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Home My WebLink About10647-z FORM NO.4 TOWN OF SOUTHOlD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z13813 Date. . . . . . .~~:P~.~n:?~:r'. } . . . . . . . . . . . ., I <t>!. . No. ................. THIS CERTIFIES that the bUIlding. . . . . ~ C?~.e.~E!?OL';Y:'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property .., 79.3.Q . . . . . . . . . . . . . . . . .~<?~~?:'Z'~~YJ. .A:v:~... . . . . . . . . f??~:t?<:~~. . . . House No. Street. Hamlet County Tax Map No. 1000 Section .,...79.... .Block .........~.... .Lot . . . . . . :"~&;}? . .. . Subdivisian. .. ... .. .4.... ... . .. . ... .... .. .Filed Map Na. .. .~... .Lot No. .....~....... eonforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . J1qY. :1. . . . . . . . . . . , 19 .2;Q pursuant to which Building Permit No. ..... .1.q?~7.~ . . . . . . . . dated. .,. )"jEjY. ~. .. .,. . .. . .. .... ..19 !3.q , was issued, and canforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ... . . . . . . . . . . .AcC~p.EiQ:rY. .Eit9;L'.8.[';E;). p:u.U\i;L;q[';" . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . .. . .. . . . . . The certificate is issued to ............. .WJ::j:,:4~. ~AI}Q;3p. . . . . . . . . . . . . . . . . .. . .. . . . . . . . (owner~ of the afaresaid building. Suffolk County Department of Health Approval .............. .JJ!.Ii. . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . .IJ!.Ii. . . . . . . . . . . . . . . . . .. . . .. . Y?~ ~~ . .... ........... ... . ........ .... .... ,.. Building Inspector Rev. 1/81 . )i 1. ",it FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N'.' 10647 Z Date ~y......I....,............................., 19f8:. Permission is hereby granted to: ......{ut/!Uf.l,.{...,..:J;/(QS,z.. ,.. .. ..". ----- .~~ .....~t:O...SfX/MR.i//.li:lki.A~.., . '" .... .CtT#Ct...t.2.:':::.U.,.1,..........., ......, ,.. . ta ...<!..(I.~..,.7.:.,:l.(,,<c.r....~Cc.Af::>s:-.o,.(.7......a/Q~.'7ifi::.....f5D''I'..:-.,6o'r4........ ., ................................................................................................................................................................ at premises located at 7J..5().....S-<9<:?/I"I.PWl!'a)..4,;;:..,.......................................,..".., ................................................................................ ...,...,..................~T+h-t!.:;:P._.it..~... ......................................................................... ...... ................................................................................ pursuant to application dated .f..(~r....."'................................, If.ZJ.., and approved by the Building Inspector. ~ Fee $./0..::-::;;;...... " , > ~ fORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMSNT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 EXamine~y(Jcr..I......, 19m Application NO./06. ~7. . . . . . . APproveA1./l~ . . t. . . . . ., 1918. ,Permit No. lOr:. ti:1.l- D"."=.",, ... ..-'..............J;/;;........ . ..................................~\... , . ~ ... ... ..;.'......... ..... .. (Bu' ing Inspector) APPLICATION FOR BUilDING PERMIT Date...~r//....7f(.) INSTRUCTIONS a. This application must be completely filled in by typewriter or 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 ar pubJie streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspeetor will isSue a Building Permit to the applicant. Sueh permit shall be kept on the premises available far inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpase whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE ta the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance af the Town of Sauthald, Suffolk Caunty, New York, and ather applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations"or for remaval or demolition, as herein described. The applicant agrees to-'comply with all applicable laws, ordin\lnces, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for neces~ct~ons. ~ ) ~ .11:~.4/. ...... (Signature af app@,mt, o.r nI!!n.e, if corporation) ~ W;lUam .ko,~z 7930 50undview Ave. . . . . . . . . . . South old, NY 11971 . . . . . . . . . . . . . . . IVHUJ..Ulg d.UUICi)1!Io Ul UPP.llcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9)~N::f,ji. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nameofownerofpremises ......... .W~;L.1.j,I;I.IIl. .e.r+<J.J?Ay,:t.J.'-.a .Jal'P.sz................................. (as on the tax rail or latest deed) If applicant is a eorporation, signature af duly authorized afficer. .. ,... ,... .......,. .............., ,...,. ...... (Name and title of corporate officer) /.' JT1,-V y\ t -, Builder's License No. ........):{ .f4.. . . . . . . . . . . . . Plumber's License No. ....... .~(~. . . . . . . . . . . . . Electrician's License No. ..... N./A. . . . . . . . . . . . . Other Trade's Lieense No. .... N./.!!. . . . . . . . . . . . . I. Location of land on which proposed work will be done. ................................................. 