HomeMy WebLinkAbout4388-zNO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.. 3.763 .g .... Date . .February,., 27, ........ , 19 ~?0.
THIS CERTIFIES that the building located at .Park .View .I~tae ......... Street
Mal~ No, . ~ee~ .Acr~ock No .... .' ...... Lot No..8. ~tant:,..Ne~ .York ..........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ...... ffuly' '"16¥" , 1969. pursuant to whic~h Building Permit No. 43.88Z..
dated ...... July.... 16, .... , 19 69, was issued, an~ conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ...pr.irate..one..famil.¥ · ~elllng .....................................
The certificate is issued to ..... Ra!anond-Sm;I, th ....... : ............................
(oWner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .Febr. Uar¥..26,. 1970,..Rob~l~t..V.illa
......... .... i, .......
Building Inspector ;
House ~ 230 Park View Lane
FOKi~I 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? 4385 Z
Permission is hereby granted to:
.... Geo.. ,~..or-d.....A./~.. ~t...$~.th ......
............. ~.u.teb. o gu, e .............................................
to ........... t~;]~,.. ~e~.. e~e..~- ~.~.:~y.. ~,e .~.~ '~t~ .........................................................................
at premises located at ...................... ~ot~..~....4t.~ee~e,~-es..~..O,z,i~ .......................................
....................................... P~...~/.~,;...~-ene ......... O~e~,-.....: .........................................................
pursuan~t to application dated ............................... ~!J~L~r ............ i~.., 19...~, and approved by the
Building Inspector.
Fee $..~.0..(~ ...........
:. Building" InspectOr
TOWN OF SOUTHOLD PROPERTY RE(:ORD CARD
OWNER '-¢'~:REET ~ ~' 0~.~ VILLAGE DIST, SUB. LOT
FORMER.. OWNER,,~N E A.~¢r I
S ' W ~PE OF BUILDING
ES. ~ I O S~S. VL FA~ COMM. CB. MISC. Mkt. Value
~ND IMP. TOTAL DCTE
AGE BUILDING CONDITION
N~ NOR~L BELOW' ABOVE
FARM Acre Value Per Value
Acre
'iHoble I
'ilbble
illoble 3
/oodland
wampland : I FRONTAGE ON WATER
: FRONTAGE ON ROAD
rushland
louse Plot L-"' DEPTH
ot~l q -:- DOCK
COLOR
TRiM
Extension // ,~ tV._ /;,f.&/ ~ / lasement /-4,~ :loors 0 C.k J~. K.
- ~ s-~¢ ~t;, LR.
~,ension
~tension Fire Place ~ ~ ~eat ~ DR.
Type Roof ~ &,~ Rooms 1st Floor BR.
Porch //Z ~'- ,.~''.-~ ~ -~0~ ~ ~ ~ Recreation Room Rooms 2nd Flor FIN. B.
Porch Dormer
Breezeway ~riveway
Garage
Patio
O.D.
S-9
SCHD
SUFFOLK
COUNTY DEPARTMENT OF HEALTH
Bldgo P~rmit No.
TO WHOM IT MAY CONCERN:
at
The sewage disposal facilities for a structure
(Give deed location)
located
have been i~spected by this department and found to be satisfac~tory.
DJ'st rict Engineer
TOWN OF SOUTHOLD
BUILDING DEP*RTMEHT
TOWN CLERK'S OFFICE
."~'....(..~ .......... 19 ~' ~ $OUTHOLD, N. Y.
......
~omined
pprove~ ........................................ , I Y ........ ~rmlT ~o....! ............................
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 propertymust be drawn on the diagram which is part of this 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 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 herei~described.,
The applicant agrees to comply with all applicable laws, ordinances, building code and regulations.
(Signatur~bf~iiiiii~'iiiii~appticant, or name, if a corporation)
iiiiiiiiiiiiiiiiii C,J (Address of applicant)V ...............
State whether applicant is owner, lessee, agent, architect, ~eral contractor, electrician, plumber or builder.
~ aa~ I ~¢fa ~i~ra°fcop;peor~ 'o~i '~i'~'~'~'; 'u'; 'e'"~ ;"'~ '~[';"~ '~ ~ ........ ~ ..........................................................
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: .............. ~.~.~..~.e.~...~.~:.r..¢~..... Lot No: ..... ~ ...........
Street and Num~'l~/r-....~....~....~.. ........ . ..~...~ ...... '"~"-~ ......~ ............... i.'.,0,,.~,,~,,~,,~ ........ i ..............................
~_~> O Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Ex st n use an ' an
a. g a occup cy ...... I~. ........................................ '~s ...............................................................................
b. Intended use and occupancy .....~..~....~.. ~ ...........................................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...........................
4.
Estimated
Cost
Fee
"~--'"" '~'"'""~' ............................ (to be paid on filing this application)
5. If dwelling, number of dwelling units ..... ...~'... ................. 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 adclitions: Front ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ........................................
8. Dimensions of entire new construction: Front ......... ~.~.~ ............. Rear ....... L~..~.. ............... Depth .......~- ...............
Height ...... ~. ................... Number of Stories ......... /. .................
9. Size of lot: Front ............................ Rear ............................ Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises ore situated .......................... ..~.. ..................................................................
12. Does proposed construction violate 'any zoning law, ordinance or regulation?
13. Name of Owner of premises ...~.~:....~...~..~.rz ................. Address ........ .-.~.~:..~,.~..~. · No.
Name of Architect ...................................................... Address ............................................. Phone No .....................
Nome of Contractor ....~..~2....J~...,,~. ..................... Address ...~,.~.~...~....~...~.~./~:.. Phone No. ~..~.~.....~'.~.../.~..
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether eXisting or proposed, and indicate all set-beck dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot. / ~, ~
STATE OF NEW YORK, '( ~ ~
COUNTY OF ........ ._. ...................... I _'"~ /~ J~ .
........... ~ ...... i..~ .............................being duly.~vorn, deposes and'says that he is the appl.cant
L. -- ............................ ..............................................................
(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
th s application; that all statements contained in this a.pplication are true to the best of his knowledge and belief;
and that the work will be performed in the maoner set torth in the application filed therewith.
Sworn to before me this
.... ....... dayof ......... ........... ,
.... J~, ~ ,,//~ K,~r~T~ ~."~,L~ .... ~;~...~.~~. ....... ~ ....................................
Nato Public, ~..~j~.P~~,~tY~X'~u-ht~/-~ ~l/~.gnature of apphcant)
ry (/ -~...u. a~a~e~3, Suffolk Coenlv U