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Home My WebLink About4362-zFO~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . II--cert. ]~ ............ Street Map No..~.$U, .l~&~'kBlock No ...........Lot No.. 3~ .....~O~a~,~old ..... ]~Yo .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........July .....?., 19..69 pursuant to which Building Permit' No.. ~+.~$~. Z dated ........... ,I~y .....7-, 19..69 was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .Pre-ate. o~. fe~atl~- .d¥®.~lZu~ ...................................... The certificate is issued to .... RXehard. Eh.].~.~ge~' ........ 0~er ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ]~OW' ~',' 'l~j~ ' 'lr~ 'R6' T~LII& ....... · · · / '~ "c'~ .ui~l~l~,~-?pedi~r· ........... FOI~ HO. ~ 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) N? 4362 Z Permission is hereby granted to: ...... .~.e~...lk~l..e..... ~..~.~:~'~1....!I~.~" to .... ~...~...~.?...t~!~..~.!!~ ................................................................................ at premises l~ated at ............. ~...~.....~.~.~.~..~.~ .......................................................... Ze~eo~t ~ 8ou~ pursua~ to applicotion d~ed ............................ ~ ....... ~ ............. , 19....~ and approv~ by t~e Building Inspector. Fee $ ,1.0o00 S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Date Bldg. Permit No. TO WROM IT HAY CONCERN: have been inspected by this department and found to be satisfactory. NOV 5 1666 District ~ngineer District Engineer BUILDING DEPARTMENT T~N CLERK~ MFI~ ........ ....... A~ra~ed ........................................ , 1~ ........ ~it NC ......, ....................... (Building Insp~tor) CU 'l .eJ' o 4 APPLICATION FOR BUILDING PERMrI' 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 port of thie 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 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bud ng Perm t pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnances 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 lows, ordinances, building code, housing code, and regulations. · 1'otto l~ponic (Signature of applicant, or name, if a corporation) SouthoZd, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engis~eer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ...~ghl~.r..~....~..J~..~..~.e...r. ............................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. LocatiorL~f land on which prapc~ work will be done Map No: ~.e....A~....~..c..o..~.t. ................. Lot No' 33 IF'/- ~0/.5~ . ..... ' ......................... Street and Number ................ ~.-e--~-.n..l~.~.~.t~ .D.~.~.IJ ......... ~9.1~.JJ.q.A.q. ................................. Municipolity 2. State existing use and occupancy of premises and intended use and occupancy of praposed construction: a. Existing use and occupancy ca t b. Intended use and occupancy ...... OZl~ Family c~welling ,. 3. Nature of work (check which applicable): New Building ...~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost 21+ 000 ~+ .. Fee 10.00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .~.~.e. ............ Number of dwelling units on each floor ............................ If garage, number of cars ..............2..0..8....~. ....................................................................................................................... 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 ........................ Humber of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Humber of Stories ................................ 8. Dimensions of entire new construction: Front ...6~ ............................ Rear ....~.3 ............... ..~...'l~pth .......... /...2~. .... Heighf. ................... Number of Stories ........... o~e ................................................................................................... 9. Size of lot: Front ............................ Rear .................................. Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in Which premises are situated ..... .?~."....~Jj.t~ ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ 13,Q ............................................... 13. Name of Owner of premises ..]~L~tJLa,3:l~..~JL'J,,~l~.e.:~kddress ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ~.~..]~4~Dl:)~:l,.q ............................ Address ...~.O...U:.~..b..O..3'..0: ...................... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or pr. oposed, and indicate alI set-back dimensions from property lines. Give street and block number or description accoraing to deed, and show street names and indicate ? 0 whether interior or com~ lot. STATE OF NEW ~4[,,~, (cc e/~, COUNTY OF ..... ?...?:..5..u....'~/. .......... .f '"'"" 'otu ttapon c ................................................................................................ oemg duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the; .................. ~.OD.1;~'~.~.Q~' .............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ah~l is dulY authorized to perform or have performed the said work and to make a~d file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tl~at the work will be performed in the manner set forth in the application filed therewith. Swam to before~...~.~.. -,me this 19..6..~....~ ~ .......... .............................