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Home My WebLink About4054-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 3.37.~ .... Date ............. Feb .... 17 ..... , 19. ?.0 THIS CERTIFIES that the building located at .. ,8111~e~;. ~ ............ Street Map No. ~ Block No. X~ .Lot No. conforms substantially to the Application for Building Permit heretofore filed ~ this office dated ....... ~.p~ ..... ~.. , 19.$~. pursuit to which Building Permit No...~.~ dated ........... 8ep~.. ]~.., 195~., was issued, ~d conforms to ~1 of the req~re- merits of the applicable provisions of the law. The occup~cy for which this certificate is issued is .... ~l~e. ~e. f~lY..5~11~ .................................... The certificate is issued to . .. ~ .R~te~ ...... ~ ........................ (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval ..... ~?R.* ........................... ....... .......... Building Inspector FOR~4 ~O. 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? 4054 Z Permission is hereby granted to: A~thm' ILleblm~' ............... .~.~.~t~ ........................................... Build a~ addttlo~ & ~ake a,,1.terationz .e,p., an ~,~,a.~,p.~ ~...~#,~.1~ ... at premises located at Bu~met. ~1~ ........... .................................................. .~.r,.,e.,e...n.p**o....~.. ....... .I....X~ ....................................................................... pursuon~ to application doted ............................. ~.~P-~ ....... ]8 ......... , 19...~8, and approved by the Building Inspector. Fee $...~.~..(~... ............. Building Inspector TOWN OF TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved~ 19 tx ~".?... Z.,- ........................................ , ........ Permit No. ~/0 Disapproved a/c ..~.....~ ..................... .~ (Building Ir/spector) APPLICATION FOR BUILDING FERMIT Date ..................... ~. ~..~...e..~..b...e..z'.......1..~ ....... , 19..~...8. ...... 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 applJcatlon 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 progress of the work. e. No building shall be occupied or used in whole 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 Department for the issuance of o 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, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations. Arthur Richte~ (Signature of applicant, or name, if o corporation) Greenport (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. Owner - builder · Arthur Richter ' Nome of owner of pram sas .................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ~ Lot No.: Street ond Number ....~,.e.,~.....~..&...~.? .......... ,G,,,~..e..e..~.,p,,o,r..,~, ................................................................. ,'~ / -- -~' ~ 3 _~5 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy dwelling b. Intended use and occupancy same with add & ~lt 3. Nature of work (check which applicable): New Building .................. Addition .....~ ...... Alteration ...... ~ ....... Repair .................. Removal .................. Demolitian .................. Other Work (D~scribe) ........................................ ,4. Estimated Cost ..~..1.0.0...0. ................... ?~... ................... Fee ...~'..?...0~... ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .o..~...e. .............. 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 Stories ................................ 8. Dimensions of entire new construction: Front ~..~. ................................. Rear ..... ~ .................. Depth ....... 28. ............ Height .................... Number of Stories ....O..~..$. ............................................................................................................ 9. Size of lot: Front .........~..~.~'.. ........... Rear ............. 1...~.~. ................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............ "...~."....~]1~.~. ...................................................................... 12; Does prop0sed'~on~truction Violate any zoning law, ordinance or regulation? ................ ~.O. ....................................... 13. Name of Owner of premises ..A...9..~.°...~..~...e..~. ............... Address ........ .G.~.e..e...~.]?.0.~..~. .............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...... .A..;....~..~.q~..e.~.. ...................... Address ...... ~'.~..~TX~.~...I~. ................ 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 corner lot. STATE OF NEVVc~.~K.~_ ~ S c COUNTY'OF ....?...~+...~..u...~:~... ........... ,f .fi: . ................................................................... be ng:duly sworn, deposes.and says that he is the opplicont (Name of individual signing opplicotion) above named. He is the .................. ...~.~,~....-....~.~.]..O...e..~. ................................................................................................ (Contractor, agent, corporate officer~ etc.) of said owner or owners, and is duly authorized to perform or ha~,e performed the said work and to make and file this application; that all statements contained:i~ 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 ................. .1...8.. day of ................. ..B..e.~.C...e..m..l?.ez' , 1 · ' .................. . ..... ._//. :. ................................ Notary Public,~~ County"'~'~,"~'v'~:/) (Signature o~/~'~ t~0.