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Home My WebLink About4556-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z39~g ' ' Date THIS CERTIFIES that the building located at Map No. ~X . . Block No. ~x . Lot August. a6 , 19. t~rt Roa¢l W/8 ¢ar~,oll A~Fl~treet conforms substantially to the Application for Building Permit heretofore filed in this office dated ~OV,. ~ , 19 69, pursuant to which Building Permit No. ~6Z dated NoV ~ , 1969 , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ., ~rtva.te one family, dwelling ......................... The certificate is issued to James H,abba~% .... Owme~' ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Atlg...26..i970. - .by R., ?itta Underwriters , N82~963 /.~...~ ~..~ House # ~%+~ Carroll Ave ...... r~..- ...... Building Inspector { TOWN OF $OUTHOkD BOlIDING DI:PARTMI:HT TOW~ O. ERIC$ OFFICE SOUTHOLD, N. Y. BU~LD!NG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 'O N. 4556 Permission is her~y granted to: .... ~:. ~~.t~,...~..~ ~t,,~..~.~ ............. .~,t~'~ ....... ll,tr-, ................................ to ........... .,...~.~....~...~i~... ~.~l,~.,. ~WtlJ~. ........................................................................ at premises located at ............ ~O.~MA...OF..~..[~.~...(~&,~/'*~O~..A.TIL~J~...i~I/~L.,L,~eR,.J/~. ............ ............................................ ~,~ ......... .~I~ ................................................................................ pursucm~ to ~ppli¢otion doted ......................... ~.~.: ........ ~ ............. , 19.~1~.., ~nd opproved by the Building Inspector. Fee $...~..~..~...~,. ........ '.. Building Inspector ~ ' S-9 SCHD RECEIVED F;70 AUG 26 P~ t2:22 ~EPARTMEN? OF hLALTH RI/ERhEAD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located e (...a~. ed loc~lon) have been inspected by this department and found to be satisfactory. District Engineer Title No.' 5159 NOTE: I-- MONUMENt' FOUND O-'MONUMENT I~AGED SURVEY FOR JAMES M. HUBBARD PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: I "= 40' OCT. 12, 1969 RUTH A. HUBBARD ~UARANT£ED TH~ UNITED ~TAT~ OF ~M~RICA FARMER~ HOME ADM/N/STRAT/ON P~S$1ONAL ~IN~ LAND ~VE~R,H~ L~ NO` RIV~BH~AD~ ~.~, T/t/e No. 1365159 NOTE: ~= MONUMENT SURVEY FOR JAMES ~ HUBBARD PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NY, SCALE; I"=~0' OCT. 17, 1969 RUTH A. HUBBARD Title No. 1~6~159 o N~I'~: ~-' MONUMENT POUNO 8~ MONUMKN~' PLA¢~O SURVEY FOR JAMES ~. HUBBARD PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY. N Y. SCALE: 1'--40' OCT. 17, 1969 AUG. II, 1970 RUTH A. HUBBARD shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pureuant 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, building code, housing code, and regulations. - I ~ ~ . ~ 1~ ~ t ~min~ ......... 1.:.~..:......7 ............. , lg.~J.. ~- _ A~li~tion N~ ..~.~.~ ....... ~ed .......... Z.~.~.~ ...... .,J, ........ , 19.~:~. Pe~it No....~.~..~ .......... ~ ~ ~ .................................... APPLI~TION F~ BUILDING PE~I7 ....................................... , ..... INTRUSIONS ~. This Qppl{cati~ m~t be completely fill~ in by ~ewriter or in ink and submi~ in ~plic~e to ~e Building In~ector. b. Plot plan shying I~ation of I~ ~ of buildings ~ premiss, relationship to adjoini~ p~mi~ or p~lic st~ts or ar~s, and givi~ a ~ailed ~ri~i~ of I~t of p~ must ~ dr~n on the diagram which is ~ of ~ application. c. ~e ~rk c~ered by this applic~ion may n~ be commenced ~fore i,uonce of Building Pe~it. d. Upon ~pr~al of this applicati~, t~ Building Ins~ctor will issue a Building Pe~it to the ~plicant. Such ~rmit shall be k~t on ~e premi~ avail~le for in~ection throughout the p~r~ of the work. e. No building s~ll ~ ~cupi~ or u~ in whole or in pa~ for any pu~e whatever until a Ce~ific~e of ~cupancy (Signature of applicant, or name, ifg corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contr.actor, electrician, plumber or builder. Name of owner of pmmises ..~....~LP4~--~ ............................................................................................ (Name and title of corporate officer) I. Location of land on w~ich done. Map No.: ...~/...~ proposed work will ............. Lot No.:~. ,- ,, .-.~.......be Street and Number '~,I~'-~' ......... ~': .... : .......... ~t- /.~/z..~' ~&~. ~ww ~ ~ ~ Municipality 2. State existing use and occupancy of premise~ and intended use and occupancy of proposed construction: a. Existing uee and occupancy ....~ .............................................................................................................. ................................................... 3. Nat~e'af ~ork (check which applicable): New Building ...... ~ ...... Addition ' Alteration ~ ' ~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ............................ .: .......... 4. Estimated Cost ...... L..'~..J..~.....~... ................................. 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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ~...~...~.~../!. ............. Rear ..4~.~..~..~ ......... Depth .~.....~..~....~...~.... Height .................... Number of Stories ........ ./. ........................................................................................................... Size of lot: Front ...... ~.....r~.. .............. Rear ..... /~.~. ..................... Depth ...~...~.. ..................... Date of Purchase ........................................................ N~e of F~r.rner.~vner ...................................... ' ........... ....... Zone or use district in which premises are §ituated ...... ~Z.., ......... _/I./R~F~..~ .................................................................. Does proposed construction violate any zoning law, ordinance or regu at on? .~ ' Name of Owner of premisesr,./ dclress/...~...~.~...~.e/-~Lx:w~... Phone No.~...~......'~'....~..~ Name of Architect ............................................ ~--t'-~ '. ~: ......... Address ............................... t'~';'-;;' Phone No;~.~.f. ............ Name of Contractor ,~.~..~..-Address/~f~..~.-)r~.~. Phone No.~..~.,~....-,~,~.a... U 10. 11. 12. 13. 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 comer lot. STATE OF NEW YORK, J e e c ................... :~...,~.~¢,cT:I~%~....~.....iX...~ .......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........... ~..~ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rnoke ond file this application; that all statements contained in this application ore true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ........................ day of ............................................ , 19 ........ Notary Public, . ........................................................... Coun~ (Signature of applicant) ':. ' d;, , ,. i II