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Home My WebLink About4173-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..Ii. 3~S.3,~ .... Date ........... ~l,y ..... 7, ..... ,1919. THIS CERTIFIES that the building located at .O~l~zey Ilewt. ~o~4 ...... Street Map No....2.7.~ ..... Block No ........... Lot No. 4, .(~reenport,. Ile~. ~ ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ~.o~/~eK..4~., 19.68. pursuant to which Building Permit No..43,?3. ~. dated ...... Jmm~'y...23.°..., 19.6~, 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 ... pxlv~te .orm .£~m!1¥. ~elllng .................................... The certificate is issued to . .Igltz~l:h .A.O~l~r .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval May. 2~. 1.9~9~. i~olm~.t .Villa ..... Building Inspector FOB.M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4173 Z Permission is hereby granted to: ....... ~....c....~...~L.~.....Z~...~t~ ~ to )bttl.4.. ~me.. mm..f~m.tl~...~:lJJ~n~. ................................................................................... at premises located at ......... .,~,,.~...1~....~.. ....... ..~....,~..,?..~.'..~...r..~.~..,~..,.....~. ............................................. pursuc~t to application dated ............................ ~ ...... )~ ............... , 19..~., and approved by the Building Inspector. Fee $..10.(~ ......... $CHD SUFFOLK COUNTY DEPARTHEHT OF HEALTH Bldg. Permit No. .~/~'.~ TO bIHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~ ~ ~on -~ ) have been inspected by this department and found to be satisfactory. District Englneei, ~. MAY 2 6 1969 District Engineer TITLE NO. 9-~8700 LOT 5 NOTE: LOT NUMBERS REFER TO MAP OF 9ECTION I, CL EAVES POINT, FI L ED IN THE OFFICE OF THE- CLERK OF SUFFOLK COUNTY ON ~PT. 10~1987 A~ MAP NO. · · MONUMENT SURVEY FOR ELIZABETH GEYER EAST MARION TOWN OF SOUTHOLO SUFFOLK COUNTY, N.Y. SCALE: 1% 40' NOV. 19,1966 MAY 27, 1969 GUARANTEED TO: HOME TITLE DIVISION CHICA~O TITLE INSURANCE COMPANY. ELIZABETH BEYER. LAND SURVEYOR N.Y.S. LIC. NO. E8725 RIVERHEAD, N.Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be,completely' filled in by typewriter'c~r in ink and submitted in duplicate to the Building Inspector. b. Plot plan showin~ location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, ama giving a detailed description of layout at property must 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 through_oUt the progress of the work e. No building shall be occupied or used in whole or in part for any purpose whateyer 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, S~. otk County/:New York, and other applicable Laws, Ordinances 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 laws, ordinanc~es, building code, hou~g cod. e~and regulations. . ~1/~ (Address o'~pplicant) L ~'"~"~' ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician~ plumber or builder. 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 be done. Map No.: ...~:.?~:. ................. ~ ......... Lot No;:' ..~... Street and Number .......... ~.~-I}.~'.~,.Z..~..e.~....~...~..*....~...~...~. ........ ~ .................... ..... .... 2. State existing use and occupancy of premises and inteflded use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................. b. Intended use and occupancy ........... ~.~...T~....~..e.....~....w~..~.l.~...l~ .............................................................................. 3. Nature of work (check which applicable): New Building ...;1[: ............. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .~,~:.~Q.0.Q.,.(~ ...................................... 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 ............. J~g~D ....... . ........... 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 additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................. .~..~.~ ........... Rear ............................ Depth Height .....~,~ .......... Number of Stories ..,1, ................................................................................................................. 9. Size of lot: Front ...~2 .................... Rear ..... ~,3J. ........................ Depth ],.6..0 ......................... 10. Date of Purchase ...........X.9.'~.,...~..~..~.~. ...................... Name of Former Owner ....]~...1~......~..~.~.~..8...~..3:.~.?..~..$.... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ~.~11~ ~. Geye~' Address ~600 ~;~ ,~.~'~ , . .................................................. .l~,.,.(:L.,l~ri;n.y..~... Phone No~. ~.8...'.~,.~-.9.2..... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~g,~f~.~...(~g~/il.~..n..,l~.~.~ ........ Address ~.2~.0 8tiZl.l:'t,~_~ 1~'~7[- ........ ~I.~;~."I'Z~'~'~"Z'" 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 whether interior or corner lot. STAT, CO ............... ' . ing duly sworn, deposes and says that~e is the applicant ~~i~.~n).~ above named.~fte is the .................. ~..~...~C.. ...................................................................................................................... (Contractor, agent, corporate officer, etc.) ~s, and is duly authorized to perform or have performed the sa d worJ~ and to make and file this applicatio~ that all statements confained in this application are true to the best of h~nowledge and belief; and ' that the ~be performedjn~the manner set forth in ~e~pplication filed therewith. Swor~b~ ~e this ......... ' ............. ................ ............ 1r qr ~H i I b I¢ ' ' 52'5,5 SO, - SAYV ~LE NEW ~'ORg:'11782 FI, .r'- L ,LIVI KG ,'1 8532 8532 8532 C~LLAN L E,~L I.P_.,. H