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Home My WebLink About4539-zFORM NO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z 3712 ... Date December 31 , 19 69. THIS CERTIFIES that the building located at 8o%md View Road Street Map No. Orient by ~l~ck No. I Lot No. 23 0rlent~ N,Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated . NOV, 3 , 19 $9 pursuant to which Building Permit No. k,~39Z. dated ..... NOW, 3 , 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 £-mil~ dwall:t~g . The certificate is issued to . . George Bents. of the aforesaid building. Suffolk County Department of Health Approval 0~rne~, ...... (owner, lessee or tenant) Building Inspector l~Olt~ ~0. 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.o 4539 Z Permission is hereby ~t4~! ....... z~.:.~..~.~.~/~ ...................... ~ at premises located at ......................................................................................................................... Building Inspector. Fee $ ........................ FOI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Perm,t No. --" Disapproved a/c .............................................................................................. (Budding Inspector) Application No .......................... APPLIGATION FOR BUILDING PERMIT Date ......................... ~.0.~. ...... ~. ............... , 196~ . INSTRUCTIONS a. This opphcation must be completely filled m by typewriter or ~n mk and submitted in duplicate to the Buddin. Inspector. b. Plot plan showing Iocahon of lot and of bu,ldmgs on premises, relahonship to adjoining pram,sas or public streets c areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatior 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 apphcant Such perm shall be kept on the premises available for inspechon throughout the progress of the work. e No building shall be occupied or used in whole or in part for any purpose whatever unhl a Certihcate of Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additions or alterohons, or for removal or demolition, as herein descnbe~ The applicant agrees to comply with all apphcable lows, ordinances, building code, housing code, and regulations ~tenz~ Mois& (Signature of applicant, or name, if a corporation) Orient (Address of applicant) State whether applicant ts owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu~lde ¢ontr&c tar Geo ~entz 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 wdl be done Map No .... Q~'.$e~$. ~.. ~.~.~... Lot No 2.3 ............. Street and Number S0~6 View Roa~ 0~e~ Munici~li~ 2 State existing use and occupancy of premises and intended use and occupancy of propos~ construction dwell~ a. ~isting use and ~cupancy ................... ~-.~ ................................................................................................. ~e wit~ e~arge~ front porch b. Intended use and ~cupancy ............................................................................................................................... 3. Nature of work (check which applicable) New Building ..... :ll[~..... Addition .... ~, ....... Alteration ... R, epair .................. Removal .................. Demohtian ................. Other Work (Describe) ................................... 4. Estimated Cost ............................................................ Fee ..... ~'~ ........................................................................ ~ttobe paid on fihng this application) 5. If dwelhng, number of dwelhng units ........ -O~ ............ Number of dwelling umts on each floor ......................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or m~xed 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 Stones ............................ 8 Dimensions of entire new construction' Front .... ~ ............................. Rear .... ~ ..................... Depth .....~ ........... Height .................... Number of Stories .......................................................................................... 9. Size of lot: Front ............................ Rear .................................. Depth ............................. 10. Date of Purchase ....................................................... Name of Former Owner ............................................ 11. Zone or use d~strict in which premises are situated ............. ~.~...~,.~ ..... .. ....................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation:) ............... ~ ............................ 13 Name of Owner of premises .... G','"~'~ ............. Address .......... (~.~1~1.'~,' ............Phone No ................... Name of Architect ................................................... Address ........................................ Phone No .... Name of Contractor .......... j[~..~ ................... Address ......... 0~'~'¢ ................... Phone No ............. PLOT DIAGRAM Locate clearly and distinctly all bu~[dings, whether ex~sting or proposed, and md~cote all set-back dimensions fro~ property lines. G~ve street and block number or descnpt~on according to deed, and show street names and indicaJ ~vhether interior or corner lot STATE OF NEW YORK, ~ ~ e COUNTY OF "'1~1~ ............ ~' .... .................................... JJi~.-~lJ ....................... being duly sworn, deposes and says that he ~s the apphca, (Name of mdiwdual s~gning apphcahon) above n~med. He ~s the .................................. ~,~t,~,~,~:~. ........................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fi this application; that all statements contained ~n th~s application are true to the best of h~s knowledge and belief; ar tha~ the work will be performed in the manner set forth ~n the opphcation filed therewith Sworn to before me this , ................... doy of .......... ............. , /,' l,. .......................... Notary ELIZABETq A~'~N NEVILLE NOTARY PUBLIO, St~e of I'~e',~ York No 52-812595fl, Suffolk COUo~A Term I:xp~res March 30, 19Lf,,z