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Home My WebLink About4571-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.~ ~'-~.;.~.. ..... Date .......... THIS CERTIFIES that the building located at PV~ H~0,~, .~ .~a~ ~. S~n~ MapNo. ~ .... 'BlockNo.. ~...LotNo.. conforms substantially to the Application for Building Permit heretofore fil~ in this office dated .... ~o~ .... 2t, 19. ~ pursuant to which Building Permit No. ~7~Z dated ..... ~Qy.. 2~ . , 19 ~, was issued, ~d conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate issued is .. ~l~t~ ~ family dwett~g ................................... The certificate is issued to ~r~ & E~.M~S ~e~ (D. fi~lakson..tenant) (owner, lessee or tenant) of the afores~d building. Suffolk Cowry Department of Health Approval .Feb .8, ].9~]...by. R, .V~la ...... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°` ~571 Z Permission is hereby granted to: ............... ~ia~...Y~a~..&. ]R~.~e. .................. .................... 9~-....~.r -.~e~.-~.~ ................ .................... ~'~e~...~mle~ ....... ~,,~ ..... tO]itC to ............. ~la~L~l..~..~e. '~edl~ ~, ~ · .d~e~!-t:~ ....................................................................... at premises located at ................... W~..-..-~-e~l~l~..~[~/[~.-Z~g~J~-)...~.~--.~,~..----~:~14~..~ ..... ....................................................... ~e~t'""7,~'~' ......................................................................... pumu~cm_~ to application doted ............................. ~O~ ......... ~$ ......... , 19...~, and' approved ,by the ,%? Fee ~....~t~,~ ........ Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $ou~hold, N. Y. TEMPORARY Certificate Of Occupancy No. ZI*I 56 .. Date THIS CERTIFIES that the building located at l~t Map No. xz Block No. XX Lot No. ~x Feb 16 ,19.7t ':Diedricks RA" Street Main Rd. Orient N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .New .. 21. , 1969 · pursuant to which Building Permit No. dated ·. · Ney · 28. , 19 69 , 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 Priva'te' erie The certificate is issued to of the aforesaid building. family'*we~2ing ........... H~rry & Evelyn Mear~s ...Owners (owner, lessee ortenant) Suffolk County Department of Health Approval Feb 8~ 1971 · b2 Ro. Villa House ~ 2~05 Diedricks Rd (PVT RD#7) /Z. , ~ Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewag.e disposal facilities for a structure located / (Give deed locatio~) ' have been inspected by this department and found to be satisfactory. FEB. 8 1971' Ckicf of e~-,-~.l F~mineerin~ Services INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plo, t .pi.an sho~w!n.g. I .oc.ation. of. lot .a.nd of buildings on premiMs, relationship to adjoining premises or public streets or areas, cna g~vlng a deta,ea ~escnpt~on at ~ayout aT property muSt be drawn on the diagram which is port of thie application. c. The work covered by this' application may not be commenced before issuance of Building Permit. . cf,.,, U,ppn. app.r, oval of .this ap~.!ic, a, ti ,o~, the Buildin~l. Insi:~. ctor .will issue a Building Permit to the applicant Such perm t snail De Kept on me premises aVOllODle ror inspection mraughout tt~e progress of the work. e. No building shall be occupied or used in whole or in port 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 Bu Iding Perm t pursuant to the ~Bufldln.g' Zone. Or.dinance of the Town of Southold, Suffolk County, New York, and other app cab e Laws, Ordinances or~l~ ~egu orions, rot 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. (Signature of appl~6nt, or name, if a corporati~'~')' ........ .............. ........... (Address of applicant) Staten Island, N.Y. 10310 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OTd~D-e ~ Nome of owner of premises ......... ~az~.;~_.a.:.~s..~.nd...~..e'l ~..Fm.a.~z~s ................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of Ioncl ~ which prapeeed work will be done. Map No.: ........................................ Lot No.: ........................ Street and ...... ~ ....~.~, S.~.~L~-,~.~... ~.~. ~..~, ~,D ..RG I~.~ .,...Q)?.~,~ ...,... ~0.~. ~g.~. ......................... .......... State existing u~ o~ ~cu~y of premiss and inten~ ~ a~ ~cu~y of pr~ c~i~: a. ~i~i~ ~ and ~cu~ ............. ~.~.e....&~...~.D.~.~...~...~.~.~...~ ................. ~ror ~ daughter ~d son:'~law,'"~tha~e' ~ ......... Donald Gulla~son) 3. Nature of work (check which applicable): New Building ...... .~....:.... Addition .................. Alteration .................. R~pair .................. Removal .................. Demolitior .................. Other Work (Describe) ........................................ 4. Estimated Cost .............. .~.7. Z.0...0..0.. ............................... 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 c~rs ............................................................................................................................................. 6. If business, commercial or mixed occupancy, spec!fy nature and extent of each type of use ...~/.A ................. · NA 7. D me~s~ons of ex sting structures, f any Front ........./. ................ Rear ................................ Depth .................. Height ........................ Number of Stories ................................................................................................................. Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......~..6..t. ........................ Rear ......~...6..~. ................ Depth ....3..It-.I. ............. "....~...?~._..~ 1 - with attic for ezDansion Height ~ umber of Stories ---t0 ~ ' 9. Size of lot: Front .; ...... I~.;.,':...;..Lu... Rear :..1.O~:,..~.... ~ ............... Depth...,,~ J~0G! ................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... no 12. Does proposed construction violate any zoning law, ordinance or regulation? ........................................ ~.]:.~. ........... ~ , . Harry Mearns & Address 96 E. Raleish Ave. Phone No SA 7-2028 13. Name of uwner o¥ prem,ses '~-'~'~"1"~:~'"~'~'[';~ ........ ~'~.'~"~'~T~n~l."s"'~'~' ........................ · none .. Name of Arch,tect ...~.~4~...~.[~..~..~_~..-[~;Icl~r~Su.~.l....~.~.~.~..~-~...~.6~ ~Lt~l~yt~.~· ............... Nome of Contractor elect~.i¢~ ezcavatTLOnsAddress z~cta=~on~ e c. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, ond indicate oil set-back dimensions from property ~ines. Give street and block number or description according to deed, and show street names and indicote whether interior or corner lot. "A"-District N/S Main Road, Orient, N.Y. on land owned by Harry and Evelyn Mearns which is located between land owned by Deidrick and Brown in front of Hess. l~or greater clarity of below diagram, see attached diagram. 1-- / ST^T OF ................ ~ ................................................................ g duly sworn, ~ ~ / ~% ~ n d~es and say~ t~ he is t~ applicant (Name~ individual si~ing ~licati~) a~ve named. He is the ......................................................................................................................................................... (C~t~tor, ~t, co~orate officer, ~.) ~ said owner or owne~, and is duly aut~riz~ to ~rform or h~e perfo~ed t~ ~id work a~ to ~e ~ file this application; that all statements contoin~ in this application am tree ~ the best of his kn~l~ge and ~lief; and ~at the work will ~ ~rfor~d in the manor set fo~h in the ~lic~i~ fJl~ ~ith. Swam to ~fore ~ this ~ . , ....................... .............. .................... Nota~ Public ...~~~.~ ......... ~ c. eE~SON (Sign~m of a~li~nt) / W o \ \ \\ \ \ i H~$