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Home My WebLink About11111-zFORM NO. 4 '[OWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Itall Southold, N,Y. Certificate Of Occupancy No. Z12270 Date FEBRU. AR¥ 16 , 19.8z~. ADDITION TI{IS CERTIFIES that the bmldlng ................................................ Location of Property ...~.V, 5 .~.QRTH. .QA.K. W.O. QD. . ~p. ........... .L.A~I~3 ................... House No. Street Hamlet County Tax Map No. 1000 Section 1 2 7 .Block 7 .Lot 3 2 Subdiwsion ,. b.A.U,E.~,L. .F..'5.~? ................ Filed Map No. SUB...Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ??.~ .~.L. fi.z! ............ 19 .8.~. pursuant to which Building Permit No. 1 1 1 ~ 1 g dated A P .g .I.L.. ~. 7. ............... 19 8. !., was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is issued is ......... FOR g DECK ADDITION TO A ONE FAMILY DWELLING The certfficate is issued to ,JAMES & EDNA MAY CIIRISTIE {owner, lessee or tonanO of the a£orcsaid building. Suffolk County Department of tIealth Approval .. ~./.g, .................................... ~/g UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev 1/81 TOWN ~01; ~OuTHOI~ TOWN, HALL SOUTHOLD, ~1~ Y~ BUILDING FER~iT (THIS PERMIT MUST BE KEPT ON THE PP,£~IS~S UNTIL TULL COMPLETIQN OF THE WORK AUTHORIZED) No. 11111 z Permission is hereby granted to: {0 ....... : ......................................................................................... ~ ................ ~ .......... ........... "' ............ at promisos located at ....................................... , ........................................................... A I ,, , - . ........... .. ,,..,.; ..... ., ........................................ · ..LZ .............. Co~w ~ox ~p ~o. ~000 s,~t~o~ ...... (.~..~[ ....... e~ ~..., ...... ~ ...... Cot ~o. p~rsu~nt to opplic~tion dotod .......................... ~ ........... ~.~}~..,!¢/ 19~.,., ~nd ~pprovod bv tho Building Inspector. Fee $..../..~.,.. .............. Buildin! Inspector Rev. 6/30/80 FIELD INSPECTION FOUNDATION FOUNDATION 2. ROUGHFRAME & PLUMBING (2nd) COMMENTS INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ....... ?..'..', Pe it No ............ Disapproved a/c ..... ' .~'~ .~. ..................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~., .~.~. fo..( .~ .... t.~.., 19~.( INSTRUCTIONS 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 of property must be drawn on the diagram which is part of this appli- cation. 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 fro' 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. i (Signature of applicant, or name, if a corporation) (Mailing address of a~licant) State whether applicant ~lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the tax roll or latest deed) ........................ If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~, ) Builder's Lk~nse~4o .... 5,; ~2'.~,~-~z,c:?~'. ~: Plumber's License No ......................... Electrician's L~cense No ...................... Other Trade's License No. 7:'~: ................. 1. Location of land on which proposed work will be done ............................................. Q ,. ?. l ~ House Number Street Hamlet County Tax Map No. 1000 Section /2. ~- '~ - ~',t~ Block Lot '~>~ ~" Subdivision .~.~.~../{~'.~,.*. to ....... ........ ~.~1~; b?k...G.t~.. Filed Map No ............... Lot ............... ,~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction' E iti gu ndocc p ~ a. xs n sea u ancy ..................................................................... · ......... b. Intended use and occupancy .... ~ ....................... ~ :~' ":i ~ ,~ 3. Natureofwork(checkwhichapplicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .... ~?.~ .~... i i (Description) 4. Estimated Cost ....................... Fee .../.~ .................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of cars ........................................................................ 61 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 Mth alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ................ Depth ............... Heig)tt ........... ._... tNumber of Stories ............. ~ ............................ v ........... 9. Size of lot: Front .. ~.l~. .... ' ........... Rear .... ~. '..~) .............. Depth .... .e~..t~.. ............. 10, Date of Purchase ........... ' .................. IXlgme of Former Owner .................... , ......... . 11 ~ Zone or use d~stnct ~n which pr~m~ses are s~tuated .... &cT~' '~' ~ ................ A 2 ......................... ' 12! Does p.roposed construction violate any zoning law, ordinance or regulation: .... a.p,..~. ........................ 13. Will lo~ be regraded ..... ,.~O. ......... '.~o. ,,~...~_.-Will e~lc~s fill be~removod f~om premises: __Yes 14.~Name of Owner of premi~~. ~.. ~ddre~;s~.J~.. r.~'~,ff)~ )~.~nve No.~.~. ~... ~F~.~ ~..'. Name of Architect .... ~ .................. Address ............ ~'$P~te'No ................ Name of Contractor ......... ' ................. Address ................... Plfone No ................ PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lifies. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YOR__K~. COUNTYOF..~O.rT-...F-~...c.7.[.~...: iS.S. · .~'~L~tql&(.~.................,..........,../~ · ~_M-4~t~TI-C-: - being duly sworn, deposes and says that he is the applicant . (Name of individual signing contract) above named Hefs the ...................... ................................................................... (Contractor, agent, corporate officer, etc.) uf ~al~l-owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannek set forth in the application filed therewith. Sworn to before me this ............. ./ ......... day o ...~/q..~:-..t..r--: ........ , 19 Not ub,i , . . County. (lul#fi~ in 8u#l~llml~