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Home My WebLink About4148-zFO1U~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...~. 352~... Date ....... ~.uly ..... 11, ........ , 19~.9. THIS CERTIFIES that the building located at .. V£11aqa .~ane .......... Street Map No. viJ,.J, age .... Block No ........... Lot No. 22... ~at~;.ltvck.,..I~l~w..Y..o.~.~... ~anoz conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... Oct6ber...~k5,..., 19.68. pursuant to which Building Permit No. A148..¼. dated ..... OctOber.. ,28, .... , 1968.., 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 . p-~.ivate .one..fam&-]~y. d~ellinq..with .acldition.¢doee, .nOt..&aCku. d.e.. porch) The certificate is issued to ...... ~red .I.~et~;1.a~; .................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... Building Inspector House $ 460 Village Lane FORI~ NO, 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? 4 48 Z D~te DeC. ~ Permission is hereby granted to: ~32 ~i~dle Cou~t~y ~uild ~n ad/~itJo~ on ~ ~x~st~g dwelli~g (App~ov~ by ~ ~f Appeals Nov 21) at premises J~oted at E/S Vil].a~e L~.ne ~ Pvt. Head t~a~t~tuvl~ ~.~. pursuant to application dated ..................... .0..~...~. .......... ~.~. ................. , 19..~..~.., and approved by the Building Inspector. Fee $ ~,, O0 Building Inspector ~ FOI~M ~0. I 4 TO~VN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. ¥. Examined (~×~/ ')'' ~- 19..~., fT' ~r Application N o...~..(....c(..~: .......... A roved c- .... ,Vi sop rove a,e ...... ........ ..................................... ........... (Building In~ector) ' APPLICATION FOR BUILDING PEPdv~IT 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 o 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 befoFe 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 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 Southold, Suffolk County, New York, and Qther 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. (Signature of applicant, or name, if a corporation) ~.2 I{iddle Ooun~r~. Road~ Salden~ NY. .~¢.. L ~ (Address of applicant) State whether appllcant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. .............................................................. b~-.?~d ~.~ ................... ,.ii ..... Name of owner of premises Fred K,~.t ~,~r ............................ :.~ ........... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) / / I. Location of land on which proposed work will be done. Map No.: .....~:L1Z.a~fl,.~g~.... Lot,No.: ....?=~ ............... Street and N~mber ~/.S.....o..C.:~.t...Z..L.a.~e.....~,~.e.. ................... ~.~.~.q~.,.,,.'.~.... ............. :: .................................. Municipality 2. 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 .................... ~?.,.~.~.~, .................... i ......................................................................... 3. Nature of work (check which appli~l~e): New Building .................. Additio~l~l~. ...... ;~ ....... Alteration .................. Repair .................. Removal .................. Demolition ............ ,... Other Work (Describe) ........................................ 4. Estimated Cost ...... L....~.....z~.......~ .............................. Fee .....~.... ................................................................................ (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 and extent of each type of use ............................ 7. Dimensions of existing structures, Jf 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 ........ /,.O. ...................... Rear ...... ~..,O, ............... Depth ,..,o~...,~ ............. Height .................... Number of Stories .................................................................... ; ................................................. 9. Size of lot: Front ...i..~....O.. .............. Rear ....... ~/.',,~.,,,0._. Depth ..... ,~..~...~-,~.:....~".~. .... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! I. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed canstruation violate_,/ ~ ,,~-~any zoning law, ordinance or-~ -~e-~.~- ().regulati°n? .. ........................................................... 13, Name of Owner of premises ..:.'~.~..~ ....... Address .....~ .......... Phone No ..................... Name of Architect ...%... ..................... ........ Address ............................................ Phone No ..................... Name of Contractor .,,~..~.....~~ ~2~"'"'~'~ ........ Address .......~.....~ ............. Phone No. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oil 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 YORK, COUNTY ,Q~ ...................... ,.~....f..,f '~"~' ................. · -.~..~....,,.~,,~...,~ .................... being~duly sworn,' deposes an~t says that he is the applicant (Name of individual sigr~g 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 application flied therewith. Sworn tobe_,f_gre me this ......... C~..7-.'