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Home My WebLink About4909-zFO~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. J.~.29 ...... Date .............. 0.ct ....12 .... ,19.7.1. THIS CERTIFIES that the building located at .. Pvt' Hoad' of'f 'N/~- 0ri~,n~J~et Map No..~,t'.~st. ·. Block No... '39 ..... Lot No... 6 ...... F. ish,rs · t.~ta~d ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... -.ug. · .1.2. -, 19 '70. pursuant to which Building Permit No. l+~09z.. dated ............ ,,ug...$8.., 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 ... ~f .r.i.v.a..t .e..qn..e..f.a.m..i.ly..d..w.e..i,.i.r?g ...................................... The certificate is issued to .... E ,l~...0arpente~' .......... ~wner .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .2e.D.d;i~.g .......................... Building Inspeeto~/ TOWN OF $OUIHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE i SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT!L FULL COMPLETION OF THE WORK AUTHORIZED) Perm[ssion is hereby granted to: ................ ~"JL~h~,....t~ ......... :... .............. to ......... J~1.:3~ ..~w.. ~ae..~4i~..~e~l~.... {~ ..ee~;) ....... : .......................... at premises located at~ .................................. ~J~e~a..~.~l~t~l~....~.;....: pursuan,t to application dated ........................... ~i!~....,.t.~!;..-., 19.;.,:~ and approved by the Building Inspector. Fee $.. e. ......... ,"~ :"~PO~l t'?"'""""""""'.. : au o TOWN OF soUTHOLD ,BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~amined ..........~.....[...~....., 19~'~...~. Di~pp~ a/c ........................................................... (Buildin Application No..,.Z~....O..~. ........... APPLIGATION FOR BUILDING PERMIT Date ..,~tg~Y,..12 .................................... , 19.7.0. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted In duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, re ationsh p to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whlch Is paff 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 Perm t to the applicant. Such permit shall be kept on the premises available for inspection t~roughout the progress of the wurk. e. No building shall be occupied or used tn whole or in port 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 pumuant to the Building Zone Ordinance of the Town of .Southald, Suffo k County, New York, and other applicable Law~, Ordinances or Regulations, for the construction of buildings, additions or a terations or for removal or demolition, al herein described. The applicant agrees to comply with all oppl cable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, if a corporation) F..~s.h.,.e..r..s...I...s. land New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................... .cJe=ez:al. ~n~racf-or ..... . ......... Name of owner of premises ..... E~,,.N,..,Car~enter..,.I~ ...... . .......................... If applicant Is~a corporate, signature of duly authorized officer. ×:'" ................... ~ [momeona TITle'OT corporate OTTIcer) 1. L~ation of land on which proposed work will ~ done. Map No.: ..R~.~.e=.....~ ......... Lot No.: ........................ Str.. and Number ................. ~....~I~~.....~...Z~.. ~unlcl~l~ ............. 2. State exi~lng u~ a~d ~cu~ncy of premiss and Intended use and occupancy of prop~ c~tmctlon: ~. ~lstlag use ~ ~cuponcy ........ ~e~.~ .......................................................... b. Intended use and ~cupan~., 3. Nature of walk (check which applicable): New Building ...... ~. ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....$A2~.OD.Q,D0 ................................ Fee ..... ~.~,f)...0~. ...................................................................... (to be paid on fi!lng 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 .....4~,.....,,3. ................... Rear ...~.~....~.'.~. ........... Depth ...2.?...~.....~..". ........ Height ...... ~,5 .......... Number of Stories ..... ..o..a..~. ........................................................................... 9. Size of lot: Front a~m..~3].O.t...~].~l~,ear .................................... Depth ................................ 10. Dote of Purchase ..... ~1..~.~..4. ......................................... Nome of Former Owner 11. Zone or use district in which premises are situated ......... ~e~.~.Re~t~L~l ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.> ......... ~.~. .............................................. 13. Name of Owner of premises .~l~...~.s~:~q.~.t;.~.:E4.~;~ddress .~.;fk~l~l~'~l...;T.~.~.~3.c]..,...~..~T~hone No..7..8.~-.7...5.~..2. Name of Architect Albert G. Clay An~lrn,. N:La_nt:Lc~ Conn. Phone No. 739-8546 Name of Contractor~e...~...~.f~§...~..~..~.~.~.....C.~..~..~.=..Address .~.~...~.~..]...~3~..~.~..~..r..~. ~hone No..~.8...8..-.?.2.3..~ 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 lot. STATE OF NEW' YORK, ~ e e COUNTY OF ................................ )' ~'~' .................... ~..~O~t~..~{~*...~T~..~ ................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....................~..q~....~...~..e..~..~.~...e..~...t.. ......................................... ..~ ....................................................... (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 Jn the manner set forth Jn the Application flied therewith. Sworn to be~ore me this ~-' .. , / ......... ......................... . ....... .... ....... Notae! Public, .~'I~..~ ................ County ~ [Signature of applicon[C) ................... // ~ JOHN QADA Notary PuNic, State of New York Residing in Suffolk Co. Off. No. 52-6439000 COmmission Expires March 30~ I~l"' / / // \ \ / / / / I / / I \ / d , -'ALBEg,.T O, CLAy ANCHIT[CT F-' 0 A ,D I~TE-D