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Home My WebLink About5606-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z.tt-8~7 Date .. .0c$obe~ 17 , 19 72 THIS CERTIFIES that the building located at . E./cj .B re.rs. Rc~d. Street conforms substantially to the Application for Building Permit heretofore filed in this office dated '' ~% 30 ''', 19 7% pursuant to which Building Permit No. dated .. ~ . .1 . , 19 ~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ner .... (owner, lessee or tenant) issued is Private. o~e. family, dwe!.~!ng The certificate is issued to Jot"z~, Bowie of the aforesaid buildmg. Suffolk County Department of Health Approval UNDERWR~Tt~RS CERTIIqCATE No .p~nding - I{OUSI, NUMBLR ~,'~00 ' Street Btuldlng lnspccto~ FOI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. DUILDING PERMIT - - (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED} N? 5606 Z Permission is hereby granted to: to pursuan~ to application dated ................................ 0~.~ ......... ~O ...... , 19...~.~, and approved by the B, uilding Inspector. Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date MAi~ i 4 1972 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located have been inspected by this department and found to be satisfactory. MAR :t. ~ 1972 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ~....../.. ..........19...?.f Approved ..................... .1:..~. ............... 19...i..~..Permit No. ~.~...~......~ Application No...~..1~....~.. ......... Disapproved a/c ....... APPLICATION FOR BUILDING PERMIT a · ............................................................ 19 ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in dul>licote 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 o detailed description of layout of property mUSt be drawn on the diagram which is part of this location. 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 a Iterations, or fc~r ..~ or demo t on, as herein described. The applicant agrees to comply with all applicable Jaws, ordinances and regulations. ..................... ...................... (Address of applicant~.,,~ State whether applicant is owner, lessee, agent, archite~t, engineer, general contractor, el_ectrician, plumber or builder. Nome of owner of -rem ses ¢~ (~l (A) J lJ~ ~::~ c~, If applicant is a corporate, signature of duly authorized ................... .................. 1. Location of land on which J~roposed~vork will be done. Map No: ............................. ~......T.T..... Lot No: .................... Street and Numbe ...~....~ ..........................................................~....~...., .................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex,st,nguseoedocc n ......... ............ ...................................................... : ......... b. Intended use and occuoancv . ~ ~ ~ ' ~ ~ . ........................ ~...~ ................ ~ ....... ;.~ ............................................. 3. Nature of work (check which applicable): New Building....................~ Addition .................... Alteration .................... R . o ..... ~ Demo t on . Other Work (Descr be) 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 ............. ''~ ~J.."[,~..........~... ................................................................. ~ ...................................... 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 same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. ~ . ~oNumber of Stories ......... ................................ ~..LO... ............. Depth ....~../.~.....~...'~' 8. Dimensions of entire new construction: front ......................... Rear .......................... Height ............................ Number of Stories 9. Si~'e of lot' Front ..... L..O. .~. ...... Rear ....... ./...0....~... ........... Depth ......~..?...~.".~ 10. ' J~"~p'l .Nameof F met Owner~ ;;tnee °~r PfLChd~:; ............ ........................................................................................... 11.~ rict in i r raises' ore situated.....kJ~l[.~.....i~ ......... ;.......~..... ...................................... 12. Does proposed construction viglate any~ ---z°ning law, ordinance,/~, f_~_gr regulat~j~O? ................................................... 13. Name of Owner of premises '~ ~ j~ :~.(,J£L: Address .~......~'.~ ........... Phone NO ..................... ............................................ Phone NO ..................... Name of Architect......~...._. ................... ~'Z ................... Address /~[~- .................... Name of Contractor.-~..f-,~L...P'p....L:.-.~-...E...I..(~ .............. Address .......~.. .......... ~ ............... Phone NO. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. / STATE OF NEV~YqJ~K,,J/_ ) S S COUNTY. OF ..~..':...~.,.). '- , ~V._:..~' ,~ ....... , being .duly sworn, ~epo,s and .s~s that ~ is the applicant (Name of individual signin~O~) a~ve named. He is the ...................... ~.~ ............................................................................................ (~ntmctor, agent, co~orate office[, etc.) ....... of ~id ~ner or ownem, and is duly authOrized ,~.~or~ this opplicati~; that all statemen~ Coma)ned in ~nis O~ll~O[IO~ore ...._.