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Home My WebLink About4900-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerli[icate O[ Occupancy No. ~4~41 ...... Date .... January.. .25, ...... , 19.71. THIS CERTIFIES that the building located at .~,nchor. Lane .............. Street Map No/~larbor ...... Block No ........... Lot No..5.. Southold,. ~w. York ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated . Auguat .... 12, .... , 1970. pursuant to which Building Permit No. 490~. dated . ~UgUS.t .... 2.4, ......, 197.0., 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.r..iF.a.t.e., o.r~.. ~mlly..d~el~lng ..................................... The certificate is issued to . James. A...DayJ. s ...................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 2150 Ancho~ Lane 845 ~nd~e~ lane · January..25,..1,971.,. -Robe2~t. A-.- -V:l. lla · ' ' Building In~eetor ......... FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTN~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. I'. BUILDING PERMIT N? CrHIS PERMIT MUST BE KEPT ON THE PREMISE UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ....................................... ~ ~9oo z ~e ............ /'/ ~7' '" Permission is hereby granted to: ~ ............. .~..~.--.:.~......~.~?.:~:.,~. .................. ~.~, ....... .V~...>.~.....A :..~.,~.~..L.~ u, Id.. to ....... ~ ...................... ~ ............... ~..~..~ .................................................................................. ................................................................................... ~'.O...u.:.~.. h.,...¢ .~...~ .......................................... pursuan¢ to application doted ............... ./, ( ~ .... ; .., 19../-...,;~'., and approved by the Building Inspector. Fee .... Building Inspector .. TOWN OF $OUTHOLD ~,-/~ ~,.~, ~-, , . ,~ \-- , ~ U NG DEPARTMENT/~.~ ~ ~( ~. ~ ~ , ~'~ ~ B ILDI ~L ~ ~ ~ ' ~ ·~W' TOWN CLERK~ MFICE ....................... ,o ....................... . ...... ..................... ....................................... . . ........... ~~..,....~...~~ ...................... INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink unc~ submitted in duplicate to the BuildingS, Inspector. b. Plot plan showing location of lot and of bu.ildings on premises, relationship to adjoining premleal or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whlch it part of ~hle ~l~llcatlon. c. The work-covered by this app!ication may not be commenced before issuance of Building Permit. . d. Upon approVal of this application, the Building Inspector will Imue o Building Permit to the applicant. ~u~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 whole or in part for any purpose whatever until o 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 P~rmlt punmant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other eppll¢oble' I. awl, O~linances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al herein described. The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations. ~ (Signature cf applicant, or name, If a COrl~Orotlon) ............................ i'A'~g~';;~"~' '~'l~'l~ii'~;',nt" ' '~ ............ '~/;~ ~"'"~'" ~:) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~-'¢..-./.z'~.~..~,c ........................................................................................... i ................................................................. Nome of owner of premises ............................................................................................................................................ If app. li~t is a corporate~,~slgna.,ture of duly~g~thorlzed officer. (Name and title 'of corporate officer) . 1. Location of land on which proposed work will be done. Map No.: ......~..~.~.~r. ................ Lot No.: ...~.. ............... ~ Street and Number .... ~.i~.~r..~l~.~......~..: ............. : .......................................... , ........................................... ...