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Home My WebLink About8701-z~ORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~..7.~..0.8 ..... Date ............. .~.u~. y. ..... 6. ...., 19.76. · THIS CERTIFIES that the building located at . Lir~da. l~c~td ............... Street Map No. ~.ap~. Kidd.. Block No ........... Lot No. 12;~ ..... Mat.¢~..t.l~:...N...Y... ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... J~.nc.. ,2~9 .?.f~. pursuant to which Building Permit No.. dated .......... J.u.~.y...6. .... , 19.~.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .t~rl~n.te.. ne. za~zJ, y..4we:L;L~ng .w~.th .au. ~ctd2.t:ton ................... The certificate is issued to ~T.a.m..e.~. ~9.r.k .....0~nez, .. i ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~[~.~t, .............................. UNDERWRITERS CERTIFICATE No. ~.,.~, ....................................... HOUSE NUMBER ...... ~ ~ 0 .....Street ... LSw~s. · 3oad ........................... ing Inspector ! FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8701 Z Permission is hereby granted to: J~mes ~ork ....... ~. J. ~k~.~, ~...~ ~.c,I .......... ~.~'~.$.t, ,~.~ ~ ~:,, j,~. ...................... at premises located at ...L..O.t,....~.~......~.~t~.~....K.~.d,~..~.~ ..................................................................... pursuant to application doted ........................... ~..'~...e......2..LI: ........... 19...~.~., and approved by the Building Inspector. Fee ,..J.~ ......... Building Inspector / -. YOUNG & YOUN~ 400 OS[RANDER AvF'NU~, R FOR: TOWN OF -qOLITHOLD OFFICE OF BUILDING INSPEOTOR TnWN OLERK'S OFFIO~ S[]UTHOLD, N. Y. 11971 June 29~ 1976 Mr. James York Linda Road Mattituck ~ N.Y. Dear Sir~ on home There ~as no fee for permit enclosed. Kindly remit ~ 20.00~ ~ 1%.00 for permit certificate o£ occupancy for completed addition. Your application for permit to build an additi~on (deck) at lot 122 Capt ~,id ~3states received. truly Sr Building Inspector Yours and ~ %o00 for ~amlnecl ......................................... I~ ........ IUILDING NFAILTMIKr TOWN CLIRIC'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ..................................... Disapproved a/c ............................................................................................ op,icatio No. (Building Inspector) APPUCATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter . in ink and submitted in triplicate to the Building Inspector, with 3 sete of plans, accurate plae plan to scale. Fee ~ing to schedule: b. Plot plan showing location, of lot and of buildings, on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout of PraPetty must be drawn on the diagram which is port of this application. c. The work covered by this application may not be commenced before issuonce of Building Permit. d. Upon approval of this application, the Building Inspector wiU 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 port for any puq~ose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issua,nce qf a ,Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New .York,'~nd other~ol:gicable 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 laws, ordinances, building code, housing code, and regulatlom, and to admit authorized inspectors on premises and in buildings for necessary impections. /'7 ( I~tura of applicant, ~me, if a corporation) ....... ........ ........................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... ................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of coq~, rate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which propeE, ed work wiU be done Map No.: .....-]....~...-...~. L.O. ........... Lot No. l.~ ............. Street and Number ....L.x..~d:~,.....~: .......... i..~.....,~.o ..................................... ~3,.~. '.~.c.~, ............. Munlcipolity State existing use and occupancy of premises and intended use a. nd occupancy of proposed construction: a. xisiting ond occupon , ............... .................................................................... b. Intended use and occupancy i ................... ..~....~;....~....I, ................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition ....~'-..... ....... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (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 ............................ existing structures, if any: Front .............. ~..~. ...... Rear ....... ¢~...~. ................. Depth ,~..~... ............ 7. Dimensions of Height ........................ Number of Stories .....~, ..................................................... -- -- ~, ...................... ..... .................... Dimensions of same structure with alterations or additions: Front .................. ........ Rear ....... ~ ................. 8. Dimension,~ ~f entire new construction' Front; . ..'~,,...~..... ........ Rear .......... ~'.'~r ......... Depth ..,.,~.{lo ............... Heig~tt .................... Number of Stories ......... ...;~.. ........................................................................................................ 9. siz; of' lot: Front --.--_t., .~.~) Rear ~G De~th 11. Zone or use district in which premises are situated ..................................................................................................... 12~ Does proposed construction violate any zoning law, ordinance or regulation: .... ,~f,....(~. ........................................... 13. Will lot be regraded ...... ~..~.. ............ Will ex~ess fill be removed from premise~; ( ) Yes (V Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-I:x:ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ c c COUNTY OF ................................ )' '"'~ ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .......................................... ; ...................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained Jn this application are 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 ........................ day of ............................................ , 19 ........ Notary Public, . ................................................... County (Signature of applicant)