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Home My WebLink About4949-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~$78 ..... Date ............. THIS CERTIFIES that the building located at K- .l~g. $~ ................... Street Map No..~ ......... Block No...xl~ ...... Lot No~ ....... 0l'~.e~t ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Sopt'' '10'" 19'7G' pursuant to which Building Permit No. dated .......... ~op~; ..11..., 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 .. 0~ .£~y. &w®l~g ............................................... The certificate is issued to . .R®be~'t. J...De~la~.s ... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Ma~,...26..~.97~[...~/. R..¥~3,1& ..... g mspee~o[ FORM NO. ~ 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) 4949 Z Permission is hereby granted to: ................. J:.~e, ke...Ll,to~a.tiee~ .................................................................................................. at premises located at ............... ~..J[~l~..~ ................................................................................. .................................................................. Ol,~en~- ...... Jl~,.~ ............................................................... pursua~¢ to application dated ......................... ~....~$0 ............... , 19..11~., and approved by the Building Inspector. Oullalng Inspector I $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Fermft No. TO WROM IT MAY CONCERN: The sewage disposal faciliti,es for a structure located at ~.>6~ ~l/Y~ 5 / ~-- ~JJ ~ ~ ~ ~ ~ (Give deed iocatko~) ~- have been inspected by this department and found to be satisfactory. Dlstrict Engineer 1PO, l~ NO. ! ~WN oF souT.OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~m,,.~.~., ............. IL ......... , ,~..7..~. ^pp .d . ;;. " .. ,,, ........ ,.,m,,,o ..... ......... Application No...~..~..../"/...~. ......... Disapproved a/c .............................................................................................. APPLICATION FOR BUILDING PERMIT 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, relationship to adjoining preml or public streets or(~ areas, and giving a detailed description of layout of property must be drawn on the diagram whlch Ii part of thle appllcation.,,~ C. The work covered by this application may not be commenced before iuuance of Bullcllng 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 sl~all' 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 Department for the issuance of a Building Permit pumuont to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, anti other pppllcable I.awl, Ordinances or Regulations, for the construction of buildings, additions or alterations, or f.or removal or demolition, al herein described. The appllaant agrees to comply with all applicable laws, ordinances, building code, housing code, and ragulotlons. ............ g o ~ can , or ~On) ORIENT TRUCKING & CONSTRUCTION CO. ROBERT J. DOUGLASS ORIENT, N. Y. (Address 6f applicant) State whether applicant is owner, lessee, agent, a~chitect, englieer, general contractor, electrician, plumber or builder. If applicant Is a _corp~orate, signature of~l, uly autharize~ officer. (Name and title.of corporate officer) 1. Location of land on whlch proposed work will be done. MGpNo.'.(~~.~N~.~.~, Street and NZ~be('...~*.~....~.,~' ...~ ................... ~..~......~.....~...,. ......................... Munlclpall~ (/ and 2. State existing use and occupancy of premises and intended us,e occup~ancy of pmpo~ed comtructlon: o. Existing use and occupancy ~t~., .~ .~.--~l~'.'dl~ .....~..'l~l'~...~..~e~4~..../~. e~...~.'~t~..'..r"'.. b. Intended use and occupan? .. .~.~ 3. Nature of wink (check which applicable): New Building .................. Addition ......~... Alteration ~-' "~'"r ......... ....... · Repair ................ .~L~moval ..................Demolition .................. Other Work (Describe)~. 4. Estimated Cost ...~: ..... ,.,~..~..~.*.~..~3 ............... 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 ............~J~..l~. ....... ~.4.~-~l'.~...-.~ .............................................................................. 6. If business, commercial or mixed occupancy~ specify nature and extent of each type of use ............................ "'"' "-" '"" ' "-" .~..o....'.$~ 7. Dimensions of existing structures, if any: Front ....~..,~.....~-... ..... Rear .....~5.,2......4JC.. ......... Depth Height ..i~...../. ...... Number of Stories ............ ~......~..J..). ................................................................. · . . · Dimensions of same structure with olterot,ons or addmons: Front ...~.~.......~'...:. ............ Rear ....~...~.....~. ........ Depth ...~,.~.....~,.~ ..... Height .....~,..~., ............ Number of Stories ....(.~,,~ ..........; ...... - 8. DimenSions of entire new const;uction: Front ...... ~..~..../..~..../..~ ....... Rear ....~.~.../..~...../..~.... Depth ..~.~...../~...../..~ Height .....Z~...~... Number of StOries ...... .~.~..J ..................................................................................................... 9. Size of lot: Front .........~...~...../. ...... Rear ......... .~'....~...../.. ........... Depth ........ .~...~...7....~ ..... 10. Date of Purchase .............................. ~.~..~..~.. ........ Name of Former Owner · 11. Zone or 'asa district in which premises are situated ................................. ~~ ......................................... 12. Does proposedconstruction v o at~.any zoning, law, ordinance or regulation? .......... ~ ................................... ..... 13. Name of Owner of premis . ross ..... ~¢..-. . Phone No.~'~,-~..~.~.~5"'. Name of Architect ........................................ :. ......... Address ........................................... Phone No ..................... Name of Contracto ....... Address . , .... Phone No.~,2,.~....-.~.7~' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setJoack dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. / ., /, ............. .,..,,-~....~..., .......... ~. ....... : ............ ~,~ ~,~ ~om, ~, ~ ,~ ~ ,, ~, ~NaMI of ~idual signin~pplicati~) says a~ve named. He is the ............................. ~..~ ............................................... '~ ............................................... ; ....... (~ntm~r, ~t, co~mte officer, ~c.) ' ~f- ~id ~r.or ~nem, and is duly authorized to perm or have ~ t~ ~id wo~ a~ to ~ ~ file ~ th~ aPp!ico~i~; that all statements contained in this applic~i~ am t~ to ~e Nst of his ~l~e a~ ~lief; and -- ~t tho',work will ~ ~e~o~ in ~e manner ~t fo~h in the appllc~l~ fil~ ~i~. . S~m ~ ~ls '/;,;.L,., ..... d~ of., .... ;.., ...... , 19. . NOTARY PUBLIC, e York No. 52-81258~, Suffolk Oou~ Term ~pires March ~, ~