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Home My WebLink About4849-zFORi~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~8~? ...... Date ...... ....... J..U].2/ .... 30.. , 1970.. THIS CERTIFIES that the building located at tt.$eko;t'.y..&. P&na. IM ...... Street Map No. ~e~..a~d .... Block No..~ ....... Lot No. ~. ........ 80Uthold .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... JuZy. .... .1.0 ..... , 19.70. pursuant to which Building Permit No. dated ........ July .... ~0... , 19.7~, was issued, ~d conforms to all of the require- ments of the applicable provisions of the law. The occUPancy for which this certificate is issued is .. P.~iva.t.e .one..family. a~welllng ....................................... The certificate is issued to .Cha.~l¢~. ~0~p.~Y .... ~ew .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ~.,B, ............................ ' ' Building Insp~tor FORM NO. ~8 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? 4849 Z Permission is hereby granted to: .............. ~L~.,1.e~ .. ~o~ o~.?,lK ........................... ..ll~lm.~ ..~ ~ ~i~7...,~..U~]A,4 .................... .................. ie~ebe~-....llv~., ......................... to ................ ~'.~.~..).d...~t:.. e~.~.~ .~.~..est..e,x~.~+, ~nl~..~m~ ......... ~"4edlr ..................... at premises located at ............ ,~J.o~:/o~'.~..&..~.~e...~eG~.ll ....... ~.et]:.8,~4 ....................................... pursucu~t to application dated ........................... ~TI~.~.~' ............ .~)......, 19..~..~.., and approved by the Building Inspector. Fee $.....ffa.QO .......... NO. I ~VN OFsoUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE i'i.i~! ~'/''~' 2~) SOUTHOLD, N. Y. Examined........... .... · · ............................. , 19.../..... Permit No......~..~......~'.....~......~ Disapproved a/c ............................................................................ ................ . ..... ,NSTRUCT,ONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, r~lationship to adjoining premises or public streets or areas, and giving a detailed description of layout at properb/must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced b~fore issuance of Bullding 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 wurk. e. No building shall be occupied or used in whole or in part f6r any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pureu.a, nt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.awl, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, 05 herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, end regulations. (Address of applJ-cant) " If applicant is a corporate, signature of duly authorized officer. / (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done. ,Map I~1o.: ............ ....~. .................... Lot No.: ~. .................. .,- Street and Numoer..<. ~.~z.~.m .....~ ...... ~..i ....... ~'~'~"1' '~ ........................................ ; ........................ ~/- ~ / ~ ~ ~ ~ Munlcl~ll~ 2. State existing u~ and ~cu~ncy of premises ~ntended use and ~cuponcy of prop~ constmctl~: a. ~istlng u~ ~ap*nc~ .......... ~.~~..~.}. .......................................................................... b. Int~nd~ use and ~cu[ ~nc,~ . ........................ ~~ ......................... ~ .................................. Nature of work (check which applicable): New Building ..................Additian. h~ .... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. ~ ..................... 4. Estimated Cost~/~...,/....)..~. ............................................. Fee ~....,~..~..~...~. ..................................................................... (to be paid on ruing 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, Jf 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 ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ..... ~.../. ....... ~,m..,,'4. ........ ~' ............ Address ...- ....... ~...~. .......................... Phone No ..................... 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. STAT£ OF NL:~/-YOjJ~,./JC~ COUNTY OF ....... ............................ /4.~.....~i!~.'"~"...~being duly sworn, deposes and says that he is the opp cant (Nome of individual sighting oppllc6ti~n) above named He s the ....... ~. .... ..P... '~.... U ' ~-'" ..................... i~-.ontr~'~'~,'~n't] c~rp~t~'~'~i~:'~'r';'~:i " of said owner or owners, and is duly authorized to perform or hove 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 performecJ4.n the manner set forth in-the applicRtlon flied therewith. Swam to before me this /../~. day of ................. ...... ............ , ,,...:..- /" / Notary Public, .................... ~ .................................... Count~)~ ...........~'"'(S gno re of op iig;;,';i............................. // r /