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Home My WebLink About2969-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...8.tttz..~..&..~a~]~ez~¥...I~;f~. .................. Street ,~e~t C~ee~ Detect, men% ~p--,~o ........... : ........... =~ ~o ....................... Lot No. ~ ~.~.t...~.~.~ ....... con~orm~ substantially to the Applicetion for Building ~rmif heretofore filed in this off, ce d~ted ohanged 1338 Z ~o ..Ma~2.Trf.6.1-.~v.$s~d..~a~,~ ........ , 19..6B. pursuant to which Building Permit No, 2969Z .... dated ....................... ~ ....... ~. .............. , 19...~, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ........ · ~=.~v~e...o~o...J;~$~,..awe~.&i~....; .......: ......................................................................... The certificate is issued to ...~O~O~..~O~.~.O .......... ~. ....................... (owner, lessee or tenant) of the aforesaid building. Building )Qspector ~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BI~ KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2969' Z rate .......................... 0'~'~ue~ry..-.-3 .......... , ]966- Permission is hereby granted to: ct premises located at '"'~0't~"~' ....... ~est:']Cr~e]c"8~r~io;p~n~ ............................................... .~ ........................................ ~u~'~..&,,~r~e.~-:o-'~..~ne~ .......... :.:;~'~u~o~ ..................................... pursuant to application dated i.... ...........~.l,.y...?~ .................~ 19.~., and approved by the ; - Buildino Inspector Fee S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH DaLe Bldg. Permit No. TO WHOM IT MAY CONCERN: at ~he sewage disposal facilities for a structure located n/e/c BaMberrM & Sun Lane, Southold (Give deed location) West Creek Dev. Lot 4 have been inspected by this department and found to be satisfactory. District Engineer District Engineer Builder - Owner~ Henry Mathes FOI~M NO. I TOWN OF SOUTHOLD /~(/.~, ~/ BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. 19/~(~ Examined ......... ~,j.........i.~.~. ......... , ........ Approved ......................... .~.'~ ........... , 19..~[... Permit No.,........................... Disapproved a/c .............................. ........................... ................................. APPLICATION FOR BUILDING PERMIT ote 'J 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 property must be drawn on the diagram which is port 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 o 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 port for any purpose whatever until o 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) Main Ro~, $outhol~, ~e-~ York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. remises James P. Kelly. Name of owner of p ................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) of West Creek Development 1. Location of land on wh ch proposed work w bedone Map No F.~]-e8. S.C. clerks LotNo' 1~ ............................. .. - Sun Lane and Ba~.berr~ Road Sou~hold~ Ne~ York Street and i'~umoer ...... . ...... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: vacant land a. Existing use and occupancy ................................................................................................................................... b. intended use and occupancy .......... ?..~..~.~.~.~.~.m.~.~.~..~....~`.~.~.~.~?.....~.....]~....~..m.~..l..~.~..8:?..?.~.~.~. .................... 3. Nature of work (check which applicable): New Building.... ....... ~: ,...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitiam ................. Other Work (Describe) ........................................ 0 4. Estimated Cost ....]:.]r..,'..O.....O. ........................................... ~=ee ....................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ~..$1~..~,.e....~.~l~.$.~l'umber of dwelling units on each floor ............................ If garage, number of cars .................................................... .'. ............................................................................... 6. If business, commercial or mixed occupancy, spec(fy nature and extent of each type of use ............ .'. .............. 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................ ~ ................................................................................................ Dimensions of same structure with a.lterations or add,itions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... 3(~ : Rear ........ .~.~ ............... Depth Height .....~..~..r. .......... Number of Stories ...... ~.~..~ .................................. '1'1~'0'"6~'~'"~'~'~'~ ....................................... 9. Size of lot: Front. ................... 50' ........ Rear .................................... Depth ..:t~l,O...o~.e...s.~.d.~. 10. Date of Purchase ........................................................ N~=me of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ .~..9. ........................................... 13. Name of Owner of premises ~.e,~,~B...~,,...~.~,l.~ ....... Address ....~1~.;I,~...~. ...............Phone No Name of Architect ...................................................... Address ............................................ Phone Neme of ~ontroctor ........ f. ................. ..... Address F.e,~,m~.~.~.a.3,.e.~ ~T,~. . Phone No.A~.ea...e~de PLOT DIAGRAM I.ocate clearly and distinctly all buildings, whether exisiing or proposed and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ' STATE OF NEW YORK, I, ¢ c' ~z COUNTY OF ................................ .~ ~."~'. ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......................................................... . ................................................................................................ [ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to performl or have performed the said work and to make and file this application; that all statements conta:ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the m6nner set forth in the application filed therewith. Sworn to before me this r, : ...... ~...-~... ...... day of ...~ ............. , 19...~..~---- ~'~ ~ ~.. . .............. Nota~ Public, .(.[.[.~_.~.....~fE~ounty. /7 (Signature of applicant) ~ N~uf[01k Ccunl~ j Term Expires March 30, 19~_~