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Home My WebLink About1215-zFOEM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z..3.43.4 .... Date ........ Parch .. 2~)., ........ , 1969. · THIS CERTIFIES that the building located at .8Otl~h. ~/ieW. D~.~,ve ....... Street Map No. ~:[!~.~ .467.3 Block No ........... Lot No. ~.2. ,..Or:tent,. lq.~. Yorok ...... Yage 67 conforms substantially to the Application for Building Permit heretofore filed in this .office dated .... .~.~.p.t.~er. ~.,..., 19.60. pursuant to which Building Permit No. ~,215. ~. dated .... .~.ep~:~lc..15,..., 19.60., 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 .pl:;i.~gat;e..o.~e. ~.amll~..d~,lltnq ....................................... The certificate is issued to . .~.,..$~;ew. ar.t;. ,Yohr~aola ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Nr ~' ....... ..... Building Inspector / FO1%1%! NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BU~LDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1215, Z Date .................. ~ep~e.tb~r'"t~" .......... 19'60-' Permission is hereby granted to: l~ank Zal..~ ~.~..... -.~.C...J.,S, Jonson ......................... ....... ~a.t.~i.~u¢~-~.....~..~., ................................... to ..... tr~ve...an..e~,~t .J..~g...b~t ~...t ~..t,h.t.~...1.oe~ C.C..on .................................................. at premises located at .~/f~.....~l~.~.~'.~..~C~'.1~'e ........................................................................... .................................................. ~I~. ~..~Lills..... E sta~s.)..... ~r..z. emt ~.....;~. ¥o .................... pursuant to application dated ................................... ~'~0'""]:~; ......... 19.6{).., and approved by the Building Inspector Fee $~.0..00 ............ Building Inspector TOWN OF SOUTHOLD BUILDING D~'PARTMENT Town SOU .OLD .. Examined ; ., I O Approved ........................ ' ................ 1 9 ........ Permit ~o ................................. Disapproved o/c ............~ .......... <~......~ .................. ~ .................... .................................................................. ........................ (~uilding Inspector) APPLICATION FOR' BUILDING PERMIT Date ........ 3-.,- .r¢~, .$.~.~;t... ~L. ~.0. ............. 19 ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. 'PI6t plan showing Ioc6tioh 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 location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Up,on 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 progress of the work. e. No buildin9 shall be occupied or used in whale or in part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, SuFfolk County, New York, and other <~pplicabie 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 and regulations. ...... ........................... (Signature of applicant, or ~cime, if o corporation) ........... :. .............................. (Address of oppllcd,~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ............................................................. .o.~.~Q~ ....................................................................................................................... Name of owner of premises ........................ ~'"~¥~,¢i~,~'"~b}~'~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed wor~k~ill be done. Mop Nbib. ez:.J,~Z.,.~.,~?.o.~i..~'~'ocki~l.o~...~,f~: ................. Street and Number ................ .....: ..................................... ~...~.m-cz ............................... 2. State existing use ond occupancy of premieses and intended use anld occupancy of proposed construction: w~oant lo~ a. Existing use and occupancy ................. ....................................................................................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration .................... Repair. ................... Removal .................... Demolition .................... Other Work (Describe~O..~d.~..&Zt hOUSe 4. Estimated Cost .. $2.,.000,00 ............ Fee ...~...0.. ............................................................ (to be paid on filing this application) FEES: If dwelling, number of dwelling units ........ .o.?..e. ............. Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commericel 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.....~..4.! ................ Rear ....~..~.? ................. Depth .....-!'..~.I. ................. Height ....... .1.:~ ............. Number of Stories .........O~'e ........... 9. Size o¢ lot: Front 1151 Rear 10~t Depth 1757 10. Zone or use district in which premises are situated ................................................................................................ 11, 12. Does proposed constructic~ violate any zoning Iow, ordinance or regulation?.~o .............................................. Name of Owner of premises,J,S~w~.~;...J~ddress ...:~z~o~k.l.~J~.~...~¥,. ....... Phone Name of Architect ....... . ............ ,~..~......,. ................... Address ............................................ Phone NO ................. ~ ~ ~rn~ zal es~i ~att~ ~k "h NO'MA~ 9~3~6 Name of contractor .................................................... Address ............................................ w one ..................... 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEVi. ) S st I 'F' (Name of individual signing ~lication) above named. He is the ...................... ~.~ .................................................. (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 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 manner set forth in the applfcation f/fed therewith. Sworn to before me this ................. doy of ............. ......... Notary Public ...,.~...:'. nty CorHrn,ss o EXiJi es ~arch 30, 19~f