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Home My WebLink About4835-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7-~18~ ...... Date ............. Alyr~,]' .... 1 ~' '" 19.71' THIS CERTIFIES that the building located at .. ~ay~iew. R~d. &..glem~ee~e~t Map No...~ ........ Block No...~ ...... Lot No. ~ .... ~euth~ld ..... ~.Y.. ..... conforms subst~tially to the Application for Bulldog Permit heretofore filed in this office dated ........... J~e...)0, 19..7~ p~su~t to which Building Permit No...~83~ ~ dated .......... ~y ..... ~.., 19.71., was issued, and conforms to ~1 of the require- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .... P. riva.~, o~ .f~ily. ~well~ ................................... The certificate is issued to ...~hsny..Py~o .~:-w-ire ............................. (owner, lessee or tenant) of the afores~d b~lding. Suffolk County Department of Health Approval .~ri.1 .. ~ .~974.- .by. -R,. V.Xlla. · · / / -- B~i~in8 ~nspector / FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4835 Z Dote ............................. ~.1a3~:. ....... .1 ........ , 19...20 Permission is hereby granted to: ........... ,llm~.. ~t~£alir,. ......................................... to ............ ~..zae~r..~e-..£a~t~..~l~. 33Ja~ ........................................................................ at premises located at ................ J~t~.~..~l~,..~..~ljJ~t~...~.~ll...Jjjtll. J~J. ............................ pursua~ to application dated ................................. ~gl~.....~l~..~...., 19..~0., and approved by the Building Inspector. Fee $...laJ, J~J ......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF H~LTH Date Bldg. Permit No. TO WHOM IT MAY at CONCERN: The sew~ disposal facilities for a stru~ure located (Give deed location) have been inspected by this department and found to be satisfactory. Chief of 8eneral Engineering Services APPLICATION FOR BUILDING PERMIT Date .....,~.._'~e_.....~...O. ......................................... , 19..7..0..., Lll ~ INSTRUCTIONS ~ ~ - ~ ~his application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildi~ ~ Inspector. I~, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ~ areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this applicatiofl~.~ c. The work covered by this application may not be commenced before issuance of Building Permit. ' cl. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern~_ shall be kept on the premises available for inspection throughout the progress of the work. r~'~, e. No building shall be occupi.e.d or used in whole or in part for any purpose whatever until a Certificate of Occupanc~tJ~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purs.uant to Building Zone Ordinance of the Town of.Southold, .Suffolk County, New York) and other applicable laws, O~inances 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 regulahons. (Signature of applicant, or name, if a corporation) New Suffolk Ave. New SuffoLk, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ...... · ..~..~.~L..p..o. ~.t..~.a...q~.o. ~ ...................................................................... , ........................................................................ Nome of owner of premises ..... .-J~..*.....~......J~...?.."......'~-..~.h...°..n.~.....~..~..k.o. ..................................................................................... I~,gpplicant is a co~mte, signature of duly aut~rized officer. ~c, .~a~ ... ~Name and title of co~orote officer) 1. L~ati~ of land ~ which p~osed work will be do~. ~ap No.: ........................................ Lot No.' ............ ~/~ / ~ HA, ~ ~rv~ ............. Str~ and Ndmber ~.~..~e~..~..~.~.~ ................... ;...~.~.~ ..................................... 2. State exi~Jng u~ and ~cu~ncy of premises and intended Use and ~cu~n~ of pr~ construction: a. ~isting me and ~cu~ ~aoa~ Zo~ b. Intend~ u~ and ~cupan~ .....~Y..g.~...~L~...~L~ ..................................................................... 3. Nature of work r~[ck which applicable): Ne~; Bui!ding .X ............. Addition .................. Alteration .................. Repair ' Removal ..................Demolition ............. ;..'.. Other Work (Describe) ........................................ 4. Estimated Cost .....$2,.~.~.Ct0.~0.0 ................ : .............. Fee ..$,10.00 ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ oTte Number of dwelling units on each floor .......................... otl. e .. 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 ................................ ........ (~ .................. Depth .....~.0..~. ............ 8. Dimensions of entire new construction: Front ............ ,~...6.,~.... .............. Rear /+ t Or're Height ;.....[.Z}..t. ....... Number of Stories ................................................................. ; .................................................... 9. Size of lot: Front ]-881 Rear ].88 t Depth ...... ~.~,7,..t ................. 11. Zone or use district in which premises are situated ....... ~.~.~;~:ll~;::~t[. ................................................................... 12. Does proposed construction violate any'zoning law, ordinance or regulation? ....... ..~?.. ................................................ 13. Name of Owner of premises .~',...~..~.~..~:[,~¢D...Address ...]b~....t:..~$~D..~ ................... Phone No.2.9..8.~.~)..~.,5.... Name of Architect ................................................ ,....Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-bock 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. I - STATE OF NEW YORK, ! c c COUNTY OF ................................ ~ .... ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) Corporate officer 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 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. Swom to before me this...___.~ __ ,-~ --,'~ . ,~ ..... .~~ ......................... ~ ..... -~0.1;~ ........ day of ....J't~t%e,'. ............................. , 19..7.0..' Notary NOTARY PUBLIC, State of New ~0rk ,, No. 52-3233120 Suffolk County · Term Expires March 30, 191~.