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Home My WebLink About2392-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No...~,..~1..c)~.3 ........... Dote ............................ At~.us.t....26...., 19....6.~ THIS CERTIFIES that the building located of ....]~[~...~.It..e..~C...~i~EJ...~T.~.~..~O~ ........ Street Map 1~o8~..a..~'.....~...a~...?.~Block No...X;i~c ......... Lot No .... ~0~.~1~2. ....... conforms substontially to the AppJicotion for Building Permit heretofore filed in this office doted .................................... ~ ....... ~.~ .......... , 19..~. pursuant to which Building Permit No, dated .................................... Iv[a~.....J.~..., ] 9.6.~..., was issued, ond conforms to oil of the requirements of the opplJcoble provisions of the Iow. The occupancy for which this certificote is issued is ........ ..... l~i'zate...one..£a~il~...cl~e, ll£ng. ........................................................................................... The certificate is issued to ....~J~o~s...J~i~' ................................ 0/AI~IeZt. ...................................... (owner, lessee or tenant) of the aforesaid building. H.Do Approval August by R, Villa ~ ' Building Inspector J FOItM 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? 2392 z Permission is hereby granted to: ........... :~ox...~.~ ................ ; ................................. '. ....... l~i;:Ler,..;P~a¢~..... L,.];, ........ : .................. to ..btt&ld .,ne~...o~e.. £e~;l~, ~e~34tngl ..................................................................................... ct premises located at ...~I.~t.....~O;L.,&.-302....3~T~.St~...~I~I~ .......... :.: ............. : .................... [ ....... ................... i... ~.~.~.t~ee.. ~t~d.. & · ~l~9~..Ave .: ............. t ................................................................ .............................................................. C.~u~t.....~t...Z. ................ ~ ........................... ~ .............. pursuant to application dated .............................. ~!~r.****~k~ .............. 19.~L1,., and approved by the Building Inspector Fee $ ./.,CJ .......... Building fnspector / / SUFFOLK COUNTY DEPARTMENT OF HEALTH Date August 25, 1964 Building Permit No. 2392 TO ~IOM IT MAY CONCERN: The sewage disposal facilities for a structure located at .n/e/c Ba~Avenue & ?inetree Drive~ Peconic . (Give deed location) have been inspected by this Departr~ent and found to be satisfactory. District Engineer Approved ........................................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Permit No ................................. Application No..~.~..?....?...~.. ............. Disapproved a/c ................. __ __ ............................... ~~;;i ............................... APPLICATION FOR BUILDING PERMIT D te ~//''~ 19 .~'~ / 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 premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 part for any purpose whatever until o 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, as herein described. The applicant agrees to comply with all applicable I/¢~ ordinances, building code and regulati_on.~. . ~ ........... ........ (Signature of applicant, or name, if a corporation) ............................... ........................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If ~plicant is a co~orate, s gnature of dul~ authorized officer. (~ome ond title of corporot~ officer) 1. koc~tion of I~nd on which pr~o~*d work will bo done. ~op ~o: ..... ~ ............. : ........ ~ ........ Lot ~o: .~.~.~ ....... ................................ 2. State existin~ use ond ~cuponcy of pr~isOs and int~ndod ~ *nd occuponcy o{ pr~o*~d con*t~ction: ...... ............................................................................. b. Intendod use ond occuponcy .................................................................................. 3. Nature of work (check which applicable): New Building ..../~ ......... Addition .................. Alteration .................. Repair ................... .,~Removal .................... Demolition .................... Other Work (Descr be) .................................... 4. Estimated Cost ...... ../.~./..~22.. .................................... 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 ..... c~ .................................................................... 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 Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...... D~'..~...T'.~..~ ....... Rear ............................ Depth .... ~ .................... Height ..../....~..Z .............. Number of Stories ..... ./.. ................... 9. Size of lot: Front ......'./...~...¢..../. ........ Rear ..... ./..~...~..¢~...../. ....... Depth .....,~..~../~.. .............. 10. Date of Purchase ........................................................ Name of Forrger Owner ........................................................ 1].Zone or use district in which premises are situated......,~...~ .......................................................... 12.Does proposed construction violate any TOn nn aw ord nanc~nr re,~u at onP ..................................................... 13. Name of Owner of premises ..... ~...Address .... Phone No ..................... Name of Architect ",~J-JL .......~J~ ................................ z/'J/ . ,¢ Address ................... ~;/y~ ......... Phone No Name of Contractor-~.....~.r.J///¢(~ ........ Address ,~4'¢.~../.~..~ ............ Phone No. ,~,x~.....~.?....~. ~ 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 NE~? _~.01~1(/ .,~ ~ ~ ,. COUNTY OF .~~ ~'~' ~,'~. ,', _/~ ,~¢//. /~ ............ ~..~ .......................... being (Name of individual signing application) duly sworn, deposes and says that he is the applicant above named. He is the ....... .......... L...... (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 oil statements contained in this opplicotion/~f~ true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in ~l~e al~plication filed therewith. Sworn to bef~ me this