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Home My WebLink About4569-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No~ tl~)21+ . .. Date 0et '21 , 19 70 THIS CERTIFIES that the building located at . Lakeside & 0akwood Street Map No.Cedar BeachB~oKc~ No. , Lot No. ~2 Southold N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated No¥ ' '28 , 19 69 pursuant to which Building Permit No. dated NoV 28, 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 l~ive2e one fa~!y, dwet~'ing The certificate is issued to Charles of the aforesaid building. . Owner (owner, lessee or tenant) Suffolk County Department of Health Approval Oct ~[~ 1970 House $ 8~; Oak-wood DI' .... .~B~,~.~, , ~/~,, . uilding ~n~pect~r ~ · '0]1~1~ NO. ~ 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? 4569 Z pursuo~¢ to opplicotion dote~ ........................................................... , 19...~. , and approved by the Building Inspector. Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date October lb, 1970 Bldg. Permit No. 45692 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at c/o Oakwood Driv~ ~nd Lakeside Drive, Southold (Give deed location) Cedar B~ach Park, Lot 72 have been inspected by this department and found to be satisfactory. ~'~is~trict Engineer ~FORM ,NO. 1 ~ ~ TOWN OF SOoT. tiOLD ''~/''~ BUILDING DI~A~ ~"~/?~ TOWN ,C,~E~Ir'S OFI~C~ SO~-,-nOLD, N. Y. Examined... ~...~...~., 19.~..? Approved .................... ,19 .... Permit No ......... Disapproved a/c .... ~ .... ~ ............. Application No...q.~...~. ~. ..... APPLICATION FOR BUILDING PERMIT Date ...................... 10 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the~,,,~ Building Inspec'0or.~ b. Plot plan showing location of lot and of buildings on premises, relati~mudhip to adjoining premises or publie~,L streets or areas, and giving a detailed description of lay out of property must be drawn on the dia~m 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 In spector 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 tbr any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS I-n~.k-l~y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soathold). Suffolk Oonnty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buil~l lng~ ~additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to eom ply: with all applicable laws, ordinances, building code, housing code, and regulations. ..... ................... (Signature of .applicant, or name ff a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................................................................................................... Name of owner of premises ...o.~...~..~..J-.,..~-~....e?/f..~.(. .................................................. If applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) 1. Location of land on which proocaed work will be done Map No ~-(~C~ ~ ~1 t No. '') ~ Street an: N~m~..~~..~.~.~e~ .... '.~~...~;~,:~ ..... .... ~ g ~ ~ ~ ~AD ~ ~l gff Municip~iW 2. State exi~g use and ~cup~cy ~ premises ~ d intended use ~ ~p~cy of pm~ ~t~ction. a. ~ist~g use and ~cup~cy ............. b. t aed ................................................. 3. Nature of work (check which applicable): New Building ...b~.... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost ...~..~.~.~. ............ ' .......... Fee ................................................ l~ ~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 bus!r~,, commercial ~r mixed occupancy, Spec ify nature ~nd extent of each type of use .............. 7. Dimensions of existing structures, ff any: Front . . ~(...~.-/?..~... Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .~...~..~ ...... Rear ............... Depth ................ Height ................ Number of S~ries ..................... 8. Dimensions of entire new construction: Front ..... ~ .......... Rear .. ?'.~..~ ....... Depth ~ / Height ....~.. f. .... Number of Stories .... .~. .................................................... 9. Size of iot:~Front .... ,.. ~ ..../.."Rear ............... Depth .' .............. 10. Date of Purchase ..... .-~./'/.V'./(~.~ ............... Name of Former OWner ..~.:.~: f....~..-~.. .... ......... 11. Zone or use district in which premises are situated .................................................... 12. Does proposed construction violate any z~ning law, ordinance or regulation? ...c~..~. .................... 13. Name of Owne~of premises ?.'..~..'...~.~.~?..~..(- .... Address ~,..~...~.A'. f.~.~.~ .,~.. Phone No.??)[%~..~..F' Name'of Architect ~'~ ~ .~.~, .~q .~ddress .~.?.~. bt~r.~.~.~,~.f?.~./ Phone No.,~/.~.~..Y~.-.-~?/r' Name of Contractor . .7f~. t~..~....~.~/..~. ~ ......... Address .e...(O~?..~..~.~./.~(,~.' .... Phone No ............ ? PLOT DIAGRAM Locate clearly~stinctly all buildinSs, whether existing or proposed, and indicate all set-back dimensions from property li~e~. Gj~e s .t~et an~ blo01~ dumber or de scription according to deed, and show street names and CO~TY OF ...... . ) ........ ~.'. ~(~ .............. boing dul7 ~wom, de~ and ~s (Name of ~dividu~ signing applicat}on) ~t a~ve n~ed. He Is t~.. .... ~ ............................................................ (Oon~a~r, a~t, ~-~ate ~icer, etc.) : , and is duly-aUt~:~ p~orm' er ~ve pe~ ~e'-~id ~k ~d ~ m~e ~d file th~ application; ~at ~1 stateme~s ~ntain~ ~ this applicon ~ ~e to the best of his knowl~ge belief; .and ~'at ~e w~k will be p~ in the mann er set fo~ in ~ application filed ~e~with. Sworn to before me ~is ~ day of ~ I ~ ....... ............................ ~...~... ~bl~c, .................... ~unty~ ~Z N~ ~~~~l (Si~tu~ of applic~t). NOTARY PUBLIC, State ef ,:~',v York : ' ,/ No. 52-8125850, Suffolk Co~y Term Expires March 30, 19~