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Home My WebLink About4147-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z3?I~Z ..... Date ............ Jan .... 20 ..... , 19 ?0. THIS CERTIFIES that the building located at -lg/S..ldesg. view. ~x, ive ..... Street Map No. llasoll ...... Block No..X,x ...... Lot No...xx .... Mattii;u~k.. 1~o¥, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 0e~ · ' 2{~- · · ~, 19.68 pursuant to which Building Permit No.. dated ......... Deg...6 ...... , 19 .68, 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 ...Pri~ate..erie. f~miiy..d¥~llil~g ..................................... The certificate is issued to .... Jacob. ,~!o.]:tick ..... &~ner ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~o. 20.. 1.970...by. R..Villa... Building InsPector 't FOEM NO. ~ TOWN OF SOUTNOLD 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) Z Permission is hereby granted to: .... · ~31.....~ne' .~,~ $-es...l~.l~,d ......................... ....... t~...~l~o~e ~ ....... .lt.,.~., ............. , .................. to .... i~ui3xt ..~e~...o~e.. ~eal:l,~..~l~l~Ll~ .................... i- .......................................................... ...... (.. A~preved...by...i~a~t ..oi,.. ~t.~,l~eala. li~v..21~t;) .......................................................... at premises located at ............. .~/.~.,..:~,~,~.t~,~...~.~.~.e ................................................................. .............................. ~a.~t~t~k~...t~.*~-*. .................................. ........................................................... pursuan¢ to application dated ............................ 00~ ......... $ ............ , 19..6~., and approved by the Building Inspector. Fee $...e~O,00 ......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~f~ Bldg. Pelrmit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. District ~mgtneer District Engineer ~ ~UILDIH~ DEPARTMENT F TOWN C~KK S OFFICE ' ~UTHOLD, N. Y. -~, ~: ' .... h....~: .................. , Ig~.~.. P~i~ No..~..L.Z ................ .......... ~. ..~....V.~.~ ............. ~ ...... :: .... ~../ ........ ~ ....................... , . . ' ?' ~ / ~" ................... APPLIC~TIO~ F~R B~I[giHG ~ ..... INSTRUCTIONS a. This application must be completely filled in by typewr, i~: ~/; ir~ ink and submitted in duplicate to the rju:~;-~ Inspector. , ~. - '~ b. Plot plor~ sl':~wing location of lot and of buildings on premises, relationship to adjoining premises or public streets cr areas, and giving a detailed description of layout of property must be drawn on the diagram which is ~rt of this appKcctmn c. The work cove~ed by this application may not be commenced before issuance of Building Permit. d. Upon a~?oval of this application, the Building Inspector will issue a Building Permit to the applizant. Such permit shall be kept on the premises available for inspection througkout the profess of the work. e No building s~ll be occupied or used in whole or in part fo~ purpose whatever until o Ce tificate of OCC[::(:~ ':' r shall have been granted by the Building Inspector. APPLI~TION IS HE,BY MADE to the Building Department for the issuance of a Building Permff pursuanl tc tqe Buildi~ Zone Ordinance bf the Town of Southold, Suffolk County, Now York, and other app cab e Laws, Ordin,4nces cr RegulatiOns, for the const~ction of buildings, additions or alterations, or for removal or demolition as herei~ described. The applicant agrees to co~ply with all applicable laws, ordin~building code~ housing code, and reguta ions ',~ ' (S gnature of ap~nt, or name, if a corporotinn) '~ (Address of applicant) State whether applicant is owner, les~'ee, agent, architec~ngineer, general contractor, electrician, plumber or builder ~ U J'~ ~ ~ ~ .L ~.~Z~..'~ :.' . .............. Name of owner of premises ................ ~ ...... ~.~.: : ................... If applicant is a corporate, signature of ~uly authorized officer. ,' ' :~ ~L ~ ~o~c,/~4~4' ~ ~ H~m~ ~,~ (Name and title of corporat, of~c~r) 1. Location of bnd on which proposed wo~k will b~ done. Map No.: ........................................ Lot No.: ........................ ~E/, ~,~ ~ ~,- · ~ '-~//_ ~ ~ , st,,t ,,d N,~ ..:~=.....,.[.~.[.U*~N....~.a,.....~.~ ......... ~.L.~.a.~.....~.a...~.,p, ....... a~.~'~u~ ~ Munici~lity ~/$ ~/ ~V~ .... 2. State exisfing us~ and occupancy of presses and intended use and occupancy of propos~ construction: -- a. Existing us~ and occupancy ~ ,' ......................... '~'. ., : ~'~.:k wh, ,'p able}: New Buil'din2 ......... Addit,.n ....... &Iteration .... .eF ...... r~emnvcl ................. Demolitior ............. Other Work (De~.cribe) .......................... · - ' ~ (to be pq~d on filing this opplicat~,,~ .5. I¢ dwelling, number of 'dwelling units .............. Numbei~*of dwelling Units on each floor ........................ 'f gorc,-e, number of cars, ......... ~,'~ ......................... '¢ .............................................................................. / 6. If business, commercial or rnl,c(~.~ e,:.,~pancy, ,specify nal'ure and fxL~:nt o~ each type ut use ........................... 7. Dimensions of existing struCtUres, if any: Front Rear ................~ ............... Depth .................... Height .............. Number of Stories .............................................................................................................. DJmensMn~ of s,m~e ,,trL~¢ittre with alterations or additions: Front .................................. Delqh Height ............................ Nu"r'l,er of Stories ...................... front .................................... Rear r!..tt,.:t ................. Death .................... Ne,ghr .................... Number of Stories ........ ~-.~"'~ i0 Date of ...... ~. ..................................... of Former Owner I 1. Zone or use district in which premises are situated ................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation? ......... y.,~]..~.. ..................................... Nome of Architect ......................................... ~ ............ Address Phone No ..................... .................................................................... ; ................ ; ............... ~'nane No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-b~ck 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. / ~ .............. ]~X~ '~~ ~~'x ]~ ~ being duiv sworn deposes and sa' s thot he is rhea licam (Ng~fof individual signing app'l'i~fi~) ............. ' ' Y PP bore nom~,~e .s the .......................................................................................... (Contractor, c~zzt, of said owner or owners, pnd is duly authorized to perform or have performed 'the said work and to ~ke 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 w II be performed in the manner set fodh i~ the ap¢tication f'il~d therewith. Sworn to before me this~ ~] - .¢ -- . FOI~M NO, 1 T TOWN OF~ S~ HoLp BUILDING TOWN CC . 'S OmCZ SOUTHOLD, H. Y. Approved ..... ~x.. ~ ................. ~ 1~ Permit No. Disapproved a/c ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 ar 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 throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any pprpose whatever until a Certificate of Occupano/ 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 ~Cor removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordina,~ building code, housing code, and regulations. gS? ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, enqineer, general contractor, electrician, plumber or builder. ............................. ....... ........................................................................................ Name of owner of premises ...:,.....,............... .............. ,..,..~....,...~,............, ................. If applicant is a corporate, signature of duly authorized officer. ..../...z.. ....... ......... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number ...,~.~,.....~.~..D..r..UJ.