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Home My WebLink About4627-zNO. 4 TOWN OF $OUTHOLD BUILt)lNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z3802 ..... Date .......... F~a~' ..... 19 ....... , 19 70. THIS CERTIFIES that the building located at ~I'~8 · · S~uth' t~al'b~n' 'R~- · · Street Map No ...... x~ .... Block No.. x~ ...... Lot No ...... xx ...... 8outhold · - I~,'¥6' · conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... Feb ....... ~.., 19.70 pursuant to which Building Permit No..1~.. dated ...... Feb ..... 2~ ...... , 19. '7~ 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 .... Far~n .bu.~.ld~n~ .................................................... The certificate is issued to . .. ~red..La!ope ........ Owner .......................... (owner, lessee or tenant) of the aforessid building. Suffolk County Department of Health Approval .......... ~l~I~.o ...................... Building Inspector House FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4627 Z Permission is hereby granted to: to ..... ~.e...~...~..~.~,.~.~..~..~...e~s.t~.. f~m.~ ..................................... at premises located at ................... .~.....J~jJ~.~J~JJ~JI~..~I~JL ................................................... ......................................................... ~l~1& .......... ~ ............................................................. pursucm~c to application dated ............................... Jl~Jj ......... JJ~. ...... , 19.~JJ.., and approved by the Building Inspector. ~ · J:ee $ .~.9.J~. ............. F~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~~*.~......~....., 19.~...~... Approvea ........................................ , ........ Permit No ........................... Disapproved a/c .................................................................. ....................... .......................... /,-'" ,.0 · APPLICATION FOR BUILDING PERMII' Oate ...................... ........ , ..... INSTRUCTIONS a This apphcahon must be completely filled in by typewnter or in ink and submitted m duplicate to the Budding inspector. b. Plot plan showmg location of lot and of buildmgs on premises, relationship to adjoming premises or pubhc streets or areas, and gwing a detailed description of layout of property must be drawn on the d~agram which is part of this application. c The work covered by this apphcat~on may not be commenced before ~ssuance of Buildmg Permit. d Upon approval of this application, the Building Inspector will issue a Build.rig Permit to the applicant. Such permff shall be kept on the premises available for inspection throughout the progress of the work e. No buildmg 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 Buildmg Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Buildmg Permit pursuant to the BuHdmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordmances, buddmg code, housmg code, and regulations Frederick La ~,pe (Signature of applicant, or name, if a corporation) South Larbor Roacl Southolcl .......................... ...... State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or budder ................................................... O~-ne.r ..... bu.iid~ ............................................................... Name of owner of premises ........... .~..~.e...c].?..r...J:g~..~.~.p.~.e. ......................................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) ~x xx 1. Location of land on which proposed work will be done Map No ............................. Lot No: ...................... Street and Number ........... ..G.g.g,~.h....~..~...b..o.?...~.o.~ ......... ..~..o...g:..%.~.o..Z..~ ..... ~.:..~..: .................................................. Municip i / 2 State existing use and occupancy of premises and intended use and occupancy of proposed construchon a Existing use and occupancy ........ f.~t,~..~.~j,~l,.~..:~0~ ....................................................................................... same with an addition b. Intended use and occupancy .......................................................................................................................... 3 Nature of work (check which applicable). New Building .................. Addition .....~ ........Alteration ~ ........ Repair .................. Removal .................. Demolihan .................. Other Work (Describe} .............................. 4. Estimated Cost ..... 1.,/.~.~O...~._. ...................................... Fee . .. .?. ;..0.. .0. ......................................................................... (to be paid on fJhng this apphcotlon) 5 If dwelling, number of dwelhng units .... ~.0~.~ .............. Number of dwelhng umts on each floor ........................ If garage, number of oars .......................................................................................................................................... 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 addihons. Front ................................... Rear ..................... Depth ................................ Height ............................ Number of Stones ............................... 8 Dimensions of entire new construction: Front ............ .2...Q....~..1...0. ......... Rear ...... .2..0.....X.....1...0. ..... Depth ..... ,~.Q .......... Height .................... Number of Stories .Q~f~ ............................................................... 9 S~ze of lot' Front ............................ Rear ............................... Depth ............................. 10 Date of Purchase ....................................................... Name of Former Owner ......... .K..r...~.]g...s..k..i.....B...r..°.s. ............. 11. Zone or use d~stnct in which premxses ore situated ......... '.X..A..~.'....~.i...s..t. ................................................................... 12 Does proposed construchon violate any zoning law, ordinance or regulahonP ........ 13 Name of Owner of premises .... .F...r..e..d..e..r..i..c...k.....L..a./g~..e. Address .... .S..o...'g..t..h..o...1..d. ..................... Phone No ................... Name of Architect .................................................. Address ......................................... Phone No .............. Nome of Contractor .... s~,m~, ................................... Address ....................................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and red,cate all set-back dimensions fro, property lines. Give street and block number or descriphon according to deed, and show street names and indicat whether interior or corner lot STATE OF NEW YORK, t.. COUN/Y OF .... ~£falk ........... ~ ' ' .............. ','; ........... ; ..... ;"':';~rB~l~T'±~'k",'~D..'D1~ ........... being duly sworn, d~oses and says that he is the apphcan uName ot lnalvlaual signing Oppllcamon/ Owner- builder above named He ,s the .................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authonzed to perform or have performed the said work and to ~ke and fil this apphcation; that all statements canto,ned in thru applicahon are true to the best of h~s knowledge and behef, that the work will be performed m the manner set forth in the application~le~therew~ Sworn to b~re d~tho~ ~.~b~g~; ...... ,19 .~Q ~ ~ ~' ~ , ouuolk County lerm E~p~res March 30 ~q~