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Home My WebLink About5018-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.D~388 ...... Date ............ Sop~ ..... 2~ ...., lg..?¶ THIS CERTIFIES that the building located at Yerm®~tt. 1)~ ............. Street Map No. ][~,Pk-.- - · Block No ........... Lot No.. 30 ....... 8~ltho14-- I~,X. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... O~t" '~.' · ', 19. '~0 pursuant to which Building Permit No. dated ........... 0~ .... 2I~' ' ', 19'?0, 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 .l~..Va~®. ~. F~R~.Iy .d~l.l~s ....................................... The certificate is issued to . .FI'~-][o~ ....... O~ex* ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Ho~oe J~ 1625 Building Inspector I~R~ NO. ~ TOWN OF sOUTHOLD BUILDING DEi)~RTMENTi TOWN CLERK'S oFFiCE SOUTHOLD, ~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE' PRF~ISI~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5018 Z ~e ....................... .~.~. ......... ,~. ......... , ~.'ZO... Permission is, hereby granted,to: to ..... ~l~alld...ne.~2 tm~. £m~tl~..~e.13.~g....: ......... ~ ....... i ................. ~ ....................................... at premises located at ..,.; ......... l~..~O...~O.t~L~,~ ..................................................... : pUrsuan¢ to application dqted .............. : ......... ~t,~....~..~j~.~..!.~,...?;., 19...~/0, and approved by the Building inspector. FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7J~2.~ ...... Date .............June .1 ........ , 19..?~ THIS CERTIFIES that the building located at .¥enn~o®~.t .DI' ............. Street Map No. Yem~-. -Pk- - Block No ........... Lot No...30 .......3®uthel~...It o¥, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............Oct .... 22, 1970- pursuant to which Building Permit No .....~018Z dated ............Oct .... 22, 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 . P.~:l. vate. ope. £a~ily. ~welltn~ ............. · ......................... The certificate is issued to . Fre~l* ]~mmg ............... ~'nel' ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval * ~Y' ~* 't97~'' '~y' ~o · Vi. tla ....... I~ouse # 162~ ..... ~.~j.~..~.~....-'-~.~..~.%.._., ....... Building Inspector J Approved ........................................ , 19 ........ Permit No ....... Disappravecla/c .............................................................................................. APPLI~.ATION FOR BUILDING PERMIT Date ............................. 01~.tol~e~.. ....... ~,~ .., 19...~0 .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plat plan showing lacation of lot and of buildings on premises, relationship to adjoining premises ~r public streets or areas, and giving a deeailed description of layout of proparty must be drawn on the diagram whlch Il part of ~nle application. c. The work covered by this application mc~y not be commenced blfore issuance of Bulldtng 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 Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.awl, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and ragulatlons. (Signature cf applicant, or name, If a carparatlon) (Address o? app,cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plu ar builder. Name of owner of premises ....~'~¢16..~'~1.1Z~ ........................................................................................................................ If applicant Is a corporate, s~gnature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on which proposed work will be done. Map No.: ...XI~I~.QA~t,..~Iu~IL. Lot No.: .~13...;,.. ..... Street and Number ........... ~i~.~,..D~, ......... ~O~l~.& ....... ~"e'~ ................................................................ Munlcl~ll~ 2. State exi~lng u~ and ~cu~ncy of premiss and intended use and ~cupancy ~ p~ com~ct~: a. ~isti~ use a~ ~cupancy ....... ~&O~..l~ ............................................................................. t ................... b. Intended use and ~cu[:an:-, . ......... ~..~..~ ............................................................. ~L. ......... 3. Nature of walk {check which applicable): New Building ..... ~1~" Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ..~0~00~.,~ ....................................... Fee ..... l~)~)~...~i~..~r~..~i.{i~.~..;.l~.i.~.~.~.~.l.i.~;i~i ................ 5. If dwelllng, 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 ................................ Heigh~t ........................... Number of Stories ................................ '~ 8. Dimensions of entire new construction: Front .............. ~. ................. Rear ......... ~3' ............. Depth ....,~ ............... Height .................... Number of Stories ..... ~t ............................................................................................ : ............... 9. Size al: lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ~ ! 1. Zone or use district in which premises are situated '"'#~'""~.~1~ ................................................................. ; ............ 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~ ..................................... .~ .......... 13. Name of Owner of premises ..... '~¢~"'~'O'al~ ..........Address ....... OZ~Ie~[~IDz't, ............... Phone No ..................... 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-bock dimensions fram properh/ lines. Give street and block number or description according to deed, and show street names and indical'e whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ............ ......................................... ~e~-.~=- ............................... being duly sworn, deposes and says t~t he is the applicant (Name of indiv~d~o~i~plication) above named. He is the · . . - ........................ (Contractor, agent, co~orate officer, etc. ~of said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to ~k~ ~d file this application; that alt statements contained in this application are tree to the best of his knowledge and I dief; and that the work will ~ performed in the manner set fo~h in the applicati~il~ therewith. Swam to ~fore ~ ~is hlota~/ Public . Tefra ~pires March ~, ~9~ ,' S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da,~e Bldg. Permit No. ~5-~/~ .~ TO WHOM IT MAY CONCERN: facili~ ies for a structure located The sewage disposal (Give deed location) , have been inspected by this department and found to be satisfactory. Ch~ ef o:f G~n~ral ~n~ineerfn~ District Engineer