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Home My WebLink About4974-zFOPoM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMEN'~' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCOPANCY No.Z.~.068 ................. Dote ...................... ]Jell, ....... .10 .............. , 19.-70 THIS CERTIFIES that the building located ot W,,/$..~OW~i.~bOZ~..~O&~ ..................... Street Map No. ~.gl,~'.A..~2.t*.. Block No ....................... Lot No ........ ] ................ fteuthol~t....~,¥., .......... conforms substantially to the Application for Building Permit heretofore filed Jr) this office dated .............................. tep.~ .......... 28 ........... , 19.2.0.. pursuant to which Building Permit No..~.~...Jtk.~._ dated ......................... ~O~t .......... ~8 ...... , ] 9...~O., was issued, dnd conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ........... P. ~.$va~,e ..one ..f~&~.~..d~e~.~..l.~g .......................... ............................................................ The certificate is issued to ..L Q..~..~T~LI~,~I,..J~J3~O~.. ........... 0~ ................................... (owner, lessee or tenant) of the aforesaid building. House # Building Inspec!or FO]~V~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL NV 497~1 Z Date : .. ~.. ~8 ,'i9..?..o... Permission is hereby granted to: ................. ~.ee...~...~ ~t~..~te~.~ ......... .......................... .~..~.~a~..~.: ................. ............................... · ~0~o.3~1 ............ ................. ~o .......... .~,~.. ~...~.$..t.~..o.~....o..~...e...x.~ ~.~.. ~.~..~.~ .................................................... pursuant to application dated ............................... ~.~ ....... ~.,?..., 19...~, and approved by the Building Inspector. ? ~ilding ~nspe~tor FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...;~..~. ......... ¢~..~/._..., 19..~....~. ,, ,, z¢ f??¥ Approved ........................................ , 19 ........ Permit No. ~' Disapproved a/c ............................................................................................ ;. (Building Inspector) f APPLICATION FOR BUILDING P,ERMII' Dote .... ..................... .S..e.,g..t. ....... .2..8. ............ , ,19...7.q .... INSTRUCTIONS : a. This application must be completely filled in by typewriter or in irik and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises relatienship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn qn 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 i~ 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 Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Ybrk, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or f.br removal br demolition, os herein described. The applicant agrees to compb/ with all applicable laws, ordinances, buildilng code, housing code, and regulations. Judith ~ Schnieder (Signatu(e of applicant, or name, if a corporation) ............... S~u. th.td ............................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ......................................... o.~er .................................................................. ......................................................................... Name of owner of premises .i~..~.,.....~..e...o....~.....~..,~..~...~..~..~...,.~..g..~.~..~..~..~...e..~.. ........ i. ........................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) · ' n Founders Est Re ..k 1. Location of land on which proposed work w. II be do e. Map No.: ..... ~ .................................. LStt~o.: ...................... Street and Number ..................~/..~...?..QW~...H..~b.Q~. ~/-- ~/O Municipality ............ ":~1"~' State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ..g..~[~.l~.$~g ............................ i; ........................................................................ b. Intended use and occupancy ............. .s..~.~.e.....~.~-.~..f~..&¢,¢t,.i~O~ ................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .....~ ....... Alteration ~: .............. Repair .................. Removal .................. Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... ~.00.......+~. .............................. Fee ....~..~.0..0. ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...o~e ..................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 ............... ~4D ................ Rear ........ 20 ............... Depth ........ .~ ........... Height .................... Number of Stories ....O~nG ........................................................................................................... 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 ........ ~.~.~!...~.~.1~ .......................................................................... 12. Does p~oposed construction violate any zoning law, ordinance or regulation? .......... ~Q ............................................. 13. Na~ne of Owner of premises ..~..~,..,,T...J~ghntf,~f~t~('..Address ....~.QI~,~.O.'~ ..................... Phone No ........ ............. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~.,:....G...~..o....'q~...~ ....................... Address ........... ..~..o...~.~.~...o..]...c~ ............. 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 accord whether interior or come' lot. STATE OF NEW ~'Ol~l~, _. ~'S.$ COUNTY OF ..... ~.Z~..Zj.O..~ .~.. .......... ,f · ~g to deed, and show street names and indicate ................................ .'-Z..~.~.~..~.'.9.~.~f~. ......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................ .0..~.]B.~. ............................................................................................................................. (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 in the manner set forth in the application filed therewith. ..................day .................... ............. , ..... ..~, ~.. ELIZABETH ANN NEVII,L£ NOTARY PUBLIC, State of New York No. 52-8125850, SLIlfolk Term E~@lres ~grch '~0, 19.~17