The URL can be used to link to this page

Home My WebLink About5201-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z..~2~. .. Date ..... ~tl.l~ . 25 , 19 73 THIS CERTIFIES that the building located at . .~t].]rok. e . Avo Street Map No.~.~. Block No.. 1~ .. Lot No. ~ 0;rl~ll~ ~,Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ~pril. 2 , 19 ~'l, pursuant to which Building Permit No. dated ....... Apri-'[ . 2 , 19 ~.i., 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. one, f~nily, dl~e~ling .......................... The certificate is issued to Willia~t & VirgixLta O~!~el' (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No.. ttOUSF NUMBERI'i'O~' . Street ...Aug .1~...1.9.7'1. N .?.09h-b.. .Feb ~...1973. · .Ha.~yo.k.e ,A.V~ ...... Budding Inspcctol TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CI;HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 5201 Z Permission is hereby granted to: ~ ....~.!.~.~:..~.~....~.....~.~.~.:.~.!!..~. ....... ~....~w,r ~-,~, pursuar~' to opplicotion dated ....................................... .,.~.;....6..'~....~.., lg.."Z..]., and approved by the Building Inspector. ~)~ , ~ ~00 _ . Fee $ ................. : ...... ~ Budding Inspector FOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.1+369 .... Date ........ ~g'aS.~..3(~ , 19. ?.~. THIS CERTIFIES that the building located at lh~lyoko' 'AYe'' .(I~.) ..... Street Map No. ~ . Block No. ~ .... Lot No.x:I~ . O~':f.eI~t. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... April '2' , 19 7t pursuant to which Building Permit No. dated .......... '~prll 2 ' 19 71' 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 . .Pr~.V~to. one. £a~i1¥. <lwe.l.l. Sng ................................. The certificate is issued to - l~i!.!iam &. Virg.$nia 0'Dw,,re~ -. Omae~ ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . PEh'DI~N(t .......................... l~ouse ... . ~ ' Building Inspec~r BUILDING DEPARTMENT O. ~y~. 0. '~ Tm, CL,R,C'S O,',,¢, ~ ~ ~, N.Y. ~ ~ ~/ ~/ ~ ................ ,,zz. ........ ,~ed ~' . ,,~z Perm,, ,o ..~ ~...E./~ ~/~ ~ ~ ~ ....................................... : ........................ .......... ....... ............. ~.....~~....~ ....................... (Building In~or) APPLICATION FOR BUILDING PEB. MrT ~,. ............ ~.... ,,Z./.. .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted In duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premise~ or pub ¢ ~treets or areas, and giving a detailed description of layout of property must be drawn on the diagram which It part Qf mia 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 wUI Issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the pragre~ of the work. ' e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY/v~DE to the Building Department faf the issuance of a Bud ng Perm t pureuant to the RBUildln.g. Zone, Ordinance of t.he Town .o.f .Southold, Suffolk Coun?., New York, and other applicable Lawe, Ordlnence~ or Thegeu atl..ons, tar the construct,on of budd,ngs, additions or al.terat~ons, or for removo or demolition, el herein delcrlbed. · apphcant agrees to comply with all applicable laws, ordinances, buUding code, housing code, and regulations. (Signature cf applicant, or harry/, If a Corlaoratlon) State whether'applicant is owner, lessee, agent, archit&ct, engineer, general contractor, electrician, plumber or builder. ............. ~.~.~..~. J~. ................. : ...... ~ .......... ~ .................................................................... ~ ......................................................... Name of owner of premtse~ ....... .?..!.I,~...Z~...'~. ...... ..~...Y./~.~'/.~.~../.../...~ ........ ...~....~.."/~":~'.M~'.~. ....... ' ............................... i..'. .......... 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 dane. Map No.: ........................................ Lot No.: ..... ............ Street and Numb r ......................... ~'~....~. ........................................................................ Municipality 2. State existing use a~d occupancy of premises and Intended use. and occupancy of prpposed conltructlon: ~ a, Kxisting~seondoccupanC~,/ ............ ~,/~,.~,,4~,.~.,.,~/.-- .......... ~.~..X..~'..~,..'~,,~ ...... ."~....~....~'., ....... ~....~..~,~ ..... b. Intended use and occupan:', . ......... LI.~...C.~..'~../.~..~........~...~.~...~/~ ................................................................... 3. Nature of walk (check which applicable): New Building .................. Addition .................. Alteration .............. Repair .................. Removal .................. Demolition...i .............. Other Work (Describe) ...................................... 4. Estimated Cost ..... ~ ............ '~ Fee .......................................................................................... (to be'paid on filing this application) 5. If dwelling, number of dwelling' units ......... J. ................ Number of dwelling units on each flOOr ............................ If garage, number of cars 6. f business, commercia or m xed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures, if any: Front ............ ..~...~ ....... Rear ............ ~...~......:..L .... Depth .....~-~.,~.. ....... Height ....... ~.~. .......... Number of Stories ............... t~ ............................................................................................ Dimensions of same structure with alterations or additions: Front ....' ............ ~...'>...-..'......L?Rear ...... ..~:..Z~.~..~.......Z..~'' Depth ............. .~..~....../,.....~-.?Height .......... ~,~.....~....~....Numbe, of Stories ............... .~-~. ........... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front .....~...6.6..~....~: ....... Rear ...... (~..~.~'....~.. ............. Depth ...... ~..~".~.:...O. ............. 10. Date of Purchase ...~.?..~...~...~..~'.~.i ............................... Nome of Former Owner ....G./~...~.....~'~'..z...~/~....6~A~/J'.cZ.~.....c~t~f'~.- 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ .~....O. .............................................. 13. Name of Owner of premises ~..Clr..(../~....~'.y/.l~/,/~. ............ Address ....-~...~..?'~.lc,~.L.d.~...~4).: ...... Phone No...~..V....~...?,~'/ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ 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' YORK, tee COUNTY OF ................................ J' "'~' 14/I LL/...~..~ ~ ~). PWYE'~ be,n' ............................................................................ ...~. ......... g duly sworn, d~o~s ond soys t~ he is the opplic~nt (Name of individual signing application) obove homed. He is t~e ................................................ .~.. ................................................................................................. (Contractor, oG~t, co.orate officer, ~c.) of soi~ ~ner or ~ners, ond ~s duly outhorized to perform or hove performed the soid work ond to ~ke ~ file t~is opp~icofion: t~of o11, stotements contoined in th~s opplicotion ore t~e to the ~st of his knowl~ge o~ belief; ond thoT the work will ~ perfor~ in the monner set fo~h in the opplicofi~ fi]~ ~her~ith. Swam to ~fore ~ ~is A~ ~/ ..................... ....................... ,: ......... . ............ ............... (Signa~re of applicant)~ N~A~ PU~ ~ ~ N~ York No. 52~125~0, ~ffolk ~ MAP OF LAND 0~I