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Home My WebLink About4821-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .P'~ .R01g..Off..R../8. ~. JV!~treeIe~ Map No~ll~ ......... Block No... ~ .... Lot No..~...P~.t~;~'~;~.. !!~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... J.l~.$...~1~. , 19 ~0. pursuant to which Building Permit No. dated .......... J..~1.$...~..., 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 ... Prtvata .one..f~t,l.y.d.~illi~g ..................................... The certificate is issued to . .R0b.er.t. G~a~.b..& .¥.~. ~ ....0~...~.s. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .l)e~...~1~..1.970...bi. ~.: .Vii. la ..... Building Inspectol[ FOF,~ NO. 2 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) No. 1821 Z Permission is hereby gmntecl to: at premises located at ................... J~O,~e....~T,/~..O~,~I'sA~..J~III~ ............................................ ................................................................. ~.~.~t ~.tn~ll~ ......................................................................... pursuant to application dated ............................. ..~..~..17. ....... ~ ......... , 19......~.., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: at /The sewage disposal facilitie~ for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. Jhief of General ~ngineering Services TOWN OF SOUTHOLD BUILDING DEPARTMENT · TOWN CLERK'S OFFICE [2 Approved ......................... ~ ........... , 19 ........ Permit No... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS filled in by typewriter or in ink arid submitted in duplicate to the Buildingi~ must be ~completely Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street? or areas, and giving a deta led descr pt on of ayout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building 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 pursuant to the Building Zone Ordinance of the Town of Southold; Suffolk County, New York, and other ~plicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, ,or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. .o. ............................ (SignatUre of appli~ ar.name, if a corporation) New Suffolk' N~: 11956 (Ad'tress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. & rs. .obe 't oraeb Name of owner of premmes ..................................................... ? ............................................................................................. ~ I, applicant is a corporate, signature of duly authorize(~ i~ifi~e, -' 1. Location of land on which proposed work will be done. Map No.: ..................................... ... 'Lot No.: ................ ~ / -- / 7 ~ S Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ....... N~,w...Qne,..f. all~.l~..dwe,].l//l~. ................................................................. · 3'7 3. Nature of work (check which applicable): New Building ']......~ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cos*t ..'..$2,~.,~0~..0D. ................................ Fee ..... i.$10e.O0 ..................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ,1, ................. Number of dwelling units on each floor'. ........................... 'If garage, number of cars 2 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 ....6.0 .................: .......... Rear ...... ~0.! ............... Depth ..... ..5...8...~ ............ Height ....... ~.6..t. ...... Number of Stories ..,..,1. ........................... 9. Size of lot: Front .],Q.~. ................... Rear ..~.]t..0... 10. Date of Purchase ...,J~.D~...7..i,..~L96~ ....................... Name of Former Owner ....~'i~.¢e.n.~..J.?.....A...q.u...~..t..o.. .......... 11. Zone or use district in which premises ore situated ~es~de~t~a~ 12. Does proposed constructic~ violate any zoning law, ordinance or regulation? ............ ...1~.. ........................................... 13. Name of Owner of premises ...~.o..b..~.T~.t;:....~.a~.b ......... Add~ess .-Ha.t:t+l-,,,~-lct..~o¥. .......Phone No..;?,98,.4~,0 Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~l,~P~e...G,...~z'Y-olz..&..Sozt~cldress ..Ne, w..,~t~'l.~...b]~¥,.. Phone No. 7..~-~.~o.. PLOT DIAGRAM Locate clearly end 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 comer lot., STATE OF NEW~I~)P~I~I~ ~ COUNTY OF .~F,~. .......... ............. ~'~.~...~...~/~.1CJ;.gT~. ............................................... being duly sworn, deposes and soys thor he is the appli (l~a~ne o~ individual signing application) above named. He is the .~.....z~orate office~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to me;ke and 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. Swam to before me this ...................... ... ayof ...................... ; ................. , ] 7o ,., _ _ - . .... ..r..:... ........ ~ ELIZAI~H ANN NEVILLt /)",,a,,~'~'-I - ~ NOTARY PL~LIC, Stete of N~W York ~,/ ·" - No, 5~?~5850, Suffolk Cou Term f.2-/~res March 30, 19,.~