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Home My WebLink About4526-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerl/'s Office Southold, N. Y. Certificate Of Occupancy No. Z372~ Date THIS CERTIFIES that the building located at Map Nopec,By, Oaks Block No. .xx Lot No. DeC 31 , 19 69 Robinson Lane Street ? Peconic.. N,Y, ., conforms substantially to the Application for Building Permit heretofore filed in this office dated · 0ct 27 , 19 69 pursuant to which Building Permit No. t~t~Z~ dated Oct 27 , 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 accessory' (tool' Sh~l) Building ............... The certificate is issued to Marie Reird~a.rdt-- · Owe.er '" (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N Building Inspector 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? ~526 Z Permission is hereby granted to: to ....... J'~ .,m~,...~l,..~ft,..t~l~.~.~...1~1~ ............................................................ at premises located at ................... jJdj~..JJJ ....... ~..~Jl~...JJJ~ ................................................ .......................................... Ji~btz~J~.~bime ............ I~e!j~....:....ll,Z, ...................................... pursuan$ to application dated ..................... JJJ~ ........... J~. .............. , 19..J~., and approved by the Building Inspector. FOR, I! li'O. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~...~.....~.Z....,19.~..~.. Approved ........................................ , 19.~ ..... Permit No .... D,sapproved a/c ............................................................................................. Appl,cation No ..~...~...¢~.~.....~. APPLICATION FOR BUILDING PERMIT Date ............... ~-..~....~- 7.. ......... INSTRUCTIONS a. This apphcation must be completely filled in by typewriter or in ink and submitted ~n dupl,cate to the Buddin& Inspector. b Plot plan show~ng location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and gwing a detaded 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 Budding Permit to the apphcant Such permH 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 ~n part for any purpose whatever untda Cerhficate of Occupanc~ shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to thc 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, as hereto described. The applicant agrees to comply with all applicable laws, ord~nar~ces, building code, housing code, and regulations. (Signature 9J~ applicant, or name, ~f a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder Name of owner of premises ..... ./~ ..... ~ ................................................................................. 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' ....~' .~....~.~.......6Z'...~.../.~..~.. Lot No.' .... ./ ........... Street and Number ./?o b/g~o/') L~/~..~..?..,,z ,t~2~°c~./') /.~..,, ,~, Y // ~,~C~ ~)?J~ ~>-.-~ 0 ........................................................................................ ~ i~'i'l~'li't~' .................................. 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 ............................................................................................................................... 3. Nature of work (check which applicable): New Budding .................. Addition ................Alteration ......... Repair ............. Removal .................. Demohtion ................ Other work ~uescrioe~ ............................... 4. Estimated Cost ............................................................ Fee ..................................................................................... (to be paid on filing this application) 5 If dwelling, number of dwelling umts ............................ Number of dwelling un,ts on each floor ......................... If garage, number of cars ........................................................................................................................................... 6 If business, commercial or mixed occupancy, specify/..4, ~- nature and extent .,f c, ~of eqch type of use ................ ~;~ ~ ......... 7 Dimensions of existing structures, if any: Front ...... ..-C~_ .............. Rear ....... .-C...¥...' ................ Depth .....<r.(-~... ......... Height ..... ..~.?...:. ......... Number of Stories .......... .f.. .............................................................................................. D~mensions of same structure with alterations or addmons' Front ................................... Rear .................. Depth ................................ Height ............................ Number of Stories 8. D,menslons of enhre new construct,on: Front .......... .~..../. ................... Rear' ............. ...... .?.. .................. 2' ............... Depth ......... ~' /' Height .................... Number o~ Stories ...................................................................... ~ ,~ ~ ,,~/~>,~p ! ,~_~' ( ............. q,-e ,-f lot Front //~ ' Rear Denth ~..~..?.~) 9 Date ofPurchase tl I~C~C~i~iC~II I~1(~(~ ....... Name of Former Owner~/-.?..~ ~ .~...~?.~/L~......./~...t..'~.../~./...~ I0 11 Zone or use dtstrict in which premises are situated ..................................................................................... 12 Does proposed construction wolate any zoning law, ordinance or.,re;u4ation~ ,~/2.,..;,~ /2,,: ~. ,./¢-' ' 7(0~72;~'~f; Z'~ .......................... ~,;'5""~."~';'~ 13 Name of Owner of prem,ses'.'.z.L~..,L../~...z.~¢Z./'~Z...C~..f4./...Address ,~(e~.~r~/'C;,.~'./~X/~"~ .. Phone No./..~'..~...'.? Name of Architect ...................................................... Address ........................................ Phone No Name of Contractor ............................................... Address ..................................Phone No ............... PLOT DIAGRAM Locate clearly and distinctly oil buddings, whether ex~sting or proposed, and ~nd~cate all set-back d~mens~ons fro~ property lines. Gwe street and block number or description according to deed, and show street names and ind~cat whether interior or corner tot. : /*=40' STATE OF NEW(j¥ORJ~ COUNTY OF ~.. ....... ~.~'~"~' / (Name of ~ndlv:~at slgmng application) ........ being duly sworn, deposes and says that he ~s the applicar 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 satd work and to make and fd th~s apphcat~on; that all statements contained in th~s apphcahon are true to the best of his knowledge and behef, an that the work will be performed in the manner set forth in the apphcation filed therewith, Sworn to before me this ,0,¢. /? .'YL · Il_ ............. , ..... ..............................