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Home My WebLink About4207-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy /' /NQ. I. 3600.. . . . Date ............. Oat. .. 6 . .., 19.69. / / THIS CERTIFIES that the building located at . B/S.II. . Road . to .Barr.1ewStreet . / Map No. . .~........ Block Noµ........ .Lot No. ~..... 8.~~~.J,4.. ~.~y~........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Jlarob . . .,20). .69 pursuant to which Building Permit No. . ~~. . dated ...... _ . . . Mareb. . ·20· -, 19 -69" 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 ...... .h'~~~. MIl . t~¡7. .~w.U1'q. . . . . . . . .. .. .. .. .. . . .. .. .. . . . . . . . The certificate is issued to . . 'ftaurJ.o.· . 1hD....".r. .. .. . Owner. .. . . .. .. . . . . .. .. " . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... .Ot:.t. .. 6.,. .1~9.. . Þ7. .~,. 'n¡~. ~ --r rµ. l é (/II . . . . . . . . . . . B~Ùdi~gÏ~~p~~t~~' " ·1· .. " . Boue I ~7't, / FORM NO.2 TOWN OF SOUTH OLD 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) NV oJ r i/f A Rrfl ¡.r Date ........................................................, 19........ 4207 z .I Permission is hereby gran.~~~..~~:....<...P~......../!;.....!!!f::.~!.~u/ lh 7,'6-"'1 y[ 1-1' ................................................................................ ................................................................................ Bt'lLD IIIE/V /r,APIILY /-{{1VS'L-- to .......................................................................................................................................................... ................................................................................................................................................................ . if 7'1.b- þfÇ r,- 7H l?,A Y V 11:'- ~V !l'CA D at premIses located at ............................................................................................................................ StV7f-IOL D. ................................................................................................................................................................ ................................................................................................................................................................ . . f1{' 1'1.Ar.'('H 6J pursuant to application dated ............................................................. 19........, and approved by the Building Inspector. ,;1/ /1--- Fee $........................ /J ~¥ .....L~.~?.:~...../:....:..~~............ Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date /o-t-IP9 Bldg. Permit No. -;/;;;O'/' z... TO WHOM IT MAY CONCERN: at The sewage disposal facilities far a structure located ,ý?~1-- / ~ d & (Give deed ~ocation) ?þ' /./1' J'./~) ( YC/--! J¿' - / Û/Y.ðL have been inspected by this department and found to be satisfactory. 7? ~ a:?/x{ on 6 1%9 District Enginep.r District Engineer FOBIII NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............9.?:P.......!l1..qj,-.., 19..~:J. Approved ..........:?::..f!..........!1.!./!.1., 19..'if. Permit Na. .....'i<i?J!...?b Disapproveda/c .............:~~.................... Application No. ...'f..'?..~.7........ ......................................................:::::::...::::::~;::::~~~............. (Building Inspector) 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, relotionship to adjoining premises or public streets or oreas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicotion. c. The work covered by this opplication moy not be commenced before issuonce of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit sholl be kept on the premises avoiloble for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall hove been gronted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ond other applicable Laws, Ordinances or Regulations, for the construction of buildings, oddltions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinonces, building code, housing code, ·and regulotions. ...........~.....uI...l?.~....................... (Signature of applicant, or name, if a corporation) ...........;¡.......................,......L:...................................................... (Address of applicant) State whether applicont is owner, lessee, agent, architect, en9 ineer, genera' 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) I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number .......:.....................:..:...............~...................~........:......~................................................ .. .. R / - if 7 'IS- Municipality' . .. . ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ... .~!!.t.:. ~-t !'X: ...p.]. ~.t;............................... ....... .......................................................... b. Intended use and occupancy ...."?r.~:..~~.~._.~!.~~.:.'..~.~!{....................................................................................... 3. Nature of work (check which applicable): New Building :.-.~~........... Addition .................. Alteration .................. Repair .................. Removal.................. Demolition.................. Other Work (Describe) ........................................ 4. Estimated Cast ....~ ~.~.,.~.9.º....................................... .Fee ...... .$J0...90.. .................................................... ................ (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 occuponcy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ......n.()T)..~............. Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories ................................ D· . f t· t t· F t 7:" R 73' D th 3·~ I 8. ImenSlons 0 en Ire new cons rue Ion: ron .................................... ear ............................ ep .....~.................. Height .....2.?~......... Number of Stories ...}..:L........................................................................................................ 9. Size of lot: Front ............................ Reor .................................... Depth ................................ 10. Date of Purchase ........................................................Name of Former Owner ........................................................ -. 11. Zone or use district in which premises are situated .........R~.1'!.Ü¡.ç.n.t.i.¡..t.................................................................. 12. Does proposed construction violate ony zoning law, ordinance or regulation? .......!!.~................................................. 13. Name of Owner of premises Th.ur~a1l'...lìu:cgmy."':ç..Address .G"'~.;J,en...G.it:;·................. Phone No. .:P.L.§....S;:;J.6 . NOne Name of Architect ......................................................Address ............................................ Phone No. .................... Nome of Contractor ç;.,.~.·....p.!:':!':~J.L........................Address ....Gr.e.lm.µ).t:t.....N...Y~..... Phone No. .17.7...0.9.9.5. PLOT DIAGRAM Locate cleorly and distinctly all buildings, whether existing or proposed, and indicote 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. ~ 'to , ...¡. 1'7 I "- 3i!. ,F- ì3 .. <> '" 1_1_ a~ > /30 I STATE OF NEW YORK, lSS COUNTY OF ................................f . . ........et~,(f!å¡;¡,i~f.iM\Î-?ci~~8~~ïi~~)............... being duly swarn, deposes ond soys thot he is the applicar obove named. He is the ....~~.................................................................................................................. (Controctor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make ond f this opplication; that 011 statements contained in this opplication are true to the best of his knowledge and belief; a that the work will be performed in the manner set forth in the opplication filed therewith. Sworn to before me this ....·....Q·v........· day of ......~...................... 19..(:)",,/. A. JJ ß Notary Public, ............................................................ County..··..··..~ig~~;~ ~~).........................