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Home My WebLink About4506-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ottice Southold, N. Y. Certificate Of Occupancy No.Z 3719. Date THIS CERTIFIES that the building located at Map No. Nass. Farm~Block No. .. Lot No. Dee 31 ,19 69 PS~us Tree Road Street 26 & Pt 27 Cutchogue N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept '30' 19 69 pursuant to which Building Permit No. 1+.506Z dated Oct 11+ , 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 family dwe.!.~ing with. a-ttaeked .accessory bldg. The certificate is issued to William Peters. .Owne~ .... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. lq .,R ....... Eouse ~ 1600 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4506 Z Permission is hereby granted to: · .~.~..~.~.,..~ .................. , ....................... pursuant to application dated ............................. ~t ...... ~.~/~ ......... , 19.i~.., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ...........:.. Approved ........................... :.~. .......... ,19 ........ " Permit No. . ........................... I ~) O (~ (Building Inspector) APPLICATION FOR BUILDING PERMIT / / .............. .................... INSTRUCTIONS a. This apphcation 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 pubhc streets or areas, and g~wng a detailed description of layout of property must be drawn on the diagram which is part of this application c. The work covered by th~s 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 apphcant 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 port 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 other applicable Laws, etd,nonces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as harem described The apphcant agrees to comply with all apphcable laws, ordinances, building code, housing cqcL~, and regulations. (Signature of applicant, or name, if a corporation) ........... ...... z (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................. ().!.x.::.~, ................................................................................................................................. Name of owner of premises ~ J. ! [./...~..ff? /"~'~ X/'~Z If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) /t~//~; $ j] ~ A/¢/I~ S ! Locat,on of land on which proposed work will be done Ma~p No ........ j.J...~'...? ............. ~ot No.. ~..6.~....~....~.J'~. ........... .(3.. ................... ................................. Municipality 2. State existing use and occupancy of~_,_remises and inten~ed use and occupancy of ,~r, oposed construction' a. Ex sting use and occupancy ..... f~...A,..~...4....~..x~.~......~...~..~.~....~..~..,...~...'.?~..,{. T. ~ ~~. 3 of work (check which applicable). New Budding Addition Alterahon Nature .................................... .............. ........ ............... 4 Estimated Cost ..... ~./:~)....l~Y,:.~.....t...~- ...... ~zz~z/.. Fee .................................................................................... (to be paid on filing this applicahon) 5. I¢ dwelling, number of dwelhng units ........................ Number of dwelling un,ts 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 D,mensions of ex,sting structures, if any: Front ...... ~..~.. ............. Rear ........ .'.~...~.. ................. Depth ...~..~. ......... Height ...... /....~.. .......... Number of Stories ................. .~. ........................................................................................... D~mens~ons of same structure with alterations or additions: Front ............ ~....: ................. Rear ...... - ............. Depth ~ Height ~- . ..... Number of Stones ......... :: .................... 8 Dimensions of ,entire new construchon: Front ......... ~/.1~. .................. Rear ...... /.2~ .............. Depth ...~.....~.. ...... Height ...... .~....'. ....... Number of Stories ............... // .................................................... ~n,~ '? ........................... 9. S,ze of lot: Front ...... /..1~..~ ............. Rear ....... .t~.~ ................ Depth ....... ..~..Y.z.?. .... ~,~. 10 Date of Purchase ............... ./..~.~...~.. ........ ./...~/'~..~.. ...... Namz~ of For~er Owner . .~. .... (.'~O....T...~....L....~....~..~/~ .... 11. Zone or use district in which premises are s~tuated ........... I..'/..~.~./.~..~.'..~..~./.~...~.. .................................................... 12 Does proposed construchon violate any_zoning law, ordinance or regqlat,on~ ...... .~/. ~.~. ............ ,~ ........... ~,.v 13 Name of Owner of prem,ses .....I,:~......Z...~. I ?..~.~' ....... Address .4:../...~...~.~..~...~.~...~...~...~. Z/./C.... Phone No ,,Z.~.~,....~_/. Name of Architect .............. ~.~.'..~.~...~.~?~Address ................................... Phone No ............ Name of Contractor ........... .~'~.~.~.. Z~..Z......~.../).~.~....Address .......................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fro property hnes. Gwe street and block number or descnphon according to deed, and show street names and indica whether interior or corner lot. COUNTYI'~1~11, ~_ oF ......~~.?...~ o.~.~ ............... ~..~...~.t.,~..i.t./-..~l ...... t...,~...t..~......~. ............... bein~ duly sworn, d~oses ond soys thor he is the ~pphcn (N~mo above named He ,s the ............... 0..~..~.~ ................................................................................................................. (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and f this apphcation; that all statements contained ~n this apphcat~on are true to the best of h~s knowledge and belief; that the work w~ll be performed ~n the manner set foRh ~n the application fil~ therew,th ,Sw°rn~f°re~..~.' menv nfz ~~ ~this ~'~19~o~.. ~~l~O.'~.~;..~' ' .~~'"' ................ c ............... ................ ~otaw Pubhc, Sh,~ of New Yor~ No 60-7~2~50 Q,~hfie~ m We~tc~*~te~ County ~e'~[~cale F,ied ~,~ f'ew Yor~ Count,/