The URL can be used to link to this page

Home My WebLink About4797-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . W4fS. K~Y.~ ~..Road. ....... Street Map No.. X3; ........ Block No..XX ....... Lot No. ~X:X... Bo~ttho]d · · 1~.¥. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ A.-ri[. · .19. ·., 19.70. pursuant to which Building Permit No. l~.~?Z.. dated ............ Jtme. ~ .... , 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 ....~.ri~te. one. family. ~el ling .................................... The certificate is issued to .Cart .D .'Antel~io ,&. W.i.f,e .... O~ner~ .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health ApProval A~g...~ ~..%972 ..................... UNDERWRITERS CERTIFICATE No... ~S96.5.5~, ...................................... HOUSE NUMBER. ~.'1-7~; ....... Street ....K~I~. l~O&cl ................................. ~xeeptie~s need steps & handralX ingarage. //z.~,k:' .{..~'.'~.,.... Building Inspector FOB. M 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) 4797 Z Permission is hereby granted to: ............. .C.~.~L..~.:~..t.~r..,~.p...~...~.g..e. ................ ..t .~ ....~l~.~.~;u:f.....~'~, ................................ to . .~. ~ ;..1.~...~..C.y....~.~.e....f..~,~:;~,~ ..~,,~I ',,~,,t~S ........... ................................................... ~,~,nt~.. ~r..l~..Ammaa) .................................................... at premises located at ........................... ~.....I[.er..z~..~o41~ ............................................................ .................... J~a~thol~ ...... ~,.~ ........................................................................... pursuan¢ to application dated ................ r....&priL ......... .~.9.: ......... , 19....~0, and approved by the Building Inspector. Fee $...1.:'~ e.~.~} .......... ........ ~':.-%'.:~::..;..~..;; ...... :; ....... :;;.::....:-.......i ............... Building Inspector / SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg, OF HEALTH AU6 3 1972 Fer,~it No. ~1 t 1 'Z. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ¢ (Give 'deed locat&on¢ have been inspected by this department and found to be satisfactory. AU6 3 1972 Chief of General Engineering Services INSTRUCTIONS , a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildi~ Inspector. b. Plot plan showln.g, location of lot and of buildings on premises, relotionship to adjo n ng prem ees or public streets or areas, and giving a detaded description of layout 0f property must be drown on the diagram which is port of thio application. c. The work covered by this application may not be commenced before issuance of Building Perm t. d. Upon approval of this application, the Building Inspector wil ssue a Building Permit to the applicant. Such permit shall be kept on the premises available for ir~pection throughout the progress of the work. e. No building sholl be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy sholl have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ssuonce of a Bud ng Permit pursuant to the ~Build!ng Zone. Ordinance of the Town of Southold, Suffolk County, New York,- and other app coble Laws, Ordinances or Kegulations, for the construction of buildings, additions or alterations, or for remova or demo t on, as herein described. The applicant ogrees to comply with all applicable lows, ordinances, building code, housing code, end regulations. (Signature of applicant, or name, if a corporation) ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premses:, ,~.a,~.~.. b'~ ~ i f applicant is a corporate, signature of duly authorized officer. ' (~am;';~';/~l; '~i"-';rpor;;;"~'~;;;~i ............... i I. Location of land on which proposed WOrk w he done. Map No.: ...~&.. Street and N mbo ......... I.~6<~4j.'~. .............~ ........................... ~ ...... 7'~ ' 3 1"7...~ / Municll:xdlty '" 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ...~ ./~ e..~,~..?. b. Intended use ond occupanc'~ ....'....~... ..... ~~ ............................. 3. Nature of work (check which ble): New,Building ......... AcOrn .................. Alteration .................. Repair ....... Z ......... Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated :~;ost ....... t'tj;"~;4~ ..................................... Fee / B, .......... .................. 5. If dwelling, number of dwelling units .......... 6' ............. Number of dwelling units on each floor '"'~'a;o~'k; ........... - "If g&rage, 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 ................................... P, ear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... L~.l~t. ................ Rear ........ W4~.*. .......... Depth ...... ~.~../ ......... - Height_ .............. ~......~?nber of Stories ............... '~d....:.~; ............ ~ .......................................................................... 9. Size of lot: Front ........ j.~l~.~. .......... Rear ........J~.~..~. ................. Depth ....f~;~x...~.~...?.~!~ 10. Date of Purchase ......... {~.~a,.,Z. ............................... Name of Former Owner ...~Z.~,~....~t~_.,.',~,~,....~.,,.~...~. ...... 11. ' ...... ~ ' Zone or use d,str, ct 'n wH,ch prem,ses are s,tuated ....... ~...._~~ ........................... 12. Does proposed constructic~n violate any zoning law, ordinance or regulation.~ ..~ ......................................... 13. Name of Owner of premises ..~4;.~).~.~j~.&.l~Address ..l~j~/.~.~..l~l~/~.~hone,../_,,.~.~_._,__~ ~'"' No. '~-;1~"~'~'~ Name of Architect ....... ~..'.&.....[..~ ......... ~ .......... Z.Address ..... ~.J~.-~..~..I.--~..'.....~- Phone No. ]'e;. ; ,r. .................... Name of Contractor .................................. Address ....................... ..... Phone · · ~, ~'~./~ &O S~'I' {~ 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. OF"'c~'~"7~-~"~: duly sworn, deposes and says ,~, he ..; ............. ~ ............... ~ .................................................. being is t · app icon ~of ~iv~~' - lication) above na~nedJ 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 and file thi~ ,~,,~ ~ntion' that all statements contained in this application are true to the best of his knowledge and belief; and that the W0'~E Will be performed Jn the manner set forth in the application' filed therewith. Swo~ to~ore m? this/-..~ -