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Home My WebLink About8036-zFOItM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. X. Certificnle Of Occupnncy No. ~6.70.8. ..... Date ........... Sep. t .....2% ..... , 19. F.~. THIS CERTIFIES that the building located at Rabbit, l~al~e ............... Street Map No. xx .......... Block No. Y,X ....... Lot No, . :t, XX.. East. ~lariorl..N...~, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ a'~e...30., 19.7.%. pursuant to which Building Permit No..8.03~Z.. dated ............ Julia..30.., 19.7~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... P~.iva.~c~. one..family, dI~e;1.1111g..with .an. &ddlll,o~ ................ The certificate is issued to . .Hazard. &. ~,lber. ta. go. ok... 0~m®r8 .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N.:.R? ............................... UNDERWRITERS CERTIFICATE No. N. :.R., ........................................ HOUSE NUMBER ..... 8.~. ..... Street .. ~.b.b. ~..t..7~.~. .......................... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8036 Z Permission is hereby granted to: ---.H..~:.-'~..Ooo~ .................................................... ........ .Ra.bbi~...Lan~ ............................................. ....................... F. aa.C..~r~or, .............................. to .9.~.C.f,...ll~ll~.... ar~..aRd~ti~...( s.t on~ ge... sac .tlo~) ...on ..ex:l. at :Lng...d~ ~ ~ng ..... at premises located at ...$/~'.t~b~'~-'-l~a'l',® ..................................................................................... ........................................................................... ~.~ · .~a.r~:on ." "N '~.tf-'~ ................................................. pursuant to opplJcation dated .................. ~'.~,11~$ ............ ~ ........... , 19..~.~.., and approved by the Buildin~ inspector. Fee$1I~.~}O ............. ~uildlng 1Bspector ~ Approved .................................. i TOWN OF SOUTHOI~D /~,n r BUILDING DEPARTMENT'-~ ~'~'s TOWN CLERK'S OFFI~ ~UTHOLD, N. Y. 19.~ Application 19.~~ Permit N~.~...~.~.-~.~ .... INSTRUCTIONS o. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building~l~ Inspector, with 3 sets 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 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.,~ork. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Ce~ificate of Occupancy shall have been granted by the Building Inspector. APPL CATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the~ Building Zone Ordinance of the Town of SouthoJd, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of bui}dings, 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 regulations, and to admit authorized inspectors on premises and in buildings for n~essa~ inspections. ......... ........ ............................... · ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e{ectricion, plumber or builder. ............................................... · .~... · .,-'~....~ ...................................... ,;. ............. ~;':, ................... x ............. : ......... ,' .................... .... z' iName at owner at premises .............. .~,.~..~.-..~. ..................... ' ........................................................................................ If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) Builder's License No ........ C~ .............. Plumber's License No ................................................. .~'. No ............................................. /(2o0 -~ '~( - I ~,"~ / ~ ~ Electrician's License Other Trade's License No ............................................... '~ ~.~ ~ ' 1. Location of land on which proposed work w' e. M ~No.~.. ............ C-'/.4~::'~ ................ Lot No..z...~ ................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........... .',~<~..%.'~..'~.~.~.~'. .................... : ........ ~ ................ f ..................................... b. Intended use and occupancy ................. :~....~...~...~':~ ........ ~'~'..~'~~'~' ·'~'~ - "'" ........ 3. Nature of work (check which applicable): New Building'. ................. Addition ........... Alteration ............... Repair .................. Removal .................. Demolitior ..................... Other Work ................................................... )~ ,?. ~) ~'~'.- / i~c/'C) (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ~ ............. Number of dwelling units on each floor Ifg b arage, num er 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 ............~....~. .......... 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 ................... , ................ Rear ............................ Depth ........................ Height .................... Number of Stories ............................................... ~. ..................................................... :...~ ......... 9. Size of lot: Front /'7~ .~.:' ,,4,~,~/'r.z~ .~. Rear ....... ~..(..~.. ..'~..~.f...~...~..~'.. Depth~ ./...~...¢..~.f....~..f.~..~-.,W' 10. Date of Purchase ....... ..~.~'~'~' ..................... ~..../..........c~... ....... Name of Former Owner ,.-...~..%.-~...~,~.,./.:,..~....-..:.~.~,...,-.~:.,.- ~- 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................... ./~'.....o'.. ........................... 13. Will lot be regraded ............'~..f?. .......... WJ[I excess fill be removed from premises: ( ) Yes (,~ No 14. Name of Owner of premises ....... :.: .............. : ................. . ........ /*aaress ...................... Name of Architect .............................................................. Address ................................ Phon~ 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 whether interior or corner lot. STATE OF NEW YORK, lc c '¢/ / COUNTY OF '"'~*¢t~O'~'~ ........... f'~'" / · , , ~,...being .......... ["[l~J~"~'~Od~i;~;[' ;i~;];;~"~'~;~'~'~')' ........ ?'/ .... duly sworn, deposes and says that he is the applicom above named. / ' / He is the ......................... O1¢Z1;~' ............................. ~; ............................................................................................................ / (Contractor, 6g,ept,//corporate officer, etc.) of said owner or owners, and is duly authorized to p~9~rf~r .m. or hove performed the said work and to make ~nd file this application'__ , that all stotemn~nts contained in thi'~ij~ q~Sp' lication are. true. to the best. of his knowledge and belieF; and that 'the war< will be performedAn the manner set fo,~h ~n the opplicat.on filed therewith. Sworn to before me this , , "'i" ~:- ~ /'~ ........ ......of .......... .................. Notary Public ................................ ~a~.~];~... County' ,,~ ................ ..~-.:...~j~ ....... ~. ...................................................... ~- i (i~ignature of appl cant) No. 52.8125850, Suffolk Term Expl~ March 30. 19/_.~ ~MORh l..ll, ll~ OF