The URL can be used to link to this page

Home My WebLink About4583-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Of[ice Sonthold, N. Y. Certificate Of Occupancy No. Z381+8. Date THIS CERTIFIES that the building located at section Map No~ard, Bay :llt[lllllllgl~. III Lot No. .. Z _mo 26 ,19 70 01d Orchard Road Street 17~ .East Marion ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated December 9 , 19 69 pursuant to which Building Permit No. 1+~83Z dated Dec 10 , 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 . .~Tivato. one. family, dwott, ing ............. The certificate is issued to Charles Woznick Owlae~ · · (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ;[Uae 26, ~970 by.g. Villa. . Building Inspe~br House ~ 1230 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) 4583 Z Permission is hereby granted to: pt premises located at ................. ~l~,.-.~ ,~.---.ll~l~lt..;~l~-]~l~, ...... ~lt~ll~..~-~- ...................... .............................................. Ii,~..... e~t.. ~a,t...~e ........... z,..x,~ ...... ~.~, ............. pursuan~ to application doted ............................. ~.~. ...... .9 .............. , 19.~t~.., and approved by the Building Inspector. .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been ~mspected by this department a~d found to be satisfa~tory. Dlstrlot Engineer ' District Engineer BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined .................................... , Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ..................................................... .~_ (Building Insp~tr) APPLICATION FOR BUILDING PERMIT Application No...~...~....E..-~... ........... ~ /¢.o. Date ............................... ~. ........................... ,19 ............ IINSTRUCTIONS a. Th~s opphcohon must be completely filled ~n by typewr ter or tn ~nk and submitted ~n duphcate to the Budding Inspector. . b. Plot plan showing Iocohon of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymustbe drawn on the diagram which is part of this application. ,::~ c. The work covered by this application maync~ m mnC:eo beco m c d bbefcore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. 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 'for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the APPLICATION 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 herein described. (SignatureUof applicant, or name, if a corporation) ............................... i~ddre'"' ' '~"of" ' "~,'l~'l~i'i~ant ) ........ ¢ .................. State whether applicant is owner, lessee, agent, architect, engineer,,g~enerol contractor, electrician, plumber or builder. Name of owner of premises ......................................... (/ ~- ......................... ~ .................... If applicant is a corporate, signat~rg~of duly authorized officer. .................... ................... 1. Location of land on which pr~sed ,orkwill .be done. Map No: ..~...~e~,...~ Lot No: ..... t.Z...~.. ..... Street and Number ...~......~.........O~ ...... ../~....c~.. ................................. ~...~ ............................. ~=~( ~ /.~ _~ O Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ........................... Intended use and occupancy .....................~...'. .............. .(~ .................................................................................. .. 3. Nature of work (check which applicable): New Building ...... ~ ...... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ............. ~.,~,/.~.~...~. ............................... Fee .......................................................................................... (to be paid on filing this application) ~ um er 5. If dwelling, number of dwelling units ............................ N b of dwelling units 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. 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 Stories ........................................ 8. Dimensions of entire new construction: Front ............ ,~..~ ......... Rear ....... ~....~'.~ ........... Depth ,..Z...~..°~..~. ............. Height ........ ~...~. .............. Number of Stories ............ .( .............. 9. Size of lot: Front ............. ?....~. ........ Pear ......... ~.~l~. ............ Depth .......... ~.~...~.. ............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ..../J~'.~ ........................................... C . ~ .................... ~ .......... ~ ..... Phone No. ~2Z.../.~.~ 13. Name of Owner of premises ....~ ....... ~.~..~1.~.~. .......... Address ]/v/,~ ~ Name of Architect ...................................................... Address ............................ . ................ Phone No ..................... Name of Contractor ......................................... ,~....~.Add ess ....~ ................ ~ .................... Phone No...?.~ .............. 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 accordin show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ ~ e ' COUNTY OF ......................... ~.~..~ ~'~' ............. .'~eL...~~ ................ being du y sworn, deposes and says that he is the applicant .... (Name o~individual signing ap~licotionl above named. He Js the ........................................................... ~ ............................ L .............................................. (Contractor, agent, corporate officer, etc.) of said owner or owners and is duly authorized to perform, or have performed the said work and to moPe and file this application; that all statements contained in this al~ph.ca.tion are true to the best of his knowledge and bellef~ and that the work will be performed in the manner set torth .n the application filed therewith. Sworr~to before me this ~ ~ ELIZAB[TH Arl~ N~¥1LLE i ,y pUBliC, State of ~,1 rk .............................