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Home My WebLink About4331-z]FORM NO. $ TOWN OF SOUTHOLD; BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~79~ ..... Date .......... Apr~t ..... 2h. ....., 19 70 THIS CERTIFIES that the building located at., 'Long 'Cre~k 'Drive ...... Street Map No. '~Yennecott ]~ck No ........... Lot No.. ~1~ ...... ~ou,~;held..--F~.,.55, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ J~a~e. 3 .... , 19. '$9 pursuant to which Building Permit No. 143~I..Z dated .......... ~tllle .....3' ' 19.. $9 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 ... PZ'~Vat~' ' one' 'fam~t'I~3 ' tl~yc~ll~ag ..................................... The certificate is issued to ' "al'la;',' '?r~e .... ¢~'~i~,~ (oWner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~Cw/...ri ..... 1~9 ................. House FOKM NO. ~ 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? 4331 Z Permission is hereby granted to: {~.od Oor~i~ A/O '~13~am l~iee .......... O~To.~.~.t, ................................................ Build ne~.~ one family dwelling ...... !o~ 1~ Y~neeot. t .~a~ . ......................................... B~.....~..O~..~l~ .......... ~ ....................................... pu~u~ to opplicofion ~ted ...........................~ .......... ~. ........... , ]9...~, ond opprov~ by the Building Inspector. Fee $.....~ .................. "'"'-/.~,~0 ~ ~--C... (' ~ /' ~' ~ ~ TOWN OF $OUTHOLD I~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... .~,~.~ ....~. ........ , 19..~.~. · ^pproved ........................................ , ~9 ........ Permit No ..................... ~ ..... Application No....~.....~......~.....~..i..*~..... 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 adjoin ng pram sas or pub c streets or areas, and giving a detailed description of layout of property must be drown 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 Perm t 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 sho]l have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bui ding Permit pursuant to the ~Buildln.g' Zone. Or.dinance of the Town of Southold, Suffolk County, New York, and other app ca~e Laws, Ordinances or Kegu arians, Tar the construction of buildings, additions or alte, ra//ions, or for remova or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordi~d ~k~t~~4~ . ............................. ...... .... ................ : ............. State whether applicant is owner, lessee, agel~J~.~, rchitect, engi~neer, general contractor, electrician, plumber or builder. .......................................................................... ..................................................................................... Name of owner of prem ses ~("~'' If applicant is a corporate, signature of duly authorized officer. 1 Locatonof and on which proposed work w bedooe /V~a No' · ~ P ......... ~ ............~ ............... : ...... ~ ................. Street and Number ~.,,~,,....,,~,,,.~..,~,,~,,,,~....,.~,, ,~:,,,~.,,~t~,,~.....:.....,.~"~,~,.~,,,,,,'J~_.~,.,~.: .................................. R.Z ' /.--~/"~.,~ Municipality 2. State existing use and occupancy ~remises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......~'.~...~....L .~ .(~,~ ......................................................................................... b. Intended use and occupancy ............................................................................................................................. ,/' 3. Nature of work (check which applicable): New Building ~' Addition Altera¢ion Repair ............ ..~ Removal .................. Demolition ............... ..~Other Work (Describe) ........................................ 4. Estimated Cost~ ....... '-' --..'f;~.~.(~..~..-..¢~:~C-~. ................ Fee ................. '-Ir L~..:...O...-~.. ....................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ J ................... 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, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with o.lterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number,,__ of Stories ........................................... .~.,~, ~ .................................................. 9. Size of lot: Front .......~.l.C) ............ Rear iiiiiii~iill ................ Depth .....?~...!...~.... ............... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...!.{.~.lt-~.~.~l~..-~:~.-~ ...... ~ ................................................... 12. Does proposed construction violate any zo13~ng law, ordinance or. Ikegulation? ..... ~J.o. ............................................... 13. Name of Owner of premises~J.L.L~-.~..l~X~Y).......~.e~l~.....Address .~.7..'~.....~....9...~....~.....~.~.;' "- "~ Phone No ..................... Nome of Architect-..,..--__ /2 _ ,_ .-~Z~Z ......................................... Address .......... , ................................. Phone No ..................... N o./~..-. J...O. ~(ae... Cant ractor ~..:....:~....~.~. .................. Address ..... !. ............................... Phone Name of PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property fines. 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, S. COUNTY OF ................................ ................................................................................................. being duly sworn, deposes dnd 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 make and file this application; that all statements contained in this application are true to the best of his l~owledge and belief; and that the work will be performed in the manner set forth in tl~e ~a~p,~ication filed therewith. Sworn to before me this J ! I II /1 ~ ,......~. ............. dayof ............. ~ ............. , 19 ..~--/V~. ,~-~ , .L (J~'"'~' ,~'//~/ Nota~ Publ,c,~.~~Cou~~; appl,cant) ~' ~. ~IZ~ ANN N~LL[ I ~ARY PUBLIg, State ~ New York No. 52-8125850, Suffolk Term ~pires Ma~ 30, · ' FOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. T214P01~It~ Certificate Of Occupancy No. ;.370b ..... Date ..............I~C,,.. ~8 .... , 19.69. THIS CERTIFIES that the building located at .. I, o1~. Cr.~ek. D.:eive ...... Street Map No[~'~eC.oJt'~. P~Block No ........... Lot No..'~.' ..... ~ll%lao~d.. N.,~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Jo,tie...~ .., 19.69 pursuant to which Building Permit No.. dated .......... gllr~e .....9.-, 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 . pl~l¥~kt.e.. 0;a.~ .fa~at. lly..dMelllng ...................................... The certificate is issued to .. ~.ikl~a.ra. Pr.ice ....... ~t-~I;~:r ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · Nov..~.,..1969..by.R,.~illa ..... :Building Inspector aouse # S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY at CONCERN: The sewage disposal facilities for a structure (Give deed 'locatio~) located have been inspected by this department and found to be satisfactory. District Engineer District Engineer