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Home My WebLink About5092-zFORM NO. 4 TOWN OF SOUTttOLD BUILDING DEPARTMENT Town Clerk's OiEice Southold, N. Y. Certificate Of Occupancy No. )+266 Date THIS CERTIFIES that the building located at ~l[ht,~So Lal~e) (PV~) Street Map No.. ~. Block No. ~ Lot No.~ S~el~ N,Y, . .. conforms subst~ti~ly to the Application for Building Permit heretofore filed in this office dated . Dee . ~ , 19 ~0 pursuant to which Building Permit No. ~09~ dated Dec ~ , 19 ~$ , was issued, and confor~ to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .~~ .q~9 ~il~ ~!~ ..................... The certificate is issued to J~e~ G~b~D~ ...... ~ ...... (owner, lessee or tenant) of the aforesaid b~lding. Suffolk County Department of Health Approval ~e. 2.]. ]~. ......... ~ ~uilding Inspector ' FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION 01: THE WORK AUTHORIZED) N? 5092 Z Permission is hereby granted to: ............ ..e..,:~.,~.,..~....e.;l,..:L.~.,,~...~.e..~...~...~.~ to ..... ~.~::lA..~...e~..~.~t.~....~.e.~?~ .............................................................................. at premises located at ..... ~,dl~.~..O _J~.~..,~..~el~t~:..~...]L ....... ~J. jr~t~.~il~l~..J/ll~ ...... .................................................... ~~,....~,~., ....................................................................... pursuam' to application dated ..... .~ ........................... ~J~ ........~. ......... , 19.~D.., and approved by the Building Inspector. " Building Inspects/ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH I Bldg. Permit NO. ~"0 q~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ~ - (Give deed loc~ion) have been inspected by this department and found to be satisfactory. Chief of General Engineering Services Examined ........................... .,C~.i ........ , ~,~, Appll~tion No ............................. ~a ........................................ , ly ........ ~erm~t ~o ............................. / ~ '~X ...................................................................................................................... , (Buildt~ In~or~ APPLICATION FOR BUILDING PERMI'T ~ D~te December 4 ............................................................ , INSTRUCTIONS a. T~Is application mu~t be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premlee~ or i~lblJc streets or areas, and giving a dMailed description of layout of property must be drawn on the diagram whlch II part of ~hle 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 Ir~pector will Issue o Building Permit to the appll~lnt. S~:h permit shall be kept on the premises available for inspection throughout the progress of the work. ' e. No building shall be occupied or used in whale or in part for any purpose whatever until a Certificate of O=cupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issUance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other pppllaoble Lawl, Oedlnances or Regulations, for the construction of buildings, additions or al.terations or for removal or demolition, ee herein delcrlbecl. The applicant agrees to comply with all applicable laws, ordinances, building cede, housing code, and regulations. (Signature cf applicant, or name, If a coq~eratlon) Robinson Roaa, OreenpOr~, N. Z. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premisel ....~..m~,.,e.,e....~..b..b..9..~.9 .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ....................... Street and Number ~.j~.~...~..~..o...~.~..e..~. ~-~ ( -- .~0 ~' MUnicipallty State existing use and occupancy of premises and intended use and occupancy of proposed conetructlon: [~isting use and occupancy, Intend~:l use and occupon:~ Oho l*ami'~y D~r~lling 3. Nature of wo~k (check which applicable): New Building ~.~..x. ......... Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ...~....4..0..~.9..0...0. ...................................... Fee ........ .~....!0.,%0...0. ................................................................ (to be paid on fYng this application) 5. If dwelling, number of dwelling units ..,.o..n.,~ .................. Number of dwelling units on each floor ..o.~? ................... If garage, number of cars ?1to 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 86" . Re~. 86" r~__.L 32* Height 20 t N(~mber of Stories 9. Size of lot: Front 185' Rear lS0 ~ Depth .....2..0...0.~ ................... 10. Date of Purchase .....D..~?..,....~.~....1...9..7..0.. ....................... Name of Former Owner Eiema~? 11. Zone or use district in which premises are s tuated ]~es/~denf, ial 12. Does proposed construction violate any zoning law, ordinance or regulation? ......n..o. ................................................... .... :_~_ James Gibbons -.. Garden Cit~. .................... ~3. Nome of Owner of ~,~,,,,~., ..................................... ~aaress .......................................... Phone No. PI 6 4613 Name of Architect .....n...o..n...e. ........................................ Address ............................................ Phone No ..................... Nome of Contractor ~.,,...~.2.~...w.~..~..1. ....................... Address Greenport, N.. Y.. Phone No. 477 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 Jot. X g STATE OF NEW/~OP.,~ ~ tee COUNTY OF ..ldr~Y~-~dm(.~/~ ........ J"~'~' ........ ........ ~..~~ .......................... ...being duly sworn, d~es and says t~t he is the applicant (Name of individual~~signing~pplic~tion) above named. He is the ..... ~~ ................................................................. ', ........................................................ (Contractor, ag~t, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke 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 fo~h in the applicati~ fil~ ther~ith. Swam to ~fore me this ........... ........ ...... ....... :. ............ , _ b:otae/ ~ubli~~~,o. 5,.812~50~u,~, :~.~o~ou~h, 7~ (Signo~re of appiicant, Term Expires ~rch