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Home My WebLink About5562-zFOEM ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy TI/IS CE~?.~FIES that the.building located at De!~ar Drive ...... Street La~e~L Map No. ~86 .. Block No.. ~ Lot No.~ ~e.1 N,~, ........ conforms subst~tially to the Application for Building Permit heretofore filed in this office dated ...... ~ ]~. , 19. ~ pursuant to which Building Permit No. dated ..... 0c$.. 1 ~. , 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 . Private' ~e' f~i!y' dwet~-~-~g ............................ The certificate is issued to H.o~ert F,. ~igl~ . ~e~ .................... (owner, lessee or tenant) of the afores~d buil~g. Suffolk County Department of Health Approval . ~ ~, ...................... .... . Building I~spee~or FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEi~ ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 5562 Z Permission is hereby granted to: .................. ~...g.,...~.~r~.~z ....................... to ~ mm a~l~I~ em ex/J~ing dwelling at premises located at ..~l~.~..~....~hT.~.l...~.O)R13,~X'~...~S.t~IR~. ................................................... .................................... f...~.....i~.e3J~e~...~.~ .............. ~me~....ll,~ ................................... pursuan¢ to application dated ........................ ...(~...~.. ....... .J.~.. ................ , 19.~..J...., and approved by the Building Inspector. J:ee $... ~.~J~ ........... Building Inspector SURVEY FOR MIL--.MATT AGENCY, INC LOT 2 "LAUREL COUNTRY ESTATES" LAUREL TOWN OF SOUTHOLD GUARANTEED TO' SECURITY TITLE & GUARANTY CO SOUTHOLD SAVINGS BA~K ALDEN PROFE~IStON&L EH'G*INEER AND I, ANO SURVEYOR ,NY.S.LIC. NO,12845 SUFF. CO., N.Y. SCALE; I"= 40' JULY 16, 1970 OCT. 2, 1970 NOTE ;B= MONUMENT SUBDIVISION MAP FtLEO IN THE OFFICE OF THE C-LERK OF 81)FFOI. I( COUNTY ON JUNE 22~ Ig?O ~ ~ NO. 5486. Approved FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV~N CLERK'S OFFICE SOUTHOLD, N. Y. Application No ................................ D~sapproved a/c .......................................... APPLICATION FOR BUILDING PERMIT Date ............... ........ , INSTRUCTIONS a This opphcat~on must be completely filled in by typewriter or ~n mk and submitted in duplicate to the Buildm, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adlommg premises or public streets o areas, and g~wng a detailed description of layout ofpraperty must be drawn on the d~agram which is part of th~s apphcat~on c. The work covered by thzs apphcat~on may not be commenced before ~ssuance of Building Permit. d. Upon approval of this apphcat~on, the Braiding Inspector w~ll ~ssue a Building Permit to the applicant Such permi shall be kept on the premises avmlable for inspection throughout the progress of the work. e No building shall be occupied or used m whole or in part for any purpose whatever until a Cemficate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolmon, as herren describe, The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations. (S~gnature of applicant, or harry, Jt ac~rporation) ....... (Address of applicant) //'~j~ State whether apphcont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu~lde Name of owner of premises ............................................................................. If applicant is a corporgte, signature of duly authorized officer. (Name and htle of corporate officer) I. Location of land on which proposed work w. II be done. Map No ..... ...C~ .~...~...~. ..............Lot No ..~ Street and Number ...~.....~'..~..../~' ~....~..~ ~~ ~~ ........................ / 2. State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction: b. Intended use ond occupancy . 3. Nature of work (check whtch applicable). New Bu~ld,ng ............... Addttton ~ Alterahon Repair .................. Removal .................. Demolmon .................. Other Work (Describe) ..................................... 4. Estimated Cost ~'/~'~'~' ..Fee (to be prod on fihng th~s application) 5. If dwelling, number of dwelhng units ........... ~ ............ Number of dwelhng umts on each floor .... ~ ................. If garage, number of cars ............~.. ......................................................................................................................... 6. If business, commercial or m~x~ occupancy, spec~ natgre and extent of each type of use ....... ~ .......... 7. Dimensions of existing structures, if any: Front ....~...~ ......... Rear .....~ ...... ~ ......... Depth ..~.~..~ ..... / Height ...... ~ .......... Nu~er of Stories .... D~mensions of same structure with alterations or addmons: Front .......... ~.....~ ................ Rear .... %..~...~ ......... Depth ~.~...~.~.ff.(.~..~..~. Hmght ........ Z.~. ............. Number of Stories ...... / ....................... 8. Dimensions of e~ new construct,on. Front ...... ~.~ ....... Reor ...~..~ ..... Depth~~'. Height ..... ~Z~.. Numar of ~tories ..... ~ ........... 7 ......................................... '2 ........................... ~..ZCC] ..... 9. Size of lot: Front ............................ ~~ --~ ~--R~r .................................. Depth ................................. 10. Date of Purchase ~~...X.~/....~C ................ Na~e of Former Owner .~..Z~..~ 11. Zone or use d,str~ in w~h premises are s,tuated ...... 12 Does proposed construction wol~e any zonin¢ law, ordinance or regulation? ....... ~ ............................................ 13. Name of Owner of premises~~~~Address ~~..~one ~o. Name of Architect .............~.~ ...................... Address ............ F ............................... Phone No .................. Name of Contractor .......... ~~ .................. Address .......................................... Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and ~ndicate all set-back d~mens~ons fray property lines. Gwe street and block number or description according to deed, and show street names and indicat whether interior or comer lot. STATE OF NEW YORK, ! ¢ c COUNTY OF ................................ $~'~ ............................................................................................... being duly sworn, deposes and says that he ~s the apphca~ (Name of individual signing apphcat~on) above named. He is the ....................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fil this application; that all statements contained tn thts apphcotion are true to the best of hts knowledge and behef, a~ that the work will be performed m the manner set forth in the apphcat~on filed therewith Swam to before me this Notary Public,. ........................................................... County .................. ~ ~(Sig~'~¥~;e'g¥ ..........