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Home My WebLink About4096-zFOIL~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT "/"OWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE nF OCCUPANCY No. Z.3.~.1~.... Date ................. ~eb ..... ~$ .... , 19. THIS CERTIFIES that the building located at~..M~.l~d~ .~1~..~ ..... Street Map No... ~1~ ....... Block No .... ~ ...... Lot No..~g3~... ~O~3,t~o~,~, .... ]~+~, ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 0~' ..... 16'" 19.6~ pursuant to which Building Permit No.. dated .......... ~ .... ~ ...... 19..~ was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. ~he .occupancy f. or which this certificate is issued is ... ~:LIIeSS. :[~L~.ld~L~g .... (14~"h~ - ~hop' .ere) ......................... The certificate is issued to ...... 1~¥,. ~[~i~l~ ....... 0~1" ......................... (owner, Iessee or tenant) of the aforesaid building. ~"' Suffolk County Department of Health Approval . . ir..~[~..~ ...... FOF,.M NO. ~ TOWN OF SOUTNOLD 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) Permission is hereby granted to: i~E~.....Ii~,. ~W~t~m ........................................ to . ~, .~.. · .~'. · .e~. · · · .1R.13~1-~.~ ~1.~. · · ~.~,'l,~'J,l~,...~.l~g~llf~...~l;l~'~ .................................................... at premises located at ................... ~j~..~ll..~Jl~l...~,~[~.~ ................................................. .............................................. ~~....ll,Z, ................................................................................ pursuant to application dated ........................... ~t~ ......... S6 ........... , 19.t~.., and approved by the Building Inspector, ,=ee ~..~...0..:.~ .......... TOWN OF SDUTHDLD OFFIr.E OF BUILDING INBPEP. TDR TOWN CLERK'S OFFICE E~OUTHDLD, N, Y. Mt.B, Commissioner of Public Works Suffolk County Yaphank Ave., Yophank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated La,ws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ...................................... ~oh~ Carpente~l~ 1~ S,~et D~t Sa2ville, ~i.~[.t Builder A/C .~..~.....~ .,.~?..,... ~.o.~..o..]:.~ ~...~.:..z..:. ~.......o~.?.~ ................................ has applied to the Town of Southold for a permit to construct a building o. ~/~s~x~i~f~(~c~)~.~.~~e~~"~ ~o~ i=~ soat~oza. as shown on the attached plot plan, submitted in triplicate, da,ted ................ ........... ~..e.~.~.......6.~1...~..¢~..~.. and titled ..~...~.~....O..~....~...~..??.....~..~...~........~...O.~.~e:~l ~Ottt,~oi¢l. ~o~, We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. 9/2g/68: Approved to theTown of Southold,Ven/ truly yours, pursuant to See. 239K of the General Munieipa]. Highway Law will be required fop aaaess to Middle Road, C.R.27. ~ SUFFOLK COUNTY DEPT. PUBLIC WORKS Building Inspector R.M.K~JMMERER, COMMISSIONER Town of $outhold, N. Y. BY. William S. M~t~unaye,Jr.~ l\ Chief Engineer U ~ '[o:vu oF ~U1UO~D. U,~/. 5 C'A'L F~: 50'= GU q ¸,2 5 C AL F-.: 50'-- AFLF:A-- 0.'b2/~3 bCF/.[S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E / ........ xamined ....~.....~. .............. , 19~'~- Approved ...~....~T......'~... .......... , 19..~.....~.. Permit No. O ^pp icot on No ...... ...... APPLICATION FOR BUILDING PERMIT Date .~.~..~....../..~.. ................................. , 19...~...~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat 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 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 sh~ll 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 o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, orf~r remora or demolition, os herein described. re~gu~ations. /< ................ // (Sig=~re of applican~or name, i~ corporat,;~) .... ' --- (Address of applicant) ~ State w~w~lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~...~....../.....~ ............................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done, Map No.: ................. ~ .................... 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 ....... ~..~ ........ ~ .~..~.....~...~...~../.....: ...................... ntended use and occupancy ~...~... ~---.~. /. ~ .~..~...Z ~. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .......... ~ ..... Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ ara e number of cars If g g , . ......................................................... f ............................................................................... 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 ................ 7 .............. · 8. Dimensions of entire new construction: Front z~-r;' / f' ~ ~ .................................... Rear ..... .~. .................... Depth ...~ ................... 9. Size of lot: I-rant .......... .(. ............... ~ear ....... ~ ............ : ............. uepm ...: ............................ 10. Date of Purchase ........................................................ Nam.~e of. ormer Ow .................................... ./..~... ........... 11. Zone or use district in which premises are situated ................................................................................................... 12. Does proposed construction violate any zooinfl law, ordinance or regulation:), _ '~/(J CP ~3. Name of Owner of premises ~' ~' //~7-~' Address ....................................... ~'~"? .......... 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 number or description according to deed, and show street names and indicate whether interior or corner lot. .7~f~ ~. /~ p y-.~ ~/~/u (7 STATE OF NEW YORK, ~ c c COUNTY OF ................................ J .... IJ ,//) ~) ' .....~O. j3./tg. ............ ~.~. .~.)/~..~.~...~..~.~'...):~..~ ....................... being duly sworn, deposes and says that he is the applicant (Name of individ~l Signing application) (Contractor, agent, 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 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 ap~,plicatJo~-filed therewitJ~. Swam to before me this ~' ~ ~'~ i ............. day of ........ ......... , ~ - ~ ~ -r~% ....~..z~,.~.:..r~f..:..~..,~,.~,%....~K.~ .......................... Notary Public, .....~..t,;~,z'./..~J~/,.,,~J~f~i~J. .....~..County~' .J ' t?~ (Signatur~ of applicant) Commission E p / o ~ ~ ~ ~ '~ ~ ~ ~ I' ' : V ~ ' ' - ~ ~ , , , ~ ,, , ~ I~[1 ; ; ;~ r, , .. . ~-, . ~ ~ _. ~ ~ ,~ ~__~ , . ,~ ~z~_..~ . . i 4 .~¢, CHARLES J. IRWIN ............... ~ ........ ~,,~ , ~ j ~' ~go ~AYPORT AVE. BAYPO~T. N. Y. I HOWARD C. PETERSEN CONSULTANT CHARLES J. IR'AqN ~30 BAYPORT HRAV~"2-O7111]AYBO[~I' N. Y.