The URL can be used to link to this page

Home My WebLink About5568-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi[icate O[ Occupancy No. Z.~..2.2~. ...... Date ........... ~..t_In. ~... 2~ ...... , 19.73. THIS CERTIFIES that the building located at . S~l~;h. D. ri.va..~or~;h ...... Street Map No. ~9.o.~e. ~.:.~.~.k Block No ........... Lot No. ~1.o,1..&. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Oat ..... 1..., 19.71. pursuant to which Building Permit No. ~.~6~z.. dated ........... Oct .... 1 ~..., 19'/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 . .P.r.i.v.a..t~..o.n..e..f. am!.lx .d.w.e.l. li~g ....................................... The certificate is issued to . .Henm. lr. Tl'aut, man ..... u. wnex. ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~,~... ............................. UNDERWRITERS CERTIFICATE No.. p.e.n.c~..ng HOUSE NUMBER. 1.1.50 ....... Street..Bra:l..th .DX'. IXo2'th. .............................. Building Inspector / ~ORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 5568 Z Permission is here~y oranted ................ ~~ ............................................ to ..~...~...~.~..~...~~..~~ .......................................................... ............................................. ..s~.t..~.. ~.~.~.e....W. ............. .i~.t~...~ .................................................. pursuan,t to application dated OGg/. ~J 19 71, and approved by the Building Inspector. FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Exemined ~ / ~ ~ ~ ~p~o~ " ~V ( P~ No. ~g 7 ~ Disapproved c/c ........................................................................ Application No. '~"~'~ ~' INSTRUCTIONS a. This application must be completely filled in by typewriter or in 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 must 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 applicant. 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 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations· of app ic;~"~';l~'~;i;~i ........ (Address of oppli~{t) ................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~-~/,~/.....~...~~ .............................................................. i'.: ................. If applicagt~ is a corporate, signature of~/clul~/ authorized officer. ~ .~ .......... ~.:~-~..~....~.-,.....~.~ ................. ~ ~ ......... (Name and title q~corporate officer) ~ .~c~C IO[ ~(/ ~ · · LotNo ........ .~. ......... .~.... 1. L o,ion of ,and on whic pro,;Led ,i,, be ne. Map No.: ....... Street and Number .,~..~.~....~..;~--~, .......................... ~-~......~. ,...~./. .................... Municipality / 2. State existing use and occupancy of~isel~s ~.~;nded use and occupancy of proposed construction: b. tended use and occupancy ........... g.z .................... .././....(2:....~ ..................................................................... ; . 3. Nature of work (check which applicable): New Building .................. Addition ...~ ..... Alteration ...~...J ...... Repair .............. .~ Removal .................. Demolition ............... =:,,Other Work (Describe) ........................................ 4. Estimated Cost ...... ~ .......... ?...; .................................... Fee ..~ ..................................................................................... (to be paid on filing 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 e/xisting structures, if any: Front .....3.....~.. .............. Rear ......"~...~.. ................. Depth ...;i~....z~.. .......... Height ..../....'~.. ............. Number of Stories ....... .o...~....~. ............................................................................................... Dimensions of same structure with alterations or additions: Front ....... ~.. ........................... Rear ....~.....~C. ................ Depth ....3~..~... ................... Height ...... ./...~.. ................ Number of Stories ..... ..~.....~...E.. .............. 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name 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 premises4~.~..~..~.Address" ' '-~-~.e~. ...................... Phone No Name of Architect ..... ............ ..............Address ............................................ Phone~No.4 ................... Name of Co,tractor -- ........ Address PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and black number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW ~J~.. I~//~ ! ~ ¢ (Name of individuo~gp~ag aaolication) 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 ~ke 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 fo~h in the application filed therewith. Swomto ~re methis ~ , _ NOTARY PUBLIC, State of New York