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Home My WebLink About4587-zFOEM NO. 4 TOWN OF SOUTHOLD BUIT.IIlNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z..38.1~ ·.. Date ............ ~y .... ~8 ..... , 19.?0 THIS CERTIFIES that the building located at . Westvl®w .Dl, t.ve .......... Street Map No .... x~ ...... Block No .... ll~ .....Lot No .... ~z ..... ltat.tituek... 1~,¥ :. · · conforms substantially to the Application for Building Permit heretofore fried in this office dated .......... ttov ..... 12', 19..6~) pursuant to which Building Permit No.. dated ........... Dee .... 16.., 19.69., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P. rivate, one. family, dwel,],il~g .... (&~proved..by. id .A~peals.) ....... The certificate is issued to . Edward. Dennis .......... 0~mer. ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . $1ay...26 ~..1.970...by- tt,. ¥1.tta. · · ..... ...... Building Inspector House ~ 160~ FORM NO. 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 CO/V~PLk-I'ION OF THE WORK AUTHORIZED) N? ~587 Z Permission is hereby granted to: ot premises located ot ........ :...{J4d~JL.-:~tJlt~. ,,])dlJ~ .......................................................................... ................................................................... ~'~t~t~ ....... ~,,:~. ........................................ , ............. pursuczn¢ to application dated ..... ~ ........................... J~J~. .. ~JZ. ... '. ...... , lg..J~; and approved by the TOWN OF $OUTHOLO BUILDING DEPARTMENT T~H CLERK'S OFFICE ~ed ..... ~../.~. ............ , ~.~.~. , ~ 7 ~ Pe~it ~o. ~.~ .............. ~..~'~ Di~ppr~ a/c .............................. ~ ................................................... ~ ....... ..., ........... ....... ....................... .............................................. (~ld~ ~n~ctor) APPLICATION FOR BUILDING PERMIT ~to ...~..../..~.... ........................ , ,9.6...~.... INSTRUCTIONS a. This applic~ation must be completely filled in by typewriter or in ink and submitted in duplicate to the Building ~ 'b. 'Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or ~.~'reas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this application. c. The work covered by this application may not be commenced be~ore issuance of Building Permit. d: Upon approval of this application, the Building Inspector 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 for any purpose whatever until a Certificate of Occupancy · ~.~ sho have been granted by the Building Inspector. · APPLICATION IS HEREBY MADE to the Building Department for the issuance of a BuJlding Permit pursuant to the 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. THe applicant agrees to comply with all applicable laws, ordinances, buil~ffne~,,cnd~,and regulations. (Address of applicant) ~'/g' State whether~appllcant is owner, lessee, agent, architect, engi~neer, genera! contractor, electrician, plumber or builder. ,;- Name of owner of ~remises ....................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ ' st,., ~ N,m~, · S.~.~..~...3.~I .... ~.~. ...~.~.~.. ~ I - /~ o~ Munici~ll~ ~ State ex~g ~e a~ ~cu~ncy of premiss and intended use and ~cu~ncy of pr~ con~mcti~: ~lstlng ~ a~, ~cupan~ ........................................................................................................................... ~ In~ u. a~ ~c~an~ ................................. 3. Nature of work (check which cable): New Building ... Ad n .................. Alteration .......... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ................................ 4. Estimated Cost ....~..(.).~.~.'~.. ........................... Fee ................................................................................. (to be paid on filing this applicoti~.r~ 5. If dwelling, n~dmber of dwelling units ........ {. .................. Number of dwelling units on each floor ..~.:~ .................. / If garage, number of cars ........ J .................................................................................................................................... 6. If business, commercial or mixed occupancy, spe(;ify 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~. ............................ ~._~-~rNumber of Stories ............ ~ ~ ,~'x ............ _,,,(?. ~ ~r~,~ 8. D~mens~ons of,eohre new construchon: Front .................................... Rear .................... Depth ................ . /,./_ - i ........ He,,ght .................... Nu~ pf Stories .......... ~,...:,, ..................................... '~7~"~,~ ................................................ 9. Size Of lot: Front ........~.~..'~.~. .............. Rear ...... ,..~..; ......................... Depth ............ ~'i .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction vio~3te~ any zoning l~lw, ordinance er r~ctuJa'don?, .... ,~.~.~,,,~z~,e/~,~..,,q,r,¢/ ,z-,--/~,~ ~,,./' l/.,,.,,w', ~"/,~,?e~"'~ ~-"~ ................. 131' "a f"' n ' · .,,- ...... u ~'~ me o gw er or premmes ........................................ ~,aaress .................... Phone No ....... Name of Architect ....~..,, ......... . .................. y~,,~ ........ Address .................. ~ ............. ,~~/,/- V' ..~.~.~-' ~"~,~' ,.. . o 'z:z. .. _FLY, Name of ~-on~racmr .............................................. l,,;.,~aclress ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly ond distinctly oil buildings, whether existing or proposed, ond indicate a~l set-~ck di~nensions fram property lit/es. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW'~ORK, ~ 1- ~ , COUNTY OF~ ............ $ :~'~' ~lame at ~na~waual signing applicot]~t) ' I. -, ~,~ , - obove.pam*d. ~le~ the ........ ~..¢~,~z~.....~.......d~L~ ...................................... ~ ............................................. ' ',: Ii . ~" ~ ' . (ContractOr, agent?corporate, o~fficer, etc.) of said owner or Owners, and is duly authorized to perform or have performed the said work qr~d to make and file this application; that all statements conta:ined Jn this application are true to the best of his knowledge and belief; and that the work will be perforn3~d'in the manner set forth in the applicj3t4ee~ed therewith. Sworn to before me this ( I ~ ~,~ of ..... ........... , . ../" of applicant) Notary Public ...... C~unty . ~.\ . NOTARY PUBLIC, Stale of r'.~'.')r .* No. 52-8]25850, Suffolk ~',' '%~ %' Term Expires March 30, 19~ · .~t .."-. ' G "t'P-.,°4~',4<D' W. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg, Permit No, / TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give d~ed location) ~ have been inspected by this department and found to be satisfactory. ~/lY 2 6 1970 ? ~-,~ Dlstriot Engineer, District Engineer 20;0" ,, mE 27'-I0 PLAN '"4 7~ 4~ k