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Home My WebLink About4490-zFOI~M NO. S TOWN OF SOUTItOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z 378b .... Date THIS CERTIFIES that the building located at Map No. xx Block No. xx Lot No. April .3 .,19. 70 Stillwate~ Ave Street xx C~tchogue E.X~. conforms substantially to the Application for Building Permit heretofore filed in this office dated Oct; 6 , 19 69 pursuant to which Building Permit No. ~.'90Z dated Oct 6 , 19 69' 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 £amtAy.d~:eliing ........................... The certificate is issued to Ev. erett Glqyq;' ............ O.¥x.~.e.r..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .Mvrgh... 3.~....~970...by .R, .V. illa .. 1' Building Inspector House # 89~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FER~IT (THIS PERMIT Mus'r BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: g.~..~....A~.....~.~.~.~.9~. ......... :......e..~..~..~....r.~. ............................................. at premises located at ~J~ ~t~L~rlll~t~ J~ (~1 .................................................. ~1~1~.t~ ......... ~..*~.. ..................................................................... pursuant to application dated ........................ t~1~ ........ ~1~ ................ , lgJ~.., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfac~tory. District Engineer ~A~ ~ i 1~78 ~istrict ~ngineer Examined ................ .................... , 19 Application No. - Approved ....... ' ~ ................ ~' ,/',//~/ ~ 0 ............. ,19 Permit No..J. 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 o n premises, relatkmship 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 throughout the progress of the work. e. No building shall be occupied or used in whole o~ in part f~r any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspects. APPLICATION IS l-ltfilel;:l~y MADE to the Building Department fo!-' the issuance of a Building Permit pursuant t0 the Building Zone Ordinance of the Town of .Sou~hold, Suffolk 0o~_~ nty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for ren~oval or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, ~ regulations. (Signature of applicant, or name ff a corporation) Robinson Road, Greenpolr$, ~.~'. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ....... ]~q ~.~l.c]. 9 Ir. ................................................................................. Name of owner of premises ....E.T.e.r..9.%.%...G.l.o..v.e.r. ......................................................... If applicant is a oorporate, signature of duly authorized officer. '~ ~,¥i~k (Name ~d title of co--ate officer) ~ ~ 1 ~at '~ of ~a~ ~h~ch ~ work win b~ ~on~. ~ ~o. ~~t ~o.~ s ................... ?r~.' ' ~.~.~. ~.~r.~. ~: ........... ~5~ .................... 2. S~te exist~ use and ~p~e~ of pmmi~ ~ d i~end~ ~ ~ ~p~ of ~ ~m~ction. a. ~isting ~e and ~p~e~ ..... Bnil~ing plo~ b. Int~ded ~ .~d ~eup~e~ ......... ~..~ll~g ...................................... 4. 5. 6, 10. 12. 13. Nature of work (check which applicable): New Building .~... Addition ...' ..... Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ........... · .......... $28 .$10 ' Estimated C~.st .... ,000 Fee ~.. · .................... (to be paid on filing this application) If ,dwelling, number of dwelling units . .o.n..e ..... Number of dwelling units on each floor ...o.~ ....... If garage, number of cars ......... }.w.o ............................................................ If business, commercial or mixed occupancy, spec ify nature and extent of each type of use ............. Dimensions of existing structures, if any: Front . ~q~e. ...... Rear ............. Depth ............ Height ................ Number of Stm'ies ....................................................... Dimensions of same structure with alterations or additions: Front .............. Rear .............. Depth ................ Height ................ Number of Stories ..................... Dimensions of entire new construction: Front ...7.8.~..47. ........ Rear . 71R!4P. ...... Depth .. 31~ ...... Height ...1~! ...... Number of Stories .... nne .................................................. Size of lot: Front..!..'~..~.' ........ Rear ....!.5.Q'.~. ...... Depth ...~00.~.. ...... Date of Purcl~ase .....S.e.p.$.,..!.9.6.9 .............. Name of Former Owner . .G.e.o.: Braun Zone or use district in which premises are situated .... .R.e.s..i.d.e..n.~.J, .al .................................. Does proposed construction violate any zoning law, ordinance or regulation? ...n..o ..................... Name of Owner~of premises , .~v..e.r.e..~.~., .6.1.o..v.e.r... Address S..o.u.~..h.o.l.c],. ~,,..y .... Phone No. Name of Architect ............................. Address ...................... Phone No ............ Name of Contractor . ~.~. l[,..P, qve~L1 .......... Address .(~.r.e..e.nl)~ple.~..N,, .Y,,. Pkone No. 475r..-0995 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. COUNTY 0 .., . ~'...ogJff. ~ ................ sworn, deposes and saya that he s the appli- ......(Name'g~ individual signing application/~ ,~9 ~/ cant above named. He is the ............... D.t~ff-er~( ............................ ' ....................... · (COntractor, agent, oorporate 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 mann er set forthi in the application filed therewith. Sworn to before me this ......... .... ... day of . Notary Public, .................. County (Signture of applicant) ELIZABETH ANN NEVILLE NOTARY PU~[IC, Stat~ of New York No. 52-8125850, Suffc)k Ccucuntvt : Term Expires March 39,