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Home My WebLink About1613-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...E/S....P.~te...W~od...Rc~a~, .................... Street Map No...~.~ ........... Block No...~ .......... Lot No. ~ ....... g.e..e...tc.~....~...e..~..~..~.......C...~..~.~..~..o.[.~.e conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... N~V. er.b~l~..~[~ 19..6] . pursuant to which Building Permit No...1~3~.. dated ............................... NQlz'~e~,...l_619._61, was issued, and conforms to all of the requirements of the applicable prov,sions of the law. The occupancy for which this certificate is issued is ........ pr.i~a~e., o~.a..~'~3.¥...d~e~ing ................................................................................................ The certificate is issued to ...]~F~.~r..~:..J]~.OltJ. a ..[~1~. ................ ~wlle~'~ .................................... (owner, lessee or tenant) of the aforesaid bulldzng H.D. approva~ Nov.~ 196~ by R.Vil]a Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1613, z Dote ............ Xo~r~be~'.....16 ................. 19..63.. Permission is hereby granted to: H~.r.~...&..G~orl&.~v .................................... 88-Ot~..,~l..st~ ................................................ Bel].r~se..26s...l~,.~, ......................................... to ........ ~t~i.~.d...nev..Gne..gG~&],~..d~e&.t.~t~ .............................................................................. at premises located at ...I~ZI~..I~OOCl,..R~ ........................................................................................ ......................................... Cuteh~K~e ................................................................................................. pursuant to opplica$[on dated ...................... ~DV~I]~-.-..~.6 ............. ]9~...., ond approved by the Building Inspector Fee $.~l, Oe.O(~ .......... Building Inspector / FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. YJ. Exam,ned ....... ........ · Approved ........................................ , 19 ........ Permit No ................................ Disapproved a/c ~ f_ ~._.~...:... Application No...../..~..../....~... .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on p rem~ses, relati~)nship'to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be dr~wn 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 progress of the work. e. No building shall be occ~:fl~J~l~r used in whole, or in po rt for. any purpose wh(~tever un~il a.Certificate of Occupancy shall hove been granted by the Building Insoector. APPLICATION IS HEREBY MADE to the Building Deaartment for rne issuance of a Buildi:ng Permit ptJrsuant 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, (~r~ for removol or demolitior~, as here, in described. The applicant agrees to comply with all applicable laws, ordinances or~d reg,/lotions: / (Sign'at[~re 0Le~ti~ant,,6r name,'if a c6rporatian) ...... ......... (Address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... O~ ............................................................................................................................................................................ Nome of owner of premises ....~..~...~.?.~.....~.~....~..~...~.....~..~.P..~.~...~...~? ................................................................................ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...............~..L....: ......... ::'. .......... ~J~J ............ ~.~.[*...~.~.~ ......... ~ ....................................... Municipali~ 2. State existing use and occupancy of premises and intended use and ~cupancy of proposed construction: a. Existing use and occupancy ...~ .......................................... , ........... b. Intended use and occupancy [~.~.~ .~g~.~ ..... . .... 3. Nature of work (check which applicable): New Building ........ ][ ...... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition.: .................. Other Work (Describe) ........................ 4. Estimated Cost ...$....~...~..~.~ .................................... Fee ..../..~ ...... ' ........................................................................... (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 ...........]L~ ....... .. 6. If business, commercial or mixed occupancy, specify natureand 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...2,8...! .................... Rear ...~,8 .................... Depth .......2..4...1. ................ Height 20! Number of Stories...].~'. ......................... 9. Size of lot: Front ....l.Q0...]..~. ............. Rear ....~..0..0..,..0..0. .......... Depth ...1...8..4..*..0..0. ....................... 10. Date of Purchase ........................................................ Name of Former Owner ~-eo, FI. eat l~,etate ! 1. Zone or use district in which premises are situated ................. . 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~'.1~. ............................................ 13. Name of Owner of premises .~I'~'.,...J~h&IR ...... : .......... Address .8.~..'.0.~...2..~.].....~.$. ............. Phone No.F..~..'.....7..-...4..8...7.? Name of Architect ...................................................... Address: .................. : ........................ Phone No ..................... Name of Contractor ......... 0B~D,~:F. ............................... Address ............................................ 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. Begi~nin~ at a point on the easterly side of Pinewood Rd. N.35~43~50" W. 300.54 feet from the notherly line off South Cross thwnoe along the easterly line of ~ine- wood Rd.N,35~43'50" ~est 100.18 to land of Carl ~nk;thenoe along said land of Carl LenkN.5?'4~'00" E.184.00 feet;thence along other land of the party of the first part.two courses as follows:(1) S.3~t8'00w E 100.00 feet;thence 3. 57'42! 00" W. 178.00 feet to the point of beginning. Interior Lot STATE OF NEW Y_OR_K., ) COUNTY OF ...... ~..'~. ~..0..],~.....) S.S. ....................... ...~.....~..~....F..?....~.._h~...~...;......:....: ............ ................ being duly sworn, deposes and soys that he is the applicant (Nome of individual signing application) above named. He is the Owner (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 will be performed in the manner set f~rth in tHe'application,~filed therewith. Sworn to before me this /Y / // / /~ tary Pub of New York . ............... Notory Pub' c~..t~.~..~o~t~1`'~" ~u, z~o (Si~ture o¢'opPii~ont) S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ~,~ ~/~/~.~ ...... Building Permit No. !/~/ ~ ~--- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ' (Give deed location) - f - have been inspected by this Department and found to be satisfactory. District Engineer