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Home My WebLink About5506-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southol& N. Y. Certificate Of Occupancy No. Z..[k.9~9 ..... Date ............ Deee,,be~'...1+.., 19 THIS CERTIFIES that the building located at .I~//S. lla~']ool~ .],ane ......... Street Map No. x.x ......... Block No... XX ..... Lot No. 3~x .... Cutahoglla..1~,¥, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Sept · - · -13., 19. ?.1. pursuant to which Building Permit No..~505~. · dated .......... Sep.t... 13.., 197.1.., 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 .. l~l'ivate, o]3e. family. ,~,welltn{ ..................................... The certificate is issued to .. l~dolph .K~l~ek ....... 0wlle~. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ltov...~0, · ~197.2.. b~r. Ro..Villi. UNDERWRITERS CERTIFICATE No.. ]l ':~'7.~'~$ .... 1~O$'...~8t. 1972 ................... HOUSE NUMBER..80~' ........ Street .... I4lt~'bOl't..L~II~. ............................... Building Inspector FORM ~0. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5506 Z Parmission is hereby granted to: .................... ~~'-~a~ .......................... ~o ..... ~..~,...,~...t,m~t,.~.- ~..,il.,~mt.~.t~,~ .............................................................................. at premises located at ............ ~..~..~ ................................................................................ ..................................................... ~~ ..... :...Il,Z, .................................................................. porsucn~t to opplicotion doted ............................... ~tt~p~**....ql.~ ......... , lP...~i, aod opproved by the Building Inspector. .Fee $'-'-JOtl,~ ....... FOB][ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved o/~ ......... .~ __ APPLICATION FOR BUILDING PERMIT Date ..~... .......... ../...~... ............... , INSTRUCTIONS a. This application must be completely filled in by typewriter or iff ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty mu~ 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 Pppticar~. 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 Deportment 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, qnd regulations. ii'~;~i ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ ~, .~...~ ~.:......~..e..e.g.~ ~..:. ..... C~ ~. ~...c.....r:.~ ..~ ............................ ~ame of owner of premises ..... ~..u...~.~..~.~ ......... ~.o....U...~..~..~ .................................................................................... 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 No.: ........................................ Lot No ........................ Street and N~mbe~ ...~.~...'. ...... .~N......~..,.~:....~.~......,..~/.z....ZZ...,f~.....~....z.~.e..e .......... ~.~R~.e.~.~..e...~, 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: /'~ a. E~siting use and occupor~.y .......... ~...~.,.z~.....A.~.~ ............................................................................ b. Intended use ond occ~ncy .......... Z.....~.~.:/.~......~.¢...~.~..'.~.~.. ............................................................... 3. Nature of work (check which applicable): New Building..................J Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost.~......./'..4.......c~............~' ...... . ............ ....Fee .......................................................................................... (to be paid on filing this application~ L ° 5. dwen ng, number of dwelling un,ts of en ng un,ts on each .............................. f r . lc ~. If garage, number o c~ s ................ ?-.-~..~ .......... 6~3~.~....~. .................................... 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 some 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 ..... ..~...c...~...../..~....../~'.~..~. ................... Name of Former Owner ......~...~j.......,5~,..~....~./....~(.....d~.. ............ 1 1. Zone or use district in which premises are situated ............ ~ ............. ~4~.~, .............................................................. 12. Does proposed construction violate any zoning Jaw, ordinance or regulation? ....... ..~(.o. ....................... 13. Name of Owner of premises ...~.~.~..¢...P..'~......~..~...~....~...A(..Address .~..4~X...¢.4]./~..~.~..~'~,¢/,~phone No ..................... Name Of Architect ............................................. ~ ........ Address .....~.~C~..~...~...~....~. ................ Phone No ...... ~ ............ Name of Contractor .......... ..~./,~.~. ............................ Address ................. ..x~.;~....../../~.~..~..... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from properb/ lines. Give street and block number or description according to deed, and show street names and indicate whether i~terior or come~ lot. STATE OF NEW yORJ~,~ , COUNTY OF ....~u...~...~..?...4...~.. ...... ............................................................ oemg duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~ ed ~ ~' ~ - above named. He is the .~..?,.~.?..?.~...~. ....C.o....~...T*..C~.,~....c.,..7~..o....~.. ................................................................................ (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 Jn this application ore true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the application filed therewith. Sworn to before me this ............. County BED RM PLAN I WITH BASEMENT g ESIGN A--Brick Veneer A good plan for a 50 foot lot Kitchen is most efficient.., it looks ou~ upon the rear patio.., ideal for child supervision Outdoor living convenience is further enhanced by the second patio off livin_c room Location of bedrooms in the quiet zone is a desirable feature Living Area DESIGN A- 1,234 Sq, Ft. DESIGN B- 1,174Sq, Ft Please Specify Design A or B and Plan 1 or 2 When Ordering Blueprint Plane DESIGN B--Frame PLAN 2 WITHOUT BASEMENT · Designed to g md space, with sheltered entry with and bright, cheerful kitchen. · 3 large bedrooms, each with quiet area of the Mom protection and · Form ..... ~'/" ' a~ dmmg area Is/provlaeo traffic living room. Every day dining enjoys a pleasant view of the patio from the kitchen. · Planned for maximum living on a narrow lot here is a perfect combination of luxury and ~pace. :ize closets, are in the from the garage gives time. nd of the out-of- 26~-8" BED RM BED RM II'x9~ K?.C, HEN PATIO GAR. PLAN 2 WITHOUT BASEMENT LIVING RM Living Area Plan 1 or2- 1,122Sq. Ft. BED RM. KITCHEN DINE DINE ENTRY PLAN I WITH BASEMENT BLUEPRINT PLANS AVAILABLE ]'~UFFO~K COUNTY EEALTN DEPARTMENT OA~E NOV ~0 1~?~ ~. o. ~EF. ~-///~ tO ~e sa~isfhc'tbr~ Chief of General Engineer~ ~ ~'~ x; x,., '" ~ '~ ~ ~ LAND ~OS s.zsho'm" w 54k~ ',UPR~E ¢E:D F'OiZ , -- ~ -' VAI4 TUYL ,~r S~AL.E- 30 EAST CUTCkI~U E ~ ~ON U fl E TOWN OF 50UTNOLD, N,"d O' I~.0N [,)l LICENSED GI~E h H PO QT, N,"¢