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Home My WebLink About2976-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTAAENT TOWN CLERIC`S OFFICE SOUTWOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~...~~05 Dote ...................,A.h~.~,~........k`~,~.............., 19~!~'.... THIS CERTIFIES that the building located at Street Map No..... Block No......... Lot No. xX ~~~it~aai+"y.....i~~~Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated 19. pursuant to which Building Permit No....~~~.~...'"4 r~'$tl.,..~,~......., pfd dated 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 ...'~`rivati~..~irie'..~a'ra3.~~; ..~.we7~ari~ The certificate is issued to ~~.'>RtS4~J..~..~,1t~FS~"'~H~','~'d~ie~ee orbtenant) of the aforesaid building. H.D.spprgval ffeb 9, 196b by R. Vi13.~ ......r..~~,;.~4 ll Builldmg nspector. FORM NO. 2 TOWN OF SOUTFIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTFIOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N® 29'76 Z Dote ...............~'.~d:.......a,~,................., 19.~Ia.. Permission is hereby granted to: ddQ~i.. ~kae,~...........:................................ to .~u~.~lc~..tags.~..ea~3e..~:'st~~~...u~~.~:#i2 at premises located at..~.....IYe~sp..s~~~F3•~~°3.'-~ta3 ' ~ - putsudnt fo,app'licotion~dafed ......::.~'4...... 1"9..~~:., and approved by_'the - Building'Inspector ~ - Fee ~.{~w Q~.:...'....:.. F' .e..d,.a•-_ , s...~..: bt 1. C:.. . i~... r...:. . Building Inspector S-g SCI SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit No.~,~~ ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Give deed location /~~TT7 7~~~K ~ have been inspected by this Department and found to be satisfactory. D1:;trict En~ince~y Dis rict Engineer FORM NO. 1 TOWN OF SAUTHOLp BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. t 0 Examined ~ j 19.~?C~ A lication No. ~:..7.. Approved 19........Permit No.. ' j`~~ Disapproved a/c ~ ,:.;.;,.--L._...-.--""~~,.::::,.»r•••~...~......~....`.'.'~_ ..........................r''...r.....................................................'.'"" ~ r (Building Inspe tor) APPLICATION FOR BUILDING PERMIT Date .....,jf.~l 19.~0..~'P......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplica#e 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 thediagram 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. 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 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. Name of owner of premises ..,r....L:A. ~.~:.....a-../E~.CIC..~.~~~.....~~'{'-~....~~.1..J./,l!~.C.+....... If appli°capnt~~is a corporate, signature of dulJyuthorized officer. (Name title of corporate officer) 1. Location of land on which proposed work will be done. Map No:p~~J.~L~. ~~i~~~.fiP~.jtC.C Lot No:...Cy,,............ e -y Street and Number 6~~~'a`'•.......~-.~'....~(~'...~UG(-.~ ............../.:/•,r'.~L..t.j.~~'.~1~.........................................................., Municipality 2. State existing use and occupancy of premises and intended use and occupancy"of proposed construction: a. Existing use and occupancy r b. Intended use and occupancy ....Q.d.`.'~.~;....../.~/Pl.',1.L~:.~......~W...~~ L..LN...G 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition.................... Other Work (Describe) 4. Estimated Cost .............1 Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .....................Number of dwelling units on each floor If garage, number of cots 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 some structure with operations or additions: Front Rear Depth Height ................................Number of Stories i ~ 8. Dimensions of entire new construction; Front.......~.rl Rear .....5~,.............. Depth Height .....~s Number of Stories........... ~ r~ ~ 9. Size of lot: Front .....~..,.ff......// Rear Depth .,7.........'.~..... ~.~~....e 10. Date of Purchase .....f,/..~~¢,.~ Name of Former Owner /h~~' ~'9~.T {'GE~C~/ /~vC, 11. Zone or use district in which premises are situated....../..`...~ 12. Does proposed construction ~vaiolate any zoning low, ordinance or regulation? 13. Name of Owner of premises/...~«...~~~U~~......Address .~~.T.°~..r!t.!~~~:.~.~...~~N~. Phone No~~~.'l.!~6~ li p a ~i Name of Architect ......................................................Address Phone No...;................. Name of Contractor ~........................Address Phone No... PLOT DIAGRAM t_ocate 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. a as 0 ` \ n c, ~ ~ ~ , ~ ~ ; ~Pp ~ ` O ~ - ~ ~ t C~~e ~ 7a 7`/fF~~rA i7/1. ~ r " ' _ STATE OF NEW YORK, ) S.S. COUNTY OF ,...~y..s,;~...~ .................................................being duly sworn, deposes and says that he is the applicant (Name of ' vidual signing application) above: named. He is the (Contractor, agenty corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this application; that all statements containod 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 day of 19........ Notary Public . County (Signature of applicant) ~ ~ S !g°47'W NOW OR FORMERLY F`RgNIT of v / 2q~ES/~I ,n /j N M I n FI W m m ~5j~42' M N N p W N r Q 52,06' ~ V ¢ U7 26.c^4' ~ f0 m ~ N ~ ~ W _h 2.02' > w ~ ~I N O ~ O O e h ~ V Y m w W N n w w J -a u p ~ z9e' = a.ol• w e ° V m ° O ~ 20.29' N W ' V ~ J a 3 0 0 SA 5A, V ~ O ~ N u) ~ o a ~ rn w m w W ~ N.10°28'11"E, z ~ W ~ tL (50.33' ' O O LL W O O Z L~ J ~ I a ~ o W ~ GUARANTEED TO SECURITY NATIONAL BANK ~ ¢ O ~ GUARANTEED TITLE DIV-AMERICAN TITLE INS. CO. O o w ~o MAP OF LAND LOCATED AT N ~ MATTITUCK a ~ A/-^¦ TOWN ?F SOUTHOLD COUNTY ?F SUFFOLK ' r SLIRV EYED FAR VN' a PLACE & KRUEGER y9 5' GEOR E H. LUT ~ r. I" 20' FINAL LOCATION 4 - 16 - 66 aocrr ooINT,N.r. LICEN9EO LANG S'IJRVEYOR _ 6 S 57 •=STAKE. ''~=MONUMENT FOUNDATION LOCATION I - 26-6G .~AKS~>TEL~~~~~~~~o zssa~ ^P~°