The URL can be used to link to this page

Home My WebLink About4073-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. ¥. Certificate Of Occupancy No.. ~ .34.4.8... Date ....... ~prtl .... 15, ........ , 1969.. THIS CERTIFIES that the building located at ~rd. ~Itree.t .w/s. Bray. ... Street Av~nu~ Map No.G.. X. Tuth £11Block No ........... Lot No. 73~74. Laurel ~. Ne~. York ..... conforms substantially' to the Application for Building Permit heretofore filed in this office dated ....... Octol~er...7., , 19 .tiS. pursuant to ~vhich Building Permit No. Z..407;~.. dated ....... o~tol:~r...7.° ., 1~68.., was issued, and conforms to all of the require- ments of the applicable prowsions of the law. The occupancy for which this certificate is issued is . .pr£v. ate. ~ne. f. amll¥ .d~lllng ...................................... The certificate is issued to ....... ~c]~a=.cl. Mi].~e~ ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval '" Building In~ FO~M NO. ~ 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) - e,t,,,,~ ? ~9~... N? 4073 Z ~,~,e ........................................................ , Permission is hereby gronted to: at premises located at ...JOIIL~..~..J...~t.....O.A~,.,.'+.I~1~,,~I, ............................................................ ......................... ,{,~l..{{~,..e,.tf.. MY'L .]~,~'.. A~ ........... /,mm~....llt~lh .................................... pursuant to application dated .............................. .~.9.~ .......... [7. .......... , 19..I~.., and approved by the Building Inspector. Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date TO WHOM at IT MAY CONCERN: The sewage disposal facilities for (Give deed location) a structure located have been inspected by this department and found to be satisfactory, Dtstrtc~ Engineer Examined 19 Disapproved a/c .................................................. ~//~,'/~; APPLICATION FOR BUILDING PERMIT 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 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 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 throug? out 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 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 Southald, 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. Aa4ie Lossard Zue (Signature of applicant, or name, if o corporation) Riverhea4 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises .....~...~.1(.e....~..:~.e..~.. ..................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) · . G.I. Tuth~ll ], Location of Jand on which proposed work wili be dome. ~ap mo.: ........................................ lot No.: 7~d: ~ Street and Number ..~A..B.t~....M/.~.....~.Z'.IR~r....A.Y.~ .......... ..~.lJl~.~.~,...; ................ : .............. ~ .................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~..a..o....a~....~...,.]:..~..~...~. ..................................................................................................... b. Intended use and occupancy ...... ~DZ'...;['~L~,3.y...d,VO,],~.~:t~ ............................................................. ............... 3. Nature of work (check which applicable): New Building ..~ ........ Addition .................. Alteration .................. Repair .................. Removal ..................Demolition ................ ~. Other Work (Describe) ........................................ 4. Estimated Cost ..... .2...0.$.~ ........................................ Fee .....1..O...e.~ ...................................... .................................... (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 .e...~... .............................................. 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 ...... ~'0 .......................... Rear ......... ~0. .............. Depth ........ ~6~.33.-..~. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..... .1.0 ............... Rear ...... .~.~.,.6. .................... Depth ............ .~5J.../...1.~.0 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... ~ .~.~....~..~...I..~. ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............... ~ ........................................ 13. Name of Owner of premises ..~l.T~..~,~[].let~ ..............Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of COntractor ...~...,......[~....S.~?..~.....[...~..e. ................ Address ......... ..~.~.?..e..z'.~.e.~.~. ............. 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 comer lot. ~'~', ~- STATE OF COUNTY OF ................................ .~.~,lll .~f~.(l.~..~.~..d. ~. .... ~ing duly sworn, d~oses and says t~t he is the applicant (Name of individual signing application) above n~ed. He is the ................... g~.?.~.~ .............................................................................................................. (Contractor, ag~t, co, rate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and ~woat the ~o[k will ~ performed in the manner set f~h in the applicat~ _filed ther~ith. m to betore me this /~ ................. ......... , es I ..... / ~m ~plres ~rch ~to~G~) ~LL~D ,A,.:RNT£~[)'TO 'TH~ HaMrr. '~ITLr- DIV. :t~H U~ft.~ 50!4