The URL can be used to link to this page

Home My WebLink About2707-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 2179 Dote ~1-1-7 2 19 6~ THIS CERTIFIES that the building located at ~/S ~ll'l;h l~l~a~. Street Mop No ...... ~ ......... Block No ....... ~ ......... Lot No. ~ ....... J~...~...~.~.t...~.?...k~...~.t..~.p. .................. conforms substantially to the Application for Building Permit heretofore flied in this office dated A]~.l 8 19 6~ pursuant to which Building Permit No. 2.70? ~- dated .............................. A..D.~.~..~.......1.~...., 19.~.?....., 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 ........ Private one family dwelling The certificate is issued to Edward C. Jaakowiak Owner (owner, lessee or torrent) of the aforesaid building. H.D.Approval ,Tu~7 1, 196~ b~ R. Villa Building Inspector FOI~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? 2707 z Permission is hereby granted to: gdw...Ahi.ta....A/C.....Edw....Jaakoa'tak ............ .............. Mm~t titu~]c ........................................... to ...... .~ 1.4.. n~.~..gne...£ rurally....riMe 11 ~n~ ................................................................................ at premises located at ..:~/J~.....R~t~.'~Oa~ ........................................................................................ ............................................... ~a.t *~.t.t~ek ............................................................................................ pursuant to application dated ....................... A~..'L ....... .1~% .............. ]9..(~., and approved by she Building Inspector Fee $..~.Q....i ........... $C~ SUFI~LK COUNTY DEPAI~I~iIqT OF HEALTH The se~a~e dispo~ fac~lities for a structure located at have been inspected by this Depar~ent and found to be satisfactory. District ~;~ineer I~)~.M[ ~TO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. Examined ...... Approved ........................................ , !9 ........ Permit No ................................ ............................ 'i;ri ........................ APPLICATION FOR BUILDIHG PERMIT Application No..,~.,. ~ ~ 7 ' INSTRUCTIONS o. 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 propertymust be drawn on the diagram which Js 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 shell 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) (Address of applicant) State whether ,applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. i ............................... ........................................................ r ,ses ~ ~ .,~....~.~....~...Qcd J'A ~ Nome of owner of p em ........................................................................................................................................ If applicant is a corporate, signature of duly outhoriz~ officer. (Nome and title of corporate officer) 1. L~ation of land on which pr~osed work will be dane. Map No: ...~ ............................... ~t No: ..~ ........... Stre~ and Number ....... ~.....~u~..~o~, ....... ~.~o~t..~.~ ................................................................. Municipali~ 2. State existing use and ~cupancy of p~mises and intended use and ~cupancy of proposed const~ction'. o. Existing use and ~cu anc vacant land one fami~,x dwellin~ b. Intended use and occupancy ............................................................................................................................. 3. Nature of work (check which applicable): New Building ..-.~-'~..~.... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................................... ~m Estimated Cost ...... ./...~..u...OTT~'~ ................................. Fee ...... lQ ............................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... .9.D9. .......... Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................... 6. If business, commercial 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 ........................................ ~ Dimensions of entire new construction: Front ............................Rear ....... L .................... Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ........ 1.OO ............. Rear ......... 1.~Q ............ Depth ..2D.O..~./.~ ............. 10. Date of Purchase .................. ~.~.~.~ ............................ Name of Former Owner ...... ~.~,.~.~_i.~ ............................ .... "A" di~* ] 1. Zone or use district in which premises are sltuat'ea ..................... R.v ........................................................................ ]2. Does proposed construction violate any zoning law, ordinance or re{3ulatJon? .......... .~9,Q ....... ~ ........................ ]3./ Name of Owner of premises ........................................ Address~..:../. ..................... ~ ..........J:~one No ..................... Name of Architect ...................................................... Address ............................ · ................ Phone No ..................... Nome of Contractor ....,~.~..,~i.~;~ .......................... Address .............. ¥~.t.~i.~¢k ........ 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 YORK, ~ COUNTY OF ....~.U,~ZO3,J~ ........... / S.S. t J GO' ........................... Rd~az'~l..,~b~t~ ........................................ being duly sworn, deposes, and says that he is the applicant (Name of individual signing application) above named. He is the ............... .C.D~.~,Z'~,~.~,O.~. ................................................................................................................. (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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ .......... ......... Notary Public, ~~?~~ounty"~~r:~c' i~'g' · '~f a~ ";~"'~i,~"' ' ................... Commzs~ion Exptres March 30, 19~Z x/6~