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Home My WebLink About4232-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sonthold, N. Y. Certificate Of Occupancy No. Z '~7-~9 .... Date ............ Febural~y. '~ , 19..7.0 THIS CERTIFIES that the building located at lg/8. Harbor..~ne .......... Street Map No..~ ....... Block No...~ ...... Lot No.. XX ..... C~t~o~ ~. N.,~. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ A~ril .... b.. , 19 $9' pursuant to which Building Permit No.. '~3.~ .Z dated ......... a~ri}.-. 9'"' 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 ... Private' o~e ' family' dwe].iin'g .................................... The certificate is issued to ... Chester.~r~owsk.i ... ~e~ .-. builde~ ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · · 0ct. a0 .~ 969... by. ~.. ~illa ..... B~¢' ....... .q.~f ~ k~.-1 ...... ding Inspector House ~ 2~00 FORi~ NO. 2 TOWN OF $OUTHOLD 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? 4232 Z Permission is hereby granted to: ........................................................ ../.:6...:(~ .......... to ..................... ~ ~ :. ~.. A./:?. ........... 2.~..L.~./.~: ............. L...... £Z?. Z:: ./.~. >L: .......... L/,: ?..~'. :..~.:. ............ pursuant to application dated ................................ ~.. ........ ~'!,~t, 4~t..., 19..~.7~and approved by the Building Inspector. Fee $ ...... ./..~:...:........ Building I~gpedto~' S-9 $CRD TO WHOM IT SUFFOLK COUNTY DEPARTMENT Date Bldgo OF HEALTH Permit No. MAY CONCERN: The sewage disposal facilities for a structure located (Give dee~ location) ~/ have been inspected by this department and found to be satisfa~toryo Dim~riO~ ~r~insOr District Engineer TOWN 'CLERK'S OFFICE ~,e/7~ SOUTHOLD, N. Y. Approved ............................... ............................. 19.~...Permit No. /7/~'~"~ ~'~ Disapproved a/c ..... ~......................-...................... ................ (Building Inspector) Application No. /T/"~-~'~ ~n APPLICATION FOR BUILDING PERMIT Date .. :.....~... ......................... , 19..~..Z. 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 property must be drown on the diagram which is part of thi,~ applica- tion. 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 th& work. e. No building shall be occupied or used in whole or in pa rt 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, alterations, or for removal or demolition, as herein descr bed The applicant agrees to comply with all applicable laws, ordinances_and regulations,_ ~ (Signature of ap-pl~a~t~-or name, if o corporation) (Add,ss of applicont'~ State whether ~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is o 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 .s a o , _. · 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ...... ~/Rtz,e~.....,~..~.~......':T~... .................................................... b. Intended use and occupancy (~...~ ~ .c~,.~~~ ' ' ' 3. Nature of work (check which applicable): New B'tifld[ng ~ ................... Addition .................. Alteration .................. Repair .................. Remova! .................. Demolition .~ ............... Other Work (Describe) .................. 4. Estimated Cost ...............-A~...~..i''~ ................ ....... '.:Fee. ...... i......~..~..:...,.~., .......................................................... · (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~ ....... : ..... Number of dwelling units on each floor ............................ Ifg arage, 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 additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ~....~.. .......... Rear .............................. Depth ..~.....~. ................... Height .............................. Number of Stories .............................. 0. Size o~ lot: Front ....... /...{~71~ ............. Rear .......... / ...................... Depth ......... ~.,.('~...~. ......... ]0. Date of Purchase ....~41..?.....././...~'....~' ................. Naw~e o.f Former Owner ~~,~.~,. .................... 1 1. Zone or use district in ~hlch premises are situated...~.~ .......... ~ .................... 12. Does proposed construction v~Late any zoning !aw, ordinance or regulation? .............. .~.J..~.....'T ........................ ; ........ 13. Name of Owner of premlses~.l~),~.~,,,.~,~, Address ...~I~A:.....;~. ....... .~..~,. Phone No.~..,~.~.~.~J~',~ Name of Architect .................................................... Address ................................................ Phone No ................... Nome of Contractor ........................................ : .......... Address ................................................ Phone No .................. PLOT DIAGEAM Locate clearly and distinctly a!l buildings, whether existing or proposed, and indicate oil set-back 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, ) c ¢ COUNTY/,,.~j ~ [("~ ~ J ' _ A'OF ................... .~?.) "'"' . V(Name of in ~Ei'~cFffal si-gnincLapplication) /,~ __ above named. He is the ................... ~......~......~en~..: ..................................................................................... (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 this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to .b.~..ore me this ~....~../~'/..Z77., 19 ..~'..? ~FJ ~ ........ .S d oun- ' ...... ::"'"v: ............................. Notary Public ............................................ ry ARY PUBLIC. S~ffl,e~,~J~Tl~ Or appncanr) ~~ No* S2-8125850, Suffolk County ~'~rm D~pires March 30,