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Home My WebLink About4382-zNO. 4 OF $OUTHOLD DEPARTMENT Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building/located at .~tt~ .Rea~ &. Tepe. Trail.. Street Map No~lmlklla .W&~}~lk No ........... Lot No... 1.~ ...... ~outhold ..... ]l.,~... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... J.~l~y ...... 1.~[.., 19. ~9 pursuant to which Building Permit No..~3J~2Z.. dated ........... J~hY .... 1 ~., 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~T&te..erie. ~la~y. ~iw~lL~g .................................... The certificate is issued to .... 4~;~e.l~/..I~.¥~¥9k.~ ........ .0~ll.e.r ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~l, ease ~ 12~ ~ l~ea~ · AprSL..26.,..1971 .... by..R.. FOF, M NO. ~ 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? 4382 Z Permission is hereby granted t~: ......... · t02....~,...lleea~ate..&~e ...................... ................. ~.~,~ .......................................... to ...... J3u:LlA..zzev ..Gue...£,~134r.. 4v~l;l,~,a~ ............................................................................. at premises located at ............. ~,~,..t.~....~l~...W&~l~A~m ....................................................... ....................................... ~e~..i~..&..tee~e..~,ed~ ......... lere~ol& ........................................... pursua~¢ to application dated ................................ ~.g.~ ....... .~.~......, 19.~., and approved by the Building Inspector. Building Inspector $-9 SCHD SUFFOLK COUNTY DEPAHTHENT OF Date HEALTH Bldg, Permit No. TO WHOM IT HAY CONCERN: at The sewage.~tsp°sal~%~o.~facilitteskt~Ju/~f~-~.~f°r a structure~j~located (Give dee~ l~cation) have been inspected by this department and found to be satisfactory. Chief of General ~g~neeri~ ~e _rvi.oea BUILDING DEPARTMENT SOUTHOLD. N.Y. ~/?/~,~ .Ze r~ ~ -' App~,~ .................... .~ .... ~e~it~o. .~.~.~.~.~- ..... ~/,~ _ ~ ~,. ~_~ ~.~ .................................................... ...... ~C.~. y~ .................................................................... . z~ 0'l~c.o. ~,te ........ ~:'"t .......... INSTRU~'i'iONS 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 o n 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 this aPplication. c. The work covered by this application may n~t be commenced before issuance of Building Permit. d. Upon approval of this application, the Building In specter 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 o~ in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS I-~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, building code, honsing code, and regulations. e'of apphcant, or, name if a corporation) /. ......... (Address of applicanO State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . ~./~J/~'t~:.. ....................................................................................... Name of owner of premises ............................................................................... 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 b e done. Map No ................. Lot No.../..~.. ....... Street and Numl:~r ~ ~4./..~..~' la .~.~:~./~..~. ~.~'.~.Z~.~').~-~ .. ................ .... ... ~1 - I~' ~ ~ ~d ~ D Municip~ity . 2. S~te exi~g u~ and ~p~ ~ premiss ~d intend~ ~ ~d ~p~ of pm~ ~ion. a. ~isting ~e and ~cup~cy ......................................................... : ~. Intoned u~ .~ ~cu~cy .................................................. 3. Nature of work (check which applicable): New BUfiding Repair ......... Red,oval ........ Demolition ........ 4. Estimated Cost .. ff.~..~.~.~. ............. :.i.Fee ... / Addi'don Alteration ~r Work (Describe) ..................... · - (to be paid on filing this application) 5. If dwelling, number of dwelling units ../. i f... Number of dwelling units on each floor .............. If garage, number ,of cars ........ ~ ............................................................... 6. If business, eornm~cial or mixed occupancy, spec fly 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: F~ont .............. Rear ............... Depth ................ Height ................ Number of sO'ties ..................... 8. Dimensions of entire new construction: Front ................. Rear .............. Depth ............ Height ............ Number of Stories ..... ~ ..................................................... 9. Size of k~: Front ................ Rear ............... Name qfDepthFormer ............... Owner ~'~ ~~. 10., Date of PurcBase ............................... ~r. ff, ........ 11. Zone ~r use district in which premises are situated .................................................... 12. Does proposed construction violate .any zoning 1.aw, ordinan.c~ _or v,g~ti~?,./~..~. ........... u"-'"; 13... N~a~ne of Owne~ of prerniseS~)~*~.. Addres~~~' Phone No~)~'~'.~.~PP~. · Name of Architect ........... .................. ~ddress ...................... Phone No ............ N~r~l~o of ContractorAg~g~...: ......... Address .. ~.~'~&~Phone N0~.~.~.~.?.~'.O PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street a~d block number or description acoording to deed, and show street names and indicate wh~her interior' or co~ner lot. STATE OF N-~ ~.0 ~RI~, )S.S. COUNTY OF.~ ..... )_ , ' .......... (Nal;fe of ~divi u~ signing ~ . ~ ....... being duly swan, de~ ~d ~ys ~at he is the appli- c~t a~ve n~ed. He is ~e ............ ~ ............................................... (~a~r, a~t, ~ate ~icer, etc.) of ~id owner ~ o~ers, ~d ~ duly.auth~ ~ p~o~ or have pe~ ~e ~d ~k ~d ~ m~e ~ file ~ application; ~at~l sta~e~ ~ntain~ in ~is applicon ~e to the ~st, of h~ k~wl~ge ~d ' belief; and ~at ~e ~k will be p~ ~ ~e mann er set fo~ ~ ~ applicat~n filed ~e~th. Sworn ~ ~f~ me ~is ..... '.~.j.~y ~:,: ~,~...... 1~. ~~~~ ............... N~ ~.~ r~ty~ ~J~ ~~(Si~tu~ of applier) No. 52-8125~50. Suffolk ~ou~ Term [xpkes M~rch 30, 19~ ,I ,[