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Home My WebLink About8634-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . l~sl~a- Drive ............. Street Map No. Deel~ '~el, .~l°ac~l° ........... Lot No. ~... ~$ti~ek. - .N,Y, ......... co~o~ subst~tially to the Application for B~lding Permit heretofore ffl~ ~ this office dated .......... '~e' '~0' ' ', 19 '~6' p~su~t to which B~ld~g Pemit No. ~6~ ' dated .......... ~e...~0..., 19. ~6, was issued, ~d conforms to ~ of ~e req~ ments of the applicable provisions of the law. The occup~cy for wMch this ce~fficate ~ issued is .Pr~e..o~e..Camily .dw~?~,in~. ~tth. t~ek. a~d/~t~ ............... ~e ce~fficate is issued to . .J~cl~ .~,. Oeecb~ti ...... ~e~ ....................... (owner, lessee or ten,t) of the Moresaid bufld~g. S~olk Co~ty Department of Heal~ Approval . .~, ............................. UNDERWRITERS CERT~ICATE No..~.R, ....................................... HOUSE N~BER .... ~g0 ....... Street .. Do~a. D~v~ ....... ~t~S~ ........ FOI~I NO. ~ TOWN OF SOUTHOLD / BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8634 Z Permission is hereby granted to: ................ ~.~.s..~ .......... .............. ; ...... : ......... : Building Inspector. Fee $~ .~.~...~.,. ............ Examined Approved BUILDING DEPARTMENT( TOWN CLERK'S OFFICE ~ SOUTHOLD, N, Y, ............ Disapproved O/c ~ APPLICATION FOR BUILDING PERMIT 0 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter o~' 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 show ng Io~ation Of lot and of buildings on premises, ~eJationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this app ication. 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. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~.~g~..~...(~e.O. Cib~3~ ......................................................................................................... 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. Deep Hole ...... Creek Estates Lot No 25 Location of land on which proposed work winoe sane. nnap r~o.: ................................................................. Street and Number ....................................................................................................................... 460 DOnas Driye ~e.~JG;~.JL~q.~. ...... Municipali~ State existing use and ~cupaocy of premises and intended use and occupancy of pr~osed construction: a. Exisiting use a~ ~cupancy O~e fa~l~ dwe~i~ b. Intended use end ~cu~ncy WO~ S~. ~,~ .............. ..; ...... 3. Nature of work (check which applicable): New Building.. ................. Addition ][ Alteration Repair .................. Removal .................. Demolitio~ .................... Other Work ..... ~O...O~.....~.~...~....~..~..~...~.~....~...]-,6- - (Description) .................................................................... 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 garage, 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 ........~..9.. ................ Rear ...... ~.~ ..................... Depth ...~.~ ............. Height ........ .]:.8. ............ Number of Stories ...... .]'..4 ...................................................................................................... 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 ............ .]....]:..0.. .................................... Rear ........ ..1..]:..0. .......................... Depth ....]:..8...~. ...................... 10. Date of Purchase ....... ..3./...9./.?..6. .................................. Name of Former Owner ~.~...~.q.e.~.....R..o..~.e....~.o...~..e...~.~....Z..~...e.. 1 I. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation'. ........ .~.¢. ........................................... 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14, Name of Owner of premises Jack J. Cecchl~i Address 460 Domla Dr. Phone No. 298-8491 .................................................... ~A"~,'i~,'Q~ 1~ ............................... 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 end indicate whether interior or corner lot. STATE OF NEW YORK, t~c COUNTY of ....... :3.tt£f'Olt~.' ....... .......... . ....................... ~.~tc,l~..~....Cle,~a~:~l~5. ......................... being duly .~wom, ~poses and says that he is the applicam (Name of individual signing contract) abow~ named. He is the ................................... .q~e~. ................................................................................................................................. (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 ~nd file this application; that all statements contained in this application'are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Swam to before me this 9..~.~ / ~ ' ~'~-~ ......... J.O.t~ ..... day of ..J.~e ................................ ,1 Nota~ Public,. ............................. ~ ..... Coun~ ~~ ................................. NOTAI1Y P[JB[,I~, State of Ne~ Yatk No 52-~1~5~0, Suffolk Co~ty T.~m Ex~l~ Marc~ 3o, 1~