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Home My WebLink About2460-zFOR~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~...'l.C)~,~. .......... Date ......................... O(~,t~O~e~'...~, ......... , 19.6~.. THIS CERTIFIES that the building located at .J~/~.....]B.~e...~il~k...~o~d ....................... Street Map No. "~,5~ .............Block No ......~ .......... Lot No.....~I[ ....... ~O~h~).~t....~,.~.~ ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................... ~T~t]:~/' ......... J~'~ ............... , 196tt,... pursuant to which Building Permit No...2.)+.6J~..~J dated .................................. ~'..~.~ ....... P.~., 19.~LI,.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ............ .Pr~t~"one'"~a~"l:Y"~l~e~t~ng .................................................................................... The certificate is issued to .eouth~td..l.)ev~.tepmen~:~n. Oe~.]~.;~.;i.i~..~;~.;.~;i.e~~ .............. of the aforesaid building. H.D. Approval Oct. 1, 1965 by RoVilla ................ .................... 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? 2460 Z Date ............................ 41'lLl, Jr..... 9l ............ , 19...(~, Permission is hereby granted to: ................... So~th~Id. ......................................... to .~l~t..ae~..e~e...~,n~9-..d~e...~tt~ ..................................................................................... at premises located at ...... ~...~1~ .........~ll~t~..~.~..~Z~~. ................................................................ ......................................................... P~tn~. J~Ioek..P, oad ~ .....24)tttiwld, ............................................ pursuant to application dated .................................. ~.....~.1 ....... 19.(~1-., and approved by the Building Inspector Fee $'"'J,O'e 00' ....... Building Inspector '-'1 SOHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM 1T MAY CONCERN: Date.. October 1. 1964 Building Permit No. 2460 The sewage disposal facilities for a structure located at Pine Neck Road, Southold (Give deed location) .... ,~orge W. Smith & Sons,, have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................ Application No...~... ?t...~....O.. ........... Disapproved o/c ~~.~z.. ..................... ............................... 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 premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must bedrawn on thediagram 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 availabJe 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 a Certificate of Occupancy shall have been g~anted 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 laws, ordinan~es..,~ and regulations.//'//..~z..~ '~..~.}~ ......... (Signature of applicant, or name, 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 fgrporate, signature of d~authorized o,,f~ficer. (Name and title of c'' orporate officer) 1. Location of land on which.~pr.~oposedz,.~ /~ ~ ,'~w°rk wig be done. Map No' ~/~.~..~.~.~.'.~. Lot No: .~,~. ........... Street and Number "~'~'~"~'~'E:"'?"~"('~£"'~'"~"/'i'i~'~' ~~~''''Munic ty~i ...... : ............................ 2. State existing use and occupancy, of p~:emi~es~ ~ .. and~ i ntende~ ~.~and._ ~z~'~'~'-¢'~°ccupancy of proposed construction: a. Existing use and occupancy ..... [.~.'~ ...... -~?~.~.../..( .......... ~...~..~.. ................................................................. b. Intended use and occupancy ..~.~....c.:~..~..~..~..,.~.. ....................................................................................... 3. Nature of work (check which applicable): New Building ..... ..P~.-...-... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ............. :.~....D..c.?. ........................ Fee ................ ~ .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .~'"~4~...~k...~... .......... Number of dwelling units on each floor ............................ If garage, number of cars ........../.....:'. ........................................................................................................................... 6. If business, comrnercial 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 ........ ~'...~ ............... Rear .....~.M~...' .............. Depth Height ...... .~..~.. ............... Number of Stories' . ....... ~c~ ..................... 9. Size of lot: Front ..... .~....~....~... ............. Rear ..... '~.~...~.....,,~... ........ Depth ..... ./..~..'~.~.o. ........................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated......~.~--~,.~.~ ............................................................................... 12. Does proposed construction violdte any zoning law, ordinance or regulation? ...................................................... 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ........... i .............. "'"~ ......... .~.....Address ......:>~: ............ ~ ................ Phone No ..................... Name of Controctor~:'~'~(t../:...~...:.M~.~..~..~..~....~.Address ;~~i~...~ 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 Y(~P,I~/~,/~ ) S S '~; COUNTY OF ...~~7%) .... // . ...................... ~~..~~.being'duly sworn, deposes and soys that he is the applicant (N.c~me of individual sign_i~' application) above named. He is the .......... .~.~...-~..~,,,~4%.~. ~.,,~....~ .............................................................................. //' ~/"~ (Contractor, agent, corporate officer, etc.) of said owner or owners and is duly auth6rize~u[~j~up~.rf~lK~r .,?,ave performed the said work and to mace and file this apphcat~on;' ' that all statements conta~l~t~i~t~bl~a~n~ ~ are true to the best of his k~owledge and belief; and that the work will be performed in the~nf~4~%l~t'rl~t.t]~ed~pplication filed therewith. Sworn to be~ me this ~ommlsslon £xp~res .......... ~......-~.. day of ,,:_ ............ ~ ............... ,]9, NtorPui,,,¢ c ,t ................ ....................... o y ', ~:~--.~...~:m ..................... ~~_~ (Signa ute or app.icant)