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HomeMy WebLinkAbout4594-zFOlt~[ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.tf~03 ...... Date ........... Bant.. 29 ..., 19. THIS CERTIFIES that the building located at . Lake · Co'oa't ........ Street Map No. xxX ... Block No.. ~ Lot No..Xx~ - Bou~;ho~d. N,Y, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ' ' ~al~ · 12 · · ', 1969 ' pursuant to which Building Permit No.. dated ...... Dec '22'" ' 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 . .Prtve~:e. cme - £emily. ~2we'~'l'ing ...................................... The certificate is issued to James P ,. tdee ..... 0wnel, ..................... (owner, lessee or tenant) oft he afores~d building. Suffolk County Departmentof Health Approval Underwriters Cert ~ N819069 H~use ~ 225 June. · .1. ~ Building Inspector Villa... TOWlq OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT Ct'HIS" PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLET'ION OF THE WORK AUTHORIZED) NV 459~ Z Permission is hereby granted to: ........... ~....X,,,~,,, ..... ~J.'t~3~ ................. to ....... I~,~.. ~ ~...~..~..~~ ................................ ~ ............................................ at pre~=mises located Oi ........... j~....~J~..~.~J~.~J~41tlL~..~gJl~ ............................................. ;: ~ . .......... : ....... ~,.;....L..~.~ ............... ...l,m~lml4. ....... }{,l.,. ........................................................................... '~ ~ purmb~ to ~pphcat~on dated .~ .......... ~........::.JJee~.....~J_ ~ ......... , 19...6~, and approved by the ,,..~.,,~. ~. ~ ~u~lo~ng~nspector. S-9 SCHD TO WHOM IT MAY CONCERN: (~iJ.d 1 c&,tion) ~~ have been inspected by-this department and found to be satisfactory. ')~ J M7t Shier of General Eng: ~ooring Services District Engineer ,,.~.,~.,,,t.,.~. July 16~ 1970 OTHER ~ARATUSI rh,s certlflcc~te must not be altered in any manner~ return to the ~ce of the Board TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~D, H. Y. Disapproved a/c .............................................................................................. APPLICATION FOR BUILDING PERMIT ~ Date ............................... ./..~.....-..~.. _~.. ....... , 19..~..~... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of. lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th,e 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 Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for ir=pection 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building 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, ordinance~ building code, housing code, and regulations. / (Signature of applicant, or name, if 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 .~,~...D.~...~{~D. ................................................................... 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.: ......... ~ .......................... Lot No.: ..~:ZZ .............. Street and Number ...... ~JJ~...~r~...~.Q1J~.~;..~..~P~..~...]~GZ~.t~....~X~t~'tO.~.~ ~.~[~ ..................... ~:~l -- c~-- ~ Municipality 2. State existi.nc~ use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ode :~a~l~. Dve].l~Lz~g 3. Nature of work (check which applicable): New Building-, ................. Addition .................. Alteration .................. Repair .................. ,,Rem°vol ..................Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost~......;~.../.~.~.~.~..~. ............................. Fee ...... ~.....1..0...~..0...0. ................................................................... (to be paid on filing this application) ode 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of c~rs ............................................................................................................................................. 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 ............................ ~u. mber of Stories ................................ 8. Dimensions of entire new construction: Front .................................... "'~ Rear .......... 2~....L ........ Depth ..... .~6 .............. Height .................... Number of Stories ..............o...~_e. .................................................................................................. 9. Size of lot: Front ............ .1~6 ......... Rear .......... .1.8~ .................. Depth ...... .1.;I..1 ................... 10. Date of Purchase ............... .1.(~6.~ ............................... Name of Former Owner ........ P.,...~E~].;;Lo~ ...................... 11. Zone or use district in which premises are situated ..... .".~..". ......................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ................ .ND. ...................................... 13. Nome of Owner of premises'T....a~...e...s.....~..e..~. ................... Address ......2~26...I~7c.e..~ ....... ~J~onLe3rl~o..~../~..~'...~.~..;:~',u~ Nome of Architect ...................................................... Address .......................................... Phone No ..................... Name of Contractor~...~.~z~/~/~..~......~..~...~. ........... Address .~.~..~..~....~..O.~'~<..~.,...~.~.- Ph~o/ne~'~o/~". ~//~'...~.0'~' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end indicate oil set-hock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF COUNTY OF (Name ( above named, the duly sworn, deposes and says that he is the applicant (Contractor, ~ c~lmmte of,,e~r, ~.) of said owner or owners, end is duly authorized to perform .or have performed the said work and to make end file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn t~,~fore me this X ........ '~'""~"' ..... day of ~ ................ 19.~..~.. ...... ........... .............................. Nota~ Public, ...:..Z....v.:.,.~~...=Z.~... Coun~ // (Signature of applicant) " --50 ~N 25° 02 'E. SURVEY OF PROPERTY ,~T. SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNFY, NY. FOR' JAI~ES hlEO WILLIAM G. MEIER [ Surveyed-~0-9-69 Ilt .t fr ? // f ' I© , · ,',, _ I