~. ~ Munlclpall~ 2.State existing use a.nd occupancy of premises and intended use and occupancy of prpposed comtructlon: a. Existing use and occupancy ...... .~...~..~..~,~./.'~.........'~...~.~.... .......................................................................... use and occupant'......~...~..4~........~...4~.4~./..~]~....;~...~-r~,~..~.~.~./..~.~... ....................................... b. Intended 3. Nature of work (check which applicable): New Building ~.................. Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........... !~... ! ..................... 4. Estimated Cost .....,~..,~,~..~.~.....~..~ ...................Fee ........ a(~...:.~ .......................................... ~ ...................... (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 end 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 ..~....'~.. ...... g~ ..............Rear~...'~.......~.. ......... Depth Height ....~..7..../. ...... Number of Stories ...... ~ .................................................................................................. i ....... 9. Size of lot: Front ....,/,~..~.../. ........... Rear .../..~...'~....~. .................. Depth ../..~../..../. ................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... A ........................................................................................... 12. Does proposed construction violate any zon ng aw, ord nanoe or re_g, ulation~;;~..~_~..., .......................................... No e of Owner af ............. Nome of ^rch,tect ............. ho,. No ..................... Nome of ~.ontractor ................ /~e'~.. ........................... Addres~..,,,.'~~. ....... .l~...~s~'~'...~.~.~#~'. Phone No~.~..7~--~.'7~, PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oii 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 STATE OF NEW, YORK, 'l S.S COUNTY OF ..~..~..~. ............. ................................................................................. b~'ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) th® above named. He ~s ........ (J.~.~.T..~.e.~.~..~.....~......C~..~F.~.&P...t¢....~....p..~..(~.6/~ ....................................... (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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn t~ be~ore me this _ · ..~... ......... cloy of ....{~~... .............. , 19a~... '~' //~ ...,,~..~ ....... ~ ................. Notary Public, ..~.~,~.~:~.... .............. Count~ (Signature of applicant) Notary Public, State of Hew York $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. ~ ~--- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and fohnd to be satisfactory. S~ii~f of General Er.~Jnooring Servio~s DiStrict Engineer Zg/,V//V~ P, Aq. //Zo'~ AM. ONE FAMILY RESIDENCE. I.IERMAN II. YORK ARCIIITECT 90-~ 14. I~l 3'AMAI CA 32, NEW DATE: ~ · Z~,.c~,~. REVISIONS'. PLAN ldo ~'/4-0 DRAWING NO /0~'~ L 90¸ o4 ONE FAMILY RESIDENCE H. YORK ARCIdlTFCT 3'AMAICA 39., NEW YOR,~ f ~£o PM, ~I / I I / $2'o" ~ REVISIONS: SCALE: .I PLA.N NO .....~..../.'~ ....... DRAWING NO ........... ~ + OPE/V CEZI.,,4P.. ~= A /0-'2' ONE FAMILY RESIDENCE RMAN N. YORK ARCNI'FECT 90- 0~- IO} 0'AMAICA $2, NEW YOR~ SCALE.. ~ = /- DAT~: PLAN NO......N~/¢'0 DRAWING NO ................. ONE FAMILY R£SIDENCE ~ERMAN I.I. YORK ARCHITECT -04- ICo CA ~,~., NEW REVISIONS; SC^L~: !'¥ ' --' Ko" PLA. DRAWING N O...-~-..:C. !. ~ JdlTCAI£/V 0~b/1¢£ T-~ ~ ONE FAMILY RESIDENCE ,RMAN I.i. YORK 'ARCHITECT 3'AMAICA 32, NEW YORF~ sa'zs REVISIONS: $CALE:,~t'= /~* - PLAN NO,...~.Z."~':e ...... DRAWING ~OF~ I- If t- I I ONE FAMILY RE$IDENL. L 14. YORK ARC141TECT ,TAMAICA ~2, NEW YORK -LEF,T ~1~ ~L£~/,,4.T/o/{: DATE: ...... REVISIONS: sc^,E: ,)~."= ,.:o" ,l ONE FAMILY RESIDENCE.. HERMAN H. Y~ ARCHITECT 90-0~1~ S'l 3'2, Nr-w YOR~,. SCALE; DATE: REVISIONS: DRAWING 7 :) ONE FAMILY ~E,BIDENCE NEEMAN H. YORK ARC~IIECT 90-0~4- I~,1 AMAI CA 32, NEW YORK. -.'?.¢..'~ o/Y.' A-,4 SCALE ,- C~ OS S DATE: REVISIONS: