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HomeMy WebLinkAbout2691-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ...Z..22~1 ......... Date .......................... ~.f~..~...~. ............... , 19...0..~.. THIS CERTIFIES that the building located at ..~...&..C~.s~...]~uoaJ~L ............................... Street Map No. ~ ............ Block No ......... ,~[~r,..x.. Lot No...~ .........~[l~4~h~gt4e~...N...~', ................ conforms substantially to the Apphcahon for Building Permit heretofore filed in th~s office dated ....................................... [~l~t~....2.¥...., 19.6~... pursuant to which Building Permit No. 26.c)'1..~. dated .............................. AJ:~.il.... P.., 19..t~., was ~ssued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for which thru certificate is msued is ........ ...... ~i~.~t e...one..~am~ ly....~.el ~ ....................................................................................... The cerhficate is issued to ..... ~_~,m. lIJ~.....~TD,~h ....................... ~.~. .......................................... (owner, lessee or tenant) of the aforesaid building. H.D.Approval ~ept 1, 1965 by R. Villa · Buil~iin~"i;sp'~ ........... FOF,,M 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? 2691 Z Date ........................ ~ ........ ~ ........... , 19..6.~. Permission is hereby granted to: ........ ~.8~.....,To~t~e.. ~]~1c ............................... to ...]~zt.l~t..ne~.. on~"f~i'!F"dwe'Z'~'ing ................................................................................ et premises located at ..... I~."Hoad"&'¢~s~"Ho~d ..................................................................... ............................................... Ga~h~g~tey ..... ~,.¥.,. ...................................................................... pursuant to application dated .................................. ~h..."~ ..... 19...~', and approved by the Building Inspector Fee $'"'TOi~O ........ Building Inspector f~ t MAP OP' L~ND SF_,AMU $ LYNCH CUTCHOgu E fowlq o~ ~;OUT~OUD ~ ~.',~. Final loc, S-9 $CHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date June ,17,1965 Bldg. Permit No. 2691 , TO WHOM IT MAY CONCERN: The sewage disposal facllitie% for a structure located at N/E/C BaY Road & C~se Road ....... (Give 'deed location) .. Cutchq~ue~ Sout hhol.,,d, ........ have been inspected by this Department and found to be satisfactory. $1:P 1 Di'striCt Engineer FOE~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Dmapp roved a/c ........................................................................ ............................... ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin,~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets 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. SucJ permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or in pa rt i~or any purpose whatever until a Certificate of Occupanc} 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 th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances o, Regulations, for the construchon of buddings, add,hans or alterahons, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of apphcant, or name, cf a corporation) 2186 Jericho Turnpike, Commack, NY (Address of applicant) State whether opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. X~ GENERAL CONTRACTOR Name of owner of premises .......... .S..e..a...m..u...s....L.~.n..c...h. ............................................................................................................... If applicant is a corpo~.¢~o; ~ior~_ture of duly authorized officer ~ )~o-~-~-~ ~ ~~Ma~rc~/ P:~ot%er, President (Name and title of corporate officer) described p~:oper ty 1. Location of land on which proposed work will be done. Map No' . ........................................... Lot No: ................... Municipality 2. St&re existing use a'nd occupancy of 15remtses and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ri.grl~....-....v..~.¢..a.D.~.' ~_.a.p...c[ .................................................................................... b. Intended use and occupancy C;g..rls~;;Cg~.~ one Samil.y ranch house 3 Nature of work (check which applicable): New Building .... .Y.~.~ ........ Addition .....QP. ......... Alteration ..n..a. ........... Repair ...p.Q ............ Removal .......n.g .......... Demolition ........ .n.p. ........ Other Work (Describe) .... .n.,o...n.?. ....................... 4. Estimated Cost ..~?..g..,...2.~.0..:.g.~ ................................... Fee ........................................................................................ (to be paid on filing this application) 5. if dwelhng, number of dwelling units ....g.Q.e. .................. Number of dwelling units on each floor ......................... If garage, number of cars ....... ,n..g..q.e. ......................................................................................................................... 6. If bus~ness, commercml or mixed occupancy, specify nature and extent of each type of use ............................. 7. D~mensions of ex~sting structures, if any: Front ..~ ............... Rear .......................... Depth ......................... Hmght ............................ Number of Stories ............................................................................................................ D~mensions of same structure with alterahons or additions: Front ........... ..n..q.n...e. ........... Rear ............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction' Front ...... 66 .................. R. ear ......... .6.~. .............. Depth ....~ ................. Height ...Z6.! ................... Number of Stories ,..~ .................. 9. Size of lot: Front .... .2.~..0...~..t.:. ........ Rear .... ~..~,.q~.......f..¢.,:... Depth ...,.~..2..4......7...~..Z-: ..... ~.,t,;. 10. Date of Purchase ....N..o..v.f~.m...b..~.~....~..~..~.4.. ...................... Name of Former Owner .... ~.9.+~b...l~.~.~.~ ............................ 11. Zone or use d~stnct in which premises are situated .............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ................................................... Seamus Lynch AAH .... 209-37-32 Ave, PhoneNoBA 5-121 13. Nome of Owner of premises ............................................... ~ .............................................................. Bayside NY Name of Architect ...L...a..w..~r..e..n...c_e....d..:....K..y..h..n...e. ........... Address ..502...8~gb.y...~d~k.L~n Phone No..U.L...~.~.~ Name of Contractor ..A..M~.~.,...H. Qi~.~....~.~O.~..'~.,....~.g..:..Address ..~.~.Q.6....J..~.N.~,~.h..~....T.P..k..~... Phone No..F...q...8..r.?..O. Commack, NY PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or descriphon according to deed, and show street names and indict whether interior or corner lot. -- -~ ~b ~0~ STATE OF COUNW OF ............. ................. /s'S' ..... ~,,~,;~,~,,.,.P,;~p,~,~.~,~ ............................................................. being duly sworn, deposes and says that he is the applio (Name of indwidual signing apphcation) above named. He ~s the ............ g..~...n'.¥.~.n..g.~.a.~.~..n..n..d.~.q.9.~p..g.~.n...1:..e.~.9.~..f.~g.D.~.~D~pM~'~.~.~;..~.~' (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 th~s application, that all statements contained in this application are true to the best of his knowledge and bel and that the work will be performed in the manner set forth in the application filed therewith ..... Sworn to before me this ....... ?~,.+~h ......... day of ....... ~.~:~b ......................... , 19..~..D. ~, -~ t / , e) o4 ........... ............................. Notary FubJlc, . ...... .~..~..I]~k..~?..~......~. ~(~×fl~:~:)unty ~ (Signature of appJicant) NOTARY PUBLIC, State of New Yot~ m · © £ t',,: L) -~ '(:)/'U.-N I 0 N . ,. z5 :-~ 'f