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Home My WebLink About4684-zFORM NO. 4 TOWN OF SOUTttOLD BUILDING DEPARTMEN~ Town Clerk's Office Southold, 1~'. Y. Certificate Of Occupaacy No. 1~. gb020 .... Date .......... THIS CERTIFIES that the building located at 'I~/8' !P.a:l. er 'P~aes' (P~}' Street Map No...~ ........ Block No... ~ ..... Lot No..~.: .. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ap~.~. ·. ~b , 19.70 pursuant to which Building Permit No.. ~6~Z. dated ........At)r.~Z .... q.b. , 19..70, was issued, ~d. conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Privat-e -one 'family' awelling ...................................... The certificate is issued to · Jo~. Vosi~'~a ...... ~e~ ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~ep~.2). '~9~0 -.by--~. ~'~tla ...... ~aildiag Inspector FOR~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE i SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 468 Z Permission is hereby granted to: ........ ....... 3E,~.....:I~.'~.,T~..A.w ............ i .................. .......... ~,henk,~, ......... .L,;~o ........ t ................. to ........ ~f~%d..~..ct~.e...f~t.~...d~3.~ ............................................................................ at premises located at ................... ~J/.J~....~lJ~Tl.e~...~(;~[,~.....~,F...~,~.). ..................................... .............................................. Of.f-~;/~i.... ~o~ ~. A.~e .......... ;~ut.~o.T¢ .... ~[ ~. ,. .................... pursuan,t to application dated ............................. ~p~l- ....... ~.~.~....., 19.~.., and approved by the Building Inspector, Fee $....1.0.~.~. ........ ~ ...... ~..: -'~::....~;;1 ....................... Building Inspector L ' S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da.re Bldg, Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities (Give deed location) for a structure located have been inspected by this department and found to be satisfactory. Di NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT! TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ¢ . i(. Approved ................. L ...................... , 19..',.'.... Permit No. / '~ '~' Disapproved a/c ........... ~.~;;;;~..;;~ ......... ;..~,.~a~....;.~.7~;~....~.~... ............ ~----. ....................... -....~...~ ...~.-~...L M.'. ........ ,....~...~ ........ .......................... r (~uildJn9 Inspec~ APPLICATION FOR BUILDING PERMIT Date ~ ~ ~I 19..~.~. .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in i9k and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, re!ati~nship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn ~n the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issueib Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the prcigrqjss of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Ce~ificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk CounW New ~rk, and other applicable Laws, Ordnances or Regulations for the construction of buildings, additions or alterations or'(hr removal or demol t on, as here n described The applicant agrees to comply with all applicable laws, ordinances, ~b~ildjng, -- ~c~de'-~c°de'/a~d regulations. ......... ....................... (Signature of applicant, or name, if/a corporation) ...... (Address of applicant) State whether applicant is owner, lessee,/agent,[~rchitect, engineer, genero~ contractor, electrician, plumber or builder. I.:. :Z~Z: r~5 r~5' :~:;:~' }:~ :;',' ........................................................................................ (Name and title of corporate officer) 1. L~ation of land on which proposed work will be ~one. Mop No ...... , ................ Lot No · Munici~li~ 2. State existing use and occupancy of premises and intended use an~ occupancy of propos~ construction: a, Existing use and ~cupancy b. Intended use and occupancy ~-'~ i ..................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ./~...,.~.'.ZL,g..,O..?.~,. ................................ 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 .............. .,~...o.. .............. Rear ...... ~..?... ............... Depth ..... ~.,?. ............ Height ....i.'.¢...i ........ Number of Stories ...! ........................................................ i ......................................................... 9. Size of lot: Front ........ /...~..Q. ........... Rear .............. (./...g) .............. Depth ........ /...~.?. ................ 10. Date of Purchase ............./.(./."t..~/...CT...~ ...................... Nome of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violatmany zoning Iow, ordinance or regulation? ...:..'7?.~...~. ......... ,,~l..../.J ........................ 13. Name of Owner of premises ...~..~...~..Address .~..~.....q...~....~.... ~ ,., Phone No ..................... Name of Architect ................... ~.......~ ......................... Address ........................................... Phol~e 1~o ..................... Name of Contractor .~.:~'..~...~..:.~r..,.:. ..................... Address .~..~.~...(~....~.....,..~.'...~...: 'P~'0~nC~J~lo....O..~...~:T..~ .... / 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. TATE OF NEW YORK, J~¢ OUNTY OF ................ .,~..~ ...... 'f ~'"",-'24, ................................. · /..l..,t~.~k,~..(./..~ ............... being,duly swoJ~n, deposes and says that he is the applicant (Name of individual signing app. lication) ^ / / ~ve named He is the ~ ~ ~' ///~ ~r~ ~ ............................. 0" ............... i~'~';¥;~c¥~';; ~;~t: '~orpo ate officer, etc.) aid owner or owners, and is duly authorized to perform or have performed the said work and to make and file application; that all statements contained in this application are true to the best of his knowledge and belief; and the~ to workbefore..~/a yWillmebethis ~f,~' 'perf°rmed~/'~"~)J2)'in ,,~the manner set fed-h19 in,2.0the application~.L~..filed therewith. ...... .... ,..:...; ......... , ...... . ............... , Publi~,~..t,~CJ~..~..~.~)-~_. ......... County/~_~(Signature'"":of applicant) ~N ~E~ LLE ak t~,,;.AuguSt 26, 1970 ~ 16' 3q 20 '~' 16 1 1/12 t 125 Pan. x Warren Scott Etec. Co., ~ 32 Arlington Rd., Lake Ronkonkoma, L]!. 11779 must nor be STATE SU~?/NTENDENT:.~ , ~,~ I M