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Home My WebLink About6623-zFOI~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMI~,NT Town Clerk's Office Soud~old, N. Y. Certificate Of Occupancy No... z.~.~2 .... Date ........... Xugu~.t .Tt ...... , 19.7.3. THIS CERTIFIES that the building located at . .230. · .Bo~. Road .......... Street Map No.. D. td ,. l~.29t~[Sck No... XX ..... Lot No...13 ..... Nu~uakom~.. ~aterse..Southold · conforms substantially to the Application for Building Permit heretofore filed in this office ~lated ............. ~.. 2~.~, 19. ?j~ pursuant to which Building Pemit No... 662~Z dated ............. ~.t~e. ~,~., 197~., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. l~.lV~.~e .Aecesso~. [ltol'age)..Bu~ldl~s .......................... The certificate is issued to ... J~ules..Ids. D&~rsola .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ..-2~0 .BOt[... Street .. ~ow- Street ........................... ........................................... ...... FOI~M NO. 2 TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 6623 Z Date ............................ Jxm~.....~. ........... , 19..~.3.. Permission is hereby granted to: .............. James..,Da~sen ................................... ................... I~.2~(~-..-.]~w--.Re~ ............................. ....................... ~q~uk, h o.la ................................... to .... ~uJ.! ~...~ew...p r£~rata..a~c ~ s ~o~.7..hui3~.~ ng ..... .(.2~oo!..&...st~,~e.) .................... at premises located ut .........L~xt...l.3.....N.lxltxak~:~aa..M~.~se=s ............................................................ ............................................. 2~0 ..... B~w..:Road .............. ~a~thalc% .................................................. pursuont to opplicoHon dated .......................... Ma~-."-~. ............ , ]9...~.~., and approved b~ the Building Inspector. Fee $..:]-0.*.0~ ......... .Building Inspec~r ~ ~ TOWN OF SOUI'HOLD BUIL I G D RTMENT TOWN CLlttK'S omcl ~OUTHOLD, N. Y. Pamit No ...........~ ........................ qNSTRUCTIONS Date ............... /.~'~/.. .................... , a. 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 ecale. Fee according to schedule. .,~ b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, a giving a detailed description of layout of i~roperty 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. Upbn 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 be~n 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 appliceble lewd, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ' f'i~'~'~ of al'~icant, or name, if, corporation) (Name and title Of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... If applicant is a corporate, signature of duly authorized officer. Other Trade's License No ....................................................// / . . , 2, State existing use and occupancy of premises and int~use and occupancy of proposed construction: .. a. Existing use and occupant9 ......... .~...~.~r..~.~;:..:/ ......................................................................................... b. Intended use and occupancy ..... ~~ ...................... ~.~ ........................................................................... State whether applicant is owner,, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..me ..................................................................................................................................................................... o, ow. r ............................................................................. ............. -. i ....... 71'11- -3~. · Nature of work (check which applicable): New Building ............. Addition ..................... Alteration .............. Repair ............. Removal ............. Demolition ........................ Other Work .................................... ........................ (Description) \ ... F. ........... 4. Estimated Cost ...~.~. ............................... /., (to'l~ pei~l on filing this applica~i'~;~i ................................. 5. If dwelling, number of dwelling units .................Number 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 ................ .r .................. If Front ~.. Rear _~A,~ ~ ~ Depth ~.~ 7. Dimensions of existing structures, any: .....=.~.~_.... ...... ................. Height ........................................................... Number of Stories .........-rF .................................................................. Dimensions~r~a_me structure with alterations or additions: Front .......................... Rear ........................................ Depth .....~[7.;...'~.. ............................ Height ......................................... Number of Stories ........................................ 8. Dimensions ~f entire new c.o,7,,~,ruct, .o,7.: NFur~n~.~;/~t~o,;~;..::::: ,~,ea~ ::..~,.,~1,,:::!:::: ......... Depth ...../.?,. .................... Hei0ht.- ..! ................................... '. /. ................................................ 9, S ze of lot: Front .........~ ........................... Rear ................................. : ........ Depth .,.~ .......... = .................... ? ............. ..... .... , _. ..... _. ................ 10. uate oT rurcnase ...... .7.t{...l.t ............... m~m~ u~ rUH.~ UW~ .............. 7 ............ ~ ..... 1 1. Zone or use district in w~ich premises are situated ................................................ ~.,- ................................................ 12. Does proposed'constrbc~t¥on violate any zoning law, ordinance or regulation: ....~....~.. ............................................... 13. Will lot be regraded ............. ~ .......... Wille.xcess.~[ll beremoved.from premises: [ ] Yes [ ] No 14. Name of Owner of Premises .-.~'~./.~'/.....~/'"-'~-...~'~'~'~''~)''' ~'~ 'xx/'''~ ...... ~/"'~- .~"r-'~' '~''' (Address) (Phone ~1o.! Name of Architect (Address) ............................................................. (Phone No.) Name of Contractor .......................................... ~ ........................................................................................................ (Address) (Phone No.) 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 show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK~ ) COUNTY OF ....... . ,~'.~, ,~., .~..~... ,~,~,~, .................. ) SS ...~....~.... .............. (Na'~o~in~l~"s~'~'~'~'~'~')''''':'':r ......... being duly sworn, deposes and says that he is the applicant above named. He is the ............. ~....~.~....~ ............................................................................................................. '......~ ............................................. (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 ell statements contained in this application are true to the best of his knowledge and b~li~,~and that the work will be performed in the manner set forth in the application filed the~(~th. F- ': Z~ YV/EW