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Home My WebLink About2847-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z..~]60 ............. Date ....................... JaXt'a~I?~.....2~......, 19.66. THIS CERTIFIES that the building located at .... (jl~L~.e.t~.,~...IL~c..~.~i~J~,~(~...~.~L ....... Street MaCpro'!. O...~......~.O...~.. Block No ...... XX ............ Lot No. ~at.....}~]a~.t,..i~%~o~!t..}l,.~, ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................ AII~Ii.~J...~[9, 196..~... pursuant to which Building Permit No...~..~ dated ........................ A~I.~.IA~J.~.....[?~. ....... , 19.6.~.., 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 ........ .......... P~.~.v~te .. one ..$emi. t~..d.~e.t ti.n~ ....................................................................................... The certificate is issued to ....~I'ID,~.~...W~Oil ............................. 0~/11e~ ........................................ (owner, lessee or ten.e~t) of the aforesaid building. H. D. Approval December FORi~I NO. 2 TOWN OF $OUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BF~ KJ~PT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2847 z Permission is hereby granted to: pursuant to appj~cation dated .................. ,..,: ......... ......~...~..~...~,~......~..~., 19....~.~.., and approved ,by,the Building Inspect~>r Fee $....; ..... ............ r Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH Date.~ December 16, %9~6~~ Bldg. Permit No.~ TOWHOMIT MAY CONCERN: The sewage disposal facilities for a structure located at c/o Gillette Drive & Midland Place, East Marion , .... (Give deed location)' '' have been inspected by this Department a~ found to ~e satisfactory. FOI~M ,NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined '~::~'"~""~i?''~''''''~ ............. '~ '" Approved ................ '...' ..................... , 19 ........ Permit No D~sap~roved lc . ,,,;~" -.~'""" / .................................... ~'"";' ................. . ......... y ....... :,;"~',:z:.~'.. .............................. Z!" ?b?: ........... ; .................... '('l~'~'i'i~'i'~'~' 'i~;~ ~ ' ' v' 'i~pr ................................. APPLICATION FOR BUILDING PERMIT Application No ............................. 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 Ia.cation 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 be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issua.nce 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 regulations. (Signature of applicant, or name, if a corporation) (;Kddress at applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... /3ont~c,to~,. .............................................................................. Name of owner of premises ......... ~.e.t:h...~/~G~..?~..~.~.~'G ....................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: "~'~D]:O~"["f~O'~ ......... 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 .Va~tS,~%...~.G~ .......................................................................................................... b. Intended use and occupancy .~,'l.e~..;~e~,],~/',,~'e~,[~'tl~ .................................................................................. property I whether in 3. Nat6re of work (check which applicable): New Building .~:~1~ ......... Addition .................. Alteration ............... Repa. ir". .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estin~ated Cost. i ........ ~ .................................... Fee ....... ].O1 ........................................................................ ] ~ (to be paid on filing this application) 5. If d~ell!ng, number of dwelling units ......... O~ ........... Number of dwelling units on each floor ......................... / If g~. rage, number of cars ........ :~...~i~. ................................................................................................................... 6. If I~usihess, commercial or mfxed occupancy, specify nature and extent of each type of use ........................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Heidht ........................ Number of Stories .............................................................................................................. Dimpnsions of same structure with a.lteratians ar additions: Front .................................... Rear ........................ Dep~Fhh ................................ Height ............................ Number of Stories ................................ 8. Dimensions· of entire new construction: Front ....: .......~.O ................... Rear ......... ~. ...........Depth ...... ~9 ......... Height .................... Number of Stories ..... W ....... ~l~ ...................................................................................... 9. Size'of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner "~¥"']~k~"&"B .................... 11. Zone or use district in Which premises are situated ...... .".,~...d~t~ ....................................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ............. ~ ...................................... Na~e of Architect ...................................................... Address ............................................ Phone No ................ Nar~e of Contractor ............. ¢~e~..O~.].~B~' ........ Address ............ ~t~o~U.~ .......... Phone No ................. PLOT DIAGRAM L.ocat clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr. nes. Give street and block number or description according to deed, and show street names and india 'erior or corner lot. STATE OF Ix ~/ DRK, COUNTY iO~ .... ! ~'~O,~. ......... ~ .... ............................ ~:l~,~t,~...O~:l~r,~ .............................. being duly sworn, deposes and says that he is the applic ](Name of individual signing application) above nar~ed. He is the ......................... ~,~t~.~'~o.t~ .................................................................................................. (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to ma:ke and th,s applic~,ation; 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. Sworn to bpfore me this ................ ?.9.. day of .................... .~lt~l~lt~.~ ...... , 19.6~-. Notary Public, ....~..¢.~..~j~,,~,~'X~ounty~ , (Signature of applicant)