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Home My WebLink About4038-zFORM ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . .l~a~au. l~otnf~ Road .... Street Mal~.~.no~.d .... Block No ........... Lot No...7.6.. C. utch~ue,. ~W..Z~... con~rms subst~t~ally to the Application for B~ld~g Permit heretofore filed ~ this office dated ....... ~~. ~., 19 .~8. p~suant to which B~lding Pemit No. &~. ·. dated ...... 8~K..~1~., 19.~., was issued, and confoms to all of the req~re- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .~l~t$. ~n~. ~.~ .~ ....................................... The certificate is issued to ...~lXton. ~$~ ................................. (owner, lessee or ten,t) of the aforesaid building. Suffolk Co~ty Dep~tment of Health Approv~ .................................... B ~uilding Inspec~br 9475 FORM 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) Ne 4038 Z Permission is hereby granted to: ......... .~T.e...~J~IZ~Q~....A/C.....~[;L~te~... G~eeT~te t!~ to ..[~U/ld..~,u..ad.d,tti~r~..or,..a~..ex.t. st.i~g..~t~et.]:ir~g ..................................................... ot premises locoted ot .....1..o...t....7...6.......&....m~...e...n.~..e..d... :i'.~D...l~au..P.~,J. nt,...~.rap ............................. ............... ~l.s. ~.a..s..o. au....P.o~.t ~o~t C.u~h~ ...... pu~suo~t to opp,¢at~on doted ........................... ..S..e.~..t. ....... 9. ............. , ~..~.~.., and oppro~ed b~ the Building Inspector, Fee $..~,.?...0~.., ............ Building Inspector ·OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................, 19 ........ Permit No ............................ / App,cat,on No ...... Disapproved a/c ............. ~ ................... ~ 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. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and givlng 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 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, ordina/~es,/~building code and regulations. / ,~...m~..~. ~_.~.~0j neet nra ntr tr State whether applicant is owner, lessee, agent, arcqitect, engi , ge · co ac o, electrician, plumber or builder. [/ owne, o, ...... ................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~/~ ~/ /H~:'~, *~ '~ 1. Locat on of land on whicl-/~roposed work w II be d°,ne. Map No.: ~.~. ~v.~t'.~.~'~t~.....~.~..~.~...~.. Lot No' ~'~ Street and Number ,~..' .~.....~..~,. ,~,, 0 .~..~./.w/4- ~.d,,~ OU ~.....,~...~c~.,.~."'"~..~.~ ........... - ........................................................................... ..... '! ..................... 2. State existing use and occupancyl~ -~.'.°f premises and intended/,uz/~....~..../~(.....~.,and occupancy of proposed construction: a. Existing u.s~e and occupancy~,--L/./.....~'/~.....////'...~../~.., ........ .................................................................... b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ....... ~Alteration ...~ ..... Repair ................Removal .......... Demolit on ............... atilt Work (Describe) o ........................................ 4. Estimated Cost .......... ~.~..~......:.~...~.. ......................... 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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of exis~.~tructures, if any: Front ...;....7/.'..~. ............ Rear ...... .?.../.:.~ .............. Depth .......~..~......~... Height ~r./~...~.~...~..~. Number of Stories ...... / ................... i ............. ...................... Dimensions of same structure with alterations or additions: Front ....... ~..../.'..;~..! ................. Rear ..... Depth ...(~/.:..~ ................. Height ~lrj~...../~...~..../~'.....Number--~' of Stories ........ ~ ...................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ....../~.~...~...:..~.. ....... Rear ......... /..~...~.:...O...~ ...... Depth .......... ~.~..~..-....~....'~-... 10. Date of Purchase .................. : ..................................... Name_of Former Owner ........ ~.....; ........................................ 11. Zone or use district in which premises are situated . 06~ .~.~...~..0..~.~'..~ J~..~..'i ...... D r n ~:~ ~' ................................ 12. oes p oposed co struction violate any zoning law, ordinance,or regulation ......... ~ ........................................ 13. Nameof Owner of p~remT/~.~Z,.~'...~...~....~../~..~.~./~.~/~s//l/ ' /~'~ ~//'~..~..~.Z~. ~o'ne No ~/.~'.~..~ Name of Arch tectf./~.~....~'.~...~.~. ~. ~Z'..~...~..../.~...~..~_ Addres~.'.'.'~-.'i ~.'~i~ii~[~'.~ ..... Phone No' "i.~'~.'~" Name of Contracto~JO..(...~.....~..'../i~..//~...~.~..~ ........ Address )4~.J..~...~..~.~.g~...~..d.~.~ .~. 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 dumber or description according to deed, and show street names and indicate whether interior or corner lot. ,, I [o~' STATE OF NI YORK, }SS COUNTY OF ................................ '' .Lo'/' 77 .......... ,~..,9:.Zl-..,/~,,.....JM,~.-.--~,~.~,,.~..~...~,,, ........................ being duly sworn, deposes and says ,ha¢ he is the applicant (Name of individual signing appli~ion) ~__ __ above named. He is the .......................... Z~..Z.~....~ .............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke 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 fo~h in the application filed therewith. Sworn to before me this ....... ..... ....... Nota~ Public,. .................. , ............... R.~...b .......... :.. ~¢n~ ~t~,::L'"~'~;;';~";~i[~;~t) ............................. ~ ~ ~ ~ -~ Neta~ vu~lic, ~tate Ot ~ew YerK ~ k ~ ~ld ~ ~U ~ ~ Residing in Suffolk ~un~ ~ ~ ~'~~ ~ ~ No, 52-7031050 ~ ~m~ission Expires March 30, 1970 "Unauthorized alteration or addition to a survey mll~ bearing a licensed land surveyor's seal is a violation of section 7209. sub-division 2, of the New York State Education Law." "Only copies from the original of this survey marked with an original of the land surveyor's embossed seal shall be consi- ~Jered to be valid true copies." "Certifications indi- cated hereon signify that this survey Was prepared ~ accordance with the existing Code of Practice for Land Surveys adopted by the New York State ~ssociation of Professional Land Surveyors. HAP OF LOT No. 76 AS SHOWN ON 'AHENDED NAP A OF NASSAU PO]NT"~ SITUATED AT NASSAU POINT, TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK CERTIFIED TO ARISTIDIS & ELIZABETH SPERES FIRST AHERICAN TITLE INS. CO. TITLE No. 610-S-1036 ~HAP No. 156 FILED 8/~6/22 SCALE: 1"=50' BERNHARD H.HENN L.S. 121 EDDY DRIVE DIX HILLS. N.Y. N.Y.S. LIC.NO. 49175 DATE 7/1B/S5