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Home My WebLink About4435-zFORM NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificete Of Occupancy No.. Z~...:.<)~ ..... Date ............. ~u~uei~- 2.Z.~ ..., 19.. 73 THIS CERTIFIES that the building located at . .. C~.oz~y..~d ~& .Bayv.~-ew. A~jreeet Map No ....~.].~ ..... Block No. 'X~ ....... Lot No.. '?6. ~ '7'7 ....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........~,ugust' 26~, 19'69 pursuant to which Building Permit No.. ~1+.3.~, z dated ..........August' 26j ', 19. f~9, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... ?~$vate' 'o~e' z~m~.].¥ 'dw~:]-~ng .................................... The certificate is issued to .... Paul' 'I~' ~hzth ...................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No.. P.e.z~d.~.T~g .................................. HOUSE NUMBER ..IP, i,O ........ Street . .Bay~r~.e~. ~e, .......................... ...................................................... ~autho~d ................ FORM 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? 4435 Z Permission is hereby granted to: to ............... I~t~...ea..&~tttl,QG. ,ea., m...ex,~t~,a..m ;LM~ ....................................... at premises located at ................. ~d~t~..~.~..~..~. ....... ~lllll~l~.~J~ ............................................ .................................................. ~e~..A~e ....... ea~a,w,e~....ll,X. ........................................ pursuan¢ to application dated ..................... ~ ....... ~r ........... , 19~1~.., and approved by the Building Inspector. Building Inspector APPLIC~,TIOH FOR BUILDING PEI~n' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submi~tecl in duplicate to the Building Inspector. . b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premiere or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pm1' of this application. c. The work covered by this application may not be commenced before isstmflce of Building Permit. d. Upon appra~al 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 progrms 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 shotl have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, ,,New , and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteration, or removal or demolition, as herein described. The applicant ogrees to comply with all applicable laws, Qrdinonees, code, and regulations. r ...... , ................. .............. '""T ...... ippIicant is owner, lessee architect, engir~er, of owner of premises ..........K~..~...~... ......... /~.:..[....~..,~....~....~'~ .................................. :. ................................ applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Street and 'Number ~..~-~..f...~.....~..~.a. (~.~' ~ ...... Stat~ exiSting use and occupancy 9f premises/and intended use and ,occul:~m~y of proposed comtmctlon: b. Intended use and occupancy ................................................................................................................... 3. Nature of work (check which applicable): New ;Building ............ .. ..... Addition ....... ..~........ ion Repair ..................~,emoval .................. · ~e~liti0~..~..:i,..!....V~ ',Other Work (Describe) ........................................ 4. Estimated Cost ....... /.~.~.~. .............................. ~': 'r".'" ee .....,~ ................................................................................ (to be paid on filing this application) /(/'~ Number of dwelling units 5. If dwelling, 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 Stbries ..~.~.,~ ............ .., ..................... .. ............ ~ .................................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Nu.rnber of Stories ............. ' ................... Dimensions construction: Front 8. of entire new ....... ...... '.".'.. Rear ...... ............. Del)th ../.....~.. ............. :. Height .................... Number of Stories ......... ~....~ ............. ; ............................................................................. 9. Size of lot: Front ............................. Rear ................................... Depth ....................; ........... 10. Date of Purchase ........................................................Nc~me~ of F~rmer Ch~:~er ........................................................ 11. Zone or use district in, which premises are situated ....... ~ ......... ~ ....................... ;~_ ............................................... 12. Does proposed col3struction vi~ate any zoning law, ordinance or regulation? ...... _~1~'..~. ............................................... 13. Name of Owner of premises .~J3/[,...~..,'-..,.'..Addr~e~%.~....~...~...~~j ............. Phone No.~,,..~...*.~..~.~..~.... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...... ~."....~...."...~ ...... Addr~ss:....'..'....i.~i~...i.".il .................... 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 according to. deed, and show street names and indicate whetheri-nteriororcornerlot:~/~ /1~//~3 - 7 ,- ? STATE OF NEV~OJ;~, ~j~ ! ¢ c ' '~ !' : cou, , ........ above named. He is the ........................................................................................................................ L .......... ................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the ~i~ work and to rnc~e oncl file this application; 'thOr dll Stoternehts contained in 'thi~ 'application are true t~he best 6f his knowledge and belief; and that the work will be performed in the manner set forth in the application fi,l&:l/therewith. Swam to befQre me this ~, - / / -- ~ ~ .......... .,, ....... .... Notary Public,//...~../~tg~~f/~ou,n,~ -- ,~,~(Signature o¥'~pplicant) .. ~tTARY PUBLIC, State of New rgrK /7 - , i~' ~10. 52-0618100 Suffolk Count~ . ' *' __ ~._ ~ ~omm,ss on Expires March 30~ 1g~ ~ .