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Home My WebLink About9936-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z9693 Date September 26 19.7.9. THIS CERTIFIES that the building ................................................ 645 Richmond Road East Southold Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ...... !.3.5...Block .... .3. ......... Lot ...... 5. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...S.e.p.t.e~..e.r. ?. ...... ~97.e.. pursuant to which Building Permit No .... .9.9..3.6.Z ............ dated ..... 5.' .ep.t.e.m.b. 9.r..? .......... 19.7.8., was issued, and conforms to an of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .................. 9.~?..~..~..~?., ~:~.z..z.~.n.g. ....................................... The certificate is issued to Henry and Marle.n.e Ooetz ..................... io¥.'e~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N/R UNDERWRITERS CERTIFICATE NO. N/~8576 Building Inspector Rev 4/79 FO]~M NO 2 TOWN OF ~uTHo£D TOWN CLERKfS OFFICE SOUTHOLD, H. Y. BUILDING- PERMIT, COMPLETION OF THE WORK ^UTHORIZED~ N°. 9936 Z Oot~ ~ ~wr , t '~ · Permission is hereby granted to: ..................... 7 at premises located at ....; ..................... Building InSpector. .... pursdant to application doted /,.'~ ....... ; ' ' , t ; . ,: . ' TEL. 7~5-2660 TBWN E]F SDUTHOLD OFFICE OF E~UILDING ~NSPEOTOR TOWN CL£RK'S OFFICE c~OUTHOLD, N. Yo 11971 t~O~.~t~ lq*O. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~proved ............... .~ 19.~P No. .. ermit .................................. ~ Disapproved a/c .................... L..,.; ............................................................... ...................................................................................... ....... ............................. ...... ~ (Bfiildin~ Inspector) Application No....~.....~,~ 4 ............... APPLICATION FOR BUILDING PERMIT Date ......... ............................. ,,9.7.£.... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 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 areas, and giving a detailed description of layout ofproperty must be drawn on the 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 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 applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os 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 ir~ buildings for necessary inspections. (Signature of appliccrn~, or na~J, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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 .................................................................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~f.~ % ' b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Buildin§.. ................. Addition v ~ Alteration Repair .................. Removal Demolition .................... Other Workl /,5/~- (Description) ............. .......................... .......................................................................................... 4. Estimated Cost J (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 ~N ~ 6. If business, commercial or mixed occupancy, specify nature and extent ~f each type of use .......................... 7. D~mens~ons of ex st ng structures, f any Front ...... ~ ................ Rear ................................ Depth .......... ~ ....... Height %~ Number of Stories ~ Dimensions of some structure with alterations or additions: Front ..~.ff.~C~ .................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth'~z.~ ........... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ....... ~.~,.~.~.f ..................................... Rear ...~.::~ ............................. Depth .~ ......~.~.~T.~ ....... 10. Date of P,,rrh~ [~ "~ - ~ ~ klnm~ nf Fnrmer ~wner 1 1. Zone or use district in which premises are situated ....J_~..I ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .~fl ................................................. ~fl~lC~ j(~ II ed fr 13. Will lot be regraded . ........................... Will excess fi be~emov om premises: ( ) Yes .~ No / ~...~.....~ddress 14. N me of Ow. r of ............. ........ ....... ....................... Name of Architect .................. ~ ........................................ Address .~:....'..~..'.~Phone No. Name of Contractor ............................................................ Address .............................. Phone No ....................... Locate CleGrly and distinctly ali buildings, whether existing or proposed, and indicate oil set-~ck dimensions from prope~y lines. ~ive street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YO~(, C 0 U,~in TY OF ....... ~~ . ~ bmng duly deposes and that he is the opplicam sworn, says (Name or ~na~vidua" ' sJg/~in c°ntr°cf)' g above named. ~e is the ................... ~ ...................................................................................................................................... (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 all statements contained in this application are true to the best of his knowledge and belief; and that the work wiJl be perfor~d Jn the manner set fo~h in the application filed therewith. ....... .................. ,'r ....... ~o1~ Public, . ....... ~~ ........... Coun~ .... ~..t .............. ; ............ ~ ......... ~ ................................ t ~I~: 50'=;"