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Home My WebLink About6899-zFOBM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, iN. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . Bayl~e. rry.& .Bridge. ~-~.. Street Map No. 1ia..s.s.~. ~.t... Block No..I~.-..s.u~.....Lot No..~.2.~. .....CU.t.e. h0~...e... N.o.~.: ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. .0C.t... 2.., 19.73. pursuant to which Building Permit No..6899Z. dated ............ ~C.t...2 .... , 1973.., 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 .Private..one. f. amlly..Ow.e.ll/ng .... w$~h .e,~..~ddkt. lo~ ................ The certificate is issued to .Loulae. 'J....PfeJ.'l .... 0~rner ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~ ;.R.. ............................... UINDERWRITERS CERTIFICATE No. l~e~d~P.g .................................... HOUSE NUMBER .... ] 0~.0. .....Street .... .]~y]!e.r.~'y..L.~ ........................ 70~ Bridge ~a ........... l~'~i~i' i~p;~t;;/ ........ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO£D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT~IL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6899 Z Date .....................t~.~.t, fj]~.~.l~.....J~ ........... , 19-.23 Permission is hereby granted to: ..~..o.~.~?.....r. £..e..t...z. ........................................... ......... .g.~.~.~t.~.g~ ............................................. Build an addition & n~._~e alteration on e~:stin.6 dwe]lin$. ['0 ..................................................... ~- ............................................... ; ........................................... at prem~s locoted ot ...... ~.o.~...~.~. ..... ~.-.?.~.....~.~.s...s..a..u.....r...o..t.~ ............................................... ......................... .r...a.~r~..~..~....s.~..t..a..~.e....~..q.e. ......... .~.a.,.s.~......p.~... ....... .c..u.~,c.h.o.~ .................... pursuant to application dated ....................... .?.~...~. ....... ~ ......... , 19..~.~.., and approved by the Building Inspector. Fee $..~!~.,t...Og.. ......... Building Inspector Examined ....... ..~.....~... ,?.., . .0~.. ............ , Approved ........................................ , TOWN OF SOUTHOLD ~,._, BUILDING DEPARTMENT ~-4' ~ ~/-~-~( TOWN CLERK'S OFFICE ~ ~,~., ~'t</~', o, SOUTHOLD, N. Y. - Application No. ~..~..2. ................ Disapproved a/c ............................................................. ~ ...... ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate to the Buil~g~ Inspector, with 3 sete of pla.ns, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streetcar areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. Q, c. The work covered by this application may not be commenced before issuance of Building Permit. _'~ ,1~ d. Upon approval of this application, the Build ng nspector w issue a Building Pa}mit to the applicant. Such perrY', ' shall be kept on the premises available for inspection throughout 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 pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk .County, New York, and other app cable Laws, Ordinances or Regulations, for the construction of buildings, additions or a.terations, 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. (Signature of a~plicant, or name, if a corpora~i;~ $~,~rh~r~y...~....~'.J~.Ee L$ Cutc,.h..o.E~...e' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................. .A..~.e...~.~. o£ owner Name of owner of pram ses ~...o.~;[..$..e..W.: ~...~..~.~l If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. /V~ap No.: ...... .~..e..~.~...b....N.~..s...s.....~..°..~.TJL~t No. 12~ Street and Number .~'~.~,~.~r. ~P.~,~. ~ .~.~.~,~Lg{~ ~{~t~ ~.g~g.~ Poi~.$ Cutchogue Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwelling b. Intended use and occupancy same with an addition & alteration 3.° Nature of work (check which applic&ble): New Building .................. Addition ....~ .........Alteration Repair .................. Removal .................. Demolition .................... Other Work ..............~ ..................................... (Description) 4. Estimated Cost .......................... 1.,2.00..~,e ................. Fee li~o00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... .o...~...e. .......... 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 ...1.?:.. ................. Height Number of Stories one 9. Size of lot: Front ........................................................ Rear ................................ : ......... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ "A" dist 1 I. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~Q .............................................. 13. Will lot be regraded ....... ~.o. ................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..,~D.~l~e..~.~'.~, .................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...... .A.....~.:..~..~...e..J:...]:. ................................ Address ..O~..~.c...h..o..~.~..e.. ......... Phone 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~ORI~,, t, ~ ~ COUNTY OF ....... I~..~... ~ .o...3:~... ........ ~'~-~ .................... ~l~.~.~.~,~.f.e~,3,, ...................................................... being duly sworn, deposes ond says that he is the applicant (Name of individual signing controcO above nomed. He is the ............................ Ag~g.~....o.f....o..~g.~.T....~...~..~..Z.~..e.?.. .......................................................................................... (Contractor, ogent, corporate officer, etc.) of soid owner or owners, ond is duly authorized to perform or hove performed the said work ond to make ond file this application; that oil statements contoined in this application ore true to the best of his knowledge ond belief; and that the work will be performed in the monner set forth in the opplicotion filed therewith. Sworn to before me this ..................... of ............ ............... , , (Signbture of applicant)