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Home My WebLink About4893-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~LI'~I..~. ...... Date ......... AI~.I~!! .....~1!+. ..... , THIS CERTIFIES that the building located at .. Stored. DA~.vo ............. Street Map No.E.a.~t :..S.I~S. Block No ........... Lot No... ~ ~9. ....... Gr~.e.~p.er.~ .... .1~ :~.: conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~ugust...10, 1970. pursuant to which Building Permit No. dated ......... A.~lg .... !0. ...., 19~0., 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 P~.l¥&.t.~. ol~.e..£alally, d.w.~tlll~[ ....................................... The certificate is issued to .. J.~h!~. ~.elr~ ........ Qwl~.e~. ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . April...9 ~-.t97~...by..ri..Villa.. # 2,00 1/ . ...... .............. Building Insp~tor FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE:S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4sg3 z ~e ............ '~ ......... Z.:(L:...d,..~.&.., ,~..7...~ Permission is hereby granted to: ~... ~:~'~ ~ . ~ ~ , at premises located at ............. &'2,...V.~ &~,i:.,:P'.~.T...~: ...................... , , pursuan,t to application dated ....................................... ~.. .......... · .~..., and approved by the Building Inspector. i Building Ihspector ~ "UILDING DEPARTMENT TOWNCL:RK'SOmC S~THO~,N.Y. ~ ~, ~ / ~ ........................................ ~ ~ ........ ~ ~ ~ ~ ~ ~.ADpHcaHon ~o ............................. Di~ppr~ed a/c ........................... ~ .................................................................. ....................................................... ........ .............. .......... ................................ (Build~nspector) , ......... ............................ , ..... INSTRUCTIONS a. This application must be completely fiJl~ in by ~pewriter at in ink and submitted in ~plicate to the Building In~ector. b. Plot plan showing I~ation of lot and of buildings on premiss, relationship to adjoining premises or public streets or areas, and giving a detailed description of I~t of pro~ must be drawn on the diagram which is ~ of this application. c. The wore covered by this appJication may not be commenced bafore 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 pr~ress of the worE. e. No building s~ll be occupied or used in whole or in port for any pu~ose whatever until a Ce~ificate of Occupancy shall h~e been grant~ by the Building inspector. APPLICATION IS HEREBY/V~,DE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordirmnces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or nome, if a corporation) (Address of applic/,nt) ! State whether applicant is owner, lessee, agent, architect, engineer, general 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) 1. Location of land on which proposed work will be done. Map No.: ......~T.....~...~..~..~ ................... Lot No.: ...J.J..~.. ........... ~. Street and Number ...~.....,~.'~ ......... ~(.~..~ .............. ~ ......... .~J...~. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~ ~ .P.~ b. Intended use and occuponc,~ ......~....~.~ .. . ........... 3. Nature of wo~k (check which applicable): New Building ...... ...~. ....... Addition .................. Alteration .................. ' Repair .................. ~R~emoval .................. Demolition .................. Othe~W. ark (Describe) ........................................ 4. Est mated Cost ....... .~.~Q.~.~. ............................. Fee ...................... './~..~ ............................................. (to be paid on fi!ing 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 additJons~ Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............. ~...~..', .............. Rear ..... .~..~. .............. Depth ...~...~. ........... Height .,../,~.. ......... Number of Stories ..... .O..,A/.~..~ ......................... ; ........................................................ 9. Size of lot: Front ......... ~ ................ Rear ...... ,(~.u....'~.. .................... Depth ..... c~...~.. .............. 10. Date uf Purchase ........................................................ Name of Former Owner .~-~-~cn..~.~..~-~C~.....~,~C~'~e.. ...... 11. Zone or use district in which premises are situated .."....~ ................................................................... 12. Does propused construct;onI ~ --vi°late any zoning law, ordinance or !,egulation? ............................................................ 13. Name of Architect ................................. .7. .................. Address ............................................ Phone No ..................... Name of Contractor ...~..¢~...~ ....................... Address '"'/J~'~"' '~"7 .............. Phone No. J¢'/.~.'..~.~.~'~.. PLOT DIAGRAM Locate clearly and distinctly oll buildings whether existing or proposed, and indicate all set-bock dimensions from property Dines. Give street and block number or description according to deed, and sh°w street names and i~dicate' whether interior or corner lot. · ,f STATE OF NEW YORK, ............. · '~...~........~,~ ........ ~.......~......~..... ........................ being duly sworn, deposes and saYs that he is the applicant (Nome of individual sLgnlng a~Jlcotion_.)- / above named. He Js 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 that the work Will be performed in the manner set forth Jn the application filed therewith. Swam to before me this ...... .....d:Y o, ...... Natal/ Public ..... County~ (SI"~"" ' -"""" "~;';'~;;; "~'~ 'c~ppllcant" '""" ""i ............................ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. 1971 Di~:trict Engineer