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Home My WebLink About5083-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ;~..~2~0 ..... Date ............. Ea~.... 2.7 ..... , 19..73. THIS CERTIFIES that the building located at -W®~t '¢l'oek Driv® ........ Street Map No...xx ........ Block No .... xx ..... Lot No .... x~Z .... Cutehegu®-..N,Y., conforms substantially to the Application for Building Pemit heretofore filed in this office dated .......... l~ov.. · ~.., 19.70 · pursuant to which Building Permit No.. dated ......... NOV. .... .~0..., 19.70., 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~r~vate. one. f~a$1¥. ~lw®.i.l.~nl ...................................... · 0~rIle ~' (owner, lessee or tenant) The certificate is issued to .... Henl:y. Tabor .... of the aforesaid building. Suffolk County Department of Health Approval House ~ 10.~0 Building Inspector FOI~IV~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST B~: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5083 Z Permission is hereby granted to: ............... ~.~. .......... ~...,..~..~-..~ ..................... .....~.. ........ ~.~.~.~ ......... ~.~.~ ..... pu~suca~t to application dined ............................... . ,~......~-.-.....-..~,../-,-.J~..., 19Z.0.., and approved by the Building Inspector Approvecl ................................... ~,, ..~ .................... Disopproved a/c ....................................................... .~ ....................... ~.. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING FERMI'r D~te ....... ~ ...... ~, ~... ........................... , 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 bu.ildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which Js port 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 inspectior{ ~?roughout the progress of the work. e. No building shall be occupied or used in whc~'e 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 pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and othei- applicable Laws, Ordinances or Regulations, for the construction of buildings, additions ~alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and .regulations. (Sign~&~re o applicant, or name, if a corpo~tion) ............. ....... ........ ......... , (Address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engig~er, general contractor, electrician, plumber or builder. Name of owner of premises ............. ..~...~ ............ ~ ....................................................................................... (~'~'-'~]~,tl, of corporate officer) . 1. Location of land on which proposed work will be do,~_~ap. No.: ............ ~ .......................... lot N~'- ........................ Street and Number ................................................... ~......~ ...... ~ ........... ~ ............... ~ Municipality V 2. State existing use and occupancy of premises and i~~nd occupancy of proposed construction: ' a. Existing use and occupancy .......................... ~"'~"-- '~'i .... '~' .............................................. b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....................... .~.~..~..~.:...o~.. ..................... 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 ................................................................................................... 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 ..................... ./....~.~'.. .......................................................................................... Size of lot: Front ............................ Rear .................................... Depth ................................ Dote of Purchase ........................................................ Nome of Former Owner ........................................................ Zone or use district in which premises are situated ............................... ~ ..................... ~.. ........ i .................................. Does proposed construction violate any zoning law, ordinance or regulation? .................. ~ ................................. Name of Owner of premises~..Ctl.~'~../~..C. .................. Address ..~'.~.~...C.?..~..~"e; .~.~¢~Z/.~.~h~e~°~.~/.~. ~..~..~y Name of Architect .................................................... Address .................. ~ ................ ~...'J. Phone No ..................... Name of Contractor ..*~..~....~)..~.i~,.Address .~..~.?....~/~.....(~...~..~,,~.' ..... phd~e:~--J~. ~..~.~......~..6.../#. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing ~or proposea; and indJcdte'al! ~et-back dimensions from property lines. Give street and block number or description according to deed, and:~h~v street names and indicate whether interior or comer lot. 10. 11. 12. 13. Io3 ' STATE .OF NEW YORK, } e e COUNTY .......... ............. ~...~.."~ ..................................................... being duly sworn deposes and says that he is the applicant · (Narrfd of individual signing application) '9.b6ve named. He is the ................................................ ~,~..~.~ ........................................ (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 thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this Notary Public, . ........................................................... County ~ ( 'g · o applicant)