The URL can be used to link to this page

Home My WebLink About6374-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No..Z.60.~0 ...... Date ............. J.l~y ....29 ...., 19..~1~ THIS CERTIFIES that the building located at ?[1..¥~neen.t .St ........... Street Map No..= ......... Block No. = ....... Lot No.. :K~...(l~:l.~t .. N.o.~, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... -Feb...26..., 19.73. pursuant to which Building Permit No. 637~Z · dated .......... l~®b...~6 .... , 19.7'~', 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 .. Pr~,vat~ .(aec~snor. y). g&~age, with. an .add&tion .................. The certificate is issued to .-~lb®l,t. E., .L&~halll ...... 9wn®l* ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .N.R, ............................. UNDERWRITERS CERTIFICATE No. N,R, ........................................ HOUSE NUMBER ..... 70. ...... Street . ¥~llCe~l~;..St ............................. Building. Inspector / FOB.~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6374 Z Date Feb 26 19 73 Permission is hereby granted to: .. ~l,h c~.~;.. ~I.,...~,~1~ ...................................... ....... .2 .q....Y.~c ~.~...0..~. ...................................... ............... Or. ie~ ...... ~,,~., .................................. ,o ...~.e..~.;.z. ~..?..?....~...~ .o.....e..x..$.~.t...i.~ ..~.?. ~y.~.t...e... ~ ~ ~..e. ...................................................... at premises located at .....~..O........V.~.e...l]..tj....~.~ ..................................................................................... .......................................................... .o.?..~.t..,...~ :~... .......................................................................... pursuant to application dated ...................... ~.R~ ....... ~ .............. , 19...~.~, and approved by the Building Inspector. Building Inspectfr BUILDIN(~ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , I~, , Pe~it Na ................ Disapproved a/c ............ ~ ........ Applicaticm k~. ............~.. ................. APPLICATION FOR BUILDING PERMIT ~,~ Date ~'eb13z'al~' 26 73 INSTRUCTIONS e. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wit 3 sets of plans, 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 streetS or arcas, an giving a detailed description of layout of property must be drawn on diagram which is part of this application. 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 Permit to the applicant. Such permit,shall be kept on the premises available for inspection throughout the work. e. No building shell be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy IhalJ have granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zonal Ordinance of the Town of ~outhold, ~uffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comDly with all applicable ordinancal, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for naca~erv in~pecttoM. (Signature of applicant, or name, if a corporation) ........ .................. (Addr-*,~s of epplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... ................................................................................................................. Name of owner of premises ..,~v],]3~....,~.,...~a.~bzt~ ..................................................................................................... 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. Map No ............... ~ .......................... Lot No ......... ~ .......... Street and Number ...... .~.O......?....:~...c...e.~.t.....~...t..~..e..e...~. ............ .O.~.:{,.q~a...~.t.][.t ............................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......~J/..~..Z.~.&....~.~,~..&~.O.S.,~.CI~'~...]~'I.~_'L~s ............................................... , same with enlarg.~,~ ~.~.~,,7.~,$,~ ~ ~. ................................... b. Intended use and occupancy ...................................... ~ ................. Jc g ....... ~ ~ Nature of work (check which applicable): New Building ....................... Addition .......~ ......... Alteration.,~. ....... Re r ......................... Removal ......................... Demolition ........................ Other Work (Description) ' Fee $ 10,00 4 Estimated Cost ............... ('m be paid on filing this application) umtS ................. Number of dwelling units on each floor ......................................... 5. If dwelling, number of dwelling ' o If garage, number of cars ......... :~a¢o~ ........................................................................................................................... 6. If business, commercial or mixed occuoancy, ~q~cify nature and extent of each type of usa ..................................... 7. Dimensions of existing structures, if any: Front ......... .1~, ....... Rear ........................... Depth ......... 1~. ..................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alteretion~-or additions: Front ....... ~. .............. Rear ....... ~. ............................. Depth ................ ,~ ....................... Height ....... ~_~_R.,~.t. Ol-j: ............. Number of Stories ...... ~ ................................ 8. Dimensions of entire new construction: Front ........................ : Rear ............................ Depth ................................. Height. ......................... .... ... .... ....... . .... Number of Stories ......................................................................................... g. Size of lot: Front .......~.~ ........................ Rear ............ l..-..-. ........................ Depth .......... 12_~{ ................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premisas are situated ....... ."..A..."...~../..s...t. ........................................................................... 12. Does proposad construction violate any zoning law, ordinance or regulation: ............... ~ ........................................ 13. Will lot be regraded ..... _~. ......................... Will excess fill be removed from premisas: [ ] Yes [ ] No 14. Name of Owner of premisas ........ :..,~..~..~p,.~IR ........................~.:~,~P~. ...................................................... (Address) (Phone No.) Name of Architect .............~Afl ............................................................................................................................... (Address) (Phone No.) (Address) (Phone No.) PLOT DIAGRAM LOCate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-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. See filed plan STATE OF NEWYORK. ) COUNTYOF ................ ~...~... ................... ) ~ ..................... ...J~...l~..?...~..~....~..~...~.~ ................................................. being duly sworn, deposes and says that he is the applicant above named. (Name o£ individual signing co.ntrqct} . He is the ................................................. ..01~e~....-....~.~.~,,~.~.~". ....................................................................................................................... (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 ell statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ........................ ..2..~. ........ day of ................ .~..?..~....1~....~...~.~. ............ 19 .~...'~. ....... \/ ..-,.. , {Signature of applicant}