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Home My WebLink About4321-zFOi~M~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y, Certificnte Of Occupancy No. ~..~6~t~ ..... Date .............. Dea... ~. ..... , 19.69. we~te~l~ THIS CERTIFIES that the~building'located at ~'1'$ "W~g~-St ......... Street Map No. ~ ~ ........ Block No ..... ~ .... Lot N0. ~ ...... 6.~ee~,..N,~, ...... conforms substantially to the Application ~or Building Permit heretofore filed in this office dated ........... April' ' '~0' 19.6~ pursuant to which Building Permit No.. L~321 .Z. dated .......... Jl;tt~$ '1 ......, 19.65~, was issued, and conSorms to all of the require- ments o5 the applicable provisions of the law. The occupancy for which this certificate is issued is , P~iva.te. one -family. dwetl~g. · (as. a~.prov~, by. }lous.ing. Board.) The certificate is issued to .. Osca~ GOtd. it~ ......... O~r~er- ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department o5 Health Approval .. -N,R, ........................... Building Inspector Ho,~se # (town system) 820 House " " 850 FOI'J~. ~O. 2, TOWN OF $OUTHOLD 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? ~13~1 Z Permission is hereby granted to: to ............... ;~..~. ~.~L.~...,~.t..t.:~,~...~...e.~..~..~}.:.~... ~.~..~:c.:~.t. ?..q~.~..~..o......~....~.x...t.~..e..t.~g...~...~. ~z ~g at premises I~ated at ..........~.].~.,...~&~Z~.,.~,~z.~:,~.~ .................................................................... pursua~ to application dated ............................. ~....,~0. ....... , 19.~,., and approved by the Building Inspector~g~ 1 F.. $..~z~ ............. ~uilding inspectort TOWN OF SOUTHOLD ,~.~ BUILDING D~PAB'fl~E~T Examin~ ~ ~ 0 , 19 ~ ~ Application No ~ ~.~.( ..... ;'~proved .'~'.'.~'.['.'.'.[ 1~.~.' Pemit No..~.~.~ f. Z..'... ......... ............ .... .... ......................... ~PLICA~O~ FOR B~LDING ~M~ Date ..... A~.~I. INSTRU~-rlONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plotplan showing location of lot and of bufldingson premises, relatimmhip to adjoining premise~ or public streets ,or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may n~t b e c~mmenced 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 ~n the premises-available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole o~ in pa~t for any purpose w~natever until a ~ertiflcate ~f Occupancy shall have been granted by the ~Building Inspectm~ - APPLICATION IS ~Y MADE to the~ Building D_~partment for the issuance of a Building Per'it pursuant to the Building ~One Ordinance of the Town of S?athol_d, Suffolk Oo~nty, New_ York, and other app_ljcable Laws, Ordinances or Regulations, for the construe/ion of buildings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to cum ply with all applicabl~ laws, ordinances, _bu_ilding code, housing c~le, and regulations. (Signature of applicant, or name ff a corporation) Greenport, NY 11944 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or 0 Wrlel' builder ................................................................................................... Os car Go id in Name of ,owner of premises ............................................................................... If applicamt is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) 1. Location of land on Which proposed work will b e done. Map No ................. Lot No .............. 711 Wi ir~ St Oreenport ~Y 11944 Street and Numl~er ............. g g ................................. ~...~. .... .. ~1~!- ~0 ~ ~r~ F~ mum~l~'~'li~ .................. 2. State existing use and 'occupancy ~f premises and in~ended use and occupancy of proposed construction. C~;'.... =es.tdence ...... a. Existing use and occupan .............................................. Intended use ,and ~ccupancy . .. Te~id~nee .................................................... 3. Nature of work (check which applicable): New Building ........ Addition ...X. .... Alteration ........ Repair ......... Removal ........ Demolition ... ..... Other Work (Describe) ...................... 4. Estimated Cost ......... ~50C) ................. Fee .... ,~v~ '1~ 'l~c~ '~I~ 'iii'~l~' ~li~ '~ii~i~ ........ 5. If ,dwelling, number of dwelling units . 1, ....... Number 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: Frcmt ..... 5f$, ........ Rear .... ~/'.~ ...... Depth . ~ ....... Height ~ft Number of Stories .... ~,. 9. Size of iot: Front ' Rear ' Depth ............... 10. Date of Purchase .............................. . Name of Former Owner ............................. 11. Zone or use district in which premises are situated .... r~. ........................................... 12. Does proposed construction violate anyzoning law, ordinance or regulatio~l? ........................... .... .. 0so~r~oldin ~,~- Greenport, EY ~.-~ -. 477-2220 13. f~ame o~ ~wnero~ pr~em~ses ....... ; ............. ~aaress ...................... ~none ~o ............ Name of Architect ............................. Address ...................... Phone No ............ Name of Contractor ........... .e. ............... Address ...... .e ............... 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 number or description aceording to deed, and show street names and indicate whether interior or corner lot. house---- new 5~y.8 addition ~f°r bathroom. STATE OF NEW YORK, )S.S. COUNTY OF .............. ) ................... 0..s.c.a..r..~.Q.~.d.i.p .................. being duly sworn, deposes and says that he is the appli- (N~me of individu~l signing application) cant above named. He is the ...... .0. .w~. .e ?. ............................................................... . (Oontractor, agent, corporate officer, etc.) of said owner or,owners, and is duly authorized to perform or have performed the said work and to make and file this applica~on; that all statements oontained in this application are true to the best of his knowledge and belief; .and that the work will be p~ed in the manner set forfl/in the application filed therewith. Sworn to before me this $ 0 Apr i i 6 9 ................ day of .................... 19 .... Notary Public, .................... County M~iON A. REGENT ~OTARY PUBLIC, State of New York ,No. 52-3233120 Suffolk Coun][y Term Expires IVlarch 30, 19 (Signture of applicant)