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Home My WebLink About4477-zFOEM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No.Z .$8.9.g ..... Date ....... Jull~ ..... 28, ...... ,19.7.0. . THIS CERTIFIES that the building located at ~lhemc~ue. Avl. ....... Street ~ap No. lke. i,~dO~.. Block No..~ ....... Lot No. 20 ..... IOu*~hold,..1~..York... · Ult. a~,,olMIp I0. 147.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated . I~Jl~,~ber.. 26,.. , 19.6~ pursuant to which Building Pemit No..447..7. .Z dated . bp~,~ber .... 26,. ., 19. &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 ': ....l~J.v&te..one. ,f-mu:Ll~..d*mlll~9 ................................... The certificate is issued to ....... J~. ~T,..~.c~..1..~. .............................. · (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . May .20,..1970, .Rol~Zt..V. 11L& ... Building Inspector Hou.o # 1605 Arlhamonaque Avenue l~01t~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPAKTMENT 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? 44?? Z Permission is hereby granted to: .......................................................... 4a,amaaalm....A~e ............ tl~ala~l,..~i ......................... pursuant to application dated ........................ kp~. ........~ ........... , 19...J~ and approved by the Building Inspector. BUILDING DEPARTMENT TOWN CLERK'S OFFICE " ' " . Disapproved a/c .............................................................................................. APPLICATION FOR BUILDING PERMIT September 26 Lt/ Date .................................................... ; ....... , '19..6.-.9. ...... 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, ;elationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is pOrt of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upton approval of this application, the Building Inspector will issue b 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 o Certificate of Occupancy shall have been granted by the Building Inspector; APPLICATION IS HEREBY MADE to the Buildi.ng Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town .o.f Southold,: SU'f)olk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buddings, additions'or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ord nonces, building code and reaubltJons t. a..t...e..a..,... ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. oWner- contractor Name of owner of premises .................~.~.g...~.x...~-.C~,~I ................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) i. Location of land on which proposed work will be done. Map No.: ....3:..4.?..2......i ...................... Lot No.: ~0 Street and ~' ~he~ Areham~m~que Ave,~ Be~xedon ]~etates, Southold, ~.¥. "'~f -- /~ 0~"- Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ..~...e..s.....A....-..~l~..~.~..c. Lt..[..'l;.l~.r...a...[. ...... : ........................................................................ Intended use and occupancy ...... l~l~e ................................................................................................................. .... 3. Nature of work (check which applicable): New B,~ildih~"~?...*. ........... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition ............. ~.~. Other Work (Describe) ........................................ $28 ~ 500, O0 - 4. Estimated Cost ............ ~ ............................................... roe .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~......Number of dwelling units on each floor ............................ TwO If garage, number of cars ............................................................................... .............................................. ; ............... 6. if business, commercial or mixed occupancy, specify nature 0nd extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ......... ~ ......... Height Number of Stories · r ~ ~ Dimensions of some structure with alterations or additions: Front ..................................... Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....2..6..s..1.~) ...................... Rear ~.,.~,D. ............... Depth ..~3~.0.4. ......... Height ...~.(~,Q0 ..... Number of Stories 'l~ro 9. Size of lot: Front ...8...2.~.~.~. .............. Rear ...~',5.,D.O ..................... Depth ........ ~2~'~,O0 ......... 10. Date of Purchase ..?..e..?.!.....1..9...5..9.. ............................... Name of Former Owner ...~..a.g.~...~x..~.~..~.~.~. ................... 11. Zone or use district in which premises are situated Re~ A- ..~lcultura.1 12. Does proposed construction violate any zoning law, ordinance or regulation;~ ~O 13. Name of Owner of premises~..°...h..n.....N..t...c..k..1...e..S. ............. Address ...[~.Ql~/~i~:~].d ...................... Phone No..7.65...3.~,.6. Name of Architect ..... ~...o..~.~.......~...L..~.....~.....A~.. ......... Address . .~..~.....~...~..~.~..~..~...~'~...~.~.[ Phone No ..................... Name of Contractor .J...o...h..n.....N...l..c..k...1.~..s. ...................... AddressS.O.g.~l~..q..1..d.' .......................... Phone No.7.~.~.....~l.a~[.6. 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 shew street names and indicate whether interior or comer lot. Lot 20, Block 20 on Filed Map of BeIxedon Estates, Filed # 1472- Interior lot Arshamomaque Avenue STATE OF NEW~RI~/ n~ ~..- . (Nome of individual signing application) above named. He is the (Contractor, ooent, corporot* o{ ~id own*r or own~r~, end is duly ~uthori~od to p~r{orm or hove per{orm~d the said work end to rake thi~ application; ~h~t oll ~t~t*m~nt~ contained in th ~ appllcotion ore tree to the best o~ hi~ knowledO~ end belief; ~nd that tho work w~ per{orm~d in tho manner ~t fo~h in th~ application {il~ therewith. Sworn t~before me this ~ ~ ~ . ~ ~ ~ . ~ ..... * .................................. ............................... S-9 SCHD RECEIVED ~EPARTMENT OF HEALTH RI:,/ERHEAD SUFFOLK COUNTY DEPARTHENT OF HEALTH Date TO WHOH IT HAY CONCERN: The sewage disposal facilities for structure located have been inspected by this department and found to be satisfactory. 1970 Dietriot ~ngl~ee~ District Engineer