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Home My WebLink About6134-zFOHM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at ..(]oldin./~%lle ............. Street Map No... 1106 ..... Block No..XX ....... Lot No..8'~Of..(~. &. ~. ~0.t.o.f.. ?.....~..u.~.h..o].d conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... SeI)t;....St ...., 19.7;2 pursuant to which Building Permit No....6.1.31~ dated ......... Set).~.* .21, .... , 19..7.2, was issued, and conforms to all of the require- ______--~rn~s of the applicable provisions of the law. The occupancy for which this certificate is is~t~ed is . l~..:].va.~8, garage..(a¢(~sasol'~ ........................................ The certificate is issued to .. ~/lll;tal~. J,..B~iOI~. .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . NI~ ................................ UNDERWRITERS CERTIFICATE No.....NR ....................................... HOUSE NUMBER ..1~.1.~. ........ Street ..... .~..1..d.ip.....La~..~ ........................ Southold ..... ............ Building Inspector l~Ol~ NO. I~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6134 Z ~?is hereby granted to: -- ......~.~p... b...~..~.~.~. ................................... at premises located at ~$ ? & ~ ~ ge Oe~.{l;~l~ O~d~n ~ $o~hol~l N,Y.,. pursuant to application dated ......................... .~....~..~......~. .............. , 19...~......, and approved by the Building Inspector. Fee ~..~. ~ .~. ............. Building In~ector / FfOCfT E L FOH/W NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. £xomined ................................ ~ 19 ........ / ,9 ?z. ........ Approved ................ ~.! ...................... , ........ Pemit No. Disopproved o/c ............................................................................................ APPLICATION FOR BUILDING PERMIT Sep~er 5, 1972 '~ "- Dote ................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspeetor~/itJ~TM 3 sets of plans, accurate plot pJan to scale. Fee according to schedule. b. Plot plan showing location of Jot and of buildings on premises, reiations~hip to ad o n ng prem ses or pub c streets or area'~'~ne giving a detailed description of layout of prbperty must be drawn on diagram which is part of this application. c. The work covered by this application may n~t 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 work. e. No building shall be occupied 6r used in wh61~ or in part for any p~'pose ~hatevi~r until a Certificate of Occupancy shall hav~"ifleer granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buildin~l Zon~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. 68 ~awrence Street ................. .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. W~a~ J. ~a~er Name of owner of premises ................................................................................................................................................ If applicant is a corporate, signature of duly authorized officer. ~, (Name and title of corporate officer) . . 3&06 1. Location of land on which proposed work will be aone. ~ap ~o ...................................................... Eot No.....~..~. Street and Number ...... .~..~,..~.~ ........................................................................................................ Municipality 2. State existing use and occupancy of premiss and intended use and occupancy of propo~d construction: a. Existing use and occupancy .................................................................................................................................... b. Intended use and occupancy 0~ 3. Nature of work (check which applicable): New Building ...... ~ ............... Addition ..................... Alteration ............... Repair ............. ............ Removal ......................... Demolition ........................ Other Work I Description) 4. Estimated Cost ..........$..]:.!.0...0.0. .......................... Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ................. Number of dwelling units on each floor ......................................... 3. 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 ....~,.~.1. .................. Depth ........ ~-~.~ .................... Height........... ........ ........]'2t ......... ......... .... Number of Stories ......................................................................................... 9. Size of lot: Front ....~jl..~all~.b~.mi Rear .......................................... Depth .................................................. 10. Date of Purchase Yebo 1965 Josegh Avet,~ ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinar~ce or regulation: ............................................................ 13. Will lot be regraded -.~-.9 ......................... Will excess fill be removed from premises: [Z] Yes [ ] No 14. Name of Owner of premises ....~J.l.~J..i~. J. ~aue~. ....... .6..8....[~., .t~....e~..~.e....S.~,.~..~..ml...~.~e...~.~A~l¢~. (Address) (Phone No.) Name of Architect ...................................................................... i~'~J~'~'~;i ................................... ii;~'4'~"~'~'.i ............... Name of Contractor ~Q~e~8~r~*Tz'~-~C~-ea-~--1~-e~ge~ttt~"~`]-]~9~J~ ...... ............... (for fo~u~i. ~ork) (AddreSs) PLOT DIAGRAM ~.ocate 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 wheth- er interior or corner lot. STATE OF NEW YOR[(,_ ) COUNTY OF ...~.~..~..~...~..,o...~..'~, ...................... ) ~ ........~....'.~.~.~..~..~..~.~...~f.......~....~.k~..O~.~!~ .......................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ...................... J~.~..~'%.(~.~. .............................................................................................................................................................. {Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his~l~l~j~l~nd belief; and that the work will be performed in the manner set forth in the application filed therewith. NOTARY PUBLIC. State of New York No. 52-6165295 ...................................... d y o ....--..~ ............. '~6m~mh"E'~pi,e~ Ma,ch 30. ~l~'"/~ j .~