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Home My WebLink About4350-zTO~N OF SOUTHOLD BUll,DING DEFARTi~I~T Te~m Clerk'~ f~iee SomhoM, N, Y. Certificate Of Occupancy THIS CERTIFIF~ that the bulldog located at . .Q~r~n. ~oad ............ Street Map No:~ast. ~k .Es~Block No ........... Lot No.. 17...So~t3uold...N,Y.~ .......... conform, substant~lly to the Application for BuiJd~-~ Permit heretofore filed iu ~ office dated ............ .~.~e. ~., 196~.. pursuant to which Building Permit No..~.Q~.. dated ..........J~r~e.. 2~..., lg.dg., wss issue~ and conforms to all of the requ~- merits of the applicable provisions of the law. The occupancy for which t~i~ certificate is ~ssued ~ P~iva.te. ona .~'amily. d~ellin$ .. (s~mer..occ~panc~.~ ............... The ce~eeomte ~s ~sued to. f~cber.~ .Lydacker...O~er ............................ (owner, lessee or tenant) of the aforesaid bufldiug. Su~o~k County Depm~nent of Health Approval Au~..~. 3.970...by. ~, .¥~a ........ UNDERWR~Tm~ CERTn~C. AT~ No~ ~7.?~ ~.... ~.e~.~..~...~77.0. ................. HOUSE NUMBER ..... t~0 ..... Street ...G~srm. ftn~d ........................... Builrlt.~ ......... FOR,~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTM£NT TOWN CLJ:RK'S OFFICe: SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4350 Z Permission is hereby granted to: ............. lgeb.~t..~Z~ek~. .............................. to ............... .J~l...ne~...m~e..Zud~..aw~lLU~ .................................................................... at premises located at ................... ~t...t?.....lJel[..~.#k..lJl.~.~lll. ......................................... ................................................... It,/Ik....gl.on.~..~ ....... Jem.~ ...... .lil.,.'L, .............................. pursucm* to application dated ......................... ~l'lJllJO .......... ~,~ ........... , 19.~1J.., and approved by the Building Inspector. FOItM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Suffolk County Department of Health Approval No..~39~1~ ..... Date .............. &~t .... ?.., 19..~0 THIS CERTIFIES that the building located at . .8/~ .Glelm .Roa4 ....... Street Map No. W....~,. ~Si; Block No ........... Lot No...¶ 7 ..... 80~lthol4 · · ll,~. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~Ttm~ ·. · ~., 19. (~ pursuant to which Building Permit No. dated ........... ,~tme.. 2~., 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 .. Pri~.~;e. 0~. family, lwelt.:Ln~ ..................................... The certificate is issued to ... Robel'.t .Ly~®sk®F. ...... 0~eF ..................... (owner, lessee or tenant) of the aforesaid building. · Aug- '3¥ .1970 · .by. a,. V~lla ..... ' ' Building Inspector/ SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTH Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located ~(Give deed location) ~ have been inspected by this department and found to be satisfactory. District Engineem District Engineer Approved ........................................ , 19 ........ Permit No. · ~ Disapproved a/c ........... ~ .............. "...~- ~ ........ /~o//(~/.~ -~ ~ _ .y,¢¢ '~, c'.e..-,~_c, ,.,,,, ~..,.~o,,,..(.~ ,¢/,z/¢..¢- ................................. / ......................................................... . ...... a. This opplication must be completely filled in ~¥ ~l~writer or in in~ aha submitted in duplicate t~ the Building I n~:tor. b. ~1~ plan ~howin~ I~tion o{ I~ ~ o{ ~i[di~ ~ premix, ~l~ti~ip to odioini~ pmmi~ or ~re~, *nd ~iving o ~Hed ~ri~ion o{ I~ o{p~ mu~t ~ d~ on the dioOram which lhe ~ork c~r~ by thi~ ~pli~fion ~ ~t ~ ~nc~ ~m i~ o{ Building ~rmit. d. ~p~:o~r~l o{ ~i, a~lle~fi~, ~ 8uildl~ Im~r ~ill i~ ~ 8uildino ~rmit to the · . ~o building ~1~ ~ ~eupi~ or u~d in w~l~ or in po~ for ~ny pu~ whatever until ~ ~h~l~ hov~ b~n ~mnt~ by the Suilding ~n~r. 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 aws, ordinances, bui ding code, housing code, and regu arians. ' (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 ..~..~.l~..e..~...~....~.~'..~..e..q..~..e...~. ............................................................................................................... ~'~. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t~. Location of land on which proposed work will be done. Map No.: ...... W.e.~.~,...~.f~.~..~.§.~. Lee No..'. ,..1.~'. ................. s, re.t and .................................................... · Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~.~.~X~...~.a-...~..~.. ............................. ~ ............................... ...................................... b. Intended use and occupancy .......... G~e..T~&]a~..]~..C1;k~,~.&z~~ ......................................................................... 3. Nature'of work (check which applicable): New Building ..~; ........ Addition .................. Alterotio~ .................. Repair .................. Removal .................. Demolitior'.....~ ............ Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... Me .............. Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commemial or mixed occupancy, specify nature and extent of each type of use ......................... ;.. 7. Dirrmnsions 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 ....... .L~ ........................ Rear ..... .~....., ........... Depth ....... 3.7../~.~.-. Height .................... Number of Stories ." ....... .~a .................................................................................................... 9. Sizeof lot: Front ........................... : Rear ................................... Depth ................................ 10. Date of Purchase ........ .~.~.~. ...................................... Name of Former Owner ....... ~:L~s~I~ ................................. 11. Zone or use district in which premises are situated ....... ~JL~...~l.'l.8.t ............................................................. ~ ............. 12. Does pmP°sed construction violate any zoning law, ordinance or regulation? ...... 2a~......; .......................................... 13. Name of Owner of premises .~ohez'.t,..T'~eclrez'...Address___~ ,~ ~. ............. ~/l~.~b.l~-~.~.~. Phone No ..................... Name °f Architect .......................................... i ........... Acldress .~.~...~.~(~/~- '~ .......... Phone No ..... ;.._,.~ Name of Contractor ......... ~.tJ/llfl .................................. At'dressy. ',~f.:,~..'. ..... Phone No PLOT DIAGRAM ~ ¢~76'1/ Locate clearly and distinctly all bu Idings, whether existing or proposed~ and indicate all set-bock dimensions from property ines. Give street and bock number or description according to deed, and shaw street names and indicate whether interior or comer lot. STATE OF NEW ~C)t~C, . tS S COUNTY OF ..... ~..~....~..o..~; .......... ~ .. ~obez't T.Tc~e¢~cez' ~.~ .................................................................................................. ,.~, duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........ ,...:~el:~e~'. .... .bla~.~e~.......;..;. ........................................................................................... (Contractor, 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 application; that all statements COntained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fqrth in the appl~ Io~ filed th~rewj~. Swam to before me this ~.~--/~ .#/ Notary Public, ~.~qe~r~...~, tall'MY P[~i~ ...... """~'~ii~;;'t¥ ........................... No. 52-8125850, Suffolk ~ o I