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Home My WebLink About3859-zTOWN OF $OUTHOLD BUILDING DEPARTMENT~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...J~'t ue[.l~Ja~'t ;I.~,..D,~L~e .......................... Street Map No.S..O...U.~.~...O..~.~.... Block No ....................... Lot No. 6.....S~t~:tho.l.~l,...Hew...Y~:~ ................... Shores conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................. ~l~..r.~.~.......~.~.~ ............ , 19..~..~., pursuant to which Building Permit No ..... 3859...Z dated ................... .A.~..~.~..~....~...~.x ............. , 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 ........ .......................... .............................. The certificate is issued to ......~.,O.~D....~...~..~...~.~.~I.~ ..................... '. .......................................................... (owner, lessee or tenant) of the oforesoid building. Health ]Dept. Approval, O~tober 7, 1968, Robert V~lla Building Inspector 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? 3859 Z Permission is hereby granted to: Build new one family dwelling at premises located of ......~...t,.....6.~....~...~:.~r~u..~rA~e.....~n~.J~t~& ................... ................................................... ...~..e.~lalae~fl~ ....... II..Z~ ...................................................................... pursuan~ to application dated .................................. ..~.~.. ....... ~ ...... , 19..~.~.., and approved by the Building Inspector. Building Inspect'or~ ........... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF~ HEALTH Date October 7~ ]968 Bldg. Permit No. 38~9Z TO WHOM IT MAY CONCERN: The sewage disposal at Blue Marlin facilities for a structure located (Give deed location) Southold have been inspected by this department and found to be satisfactory. Ownor John Sch]a~ch der Oeorf:e Ahlers Di~strict Engineer , tl ~ ~ TOWN OF $OUTHOLD t o~ BUILDING DEPARTMENT ~ ~ TOWN CLERK'S OFFI~ ,O,T.OLD. ,. ~emined Approved ........................................ , 19 ........ Permit No .............................. Application No...?....?......~.r?.....~..... Disapproved o/c ................. ~ .................... APPLICATION FOR BUI~.DING PERMIT INSTRUCTIONS a. 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 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 premi.ses 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. State whether applicant is owner, lessee, agent, orch~neer, general contractor, electrician, plumber or builder· If applicant is a corporate, signature o{ duly authorized officer. 1. Location of land which proposed wor~ will bedone.~._~, M~c)o/j No: at No: ..... Street and Number ................. ..~..~ ......... ~'. ......... ....~...~.....~~~'~... ..................... Municipalit7 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ,a. Existing use and occupancy ................................... ~....,.~..~ ~[ ~,.~ ........................................................................ b. Intended use and occupancy ................................. ~ ........................................................................ 10. 11. 12. 13. Nature of work (check which applicable): New Building / Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... Estimated Cost ............ .~...~ ..) .¢..¢.. ~ :.f~..¢. .......................... Fee .......................................................................................... (to be paid on filing this application) If dwelling, number of dwelling units .................~ ........ Number of dwelling units on each floor ........ .~.. ................. If garage, number of cars ....................... .~ ................................................................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 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 ..... ..... Depth ...,..~.,..,,~..:..~...~.... Height ........... ~.~. ............. Number of Stories ......... L ................ Size of lot: Front ........ t...~.. ............. Rear ........... j...o..~ ......... Depth ....... ..~..,,~.. ,i~. ............. Date of Purchase ........................................................ Name of Former Owner ....~...~..~.¢.~...¢~¢.. ................................. Zone or use district in which premises are situated ................................................................................................. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~ ........................................ Name of Owner of premises .~.~.m......~...(r~.¢~ .......... Address ......... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..~...../~.~/~..¢~ .......................... Address ...4T..~'~.~.....~...~.....~..~.~.; ....... Phone No. ~.~...~Z...?..'~..!.~ 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, '~ q q ........ ~ ...... ~: .......... , ..... : ........... be ng du y sworn, deposes and says that he is the app icont (~Z~Z~i~dividual signing application) above ~med He is the .............................................................. ~~~= .................................................................................... (Contractor, agent, co.orate officer, ~c.) of said owner or owne~, and is duly authorized to perform or have pe~ormed the said work and to make and file this application; that all statements contained in this application are true to the ~st of his knowledge and belief; and that the work will be pefform~ in the ~anner set fo~h in the application filed therewith. Sworn to before me this ,