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Home My WebLink About3757-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N. Y. Certificate Of Occupancy No. g. 3~?'1 ..... Date .......... April ... 2 ...... , 1970.. THIS CERTIFIES that the building located at .$o~l. Beach. Dy .......... Street Map No.Capt. Kidd.. Block No ........... Lot No.3~ ....... lqatti%uek...N,Y.,. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Dee · -28..., 196.~. pursuant to which Building Permit No.. dated ......... Dec..28 ...... , 19.67., 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 ...Prt.v.a%e. one. fami:l.y .dwe.t. ti. ng ..................................... The certificate is issued to ..... D,.~ .8trategos ....... 0wider. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... ~erx/{il~g ........................ ............ Building Inspector House # ~ %00 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N~ Y. N? 3757 z Permission is hereby granted, to: BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) D~e ........................ ~.,...~ ............... , ~9....e.~ p~rsuan,t to. application dated .................... ~ ....... ~,~ ..................... , 19.i~.., and approved by the Building Inspector. Fee $.....~.~ ~.~ ........ Building Inspecto~ '~" .,,_,,.,...,,.....",.. ' BUILDING DEPAR'rMENT ~// · . TOWN CLERK'S OFFICE SOUTHOLD, N.Y. /~. O. ....................................... . ....... ,, " Z...a... ........................................ , 19 ........ Permit No .......... APPLICATION FOR BUILDING PERMIT 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 pm. mises or pub ic streets or areas, and {living a detailed description of layout of property must be drawn on the diagram which *s 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 app. lication, the Building Inspector will issue a BUilding Permit to the applicant. Such permit shall be kept on the premises avadable for inspection throughout the progress of the work. e. Ida building shall be occupied or used in whole or in part 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 CountT, 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, ordinances, building code, housing code, and regulations. Richard ~N~ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. contractor Name of owner of premises ...~...,...~.~.R.~Q~I ..................................................................................................................... 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.: ....C.'a'~'.t......~....~.~. ............... Lot No.: ....~.. ............... Street and Number .~./.{~.....~..;~.l~$~..~.e~{~.c.~...~X'.~,~.~. ......... ...~..~.~,.1;.~.~. ............................................................. .~1 - / b-oo Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy vacant laud b. Intended use ......... o~e..t'a~ll~'...d~.e]~Jm¢ ................................................... ;.~....~....~... 3. Nature of work (check which applicable): New Building .~ ........ Addition .................. Alteration ' Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...........~.~ ................................................ ~,.0..... ..................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .....o..~...e.. ................. 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 Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............... ~.2.. ............... Rear ......... .br..2. .............. Depth ........ ,~.~. ........... Height .................... Number of Stories oTte ............................................................. 9. Size of lot: Front ...... .~ ................. Rear ................... ~Q ............ Depth ..... 3~0..+~ .............. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ .~.. ....... :~.J.~ ............................................................................ Does proposed construction Violate any Zoning law, ordinance or regulation? ............. .D...O.~.~..~..~,i..~...~.~.~.~;... Name of Architect ...................................................... Address ............................................ Phone No ..................... Mineola Locate clearly and distinctly all property lines. Give street and bloc whether interior or corner lot. · 1 '\~ PLOT DIAGRAM buildings, whether existing or prepo~ number or description according :d, and indicate all set-back dimensions from o deed, and show street names and indicate ¢ STATE OF NEW Y, QRK... ~ e e COUNTY Of ....... ~Z.O...~... ........ ~'~' ............................ ~j~. i ~ .............. ' ..................... b~ing duly sworn, d~poses an~says tk)at he is the applicant (Name indiv,dua, signing opp.ca, on) above named. He is the .................... o,tractor; e,c.) of said owner or owners, and is duly authorized to perform or have performed the said work ~ ~ke and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; a~d that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......................... .............................