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Home My WebLink About6199-z~ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .. P..vt.. R.°.a.d....F. ,.I....~.~.~. ..... Street Map No..F. :.!.,..~..~.t~..t;~ck No. ~$ .Lot No. .10 & ~ ~ Pishez'n Islallcl conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... .0~..t 2.~...., 19.7.2.. pursuant to which Building Permit No.. dated ........... .0.~..t...2.6...., 19.7..2., 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. lci.v, aSe..o.l~e, f.a~.:[ly..d..w.e~.l.~g. W~.t.h. ~ .a..d: ..5.i..t.i.o.~. ................ The certificate is issued to . .BO~. ~;01~..G.....TRe. la~.:~.$ ....... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~.,..H., ............................... UNDERWRITERS CERTIFICATE No.~. .~.6.8.'1.8.2. .... .J..u~..e..2.8....~.9.~. ............... HOUSE NUMBER ....~.0.~e ...... Street .......................................... Building Inspector FOI~.M NO. ~ 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) 6199 Z Date ........................... ~....~& ............ 19~1~... Permission is hereby granted to: ........... l~mlmrm...~.m.lm~S ................................... at premises located at ~l~l~'i~;j.'"]ill~l'"~0"~"~*l ....... '~l~'j]lle~"~'~.ll~4'"~tN .......... ........................ P~r~..~,em&..,,..{~..f~o~..l~.) ............ ~'~ii/~ii'"Z'i].~"~ii[ ........................... pursuant to application dated ........................... 0~'""2~ ........... , 1~....., and approved by the Building Insp~tor. Fee ~'~0~ ............. lvOlt~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ Iw ........ ~erm t No ...................... Disapproved a/c~ ....... .~L~......~-...-~......~ APPLICATION FOR BUILDING PERMIT ................... .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work coYered 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 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 pul'pose 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 pursuant to the Building Zone Ordinance of the 'J"own of Sou~hold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. /~ (Signature o~pplicant, or name, if a corporation) .... (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Burton G. Tremaine Nome of owner of premises If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~_ 1. Location of land on v~hich proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .......................................................................................o~.. .............. '~J" .............................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Summer cottage a. Existing use and occupancy .......................... ~. ............ ~ .......................................................................................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ....... .~ ........... Alteration ......... .~ ........ Repair .................... Removal .................... Demolition ............ ),~-~ther Work (Describe) .................... 4. Estimated Cost ....... ~.~,:.~0~..D.Q ................................. Fee .~[1~...~,~4~1~'~ .......................... (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: ront....6.(~ ...................Rear ........ 6D. ............... Depth .......... 3..~ .............. Height .......1..~...~. ............... Number of Stories ........ ..1.~.. ......... Dimensions of same structure with alterations or additions: Front Depth ....... 3.~..". ................ Height ............ .1..0..: ............ Number of Stories ........ ..1.~ ................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 4 ' 708' 382' 9. Size of lot: Front ........ ~.~. ................ Rear ............................ Depth ............................ Ed and Iiz Dane 10. Date of Purchase ...... .0...c...t..°..b...e..~....!~..6..2. ..................... Name of Former Owner ................................. : ...................... 11. Zone or use district in which premises are < tu,~te4 qe~de-ntial East ~nd 12. Does proposed construction violate any zoning law, ordinance or regulation? NO 13. Name of Owner of premises~.~G.....T~P,~D,~,,q:~ ......... Address ~'P]"lrl~-n. Corm/ · .- ......... : ................................... · NO ..................... Name of Architect. (, :::SLklk;.qflr. .......... Address J.i.$.~l~.~...~.$.:k~, N -~hone NO ..................... Name of Contractor.: ..... ;.~LL~i,2LR~.~. ......................... Address· ~'¢*~'h''~,., ,-'-. T .~_ ~.._-1 ~, ,~ ': . '*~, .... ~ ........ ~. ............. , ........ .~none 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. As per attached survey map COUN~ OF ................. · ' ' ...... · ....... beln~ du¥ sworn, deposes ond s~ that he is th~ opphc~nt ~ ' (C~tractor~g~nt, corporate officer, etc) of said owner or owners, a~d ~s duly authorized to ~r~orm or have performed the said work ~nd to m~ke ~nd this upplicafion; that all statements contained in this apD~icat;on are true to the ~st of h;s ~owled~e ~nd be a~d that the work will be performed in the ~nner set fo~h in the applicatign filed therewith. // ~ ' Sworn to~e me this~~ ~~~p~ -"1 i