~..~.....J~./~,,.......~.~..~ ....... -~.1.~.......~.../~ ........... /~...~.,~, ....... /~.~.~.j..~..~.¢~' Municipality 2. State existing use and occupancy of premises and intended use o&d occupancy of proposed construction: - a. Existing use and o~cupancy ...................................................... ; ............................................................................ b. Intended use and occu'pancy .~..,~....~. ..........~. ~....~.~./.~ ....... -/~Z~..~....~....~.~.. ·...,' .......................................................... ~. N' 'f ~e of work (check New Bud ng t/ Add ont~ ';' ~ ~'k'-' , ' Jr,;i...,....r;..-...,,,"~moval ....... ~.~,. ....... Demolition .................. Other Work (Describe) ....................... ~ , ~' ,' ,. , ~ .~ ' I ~ ~ '~r (to be paid on filing this application) 5. If dwe[! Brig units........,.........O'MI~' ...... ....NumSe~"of dwelling,Units on each floor ............................ If garag~¢ 6. If bus~ness,,c?rnmercia occupancy, specify nature and ext~nt of each type of use ............................ 7. Dimensions any: Front ............................ Rear ................................ Depth .....; .............. Height of Stories ................................................................................................................. Dimensions of same alterations or additions: Front .................................... Rear ............................ Depth ~ber of Storjes_~...., ........................ 8. Dimensions of entire ~¢-~(~z-,t,m--~;~ ............... Depth ,,,,, ............. .,. .... Height Nu~ -~.....-,.,,u~ L. 9. Size of lot: Front Rear ......... ~ ~ ...... ........... 10. Date of Purchose~..~..~..~.......~ ........ ............... Name of Former Owner ...... ~....'~......~....~/...~,.~...~.... ................. 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed Construction violat~ any zoning Iow, ordinance or regulotion~ '' 13, Name of Owner of premises ..~...~,,~...~,.~......~.~.~../.~.~'ddress ~/.....,;¢.~,~, ,~.~-~'~'.:;,,..; ............. ~..~?~./( /~"'r'none No. /..,~..f.....~..?....~. , /~ 't~,.~..~ ' " Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~....~.~..~/..x...~..~..~.T~V..t.~..~.~:..Addres~f~./....~..~.?'~..~..~.g..~....~.~.. hone No.......OS"'g"Y"~<~ ............. 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 NEW Y.~RK. COUN- · ............. ......... ..."-,~_~/-,<~..~.....L/...~.,7,.¥...T. ........ L.%.~.~ ........... being duly sworn deposes and ~ays that he is the applicant ~i:~idual signing application) above nom~L-"He is the ......................................................................................................................................................... (Contractor, a~;c.~t; ::~:~::'_':;:f. zts.) of said owner or owners, ~nd is duly authorized to perform or have performed the said work and to make and file his opphcatlon; that all ~ statements contained in this aoplicat~on are true, ira, the best of his knowledge and belief; and that the work will be performed in the mar~n'~r sb{' forth i~ th~ "al~lblicotion filSd therewith. Sworn to bef~re_~ me this ......... I' ) , , ............ ........... ............. Notary Public, . ............... ~.....~.~,f, Lf~'O6~ty ',; ,,~,=,~ (Signature of applicant) / I ' ', '-'-~' ":, :'~'~]~ ,~FI ~ ' ' ~ ,,~]~d~.[~ '~]~l'~~ ' ~ ~ ....... ~ ..... ~ ~ ~ ' ~' ~ ' ' '' ~ ' " : ~ ' I~Z¢' "t .~ , ' . , ,:J , : ,~ ', ',. ,. ; , ,, . , ~ ~, .... t , .... ~ I , :~ t:,l . , - . /L: , , ....... , 1 HERMAN H. YORK,, ARCHI ONE. FAMILY RESIDENCE HERMAN 14, YORK ARCHIT 90'O4 ICl ST. JAMAICA 37-~ NEW ~o~ ~ox ~_ WOOD ONE. FAMILY RE$iDENC. E HERMAN H. YORK ARCHI 90-O4 ~1 ST. ,TAIvfAICA ~'Z, NEW YORI, ~ /Z/TCH£W CZZ~/z/~T I~-~ Asph,,~z.r J ONE FAMILY RESIDENCE I-IERMAN Il. YORK ARCIIl 90-04 IGI ~T, JAMAICA ~, NEW C-~ =_CT · e (N.~.) h M' L.,g. CAI4TII_t~V£p__ ~ S£ C T/O/VS ,., - St'ALE: ~EE Ag~V~ ONE. FAI~ I LY RESIDENCE. HERMAN 14. YORK ARCHI 90-04 IGI ST, 3'AMAICA ~)~., NEW YOI C -~Z2,