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Home My WebLink About5203-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ZI~2~.... Date · · ~l-t;a~e '3 , 19 71 THIS CERTIFIES that the building located at 8®~,~d Drive Street Map No. Ea~t~ Sh Block No. Lot No. 120 Greenp~rt N,~f, conforms substantially to the Application for Building Permit heretofore filed in this office dated .. Apl'il 2, 19 71 pursuant to which Building Permit No..~203Z dated il~r$~. 2 , 197i , 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..line .family. ~twelling ................................ The certificate is issued to ~, WiedeI*light.& .Igtfe. . . O~33ers (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ......... 1~,]~, ................ ~ouse ~ 2000 ~(~ ~ ... .......... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5203 Z Dote ...................... ~.~ ......... Z ......... , 19....~.~'' Permission is hereby granted to: premises located at .........~11~:.~....~O~.~.....~...~...'. ...................................... pursucrr~ to application dated ............................ -A,p~*L .......... ~' ...... , 19...~J1~,. and approved by the Building inspector. FOBl~ lqO, I 'r'owN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................ Disapproved a/c ............................. ......... APPLICATION FOR BU,LD,NG PEP. MIT~. _ Date ...~......C~... .......................... , 192~ ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duphcate to the Butldin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and g~ving a detailed description of layout of property must be drawn on the d~agram which is part of this applicatio~ c. The work covered by this application may not be commenced before issuence of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perm 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 Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ord~r~nees c Regulations, for the construction of buildings, addmons or alterahons, or for removal or demolition, as herein describe, The applicant agrees to comply with all apphcable laws, ordinances, buHd~r~g code, housing code, and regulations. (Signature of applicant, or name, if a j:orporation) (Address of applicant) State whether applicant is own, etr, lessee,,,agent, architect, engineer, general contractor, electrician, plumber or builde~ Name of owner of premises ...... ,,~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_~,ll be don.e,j(/)~ -- e/J,/'Aap N°': ~"'"~'""'""~'""~' ....... I-°t N°': "!'"'~"?" .......... Street and Number ...... ~.~.P..¢;.~..i?.....~,.~..~. ....... ~..~.~.. .................................................................... Municipality 2. State existing use and occupancy of premises and intended use.and occupancy of proposed construction: a. Existing use and occupancy ......... /.....~'./~...?../.~, ......... d'~~- ......................................................... b. Intended use and occupancy ............. ~....~4~.~.~... ................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ~ .......... Alteration ................. Repair .................. Removal .................. Demolitior .................. Other Work (Describe) ....................................... 4. Estimated Cost ....... ..~....~/.S.¢~..:...."~... ...................... Fee ........................................................................................ (to be prod on filing this application) 5. If dwelling, number of dwelling unffs ............................ Number of dwelhng units on each floor .......................... If garage, number of cars ........................................................................................................................................... 6. If business, commercial or m~xed occupancy, specLfy nature and extent of each type of use .......................... 7 Dimensions of ex,sting structures, if any: Front .... i-~. ................... ~ Rear ....'~..~ ..................... Depth ~...~. ........... iJ- Height ..~..O...r, ............ Number of Stories ........~- ................................................................................................... Dimensions of same structure with alterations or add,tions: Front ....... ~.../....~.. .................. Rear ..~....~. ................ / Depth .......~..~7... ................ Height .....~. ................... Number of Stories ................................ 8. Dimensions of entire new construction' Front ........ ..~....~....~.. ............ Rear ...~...~.....~.. ....Depth .~...~.; ............. Height ,~ t Number of Stories /.. ................. i ............................................. 7 .................... 9. Size of lot: Front ..... /...¢~.....~. ........... Rear ........ /.J.~ ................ Depth ...... .~....~....~. ............... 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... ] 1. Zone or use district in which premises are situated ................................................................................................... t2. Does proposed construction violate any z,oning law, ordinance or regulation;) ...~..?.~..~. I, 13. Name of Owner of prem,ses .~..'....~...E!.&//.~...~... ....... Address .~ ~'~..~...~..~ ............ Phone No.~.2Z...~...~'..~. Name of Architect ..................................................... Address Phone No ................... Nome of Contractor ...~.:.~..~.:///'/~('(/.~ ......................... Address i~i~;~Jiiiiiiiiiiiiiiiill Phone No.'~...~...~...~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fro~ property lines. Give street and block number or description according to deed, and show street names and indical whether interior or corner lot tlgt STATE OF NEW YORK, ~ c ¢ COUNTY OF . ~'~'~' ,/- ............... ~.....~...'f'~""~"'~'"D"'"~.""'/-~.~///.,/f/J~. ............ be,rig duly sworn, deposes and says that he is the apphc~ (Name °f indlv'dual slgning apphcat~;:Z~ /Z above named. Fie is the ................................. .~.O.~./..~ ........................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and th~s apphcat~on; that all statements contained m this application are true/to the best of his knowledge and belief; c that the work will be performed ~n the manner set forth in the apphcation f41ed therewith. Sworn to before me th,s ~ , /~ ~/ .... ~ ............. day of ...~ ....................... , 19..~./. ~'//'/ Notary Public, ~...~../.~......~(...:..J~C~l~yA RC~?'T , (Signature of applicant) J,~ t~ FIOTARY PUBLIC, State oJ ~o. 52-3233120 Sullolk ~j~rrn [,xptres ['~arch