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Home My WebLink About4993-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy No. ~1~17~ ..... Date ............ Mai, eh .... -~.1.., 19..71 THIS CERTIFIES that the building located at ...p~,~. 'TI'~' 'ltlm~i ........ Street Map No. ~as..1~... Block No ........... Lot No.. -~0 .&-~l .... gutcl~g~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .Oct ..... ~0, 19.70. pursuant to which Building Permit No. ~99~ · dated ........... 0et .... 13.. , 19.70, 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 ..... Pl'~,va'te' me' fa~ly' ~i~ll~g ................................... The certificate is issued to ...¢a~l. l~tl~el,. .. 0wn~l, ........................ of the aforesaid building. Suffolk County Department of Health Approval .. (owner, lessee or tenant) .... ~oR~ ........................ .... c.~:.: . .. !. ~ :.: :'t ........... ~ ~Building Inspector{ FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN G~ERK'S OFFICE SOUTHOLD, N. Y. ' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4993 Z · Building lnspecto~. Permission is hereby granted to: .............. ¢~.~...R, 4~ie~J ~ ............... ~:. ................ .................. · ~n~..x.~e~..~.....-.4 ................ ..................... ~m~eb~......,...~3~,i ................ to ....... ~.l~..~...a~t~5.~r.~m..e~.~t~.~..~*te~..; ..................................................... at premises located at ........... -..,~J~....~0..~.~$.-~.-!~1~.~ ........... i....,.; ............................... ....................................................... lC)Ce ~tae ~2~e~ ........ ~e~ :.~;~,,e~o~c~e' -....-.li.~.~ .................. pursuant to application dated ........................ .;O~t...; ........~0~.:..~;.,-, 19..~, and approved by the BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No....~.....~.. ........ Disapproved a/c ........................................................................................... / APPLICATION FOR BUILDING PIRMI'r Date... October IO. 1920. INSTRUCTIONS %t_ a. .This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~ b. Plot .pi.an sho.win~ 1.oc.ation of lot ,a.nd of buildings on premises, relationship to adjoining premleee or.public streets or;~ areas, aaa giving a o~a,~o aescriptlon at ~ayout of property must be drown on the diagram whlch It I~art ~f thb al~llcatlon,m c. The work covered by this application may not be commenced before issuance of Building Permit. rq d. . Uponapproval 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 progr~s of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occuponcy~ shell have been granted by the Building Inspector. RB~o~.OONIS HEREBY MADE to the Building Department for the issuance ora Building Permit pureua~ to the ~inance of tl~ Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or ~egamr~:~. s, 1~9r t',e construction of buildings, additions or alterations, or for removal or demolition, al here n dolor bed The al:~ll, car~ agrees to compl~ with oil applicable laws, ordinances, building code, housing code, and .regulations. (Signature cf applicant, ar name, If a cm~mtlon) P*~ne Tree Road (lc)a0). Cutcho~ue.N¥ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner and contractor Name of owner of premlse~ Carl F. Rothleder If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................Lot No.: ..~....t~..~.. ......... Pine Tree Road Street and Number '""~1~~....,.....,.,,....'_, .......................................... .~ .............................. Munl¢lpall~ State existing use and occupancy of premises and intended use and occupancy of pmpaeed comtructlon: o. Existing use and -,'cuban-,, one f~il~ dwellir~ b. intended use and occupan? one f~.ll~', dwelli~ 3. Nature of walk (check which applicable): New Building ................. Addition .......,~. ........ Alteration ...~. ......... Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 12.0.0. . 4. Estimated Cost ......................................................... tee ..................................................................................... (to be paid on fi'.ing this application) 5. If dweUing, number of dwelling units ..... .o..~..e, ................ Number of dwelling units on each floor ....o~e ................. If garage, number of cars ...... ~.~...o....9.~.~...~...e..~...~..q..~..e...~. ............................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...3~...?..~..e..t~ ........ Rear ......... ,~.~.....~..e..e.~ ...... Depth ..~7 fe.e.$. Height .....~.0...~'~..~.$.... Number of Stories ....... ~.e. .............................................................................. Dimensions of same structure with alterations or additions: Front ............... 3.~....~...e..e...~. .... Rear ...... ~...,~...fe...e.~ ..... Depth ......Lf~...,,f'.~t~.~. .......... Height ......~...~.~.~.1;....Number of Stories ...... .gX~.e. ................... 8. Dimensions of entire new construction: Front .......... ~,.0.~..-.Q .............. Rear ...J,0.~.~..0 ............. Depth ...~..e..._.~. ............ Height ...J..~...~'.~.fl.~, Number of Stories ........ .9.$.~. ...................................................................................................... 9. Size of lot: Front ..... ~...~...e. .............. Rear ......... .1.~.0..~ .................. Depth ....... .~...L~)...e. ................ 10. Date of Purchase ....~,~.Lk.0......(],g$.) ........................... Nome of Former Owner ....................................................... 1 I. Zone or use district in which premises are situated ..."..~.."...~,~.~,~.c~.e.~$~.~...RL~.~...~.~.:~.9.~.~.~..U-~.~,~ ...................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ~...o. ........................................... 13. Nome of Owner of premises ?'.~.~.]:~.~:~`~.~1~.e~e~Address~1'~.e~.~.~.~e.~e~ ......... Phone No..~..~..~..-.,~.1.,,~,~. Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor C~.~1 ~. Rot~hle r Address Phone No. PLOT DIAGRAM Locate clearly and distinctly oil 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 comer lot. / I STATE OF NEW COUNTY OF Woo ~ Kb. .................. .~. ........................................................................ :...being duly~sworn, deposes and says that he is the app[icant (Nome of individual signing application) above named. He is the .......... ~ ....... ..o...~..~.e.~....~.~...~.....q.o..~..~.z'..~.9..~.o.~. ..................... ~.~..... ......................................................... (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 thor the work will be performed in the manner set ~orth in the application filed therewith. Swam to before me this ....... ........... ............... ..................... h ota~/ Public~.~~O~.Al~.~,~r)~.l~..~,~,..~J . (Signature of appl cant) ~uffalk County Clerk's N~52-7614~00 C~mm~sion Expires March 30,19BI ·