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Home My WebLink About4910-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk'sOffice Sou~old, N. Y. Certificnte Of Occu. pnncy No. Z1~2.37. · :..... Date ............. ltay ... 12 ..... , 19.?~. THIS CERTIFIES that the building located at . P~C 'Read .0fff..Oriental. &~reet Map No.l~shel,s 'Is' ~t'~' · ~t~ ...... Lot No... ¶9,~ .... 'Pish~rs' conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... AllgUSt' ' '1~ 19.70 pursuant to which Building Pemit No. dated ........... k~lg~lS'C ' ' 18 1970' 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 ...Pfd.'fate..ene. i~ami'l~f .dwel't 'ing ..................................... The certificate is issued to , id; ' Le'e ' lta~Iey' ~ ...... 0~e[ ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...Pend~g ......................... .... ,...:./ ............ ~ Y ~ Building Inspe~or FORM NO. 2 TOWN OP SOUT~OtD BUILDING DEPARTMENT TOWN CLERK'S OFFIG£ SOUTHOLD, N. ¥. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL KULL COMPLETION OF THE WORK AUTHORIZED) N? 4910 Z Permission is hereby granted to: ~ ~,,,,~,~,~.. ~,.,...~/~..W~~.~,l'~ .................. ~sbe~..~s~t .......... ~, ................. pursuc~t to application dated ............................. ~ Building Inspector. Fee $...~.eOt~ ......... '19.;.,~ and app~'oved by the IroR~ NO. I 'laWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................... .....~. ............ , 19 ........ Permit No .... .J....0. ..... ~... ^pplicotion No. 9~ / O Disapproved a/c ......~, .......................................................... or) APPLICATION FOR BUILDING FERMI*I' INSTRUCTIONS o. 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, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn an the diagram which is part 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 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a .Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and othe, applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein,described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, ........................................................... g.q~P,.e.~%l,., g.~l;k~IF.~g.~.~,P.g ........................................................................................ Name of owner of premises .....'lJ,,..~.eleLJ~i~l.~,.e~.,...ff~. ..................................................................................................... If applic~ant.~is ~corporate, signature of duly authorized officer. ........... ~' (Name and title 'of EO'rporate othcer) Location of land on which proposed work will be done. Map No.: ..~.az~.J~;'.el~, ............... Lo~t No.: ................. ~. ...... Street and Number ........................................................................~.;I,,~3~,3;~...;[~l.~.~13{;J~...lg. el~..~la:l:~, ........ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Rea~6ent.~.al b. Intended use and occupanc, ...... ~ I~1.~ ~.~, .1;..~ .~], ............ l.....~..~....~.~ ............ ; ....................... property, lines, Give street and block number or whether interior or corner lot, 3. Nature of work (check which'applicable): New Building ~ ...... 3¢ ........ Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...... ~.7..~,..~..0..0..~..0...0. .............................. Fee 10o00 (to be paid on fi~ing this application) 5. If dwefllng, 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 st'ructures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ......................................................................................... Dimensions of some structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................... Rear '/or 10" D__.L A=, ~, 15' 0" · one Height ................... Number of Storms .................................................................................................................... see attache~ plot plan · 9. Size of at: Front ............................ P, ear .................................... Depth ................................ 11. Zone or use district in which premises ore situated ...~.~.0,{~1;~.~,~, ................................ 12. Does proposed construction v)olate any zoning law, ordinance or regulation? ............... ~1o. .................... 13. Name of Owner of premises .W,,..~,e,e..Hanle. y. eJ;r. Address Ft~eZ:S...Is.].nnd,...N.o.~hone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from to deed, and show street names and indicate STATE OF NEW' YORK, tee COUNTY OF ................................ ~'~- ...... A~..~3..~,~,s~.. ~e. · - ........................ being duly sworn, deposes and says that he is the applicant (Name df individualr sig~ing application) above named. He is the ............. .~..~g.{I ~.~.~.~.f~. (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 ttue to the best of his knowledge and belief; and ~--um.t~'~"a~T'~th~eou=,ur= mc~inrs w~o'?i--wil--I-be'~-erf°rmed in the manner set forth in the application filed therewith. ....... ..... dayx, . , ................. , ................ / ................ ........................... Notary Public, State of New York ResidlnE in Suffolk Co. Off. No. 52-6439000 ~emmissi0n Expires Ma'ch 30, /