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Home My WebLink About4914-zFO~gM NO. 4 × TOWN ~(~F SOUTHOLD BUILDING/DEPARTMENT Town~lerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~.l.6~ ...... Date ............. Feb... 3. ...... , 19. THIS CERTIFIES that the building located aMoer~s. Lane. llal~th ......... Street Map No.East~ ;ih... Block No ........... Lot No. 10l .... GF~e!~p.o.r.t....1~ ~)[~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 8/.. 1.~ .... , 19.~.0. pursuant to which Building Permit No..~..! .~... dated .......... ~,ag ....19.., 19 .?O, 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. rl.~.at®, ellS. f~tly..d~:Lq,~ .... (2~...f.l.o.~.r.,..u~.~.n..~.s.h..~.) ......... The certificate is issued to . .(~®®rge. &biers..Bu~der. Ins ....... Qwner. ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Max, at. .¶ ~..~.97~ .... by Ro .¥1.l].& .... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .............. GeeaSo .~l~te~ .~JAe~.. 3aa ..... at premises located at ............. ~W"IOI'"'~&8~"~OI~ ....................................................... .............................................. ~le~v,a a.. ~I,~ ..ilem.t~ .............. ~mea,~,4~ ......................................... pursuont to application doted ................................ &ll~ ......... .~......, 19....~1~1) and approved by the Building Inspector. Fee $...~.~1 .......... .......... ................... TOWN OF $ouTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOU~D, N~y. A~mved ........................................ , 19 ........ Permit No ........................... Di~pproved a/c ...................................................... (Duilding InspectOr) APPLICATION FOR BUILDING PERMIT Date ............................ /~'O 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or ~n ink and 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 on 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,tshall ~e occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been g~nted,.b~the Building Inspector. APPLICATION 15 H~RiEBy ~M~DE to tl~e Building~Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count~, New York, ~nd other applicable Laws, Ordinances or Regulations, for th~ construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agre~es to Comply with all applicable laws, ordinances,~building cdde, housing code, and regulations. · ' (Signa~re of Opplica0t, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, %nt, arc~i~.~, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......... ~.k.....~ ....... ~~ .:.....~. ........................................ If applica~ is a corpor~ ~i~atu. re of du~uthorized officer. (Ncfche and title of corporate officer) 1. Location of land on which proposed work will be done. Map~No.: .......... '-'~r'~'~"~: ....... , ...... L'6t NO.: ..... ~f..~.~.. TCI -- 770 : "' ~ Street and Number .............................. ~ ......... ~...~. ~ ......... · :' ,- Munici(~l~lity . ' ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ....................................... ~ ...................................................................... ntended use and occupancy .............................. ~.. ............. ~ ................................. 3. Nature of work (check which applicable): New Building ...... ~.... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ................... ..~..,,~..~....~...~...~..,.~..~.. .......... Fee .......................................................................................... (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 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 ................ ~...~... ........... Rear ....... ~....~..-~.. ........... Depth ..... .~...~....~/. ....... Height ........~...~.. ....... Number of Stories ............... ..~... .................................................. 9. Size of lot: Front ......... ./..~...~. ........... Rear ............ ./.~..C-~. ............... Depth ........... /..~.~. ............ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises ere situated .......................................... ..~... ...................................... 12. Does proposed construction vi~olate any zoning law, ordinance or regulation? ........ ...,~.~. ............................. ]3. Name of Owner of premises ~.~:~,..~.~/~3....~..e.l/q~.[.~.~c~dress ....~,.~"~.......~p..,~...~.~....~.~.~.e,~..... Phone No..~..~.~....~4o..."O Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... 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. ! '-- 130 STATE OF NEW YORK, tee COUNTY Of ........... ~.. ~. ~.~..~ ....... .................... ~ ........... ~5.~1,~.~ ....... "· ............................ being duly sworn, deposes and soys that he is the applicant (Name of inclivid[l~l signing application) above named. He is the ..... ,: ............... i ................................... ~.~J~. ......................................................... (Contractor, agent, corporate officer, etc.) of sold 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. Swam to before me this ........... ........ day of ......... Nota Public "--Y'V~...~-. ~/~ J'~. _.' J~"-'--~ .............. '~"~ ........ ~ ............................... ry , ...~-.z./~/:l.,c,.'~./.~.....I,,&.,..~'~c/..~.'/County ~iignatur, of applicant) MAR~ON~ REGE N'~ "-" NOTARY PUBLIC, State of New Yor No. 52-3233120 Suffolk C~untv Term Expires March 30~ 19_7~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date March 1, 1971 49z z Bldg. Permit No. TO WHOM at (Give deed location) Map of Eastern Shores~ Sec. 3~ Lot 101 IT MAY CONCERN: The sewage disposal facilities for a structure located Moores Lane North~ Greemport have been inspected by this department and found to be satisfactory. Chief ~0 f General