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Home My WebLink About5484-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Cerlificnte Of Occupnncy No.Z.~.6. ?.~ ....... Date WOV ¶~ 19 ?.~.' THIS CERTIFIES that the building located at .~.qh..o.o.l.h..o.u.s.e., .R,d..&., .~9..1~.,. ~reet MaP No. m Block No. ~ .Lot No. xxx Cuteho .g~.. co .nforms substantially to the Application for Building Permit heretofore filed in this office dated .........~.e.p..t...2. ..... , 19.?.~. pursuant to which Building Permit No. dated ...........8..e.p.?....~..., 19..7.~., 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 ....r~...,~..t.e..o..n.c..~.a..~.~.~.y...d~..X~S' ..................................... The certificate is issued to ...Yl~. ~...K]..o.~...~.~z)e2 ................................... (owner, lessee or tenant) of the aforesaid building. Suborn Co~mty Dep~tment of Heaith Approvai .~.~ .e..S..W.3...~..S:. ~.U.. ~ ....... Um)ESWRITERS CERTIFICATE Zqo..~...9.~..~. ?.~.... m,..e..9..~.9.?.~ .................. HOUSE Z~;m~ER .. ~0 .... Street .... S.e..h.o.o.Z...S.t. ........................... "1~" llo~,th Street ........................................ Building Inspector lrOl~,i NO. :~ TOWN OF $OUTHOLD BUILDING DEFARTMENT 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? 548 Z Dote ....................... ~.~JJtt ......... .~. .......... , 19...~.!. Permission is hereby granted to: ........ at premises located at ........JIJIIJMIJ~D~I~J..J~..~..~IJ~J..~.~. ....................................................... pursuen¢ to application dated ........................... ~e.pJ. ........... ~ ........ , 19....~.~ and approved by the Building Inspector. Fee $.....:~Oe, O0 ....... $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: at The seyage dis?osa~l facilities for a structure located (Give deed 1Bcatiou) have been inspected by this department and found to be satisfactory. Chief of General Ez~a,i%~cor~ng 9*~'7ices - 157.3~ NO~T~ STreET '/AAP OF L&ND SUEVEYEr~ F01~ GEOI2Gg ~, AAP_.Y ..F_LOS 0 0 .SCALE- 40'= 1" I~ = /AONU/AEI,,IT ~ = IEON PlPG GLtAE,*,NTE-ED TO TW[:: GU/~,E.&IJTI:ED TITLE ~:UEVI:Y' PEr-P^.EI;;D · JUN& IG , 1965 07- 49970 Gm~[N~Om~, ~v Yomv. TITLE N? TOWN OF SOUT.OLD B~ILDING DEPARTMENT TOWN GLER~S OFFIGE ~UTHOLD, N. Y. Disapproved a/c ......... ~ ..................... ~ .............. ~.~....~'~'~ ~'~ ~ U Se tember 2 ' ~ U Dote .................... ~ ......................... , 19 ............ INSTRUCTIONS a. This a~lication must be completely fill~ in by ~writer or~ ink Inspector. ' b. Plot plan showing I~ation of lot and of buildir~s ~ ~ises, relationship to adjoining premises or public streets~ areas, and giving g detail~ de~ription of layout ofprope~ mu~ be drawn ~ the diagram which is ~ of thru ppphcat~. c. ~e ~ ~ered by this ~lication ~y n~ be cemme~ed before i~uance of Buildi~ Permit. d. Upon approval of this application, the Building Ins~tor will issue a B~ilding Permit shall be kept ~ the premises available for inaction thr~hout the pr~ress of the work. e. No building shall be ~cupied or u~d in whole or in ~ for any purpose whatever until a Ce~ificate of ~cupancy shall have been granted by the Building Insp~tor. 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 alterationsA or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws,-ordinances, building code, housing code, and regulations. Clarence Kander (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................. .c..~n~.~.~r. ....................................................................................................................... Name of owner of premises ...~r~'...~',.loS. ........................................................................................................................... If applicant is a corporate, signature of duly authorized officer. ~ .................. ......... 7- / 1. Location of land on which proposed work will be done. Map No.: .......... ~ ......................... Lot No.......X~... ............... Street and Number ............ ~chuol..E~ues~..&..Nnr~h.....~.t ....... C~t~h~i/e ............... .. ............................ '-/~ Z~ ,---~' ' c~,~O ..~ /%4unicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................ Y.~.¢.P,~,~../L~,D&I, ..................................................................................... b. Intended use and occupancy ....... ~D,~...SBi:P,~.ly....i:~ll/.,'~& ........................................................................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration .... ~ Repair .................. Removal ..................Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...... ~,.~2.~.~00 ................................... Fee ..... .~..O..t..0..O. ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... o%~ ............ Number of dwelling units on each floor ............................ If garage, number of cars D~ ............................................................................................................................. 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 ...... 3.Q ............. Height .................... Number of Stories .....~.~.e. .......................... . .................................................. 9. Size of lot: Front ......... ~.2P~ ............ Rear .......... 1.,~.1 .................... Depth ......1.~.../. .............. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... !!~...~.J.~.~ ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... ~ ............................................ 13. Name of Owner of premises ..~.~.~.~r..~LQi~ ................Address ....... O~e.e~.~c)~.% ............... Phone No ..................... Name of Architect ........................................... i .......... Address .., ........................................ Phone No ..................... Name of Contractor .~.a..~n~e.~ .............................. Address ....... ~.~.Q~,13~,0. ............... 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 comer lot. STATE OF NEW~ COUNTY OF .... .~....~t.. 2.~...~.. ........... $~'~ .......................................... ~.~,~L~:~e~nC~,..~e~. .................. being duly sworn, deposes ond s~ys thor he is the ~pplicem (Nome of individuol signing ~pplic~tion) obove n~ed. He is the .......................~~ .......................................................................................................... (Contrector, ~gent, corporate officer, etc.) of said owner or ~ners, and is duly ~uthorized to perform or ~ave performed the s~id work ond to ~ke ond file this opplic~tion; that ~11 statements contoined in this appllc~tion are true to the best of his knowledge ond belief; ~nd tha~ the ~rk will be performed in the manner set fo~h in t~e application filed therewith. Swom to before me this 1 .., .............. ~.... da~f .................. ~e~ .......~ ........ , 19....~.. Nota~ Publ'c,, .~..~ .....~~Coun~ (Signa~ No~aW ruz'j~'o63 5uf~Oik aou~,~