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Home My WebLink About6870-zNO. 4 TOWN OF SOUTHOLD Buu.nING DEPARTM~ Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No. Z..805.9. ...... Date ................ .D.e.q...1.~.. ,, 19.~.?. THIS CERTIFIES that the building located at ... To~n. Ha,~.bor. J,an~ ..... Street Map No.. ~ver2nn.. Block No ........... Lot No..~.1 .... So~.R~old...N o¥.. ......... conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ............. .S. ep.t...1{~ 19.73 pursuant to which Building Permit No..$.8~.Q~. '~'",,,~.dated ....... ....... ,., was issued, to the require. Sept. 1973 and conforms of ~,.~m~nts provisions occupancy for which this certificate is of the applicable of the law. The issued is Pr. lW.~.e..o~.e ....................................... ~a~.~ (lwel~!!,g .w,i!;h addition ..... The certificato is issued to . Paul. L....~.il.t.c.h~ll ..... .w~e.r ......................... (owner, lessee or reliant) of the aforesaid building. Suffolk County Department of Health Approval . .N...~: .............................. UNDERWRITERS CERTIFICATE No. p.e.n.d.l..rig .................................... HOUSE NUMBER ...... 1630 ....Street..Tov~ .Harbor. L~ne ........ ~.Q~ttb~d... Building Inspector / TOWN OF SOUTHOI. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT CT'HIS PEP, MIT MUST BE KEPT'ON THE P'EEMISES UNTIL FULL COMPLLq'ION OF THE WORK AUTHORIZED) · ,,._IN'.° 6870 Z Permission is hereby granted to: ..... · fia~l:.--~i.~ e i,~e.~.~ .................. : ........................ ............. ~ ~,n',...~ie..~ J~.~.. 4,,e.. ................................. ................. f~o~zth~'].~t ........................................... to ~, ~..aa.. ad~i.t~o~..~n., ax4Lsi,tn~..~;~ .~ &i~ ................................................................ at premisss Iocat~ci a~ ..... L~t..~O..~..p~,,..a.1...,.~aD..e~...Qve~en ............................................... ................................. lC/ii.-.. ~ own'"~a~b~r ..i'.an~ .............. '~otri;l?.'~t It ........................................... pursuant to application dated ...................... ileDt: .......... :~ ......... , 19.~..., and approved by the Building Inspector. Fee $.15 n.(~ ........... INSTRUCTIONS a. "Th-i;~ii;ati~n ;nus~ be c;~pletely filled in by typewriter o¢ in init and submitted in triplicote to the Building Inspector, with 3 sets of plans, ~ccumte plot plan to scale., Fee according to schedule. b. Plot plan showing location of lot end of buildings on premises, relatiOnship to adjoining premises or public streets areos, and giving a detailed description of Ioyout ofpraperty must be drawn on the diagram wl~c~is~!' ~f this ~pplication. c. The work Covered by this application rney not be commenced before issuonce of Building Permit, d. Upon approval of this epplicatien, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises ovailable for inSpeCtion throughout the work.,; e. No building shell be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occuponcy shall h~ve been granted by the Building Inspector. B ~SiPnt'CATION liSn HERE~ ~e~lnt for the ~srul~nCne of a Building Permi pur~ant to the u' d' g Zone Ord' ance o the Town ot~ Southold, Suffolk ou ty, New o , a d other appl!...c~le Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demohtion, as herein described. The applicant agrees to comply with all applicable laws,.ordinances,, buiJ, ding code, housing code, and regulations, and to admit authorized inspectors ol3 premises and in buildings for neceli~gr~/inspections. State whethe~ner, le~ ~ent, architect; engineer, general contractor, electrician, plumber Or builder. "7 ................. .......... ; ................................................ ................................................... Name of ~......, .~....~.............,.....~.. ,~,.. ......................................................... ~ ............................... If applicant is a corp~ signature of duly aut{lorized 'offlcer. .............................. ~'" i~.!' ?' .......................................... (Name ,ond~fi~ of corporate officer) · . i ~, Budder's L~ce~lr~ No .................... Plumber's Licens, No ....... Electrician's License No ............................................. Other Tmde's License No ............................................... . jll~' ~' l. Location of land on which p_r~d work ~iil be, done. Mj~p No.: .