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Home My WebLink About1469-zFORM NO. 4 TOWN OF SOUTHOLD BIYH JHNG DEPARTMENT Town Clerk's Office Southold, 1N. Y. Certificate Of Occupancy No. Z~.~.~ ...... Date ....... Oat.. 42 ........... .., lg-71. THIS CERTIFIES that the building located at .Sound .Vie,~ .~(d ............ Street Map No. 0r.i. emt..by. ~P~lack No ........... Lot No. Desc.,..prop ...... 0r~Lc, nt. · conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Ju'ly .? .... , 19.6'~' pursuant to which Building Permit No.. 1 ~+69~ · dated ............ Gu]:y .... 7" 19.6~, 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' -fam*~-y 'Dwelling ....................................... The certificate is issued to . 'Re'~:d' H'.' 'Dav'J:s · ~o~wner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · ee.t -196'1 .......................... House .... '. ..... · ...... .......... Building Inspector /'z' FOP.~I NO. 4 TOWN OF SOUTHOLD I~UILDING D~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~..O..~Ig.~.~,.~.W...~,~,.,...Q~.~,.~.~...~'.9.&D,~.. Street MapOIl~'e.~..-..~.~..'..~...~..e.~ No. ~..,e.f:.t....~ ........ Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... ...,,~.....~.~/'...?. ............... 19..~...~... pursuant to which Building Permit No ....... ~...3,.4.69 dated ........................... ~!3~....~ ........... , 19...6.1, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... PRZVATE ONE FAMILY DWELLING This certificate is issued to ...~...e.~..~...~:...?.a.v..~..?.!....o.~..~..e...~. .................................................................. (owner, lessee or tenant) of the aforesaid building. FOI~M ~0. 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.* 1 69 Z Date .......................... ~T.~. ....... 7. ............ 19.~1.. Permission is hereby granted to: Tony Nork~un....A/C..Je~d..Da~,~ ................................ ............ ~-~at ..................................................... to .. l~u~Id...new., erie. £am~. t.y.. ~wett..~ ................................................................................... at premises located at ..tet..~t .............. ~ri. ertt...by..the..~dt.a ....................................................... .................................................. Seu~l...~t®w..~o~ ........................................................................... ....................................................................... ~.ent. .......................................................................... pursuant to application dated ................................. JIL~ .......'~ ............ 19.~r~..., and approved by the Building Inspector Fee $..1Q.,00 ......... Building Inspector TOWN OF SOUTHOLD BUI~ING DEPARTMENT ~ ~ ~- ~ · TOWN ~ERK'S ~FICE/ ~//~. ~THOLD, N. Y. Application No. / ~'~ ~) ~' APPLICATION FOR BUILDING PERMIT Date ..................... ~......~.. .......... , 19..~....(.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo n ng prem ses 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. Th~ work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wJlJ 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 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 nspector. APPLICATION IS HEREBY MADE to the Building Department for the ssuance of a Building Permit pursuant to the Building Zone Ordinance of the, Town of Southold, Suffolk County, New York, and other app cable Laws, Ordinances or Regulations, for the construction of buildings, additions or a terat ons, or for remova or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (S'g ~ature~of applicant, or name, if a corporatio~i ' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....... ..~....~....~ .~.:.....~~ ........................................ '"'"'"'"'"" . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporater officer) Locatio. of ,and on which proposed work wi, be do.e Map No eeT aha .mumDer ............................ .~ ............................................ .~..~......~..~..! ......................... ; ............... /~1 ~ '7~-~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~...: .............. . b. Intended use and occupancy ~ · 3.Nature of work (check which oppllcable): New Building ......L:~..... .......... Addition'. ................... Alteration .................... Repair ...................~ Removal .................... Demolition ....................~', ,~, Other Work (Describe) .................... 4. Estimated Cost ..~'..[.~..:..?...6....o. ...................................... Fee./P/~.~ ................................ i .............................................. (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 ond extent of each type of use.: .............................. 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ......................... : ...... Height ............................ Number of Stories ............................................................................................................. Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ............................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ../7/..~./. ............ Rear ......~./....~...'. ............ Depth .....L~....~..../. ............. Height ..... ./...~....1. .............. Number of Stories......j. ......................... 9. Size of lot: Front .../...O...O...~, .............. Rear ...../...~...(J....~ ............. Depth .....~.....~...O...~. .......... 10. Date of Pu~ha~ ........................................................ Nome of Former Owner .................... ~ ........... 11. Zone or use district in which premises are situated......~.: .................................................................................. 12. Do~s proposed construction violate any zoning ~aw, ordinance or regulq,tion? ......'~.~...~. ..................~ ........................ 13. Name of Owner of premises..~./.~../.,..~.~ ......... Address .......... .~....'X...~..'...... Phone NO~ .................... Name of Architect ............................ ~..~?_.~ ......... Address .................. ~ ...................... Phone NO ..................... Of Contractor ...7.~...~'~.~....Address ..... .~..~.-~...~.r Phone NO.O.../~....~..;../...~.~'./. Name PLOT DIAGRAM Locate cleorly 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 NE~Y~RK.b ) S S COUNTY OF ..~~....) ' ' ............... ~~ .................................... being duly sworn, deposes and says that he is the applicant (Name of~jndivic'lual signing opplic~ation) ' e ~~the ~ aaove named H 's ......................................................................................................................................................... (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 application filed therewith. Sworn to before me this ........... of .... .................... ...... Notary Public, ~).~..~..~ .~.~j.~. ~Cou nty