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Home My WebLink About2812-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...Z~,1,8 .... Date ....... 0.c. tObe~ .].05 ........ , 19.73. THIS CERTIFIES that the building located at . .8/.9. ~4.a.t~¢~*S..Edge. ]ge, it .... Street Map No. ~c)0], ...... Block No..1~ ....... Lot No. ~ ..... .~..~.*f, h0~d~ . bl.o.][? .......... conforms substantially to the Application for Building Permit heretofore filed in this office ~,~ated ........ ,[ttl.¥..~.~ ..... , 19.6~. pursuant to which Building Permit No.. ~8~2. ~ dated .... .g. tlSy..8~ ...... , 19..6~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...Pr$v.a.t.o.o.n.e.. f..aa~..],y d.~.e.]...]-$ .ng ...................................... The certificate is issued to . . .R~.c.h.~. d..&.. !4a..~.. ~$.ay...0..I~. ?r.~. ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...g.tm..~...~.~.~..;¢)7.0..Blt..R.~ .¥~...~..a .... UNDERWRITERS CERTIFICATE No. ..8.9970. ........................................ ttOUSE NUMBF~R .... ~,'~ ...... Street ......~.a..~.O.~.~..O.~. g.~..Walt ........................... ...................................................... ~outho~d~..Ii. ~f., ........... Building Inspector 6~x.~ FOKM 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? 2812 z Permission is hereby gronted to: ...~..~..~..~.,.~ ........................ ................. .~....v..t...e.~..~..t.~..,.......-...~....~...~....6. ........................ ~t~o~,...~...~., ................. to .. ~...t..!~....n...e.~....o.~..e....~.~m~,.z.z....a..~l!~ .................................................................................... at premises located at ...]-...O..~.....~.S ........ .?.e..?.?.~....~...~..~..e.~'.l~. ......................................................................... ................... S/S.....~a~em~..~d~e..~ ............ .S.o...u.~.o.!~.....~.,...Z..,. .............................................. pursuant to application dated ........................... ~'.~I~..Z. ....... ~. ............... 19.6..~...., and approved by the Building Inspector Fee $.~,..O.,e....O~... ........... Building Inspector TO~ OF OWNER FORMER OWNER TREET N ViL'~GE ~ SUB.LOT ¢ LAND AGE S VL. i FARM TOTAL j DATE ' BUILDING CONDITION NEW FARM : NORMAL Acre Tillable Woodland Meadow[a.d House Plot Total BELOW Value Per Acre ABOVE Vclue FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK /:> / OWNER i STREET RES. I SEAS. i LAND ~ IMP. NEW Fc?m Tillable Tillable 2 Tillable 3 Woodland Swamp[and Brush!and VL TOTAL iFAPdv~ DATE t tDISTRICT i SUB. LOT ACR~GE~ U ~O Vaiue Per Acre I-TYPE OF BUILDING IND. j CB. I MISC. COMM. ! I ABOVE Value House Total FORk~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~ .3.~ .... Date ............ ~VBn~...a~ ...... , 19. T0 THIS CERTIFIES that the building located at ...~/~..Watera .Edge ~a7 .. Street Map No. T.crY..l~.a.te.~.aBlock No ........... Lot No. ~ ...... .8.QUth. o.l. 4...l~y., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ J;tly ....8... , 19.6~. pursuant to which Building Permit No...28}~ .2; dated ......... Jllly .....8... , 19.6~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... P.I'.iva~e. One .family. ~'dellirig .................................... · ~ ~'a~,v ............. The certificate is issued to . . RtChSI'~ .~ ....... ¢. Iinclsa~r ...... 0~ners. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,lime..2h-~..1970.. By.. It, .V:lJ, la .... Building Inspector\ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ,lag. perm, No. _.0~t~ ~-- TO WHOM IT MAY CONCERN: // The s~age disposal facilities for a structure located - d (Give dee~ocation) J have been inspected by this department and found to be satisfactory. 'District Engineer TO~N OF BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............................................................ . ....... :.).../...::/.::: ......................... ~ ~ { ~ ~ ~./ ~,-- ~'-" APPLICATION FOR BUILDING PERMIT X~- '~ n ' -- _ a. This application must be completely filled in by typewriter or in ink and ~~lic~Building Inspector. ' b. P[ot plan showing location of lot and of buildings on premises, reiationship to adjoining premises or public streets or ~reas, and giving a detailed description of layout of property must be drawn on the diagram which is pa.rt o{ 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 wor~. e. No building shall be occupied or used in whole or in part {or 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 aop icant agrees to comply with all applicable laws, ordinances, building code and regulations. ~ ..... ~ .... / - - (Address of applicant) ,', c '/~ ')'r~ r~r~r//¢-/ Stata whether applicant i~owner, lessee, agent, architect, engineer, generat contractor, electrician, plumber or builder. ................... .......................................................................................................................................................... Name of owner of premises ~A~ ........... ~....~.k~ ........ 6 .................................................. 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. Mop No.: .~..~.~.~ ................... Lot No.: ..~ .................. Street and Number .................... .~ ....... ~ .......... ~ .............................................................. ~ [ -- ~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ............... .~.~.~,.~.~..~,.~. 3. NatUre of work (check which applicable): New ,Building ..... ..~... ....... Addition .................. Aiteratlon Rep4fir .................. Removal .................. Demolition .................. Other Work (Describe) 4. EstiCnated Cost ./....~.,..,.O...o....o...,~,.. ............................... Fee i -- (to be paid on filing this application) 5. If d~elling, number of dwelling units ...... c,~..k'3..~_ ....... Number of dwelling units on each floor If g~rage, number of oars ................. ~.~..¢~- ........ 6. If I~usiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dim~ensions of existing structures, if any: Front ............ ..-m.. ............ Rear ............................ Depth Height ............ -%. ........... Number of Stories Dim.ensions of same structure with alterations or additions: Front ............... '-7. .................... Rear DepJ'h ..................... ~ ...... Height ............... ..,mw.. ......... Number of Stories .......... ~ .................. 8. DimJensions of entire new construction: Front .......... ,~...~.../. ................ Rear ......,~..¢...../. ............ Depth .~...~..?/¢...~.~. ..... Height ....... J.~..! ...... Number of Stories ......... / ................................................................... ' 9. Sizejof lot: Front ....... L,q..¢2 ............ Rear ...........Z.f2¢2 ................ Depth ....... ~2,,.J. .................. 10. Dat~ of Purchase ........ ~,../.../.,s;./...~.~.. ..................... ~ame of Former Owner ..~,.~...:....: ...... J~.~J~.¢~.../,.¢..( 11. Zone or use district in which premises are situated ................................................................................................. 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ......... .1~ ................... , . . ~ .~ ~'~ ~' . ] 3, NonCe of Owner of premises ~f~C,~'q, J~: ~ R cJ~*~ ~. J, .~.$.~ddress ~i~.l~.v/.D~.,.~,.~.'~.:~.~..'~...~2P~one No. Nar~e of Architect ..................... ..'rm..wr .......................... Address ............ ..-=: ........................... Phone Name of Contractor ......... ........................ Address .............. ~ ..........................Phone No. property Ii whether in: PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frJm qes. Give street and block number or description according to deed, and show street names and indic erior or corner lot. . STATE aFl NEW ~YORJ<, ~-, } ¢ c COUNTY )DF ~..C¢.....~' .... i(Nam~C)f individual ~igning oppli~ion) ~e nar~ed. He i above nan') d. He is the .................................................................................................................................................... ,. (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 this applic;tion; that all statements contained in this application are true to the best of his knowledge and belief; that the w~,rk will be performed in the manner set forth in the application filed therewith. Sworr~',fore me this- "~ k ('~. ,o ~ '~ \ .................... day of ...~Jf,4c/¢-rrf¢. .......................... , 19......~. --'~ ,-~, ~ /7 , ¢/ : ,¢ ,; ........... ....... ............. Notary Puldic, .~./(.j/¢,~.....~......~.. County ((Signature of applicant) / Term Expires M. arci~ 30,, 19~