~......,I,,.~..~...~.,...r .......... lot No..~.......; Street end ri.tuber .......... .'~...~f.~..../~.~..e. ......... .~..~.~ ............................................ 2. State existing use ond occuponcy of! e~?~s o?Li Municlpolity: r ntended use ond occuponcy of prppo~d construction. a.Exisiting use ond occupency ......... ~.b~¢.~,~*. ............................................. ~a: ...................................' ............... ,. .. o., =u=., ......... ........................ 3. Nature of work (check which applicable): New Building .................. Addition ......~.. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ~. ................................................... 4. Estimated Cost ..... ...~...~..~..~...~ ............................ ~....Fee ~/~-~-'~ (Description) (to be paid on filing this application) 5. If dwelling, unitS."x..'~d~.....i ......... Number of dwelling units on each floor ............................ number of dwelling If garage, nUmber of cars ............... .~.~-:'..J~/:~ ............. ~ ....................................................................................... 6. If business, commercial or mixed occupancy, sp~ 4qature extent~o~ ejTch type of use ..... ~..~... ........... 7. Dimension~sting structures, if any: Front ...... ~J{..:. .........Rear ..... ~...~... ............... Depth ..~ ...... Height ....m~w ............... Number of Stories ......... ~.¢ ..................................................................................................... Dimensions ,o~,z~ame structure with alterations ~r additions: Front ....... .~'..~. .................... 'Rear.....'~.../..; .............. Depth ....~...~.. ............. ..... Height ......... ~......~ ........ Number· of Stories ........... ~.. .................. ' ..... 8. Dimensions o.f_~ntire new construction: Front ....... .~-.~'. .................. Rear ........ ...'~-..~.. ......... '. Depth ....~i ......... Height .................... ~ Numb,es of Stories .............. / ................................. .~ ................................................................ .~.? ~9:.` $,ze of lot: Front ........~'~.., ......................................... Rear ..... ,....~...~... ............... ~ ...... Del)th ........ ~.~ ....... 10. 'Date of Purchase ...... .(~...~.[...'~...~.~.. ................ Name of Former Owner .~1~..~....~....~..{~....~ ! I. Zone or use district in which premises are situated .................................................................................................... ....:.~. 12. Does pr°posed construction violate any zoning law, ordinance or regulation: ....... ~ ........................................ ....... frqm. r mlses: ) Yes No t3. ~ill lot ~r~rad~ ......... ~ill excess fi~ ~ remov~ - ..... of ~ner of pmmi~ ..' ~x A~ Na~ of Arch~t .............................................................. A~r~ ................................ ~e No ....................... Name of C~t~tor ............................................................ A~m~ ................................ P~e No ....................... PLOT DIAG~ ~ate clearly and d~stinctly all buildings, whether existing or pr~, a~ indicate all ~t~k dimensi~s fro~ p~e~. lines. Give st~t and bilk number or description acca~i~ to d~, end ~ str~ names and indi~te~ ~ether~ interior or co~ ~ot. n STATE=OF I~1~.0.1~(.~/.~,~ liS.S COUNTY Of ,~/~~1 ............................................................ , .......................... ,.., ........ being d~ly!sworn, deposes and says that he is the applicant (Name of individual signin~ cOntracf) above name. He is the ................................................................................................................................................................................. · (Contrac. tor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make end file this application; that all statements~cor~ained in fhis application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. I~otary u b h c~;~.tlr~,~l~.~. ~ll~.~t..~=ou nty ..... (~..7.; ...................... ;..:.:...,/...;-...~.7..........x.. ......................... (Signature of applicant) JUDITH T. ~,OKEN Notary Public State of New Y~ No. 52.0344963 Suffolk Co~sn~ Commission ExplreJ March 30,