~.~.. day of ........... ~...~...¢..~...¢..C ............ , 19...~'....~/ Pub I i c ,-',~./]~....~,....~'..~. ~4~¢v~4t¢..'~...... .......... County ................................. (Signature: ..................... of :9c~ .................................. Notary '/--/7~. ~^~oN A ~r_~[~ appli(.,,/ Term Expires March 30~ Examined ,, ...................................... , · · A - ~-- ~, ; .-St-- ..... X//~....~..... pproved .......... :";"F~ /~'"'" ly ........ Per, mit mo .................... ..... ..................... ........................... 'DOWN OF ~OUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE APPLICATION FOR BUILDING PERMIT Date ........ ~c~;.ab.e~...15~;h ..,.1262 ....... , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat plan shawina location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detai-bd 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 issue, ce 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 an 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 Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to.lhe BL d ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance~ or Regulations, for the construction of buildings, additions or alterations, or fat removal or demol t on, as herein descr bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, (:nd regulations. ........ ......................................... ' /~ C~"~ - (Signature of applicant, or name, if a corporation) ~\ -' ~.~..~d.Z.e..g..o.~Z ~o~, S~Zd~, ~Z. \ " '" :","' ,'~'L-"/'~ .... (X~i~';;s;';;F;'F~ii;;;;;;i ...... ":: ................ Stale whether oppIicant~owner, lessee, ogen;t:;hitect, engineer: general contractor, electrician, plumber or b'u,!d,r .................... ~ ...... ,.;: .... X2 ............. ~.~z ~ .... .................................................................. i;.i~ ............................... Name of owner of premises ....... ~.,~.e.l~-...J~.q.l~,,~.~,~'.~ ............................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) / Location of land on which propbsed work will be done Map No.' . Street and Number ~/.:~....o..~....~.~..~.[.n.~.e.....~.D..q.e. ........... : ....... ..~.{Lt..R;L.~!~..q~.~...F~ .... , /~/ -- Z-/~, ~2 Mur, icil~.litv State existing use end occupancy of premises and intended use and occupancy :~f prop~st, d , ~ st":,. ,,,:r a Existing use and occupancy ................................................ ;~ ............. b. Intended use and occupancy ......................................................... 3. Nature of work (check which appli~ ,re): New Building .................. Addltio ........,~ ....... Alteration .................. Repair .................. Removal ..........' ........ Demolition ........... .~... Other Work (Describe) ........................................ 4. Est mated Cost ..... L.~...?.... ,' .'..'......Fee' ~ .......................................................................... (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 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 ....~..~ ............ Height .................... Number of Stories ...... : ......................................................................................................... 9. Size of lot: Front ...I..a...~. .............. Rear ....... ~J..~...0...; Depth ..... .~...~..~....~..... 10. Date of Purchase ..................................... ,t ............... Nome ~ Farmer Owner ....................................................... 11. Zone or use district in which premises are sltuoted ............................................................................................ 12. Does proposed ¢onstruation vlol~e..l ---~/~any zon ng aw, ordinance or..-; -.e~.~-- I)reguJat on?.. ........................... Nome of Architect ..?~ .................................. ,~.%.; ....... Address .......................................... Phone No ................... Contractor Name of .....~..~....~..:....Address ..... ,~,,...~ ............. Phone No. ~:3.~1.-..~..~.?.,9 PLOT DIAGRAM Locate clearly and diltinctly all buildings, whether existing or I~posed, and ind cat~l a ~et-back d mens OhS from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SLATE OF NEW YORK COUNTY ~ ...... . ................... ~';(Name of indiwduo! sigrl~g appl cati~) .c--.~ ,,~' ' " ......................................... T-~ ........................... being duly. sworn d~oses and sa~ t~r he ,~ * .e ~.. obnve named. He is the (Ccntr~tor, agent, comorote ,~fic,:' of said owher or owners, and is duly authorized to perform or have ~rforn~ed the ~id work and to th~s application; that all stctements contained in this application are true to the best of his kn,~ledge that the work will be performed in the manner set forth in the a~licoti~ filed t~rewith. Sworn to ~f~e me this ~ r ~. ,~"'~ Pt /~ ~ ~'-.~: ..~ ,.,~,.. - Notary Publi . ~.~.~ ......... ~k~ .......... County (Signehsre of ,]Df:hCd~'i} ' '