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Home My WebLink About7696-zNO. 4 TOWN OF SOUTHOLD BIITLDINC DEPARTMENT Town Clerk'8 Office $outhold, N. Y. Certificate Of Occupency No. ~7013 ...... Date ............. ~lalr....6 ...... ,19.7.6 THIS CERTIFIES that the building located at l>g.~ .Road... l~.ast, and ..... Street Map No.F.,I,Est .... Block No .....~ ..... Lot No, l,-.~A... F. lshn~s. I~].anct. conforms substantially to the Application for Building Permit heretofore filed in thi.~ office dated .............J..a.n...~..6., 19.7.5. pursuant to which Building Permit No.. dated ........Jan.. 20 ......, 19. ?.~., was issued, and conforms to all o! the require- ments of the applicable provisions of the law. The occupancy for which thl, certificate is The certificate is issued to Arth~ .~lo~lghtcn .~7~... O~nez ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N....R., ............................... UNDERWRITERS CERTIFICATE No..pen~l~g ................................... HOUSE NUMBER ..... .n .o .n.c. .... Street .......................................... FOBM NO. ~ TOWN O~ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Nb Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7696 Z Date ................................ ~aA.......~0...., 19.~/.~.. Permission is hereby granted to: A,.~..,.~Jl~tL~Xll..(~g~i.~..,...ID.C...~.g...~..~b.~. Hou~ho~ III .... r&~er.s..~s~an4 .......................................... t^Build an addition on existing dwelling at premises located atL~t...L~Ar..~lo~.k...1.....~m~.t..~o~c~ .......................................................... ~ ..... ................................ · W~..l~r~e~...P.~n~ r.....~$s~e r.s.. $ s~,a~¢l ..................................................... pursuant to application dated ............................. J~ ....... .1.6 ........ , 19~.~..., and approved bY the Building Inspector. Fee $.1.5~0 ............ Building Inspecto1 TOWle Oil ~41UTHOI, D IUIIJII~ B4PAITMI~T 'row~ CLll~'l OFFICl Examined ...~. ....... .......................... :.'. ........ . isppp o/c APPUCATION FOR BUILDING PERMIT d ' L ~e '''~'''L~ .................... ,19'''7"~' .... INSTRUCTIONS a. This application must be completely filled in by typewriter ~ in ink and submitted in triplicate to the Building Inspect?., with 3 set~ of pkms, accurate plat pkm to scale. Fee according to schedule. bl PIot'p~an showing Iocotic~ of le~'and of buildings on premix% relat onship to adjo ning premises or public streets os areas, ondgi.~ing a detailed description of layout ofpraperty must be drawn on the diagram which is part of this application. c. Tt~e work covered by this epplicatio~ may not be commenced before issuance of'gi~Jlding Permit. ~ d...U.I~O~ app..reval of this application, t~e BuJld!ng Inspector will issue a Building Permit to the applicant. Such permit shall I~e Kept on me 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. [ .A,P,.PLI_CATIO~I~ .IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the u.a~r~.. ~on,e ur.ainance of the Town of Southold, Suffolk County, New York, and other ppplicab · I.m~, Ordinances or egu~ations, mr the Construction of buildings, additions or alterations, or .for removal or demolition, as herein described. aTc~r~i~p_p, li.c~a_~ a_g~ .~es to.comply with .all app!i.cab, le.! ,.a.ws, ordinances, bull.ding c..ode, housing code, and regulations, and to aumarlzea inspectors on premises ana ir~ DUIlaln~ tar necessary inspections. (Signature of applicant, or name, if a corporation) .... ~.~..~.~.~.~..I...s..1...~..d~ Ne~ York l (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................... :g'e.~ez:a.l,..c.Qp,,t,~.e~c.~ ............................................... ..... ..... .......... .. Name of owner of premises ........... -~..~eh~r..~J~ez~.~...~Z,~ ........................................................................................ If applicant is a corporate,. ~si noir of du],~j~ze~ officer. .................. i"l~ 'c~"r~' '~'l~'c~";:'t'l'~oT c~io~l'm';e(~ot fel~'c 'e';fJ~'"" ,residez~_t Builder's License No...J~g.y..~..~.o..~...~..e~...e.:l:.~,...e..~..'. ....... Plumber's License No ......... /L62 ................................. Electrician's License No ..... 2~ ................................ Other Trode's License No ............................................... 1. kocotion of Iond on which prolx~d work will be done. Map No.: .......... ! ............................ tot No...1,...-....{.~.. ........ Street ond Number ............ ~&r'~;..~.l:~.~. ............................................:. ...., ' ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exislting use and occupan,:3t ....J::~L~......i .................................... b. Intended use and occupancy re.s.,~dence ,,, , ~., .................................................................. t.,'....~O... ~,.~.~.;,? .................................. 3. Nature of work (check which applicable): New Building.. ................. Addition .....~. .......... Alteration ............. ~... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ....$~B,~0~.O~ ................................ Fee ....... ~.~00 .................................................................... (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: Front ....66.~ .................. Rear ...... 6~.! .................... Depth ....3.~x ......... Height .....=l&! ............. Number of Stories ........ '2 ....................................................................................................... Dimensions of same structure with alterations or additions: Front ....~6.e ......................... Rear ........ 66.L, ........ Depth ....~[IJ.~! .................... Height .....26 .................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... 3Gz .................. Rear .....31~t ................. Depth ....~.! ........... Height ....,~6.! ......... Number of Stories ......... 2 .......................................................................................................... 9. Size of lot: Front ...... ~00.~. ........................................ Rear ..... .1.§O~ ............................ Depth ..... 4~.9z .................. 10. Date of Purchase ....a~Xa~m ................................... Name of Former Owner ..~l.],e4'~..~....i~g~-~ ............. 11. Zone or i~se district Jn which premises are situated ........ ~'~.de~.~.~,.1. .................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... :.~ .......................................... 13, Will lot be regraded ...... i~p ................. Will excess fill be removed from premises: ( ) Yes ( ~)n~No Name of Contractor ..,~.......~..q..]~....G..~.~.a. ............................. AddreSS ~.~'.l~..~.~l~.~.~]Phone No...7.~.~m7..;~.~1.[. 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. ~ee STATE OF NEW YORK, lc c COUN~TY. OF? ................................ [~'~ .......... ~-...~O]:lXL..(]a.~...~ ............................................... being duly sw, om ~es and says t~t he is the applicant (Name of i~ividual signing contmc~ above name. He is the ........................ ~~ ....................................................................... ~ ........................................................ (Contractor, agar, co~rote,officer~ etc.) of ~id owner or owners, and is duly aut~rized to perform or h~e performed the said work and to ~ke and file this application; t~t all. s~tem~ts contain~ in this application ~re tree t0 the b~t of his knowledge and belief; and tha~ the work will be perf~ i~ the manner set fo~h in the application fil~ t~r~ith. Swomt~mmeth~ ~ . 19~_,. ....... ~~_.' ~ ......... do, o, ~ ~~ ~- (Signotureof~pplican~ NoiSy public, St~e' Of New yor~ ~o. 52-9509185 Quarried in Suffolk C~n~ Tram ~ ~ch 30, 19~ ?, o~ ,d q I