7930 Soundview Ave. Southold . . . . . . . . . . . . . . . . . . . . . . . . . . ,. . . . . . . . . . . . . . . . . . . . . . . . . , .. . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . " House Number Street Hamlet County Tax Map No. 1000 Sectian . ~ ??~. . . . . . . . . . . .. Block .......9.... . . . . .. Lot. ~2 . /13 . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . .. . .. . .. .. .. . Lot.. . .. .. . .. . .. .. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: . . 1 fuily dwelling a. EXlstmg use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and oecupancy ............ !3-.c.q... )JJl.1;J..q.~p..g... L .~qQ;L. .Ii!).i!!i. J........... .... ... .... ~ , <~ , , I 3. Nature of work (check whicl1 applicable): New Building. . .~'.. . . Addition. . . . . . . . .. Alteration .......... Repair .............. Remdval . . . . . , . . : . . . .. Dem'olition .............. Other Work. . . . . . . . . . . . . . . , 'e(:' (Description) 4. Estimated Cost . q~.e. .J!:~~.d.:r:~I;'l. !~.f~;V. . .$+~P..q9. . . . . . Fee. . \~o.t? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , (to be paid on filing this application) , 5. If dwelling, number of dwelling flnits . . . . . . .~/I{I.. . . .. Number of dwelling units on each floor. . . . . ." . . . . . . . . . If garage, number of cars .....:...... )il/ fA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify ~tp{e an~lextent of each ty1e ?if use . . . . N/.A. . . . . . . . . . . . . 7 D' . f" t t "f F t 2 10 R 42' 0 I D th 33 ' . ll11enSlOnS 0 eXlstmg s ruc ures, I any: ron ............... ear.............. ep .. . . . . . . . . . . . Height .. ;19.'. . . . . . . . . . NUl1\ber of Stories. . , . .~ . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front ..........,...... Rear , . . . . . . . . . . . . . . . . . Depth. . . . . . , . . . . . . . . . ' . . .:. . Height. . . . . . . . . . . . . . . . . . . . . . Number of Stories. . , . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new constJ'uction: Front... 13. .ft....... Rear. 8. .ft......... Depth8. ..ft............ Height ...8. .ft.. . . . . . Number of Stories. . . . . .one. . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 9. Size of lot: Front. . .25.00.0 .;Sq. .ft. . . . .16earf.t, , . . . . . ~eo .ft. . . . .. Depth .. .250...33. :f.t . . . . . . . . 10. Date of Purchase ... ,8,,:,;1..2-:7.,7. . . . . . . . . . . . . . . . . Name of Former Owner Linj eb. .Oont... . . . . . . . . . . . . . . II. Zone or use district in which premises are situated. .f:!C!1.?~p..o),Q.. y,i),:J.aga . . r.s.i.den.t.al. . . .. . . .. . .. . ...... 12. Does proposed construction viojate any zoning law, ordinance or regulation: ..... .~q. . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded ........ .r+1 a . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes X No 14. Name of Owner of premises II r~~asm Ja;"1Z A ~ddress .. . . . . . . . . . . . . . . . . . Phone No. .. .795.-:229.2 . . oun vew 'Ie. Name of Architect. . . . . . . foothold, NY 11971 ~ddress .. . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . '. . . . . . . . . : . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all, buildings, whether existing or proposed, and, indicate all set-back dimensions fram property lines. Give street a~ b}.o.c~nu~er o~escripgon accjrdinJ!jp deed, an~hm+tteet names and indicate whether interior or corner lot. ~IJI". tlZ"c """'. At"! 4'..// tI../ /"~C,, i!'C ..11....'. cr9. t. 0 I; t.() +-t ~ -'.;:/ - /.1' J, tI.adrl J&.......,A 1I.;w At,"t. . , ~w... .;#1' ? 9 (f () . <.~~- /.M P+ >, - " ,)-f:~ Oct vl 0 "'~ H., i P'~L "'~..-..r ' -y I' ~- , ,- '- , ~ - ' .' .e:_:- ,,~, . ~ --'" 4~ , r;;r/i' M.' -t: "11iJ ....0,<:", ~ ~ Z' ~(\ ~ fJ ,;ot/<JK- 76 /-). \)-. ~ - ..,.' 'tc;Clv,o,oI/d IU \K / cfO ~-I-. ,. '?ie/ J''IIG./J - 't:ccrc.u.~ 8f~g'X,f'~ (It/aCl) ('QA.fv"/.",e-k"'",,J STATE OF NEW , S.S COUNTY OF . Wil lam N. Jat-osz b' dId d th th . th r t . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . .. emg U y sworn, eposes an says a e IS e app Ican (Name of individual signing contract) above named. : He is the.. . .. . . .. . . .. . . .. . . . .: . . . . .q'1~.e.r/1?1AJ..d, E1:r. . . . .. . . . . . . . .. . .. . .. .. . . . . .. . . . . . . .. . .. . . . .. . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d\!ly authorized to perform or have perfonned 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 will be perfonned in the manner set forth in the application filed therewith. Sworn to before me this ' ............ /.~...: .dayqf...... .4t0fr....., 19..f:'?J .~~i~r NotaryPubhc,. .... ..,...;.1.< .....,. ..~ty '1'1-I 't TERRV \ JUDI '.!to! Vi 'tbtk bl'c State 0 e Notary PU I , 1& k' CciuntYqJ . : . . . . . . . .... .. .. f 5~' M4963 Su II I .. ' ~~nI\..~n Eil!lte~ Matctl:30119. .