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Home My WebLink About5410-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~iI1~6 ...... Date ...........D. eo.. ,20 ........ , 19.71. THIS CERTIFIES that the building located at ... i~a~er~ew' I~ .......... Street Map No ....~[~ ....... Block No..~ ..... Lot No...~sr~ ....$eutholc[. · t~.¥, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............,Tui,y .... 16 19. ~1- pursuant to which Building Permit No. dated ..........Ju.l.y... ~i6.., 19..71, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P~;vat;~ 'one' 'fmat'~'y' d~re~.lSng ........................................ The certificate is issued to . ,Tames. Cast,~aa ....... ~at, mer ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Dee--1 ?f · 19~t$ ..1:~ .R,-¥1!la- .... House ~ 120~ , . , ~ ,~,~ ·.... Building Inspectot FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5410 Z Ode .......................... Permission is hereby granted to: ..... O..w..~m~.~h..&..~....~. ............ ~u.~he]:~ .............................. ~ .................. to ,. ~.t~ ..~ew. · ~e · · .~,m~t.y.. ~e~ '~. -~ ....................... , .......................................................... at premises located at ......... ~,~.~..[~/a.~e.l~....~..,~,~ 'D~,'[.-~ ..~/[.~,~e]-~... ............................................. ~eu.t, he~ ....... *~.,':~ ~ .................... :~ ......................................................... pursuan$ to application dated .............................. .~-~ .......... ~.,..., 19..~"J., and approved by the Building Inspector. ~ee $...~..O..~.C..P. ......... ........ f*4~--':~z'':'': ............ +'"'"'¥' ......... '1 .................. ' ' Building Inspector TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE . ,m ned ........... . ................ ^~,ro,~ ............................. , I~...~.!... Porm~t No. ~5-~/O 2.--- DiMl~ro~l a/¢ .................................................... ....................................... : ......... .Z. ....................... APPLIC*T,ON BUILD'NG ....................... INSTRUCTIONS o. This opplicotion must be completely filled in by typewriter or in ink und submitted in dupllcote to the Building~ Inspector. b. Plot plan showing location of lot and of buildings on premises, mlat onship to adjo n ng premises or public streets or~ areas, and giving a detailed description of layout of properts/must be drawn on the diagram which is part of ~hle appllcatlon.'~ 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 Perm t to the applicant. Such permit shall be kepfon the premises available for inspection throughout the prOgress of the work. e. No building shall be occupied or used in whole or in port for any purpose whatever UntiFa Certificate of C~cupancy/~ shall have been granted by the Building Inspect~o~r. APPLICATION IS HEREBY MADE to the Build ng Department for the issuance of a Building Permit punmant to the Build!ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.awl, etd narmes or TR~gulati,o. ns, .for the co. nstructi.on of. bu!!dings/additions or alterations, or for removal o! demolition, al heroin described. e applmant agrees r° c°mply with °" app'icable laws~:ing :Toe__and regulations. ~ ( g ure of applicon, or nome, if a ~oq)oratlofl) ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genercl contractor, electrician, plumber or builder. If appl~l~/~orpor,,/~/e~e~o~,f~(/~auth~orlzed o~flcer. (Name and title 'of corporate officer~ -~ ~;~ i 1. Location of land on which p~ooe~ed work will be done. Map No.: ............ .~, ............... .~ ........ Lot No.: ....................... Street and Number .............. .., ......... ' '"'- ~:i'~i~'~' .............. 2. State existing use a.nd occupancy of ~/~,,,~.es and intended use and occupancy of proposed constriction: a. Existing use and occupancy ...... ~.~.~ ............................... b. Intended use and occupan? ~ .................................... 3. Nature of work (check which applicable): New Building ~..~.-..... .... Addition .................. Alteration ............. Repair ........... ~.. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated Cost ............................................................ Fee ...,.e.~¢........... ....................................... ........................... (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 existing structures, if 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 ..;...~..~-~-...../.. ............... Rear ....~...~.. ............... Depth .~..~.. ............... Height .................... Number of Stories .......................................................... -~ ........................................................... 9. Size o1: lot: Front ....z~..~..O.....O. .......... Rear ....~.....~..?.. .................. Depth .....~...~.. ................ 10. Date of Purchase 7/../.~...7~. ....... : .......................... Nome of Former Owner ....................................................... 11. Zone or use district in whic' / h premises are situated ........ ~..~-~ ...................... :.~ ....................................................... 12. Does proposed construction _violate any zoning law, ordinance or regulation? ~...~.. ..................................................... 13. Name of Owner of prem~se/~p~f~~~Address~T~'~?~-~~Ph~ne`~ No ..................... // ~ Name of Architect ~~......~--......~ .............. Address ............................................ Phone No ..................... Nome of Contract~,..~~...Address ............................................ Phone No .................... PLOT DIAGRAM locate clearly and distinctly oll buildings, whether existing or propOSed, and indicate all set-back dimensions from property lines. Give street and block number ~' description_according to deed, and show street names and indicate whether interior or corner Jot. I / STATE OF NEW~'.OR~,, ~ Z 1S.S ....................... ~~ ........ ,being dUly sworn, deP°,,~ and says that he is the applicant (Contractor, agent` corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hava peri'armed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth i'n 'th& application filed therewith. Swam to I~foje me this ~. ~ .,~ / No. 52-0344963 -$uffoU~ County. s ~ Commis~iop ExpJre~ Mar¢~ 30, S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date TO WHOM IT MAY CONCERN: ~he sewage disposal facilities for a str~cture located // (Give deed location) Y /~ have been inspected by this department and found to be satisfactory. DEC 1 7 1971