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Home My WebLink About3923-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. r.E:RTIFIr. ATE: OF OCCUPANCY No..Z..11426... Date ....... .~]g...O~.. .... ~.o ........... , 19.6..~. THIS CERTIFIES that the building located at . Su~el~ I,ane ............... Street Map No ............. Block No ............. Lot No .... ~tll:~.tlt~:~. ~..YOI~k ....... conforms substantially go the Applicati.on for Building Permit heretof, ore filed in this office dated ........ .~.tl.~.~.....l,?° ..... 19.~. pursuant to which Building Permit No...~I~.~. iZ dated ........ ~]1~$ .... ~7., ..... 19~8:, was issued, and conforms to all of the require- ments of the .applicable provisi.ons of the law. The .occupancy for which this certificate is issued is . .p~J,V$.~e[. ~rl$..£1llll~ly..q~l~ll~l~ ......................................... The certificate is issued t.o .... ~..1~$...~..~.~. ~.~.e..~. ...................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~la..4,..~.~,..~.~.t...V.i..~.]...~. .... FOEM NO. i~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT PERMIT MUST BE KEPT ON...~REMISES UNTIL FULL CTHI5 COMPLETION OF THE WORK AUTHORI'Z-ED) N? 3923 Z Do~0 ..; ................... ~..ll,T.~.....J~ .............. , 19.~,~.. Permission is hereby granted to: .a. ~.~...?..-....~!e.:-?..v..e.. .............................................. ot premises l~oted ot ........... .......................................... ~:~:~..~ ................................................................................. pursucn( to opplicotion doted .............................. ~.....~ .......... , 19..$$, end opprov~ by the Building Inspector. ~ ~.~.~',.~ ........... udd~ng Inspector S-9 SCHD SUFFOLK COUNTY DEPARTNENT OF HEALTH Date Bldg. Permit No. - 4 1969 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at s/w/c ~ tend of Sunset Lane~ s/o Route 2~ Ma%tit~ck (Give deed location) have been inspected by this department and found to be satisfactory. R~lder - Harold R. Reeve :t, Sox ~.er - James F. Reeve District Engineer TOWN OF SOUTHOL ~f~ ¥,~ ~' BUILDING DEPARTMEN.T~/~/~f~'a,~ /~'~'~'~'~-~ ~'~L~ .~ TOWN CLERK'S OFFICE I' ~ .... ~ - ~ ~ ~ ....... pp,,=,on ........ ........................................ , I~..~.,L, ~*rmit ~o .............. Disapproved a/c .......................................................... ector) APPLICATION FOR BUILDING PERMIT 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 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 a Building Permit to the applicant. Such permit shall be kept on the premises available for i~'=pection 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 hove 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 applic.a, ble Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations or~for removal or demolihon, qa. berein described The applicant agrees to comply with all applicable laws, ordinances, bulling code and re/~l~tions~m. _~ ................... ...... ...... ..... (SignOre of applicant, or name, ~ corporation) ............. .............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................. i ......... ......................... iJi .................................................................................... Name of owner of premises ........ J*~J~J. '~*~....- *'*~****----*~eJ~,*~*.~ ........................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: ........................................ Lot No.: ........................ Street and Number ...... ..~.~.~I~C~........~..~... ............................. ~.~.~t..f~_ ........................... '~ I "7~-~ 0 unicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... '..V.,~ .~ ~q~_l~ .~........LR(~i.~.. ................................................................................... b. Intended use and occupancy ..... ...~..t...I~.~.t~.....EA[~I.~..~..~.....~,~.I..~II.~...~.!~.I~ ...................................... 3. Nature of work (check which applicable): New Building ..,~ ...... Addition .................. Alteration .................. Repair .................. ~emoval .................. Demolition .................. Other Work (Describe) ........................................ 4. Est,mated Cost .......... x~....~..$,~.~., ......................... 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 cars ............. ..T.I~,~.~ .................................................... ~ ................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use - · ~,Dimensions of existing structures, if Front Rear any: Depth Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additJans: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ....................... 8. Dimensions of entire new construction: Front ..... .~..~..-..~ ................. Rear ......~.~...'.~ .......... Depth .m~..~...'.~. ....... Height .................... Number of Stories ..................... ~J~J~,..~.....~P411~..~.. ............. ~ ................................ 9. Size of lot: Front .........~e..~. .......... Rear ....... ~..~.. ................. Depth .....~....~.~.. ................ 10. Date of Purchase ........ .......... Name of Former Owner~'~.~....J~..~l~J~l~.~./.~¥.i~Jl 1 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or reg 13. Name of Owner of premises .'~JJ~li~'.~..J.',.'~,l~'¥.~....Address ' ' ° - .... .~.l.~.~.lJ~,/~l, iJ ........... Phone No.~,~..'...~.~.~.~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor J~lJ~l,B..J~.,.~l~.~F,~Address ..... ~J~I~'I~..I..I'SA&~, ............ Phone No....~....'..~..~.~..:J 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. STATE OF NEW_YORK, t S S COUNTY OF ..,~,~.~..i~l~.t~,,, ........... $ · · (Name of individual signing application) above named. He is the ......................................... ~.j~..J~J.l~j~. ........................................................................................ 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. ~ Swam to before me this xx~ I ~, / J o ar}, bl ............................................ Coun~ (S,gnature of ~"nt) -- ~y~uis~l,~otary'Fu$~lc, State pf New Residing in Suffolk County, 52-5895900 Commission Ex~ires March 30, 1970 N~ / '