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Home My WebLink About1705-zFOR~,! NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~.....1.,~.~.~. ........... Date ......................... ~.~l.~.~r.....~O ........... , 19.6.~... THIS CERTIFIES that the building located at .~r/Cl/~...poo~A~..]~t~...]].~.~/.~[ ................... Street Map No ~ ............. Block No...Z,10~. ............ Lot No. ~ ....... ~,.~l,~e.]..i...~u.~Zu ........................ conforms substant~ally to the Application for Budding Permit heretofore filed ~n this office dated ......................................... ~1,~i.1. ..... ~6., 19.(~2.. pursuant to which Building Permit No..~..~0.~ dated ........................... Ap~.~.~......:l~o., 19 (~4~.., was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate ~s ~ssued is .......... ...Pr.i.V.a.t.~t...(~ma..~.amll~...~welling ...................................................................................... This certificate is issued to ..EOJ:;L~.&..~t~i~I,..,T~.o~.J.~I ............ 0~'~. .................................... (owner, lessee or tenant) of the aforesaid budding. ~.D.approval July 10, 1962 by R. Villa Building Inspector FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ('THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1705 z Date .................... &l~-.-.-l& ......... 196g... Permission ~s hereby granted to' P:~e..&. ~'~e~....A/C. Jo~n.. ~m,~..s.e .... ...... ~..~...8.2. ............................................ to .~..~..~ ~.~mL~..~..~l.~fet.]:.~,t,~ .................................................................................. et premises located at --%l[,~J~-.-]~oll-J[.-~..~r'.~'~'9~ ................................................................... pursuant to apphcation dated ....................... J~JL*,~ ....... ~ .............. lC~..., and approved by the Budding Inspector Fee $.~..00 ........... Budding Inspector ' [ FOI~M ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... ..... Approved ........................................ , 19 ........ Permit No ................................. Application No. ! 70 ~ 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 remlses, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property 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 progress of the work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ................ (Signature of a~plicant, or name, if a corporation) ....... .......................... (Address of applicant)/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of remises .~ ~ ~ '~'~'?.? - ~ ~'? p .......................... ............................. ............................... .................................. if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .~./.. .............................. ~ ...................................................................................................... ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~......4r~.....'f~...v.~......~ ................................................................................. b. Intended use and occupancy ............................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost / ,~/ L) O D 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ....................: ..... Rear .......................... Depth .............................. Height ............................ Number of Stories ....................................... ~L*'~-'7 .................................. >-' ........................ Dimensions of same structure with alterations or additions: Front .....~...?.~.~ ...................Rear ...~ .................. Depth .....~ ............. Height ..........._ .......... ~ Y'~":'"Number of Stories ....;_~ ......................... 8. Dimensions of entire new construction: Front ...... ..-~....o.... ................ Rear .....~...?.. ................. Depth ..'.~...~." ......... Height .....'.~....?...~"- ............... Number of Stories ......... '''./...'..(.../. .............. 9. Size of lot: Front ....~'.?....O..'. ................ Rear /-/)L) / Depth °~'~C) ' 10. Date of Purchase ....././.,...6/....&..: .................................... Name dr.:Former Owner '.fl/-...~.../..~......]~..~ ............ 1 ]. Zone or use district in which premises are situated ....................................................... 12. Does proposed construction violate any Ton nn aw, ord nonce or renu at onP ,- 13. Name of Owner of premises :~...~....'~...7~)L'~ ....... Name of Architect ...~LJ.~iiii...!,~ ............... Address !....~...?.../... !].L.~..~...~... Phone No. /~ n~, ~.~ ~ ~ ~ ~ ................... Name of Contractor .(..<~.....! ........... ~...~.... Address ~...ciT. ~ .).] .~ /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. STATE OF NEW~.,YORK, ) COUNTY OF .~..~..~'...,~...~..~...) S.S. ............ ~.~....(,J...~ ....................... being duly sworn, deposes and soys that he is the applicant (Name of indiv~ua~ signing application) above named. He is the .................................................. ~. ................................................................................. 6~ontractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to oerf.o,r, oa~iqM~ave performed the said work and to make and file this application; that all statements containedAii~ ~_sB~l~l~b~t~r~l~}; true to the best of his knowledge and belief; and that the work will be performed in tlt~tmaic~o~)~fib~,_opplication filed therewith. Sworn to before me th~s , ;-z?~35 .~ ~ /7.., · ,/) >.,o.: ~ .~ 7~, ..... ~..~...,,4~:~....... day of ........ ~ .................. , ~19..~. .... '/9 .~ .~// /~ /~ ~ ~ ........ ' .......................... {/.....~....~.~ ....................... Notary Public, ...~....~/~..:..,~...~County (Sign~re~/O~"~pplicant) 'I NOTE:I .MONUMENT SURVEY FOR JOHN F. INGELLIS LAUREL TOWN OF SOUTHOLD SUFF. CO., N.Y. GUARANTEED TO, SCA/E: I"= 60~ THE TITLE GUARANTEE CO. SOUTHOLD, SAVINGS BANK AUG. 30, 1961 MAY 4, 1962 RIVERHEAO~ N.Y , / ?~VC'O~J NOTE: · ~ MONUMENT SUFF. CO. TAX MAP- DIST. I000 ~ECT. I~ BLK. I0 LOT 24 SURVEY FOR <:~/.,~. ANTHONY RUTKOWSKI 8~ KATHERINE RUTKOWSKI ~,. AT LAUREL DATE : FEB. t~7, 1981 ,,~. TOWN OF SOUTHOLD S. CALE: 1",40' ~ SUFFOLK COUNTY, NEW YORK NO. : 81-5~ ~E~ ~0~ S~J~E ~OUC~O~ L~W. ~E TITLE ~UARA~E COM~NY I I~ v~,~v~,~,~ ~~.u~ I I II ~ 1 1 ~ ~. ~ou~o.[a~ ~u~v~o~ ' I TDY POST E0494