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Home My WebLink About2773-zFO~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMElqT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. CERTIFICATE OF OCCUPANCY No....Z..23.1~ .......... Vote ....................... .Veeeai~,.....?......, 19..6..~. THIS CERTIFIES that the building located at ..~o~-.~.n~o~..~.e ......................................... Street Ma~o.°.~.~..c...~?:~...0..a~oSck No ........... ~ ....... Lot No. ~.....~.e~ot'~bO.t...~,Z, ............................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ 1~'. ......... 2..~ ............ , 19...6.~. pursuant to which Building Permit No. dated ......................... ~ ....... ~ ............ , 19.D.~.., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...... ~.~..iv~te...o~...£~.3,~...d~e:[l~mg ........................................................................................... The certificate is issued to ..~O~p~..V~'.,...[,ag~ ............... O~te,~'. ...................................................... (owner, lessee or tenant) of the aforesaid building. H.D. Approval 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? 2773 Z Permission is hereby granted to: · Toseph ¥/. Laee), ................. .z. ~O.....~."....~.z..~.a.. .......................... ............ ~.~.....~.~2... ~.~.k.. ,...... ~ :. ~... .................... Bttild ne~ one famXl¥ dwe].lin~ Robi~nson Lane Peconie~ N.~. pursuant to application dated ..... ..J~...~. ........ .~. , 19..~,~., and approved by the Building Inspector Fee $ ZO, O0 Building Inspector S-9 SUFFOLK COUBYI DE?~RTMEI~f OF BFALT~ TO WHOM IT MAY CONCERN: ,,Robinson Lane, Peconic ,(Lacey) Date December 10, 1965 Bldg. Permit No. 2773Z The sewage disposal facilities for a structure located at (Give d~d location)' have been inspected by this Department a~d foumd to ~e satisfactory. FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 1¢2 ........ Permit No ....................... - Application No ............................. APPLICATION FOR BUILDING PERMIT Date. ........................... , 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 oreas, 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 a 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 laws, ordinances, ................ ~'~~.. ~....~ 'building ,code and regulafions..~ .~ ~ .~..~..~...~.~......~.' } ~... State whethe/~.applican,~-js owner, lessee, a~le~nt, architect, engineer, general contractor, electrician, plumber or b~ilder. .............. ................................................................................................................... Name of owner of pram sas ~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) which roposed workwl bedone Map 1. Location of land on ~ropo . . ............... ..... .. , ,~. ..... ~ ........ Street and Number .............. ~...~...~.~..~.~.~.~..~..~~ ....... ~.~.t~.~..~.~..~.,:~..Z ....... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ~v ~C~ ................ b. Intended use and occupancy ....... 3. Nature of work (check which applicable): New Building ..... Addition .................. Alteration ................. P, ep,a,r .................... Remov~J .: .................. Demolition ............... ~,~. Other Work (Describe) .............~...,~i, .............. !~... 4. Estimated Cost ..~..~Z.~.,~(''~:~ ~ Fee (to be paid on filing this application) 5. If d~velling, number of dwelling units ............ /(. .............. Number of dwelling units on each floor If gbrage, number of cars ........................ ~ ......... . ............ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimiensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................ Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear ............................ Depih .............................. Height ............................... Number of Stories ........................................ 8. Dimpnsions of entire new construction: Front ....... ~...~.. ............ Rear .....~....4~... .............. Depth ...'~....~ ............. HeiCht ............................ Number of Stories ............................ 9. S ze ot: Prant ............... ear ..... .......... Depth .................. 10. Dat~ of Purchase. /~.,4~.....~'...~.......~...~ ...... Name of Former Owner ....~...'~7.~....~...~ ....................... 11. Zon~ or use district in which premises are situated ..~. ......................................... 12. Doei proposed construction violate any zoging law, ordinance or regulation? ...... /~..i~./~ ............................... 13. NonCe of Owner of premiss_es .~.~...~...~...~....~...~..~.('...~...~...r:..~./~ddress .~..~..~..~..~..~_~t..~.~.... Name of Architect ...... '....j;. ............................... L' ........ Address ........... ~. ................................ ghone No ................. Name of Contractor ..~.~.~.~¢/~...../~......'~..Z......~../..t.~...Address ~.if~.../.../~¢....~..~....?.qR'~'~.~..~.~hone PLOT DIAGRAM Loc.at~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property lir~es. Give street and block ' whether intterior or corner lot. numbers or description according to deed, and show street names and indic / STATE OFiNEW~f~O~.,,~;:, ~ .~ ! S S ....... :~~ :....~.. ~ .~.*:~ .....: ........... being (Name of Jndivi~Jual ' ' ~ 'ion) duly sworfi, depose~ and says that he is the applicc above nam?& He is the (Contractor, agent, corporate officer, etc.) of said owr~er or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true ,to the best of his knowledge and bel and that tSe work will be performed in the manner set fdrth in,the application filed therewith. Sworn to bbfo~ me this ~otary uo 'c,~.~...~..%.~..c~ ~~ cm~mtssio, Expires March 30, 19~/