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Home My WebLink About4706-zFO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7...~,.l:~t~ ..... Date ........... Feb .... 10 ....... , 19.71. THIS CERTIFIES that the building located at .l~th .RU~I ................ Street Map No. $.~lla. K~lll,~mBlock No. S®a .11...Lot No..11 ...... Ma~;ti~;.~aQk.. ]{,~, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... $,l~il...2~,' 19.7.0 pursuant to which Building Permit No.. dated ...... &pl'il .... 2~ ..... , 19 7.0., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . l~riva.te, eu. faaily, dw~l~ng ...................................... The certificate is issued to .. !~eber.t. .H.$.l.t.~. ....... . .0~1..®.~. .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~'.~.b...~.(~...~9.7.1.. ~]r. R.o..1~l].a... .............. Building Inspector ~O~N~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 706 z Permission is hereby granted to: ....J, ll~...llmJ,~..ia~.....A~..... Je/~t...ll~ to ............. Jll~J~ · ~J~l.. J.. *f, JJ~.. IJ~l.~ JJ~ ...................................................................... at premises located at ............... LO~..JJ. ...... .Jllll~t,..~dl~..~..Z~ ....................................... ................................................. IIj~..Jee4 ........... Ilell. tt,.tm~. · ...lt,,ll-e. ......................................... pursua~¢ to application dated ............................. dLpJ~s....~. ........, 19....~v~ and approved by the Building Inspector. Fee $..JOo~ .......... TOWN OF SOUTHOLD/°/'~/'~ ~ BUILDING DEPARTMENT TO~ CLERK'S ~IGE ~TH~, H.Y. /~,/~o ............................ Di~ ~/~ .................................................... ................................................. ........................ APPLICATION FOR BUILDING PE~I? INSTRU~IONS a. ~is application must be c~pletely fill~ in by ~ewriter or in ink Ink,tar. b. PI~ plan ~owing I~atioq of lot and of buildings m premiss, relationship to adjoin ar~s, a~ giving a d~ail~ ~r~Him of I~t of p~ must be drawn on the diagram which is c. ~e work c~e~d by this application may not be commenced before issu~ce of Building Permit. d. Up~ ~pr~al of this applicgti~, the Building Ins~ctor will i~ue a Building Permit to the ~plicant. Such ~rmit shall ~ Kept On the premiss a~ilable for iP~e~ion throughout the pr~r~ of the work. e. No building s~ll ~ ~cupi~ or u~d in whole or in pa~ for any pum~e whatever until ~ Ce~ificate of ~c~oncy shall h~e been granted by the Building Ink,tar. 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 York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demo t on, as herein descr bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatior~s. (Signature of~pplicant, or nome, if a corporation) ., ................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .............. ~.,:._~/.~ .............................................................................................................. If applicant is a corporate, signature of duly authorized officer. -A! 41 ,/I (~ .~.-~, ~. ~' · ........................ stree and NumUer ........... .......... ............................ 2. State existing use and OCcupancy of premises and intended use and OCcupancy of proposecl construction: a. Existing use and OCcupancy ................................................................................................................ b. Intended use and OCcupancy ......................................................................... 3. Nature of work (check which applicable): New Building ~.i,~i. .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........./...~.t...a...o...9. ................................. 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 ....... .-,~...~..~..~..'~ ........... Rear ....-~..~..~...~.. .......... Depth ..~...~. .............. Height ....-/..~ ......... Number of Stories ....... ~. ............................... :~ ........................................................................... 9. Size of lot: Front ....... ~/...O....(~.. .......... Reor ........... ,J....O....~. ............. Depth ..... ~....C~...~. ............ ]0. Date of Purchase ...l~J~j~.z~...~.....(~) ....................... Nome of Former Owner...~..~..~.~N~:....~ . ,'.// I ]. Zone or use district in whicl~ premises are situated ..................................................................................................... 12. Does proposed construction violgA~e any zooing law, ordinance or regulation? ........ ~ .......................................... Owner of premise~'"'"'~'"~L ~c~ / ~-. ......... Address ..~.....~..~ ..... Phone No. 13. Name of Name of Architect ....... ~'~Z'"'l-~' ' .......... Address ............................................ Phone No ..................... Nome of Contractor ..~...~,~..0_ ~-~-.~....~......Address ......... ~ .............. Phone No ..................... ~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. _ m STATE OF NEW YORK, tS.s COUNTY OF ...... ............................................... ~,~ff~J...~T.. ................... being duly sworn, deposes and says that he is the applicant (Name o~~gning a~.L~l~~ above named. He is the ..'.' ............................................................................................................................................. (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 ond 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. Sworn to before me this /"-) e .s .... ........... Notary Public,~~4{[[ z(~~ Cou nt~'~' ~~~ ........................ ~OTARY PUBLIC, State of New York No. 52-8]25859, Suffolk C0~t~ 3'~rm Expires March 30,