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Home My WebLink About8060-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Certificate Of Occupancy No. Z.6. 7. 2. .2. . Date 00t 2 19...7.~ THIS CERTIFIES that the building located at Roaky Point Road Street ..................... .. :czx East learion N.Y. Map No. Xx Block No. xX .Lot l~o .............. · .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .J..~.F...8... ,' 19 ?.~. pursuant to which Building Permit No. 8060Z dated .......... .J.u.~.~ .... 8...., 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 Private one family dwelling with addition & fencing The certificate is issued to . .~..t.a.n.~.e.~r. ~??.o.u. .... ... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... NAR.: ............................ UNDERWRITERS CERTIFICATE No. N HOUSE NUMBER ..... ~.2.~.~. .... Street ...R.o.e.k.~-. Point Road Building Inspector I FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8060 Z Date ........................ ~[g.~jr ....... ~ ............ , 19...~.~'. Permission is hereby granted to: ............. .~.~..~,~r.~..qx~ ........................................ to .~ent..~anc~n~.... ~ ~ .~r~t..~&rd..&..l~o~...~wr...~a~...~at~o ................................ at premises located at ...JJo~ttrjr..e°..O,~l,I/~..JJoad, .................................................................................. ........................................................ lt,~m*,..l~v~,ej ....... 1~.,¥., ............................................................. pursuant to application d~ed ...................... ~'1~ .........~ ........... , 19..~.~;.., and approved by the Building Inspector. Fee ~J .~a.(~) ............. Buildihg Inspector / · 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 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 ofpraparty 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 pursu,a, nt 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 demolltian, as herein described. T~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~:~ admit author!zed inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general ~ontractor, electrician, plumber or builder. Name of owner of premises ....... .~...~.~...~ ....... ~.~.~..-~.....~.....~ ....................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ¸. Builder's License No ..................... "7;: .................... Plumber's License No ........... ~ ............................ Electrician's License No..~. ................................. Other Trade's License No..4' ...........;.: ............................ Location of land on which p-~) d work will be ~:~.~p No · ...:. ............. .~ .......... Street and Number .......... ~..~.." ...... ~...... '..'..~..:...ii..i~.. ...... ~1~...,.. ~ ............. Municipality State existing use and occupancy of. ~/~c~i~?na~)d,i~tended use and occupancy of proposed construction: a. Exisiting use and occupancy ....~i~ .......... :,, ......... .; ............ ,~..-.~. ............ ; ................................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration~'~t~. Repair .................. Removal .................. Demolition .................... Other Work .(9~..~.....~I~...~.,~....~...~..~-...' ... ~/~1-/8', (Description) 4. Estima~ted Cos~ ..... ~.~..~..:...~...~T... ............................ 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 ............................ Rear ................................ Depth ....... ............. Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Storie.s ................................ 8. Dimensions of entire new construction: Front ............ / ...... , ................ Rear ............................ Depth ........................ Height .................... Number/of Stories ................................................. ?- .................................................. .>. ............. 9. SiZe of lot: Front ....... /.~ ....................................... Rear ....~'.l~J~. ........................... Depth .~-~R. .................. 10~ Date of Purchase .......................... ~ ............................. 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: ........................................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of OWner of premises .~[~.~...,.~rk'~.,~.~t74 Address .~.i~...~.~.~.K,~/-~)~l~Phone No..~.....O.~....~...~ 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-bock 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,,~DP-,,I~ ff~- I c c ........... ~ ................ : .................. boinO duly ~worn, d*po~es ond ~y~ thor h~ i~ th~ ~pplicam (Nam~ Sf ~dividual signing c~trac0 above name. He is the ........................................... ~.~ .............................. ] .......................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or h~e performed the said work and to ~ke and file this application; t~t all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will ~ perfo~d in the manner set fo~h in the application filed ther~ith. Sworn to befo~ me this ~ ~ ~ ~ ~ - ~ '(Signature of applioen,)