height .................... Number of Stories ...... O~t~ .......................................... ~'. ................ ; ............................................ 9. Size of lot: Front ........................................................ Rear ............................. :~.. ....... Depth ................................ 10~ Date of Purchase ,,, ................................ ~.,~:a ...... Name of Former Owner ........................................................ 1 1. Zon~:~'s~d~strict m wl~tcl~ ptem,ses are s,tuated ..~L~?...~I.S.~ ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~g ................................................ 13. Will lot be regraded ....... ,~g. ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ~.h~ 1'I ]:)...~;[.Q~'~l.a,13,Q ............... Address .~Z'.~.g~,~r~ ...........Phone No ....................... Name of Architect .............................................................. Address ................................ .P?~' No ....................... Name of Contractor .....s..e....~...e. ............................................... Address ................................ PLOT DIAGRAM Locate 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 shaw street names and indicate whether interior or corner lot. STATE OF NEW,~L~.,,_ COUNTY OF .....~...1~....~.?.~ ........... ' ...]~...~.~L~ G'I .O..?.~..a~..~..O ....... be n duly sworn, deposes and soys that he is the applicant (Name of individual signing contracf) above named. He is the ......................... Ok~e3~ ............................................................................................................................................ (Contractor, agent, corporate officer,~ etC.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that oli statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................. o, Notary Public,~.,..,/,,,..,'~.~nty ~.-,,;;p?~-~,,-.;~ .. ..... · .......................... r~ JUDITH T. BOKEN ~gnarure or app.carn~ Notary Public, State of New York No. 52-0~44963