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Home My WebLink About5214-zFORM NO. 4 TOWN OF SOUTHOLD BUlLDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~,1l~+81, ...... Date ........... Dee.....t3... , 19.~. THIS CERTIFIES that the building located at . .RobilasO~l Road .... Street Map No. Pal, ad,se p~lock No ........ Lot No.x~ . ~euthold . .N,Y., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... &l~Vi,1.. -6 , 19 .~tl[ pursuant to which Building Permit No. dated ......... A~p~i~.. 6 , 19.7.t , 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 ...Pti.rate. one. family. .dwe~Liing ................................ The certificate is issued to .. Edwa~,d J., .Boy& .. .(.~.,~l~er ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~1~,c . .% '3" 4'971 .... by ttouse 38E0 paradise ......... ..... /.'. .. Building Inspector FOII~ NO. ~ TOW~ O~ $OUT~OLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE $OUTHOLD, N. Y. ) BUILDING FEP~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5214 Z Permission is hereby granted to: ..... C,......~. ~..L¢,.~.: .t,.,L,, ........................................ .......... .~/~_.....~...m..~.~..~........,Z.....~.~.~...~.. pursua.n¢ to application dated ..................................... -~,. ...... ,.~..,.'"~..,"~... ,~..7.~.., and opproved by the Building Inspector. '~ee $..../.~ .............. Building Inspector $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date September 13, 1971 Bldg. Permit No. ~214Z TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at S/S Robinson Road; Southold (Give deed location) have been inspected by this department and found to be satisfactory. SEP ~ $1971 Chief of General ]~ngtneering servlcem FOB, Bi NO. I ~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICl '/l u y. ~ {Suildi~ Ink.tot) APPLICATION FOR BUILDING PERMI'/ INSTRUCTIONS a. This'application mustbe Completely filled in by typewriter or in ink, und submitted in duplicate to the Buildiag Inspector. . .~, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premim or public streets or areas, and giving a detailed description of layout of property must be drawn an the diagram whlch is part of thio 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.~t 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 I:)unluant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Y. ork, and other .applicable La.wi, O. rdi .none.e? or ~ RegUlations, for the construction of buildings, additions or alterations or tar removal or aemolltion, as heroin aescriDea. The applicant agrees to comply with afl applicable laws, ordinances, bui ding cede, housing code, and regular ons. (Signature cf applicant, or name, If a CmlX)ratlon) .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~ .... i.... Edward J. Noyd ............... ,~ N,+~_a'me of ........ . ........................................................................................................................................... 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 done. Map No.: ........................................ Lot No.: ........................ 0~ Eo'otnaon Eo~8~ Par&d~se ~otn%~ 8ouf, ho18~ N.. ~.. st,.. and Numb., ............ ................. ...................................... 2. State exi~lng uM and ~cu~ncy of premiss and intended use and occupancy ~ p~ cons~l~: a . ng and ........................ b. Intend~ use and ~cupon:', .....~,~..~.~.~.~.~. ............................................................................................... 3. Nature of wo~k (check which applicable): New Building ,..x..x.x. ........ Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ....~...,~.~,~.~..0..Q. ..................................... Fee .....~..1..0..,. ............................................................................. (to be paid on filing this application) S. If dwelling, number of dwelling units .....o..n...e. ................. Number of dwelling units on each floor one Two If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ................. . .......... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .7...0..~. ....................... Rear............................?0t Depth ....4..~.t. .............. Height 26 ~ Number of Stories ~L~lr° 150~ 150~ 600~ ~). Size of lot: ~ront ............................ Rear .................................... Depth ................................ 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ...... Tlefi~.~.e~L.~j..~, ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......n.~ .................................................... ]3. Name of Owner of premises .]~.e...~.,...~..o. lr..d. ............... Address ~.e..n.....C..i..~'.....N'....:...I'...%.. Phone No. ?..4..6...-..5...3..6.,9... Name of Architect ................E...,...~.,.....B..o.~..d. ............... Address Garcl.e.n C~% 1~. [o ....................... ~.. ............. ;... Phone No ..................... Name of Contractor ..C...,.....1[.,;....~..o..?..e..1...1. ...................... Address ..G..~...e..e..n..?.°'?...~....N....'.:...Z..'.: ....... Phone No..4...7.~..-~....9..9...5. 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 number or description according to deed, and show street names and indicate whether interior or comer lot. D.~¢oi/ir.- ~]~/ STATE OF NEW YORK, COUNTY ...... L ......... ~' ....................................................................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing oppli~t~l~-r above named. He is the ................................................................................................ '~, ....................................................... (~ntmctor, ~t, co~omte officer, ~c.) of said owner'or owners, and is duly'authorized to pe~orm or hove perfo~ the said work a~ to ~ke ~d file this application; that oil statements contained in this applicati~ ore tree to ~e ~t of his k~wledge a~ ~llef; and that the wor~ will ~ perfo~ in the manoer ~t fo~h in the applicati~ fil~ ~ith._ ...................... ~ ~;..~, ~. ~ ......... , 19 ........ ....................................... .................................................. Nota~ Public~ .................... Z ........................... ~o~ (Slgna~re of applicant) ELIZ~B~ ~ g~ILLE ~RY PUBLIq, ~ of gew York ~o. 52-8125~ ~k C0u~ ~erm ~ir~ ~ ~,