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Home My WebLink About4394-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificste Of Occup,~ncy No. ~ .3?06 .... Date ...... , ..... DO.~ .. 2~ ....... , 19.69 THIS CERTIFIES that the building located at .. -E/~..Peqt~h. A.V~ ...... Street Map No .... ~ ..... Block No...y~ ...... Lot No. ~ ...... (~llt~cl~ogtte" N,Y~ ..... conforms substaniially to the Application for Building Permit heretofore filed in this office dated ........... ~a~ ... ~ 19 .~. pursuant to which Building Permit No. ~3~..g dated ....... ~.y .... ].8... , 19 6~, 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 .. Pr-~vate. -one..$amlty. d.w~tlimg' The certificate is issued to ...Anna .Ca$~ ....... ~: ........................... (oWner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Dee. ,~[. · .t969.. ,~y. R,,..ViLla ..... Building InspectOr ~ouss ~ 76Y FOR~ NO. 2 TOWN OF $OUTHOLD :. BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, 1'4. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 439 Z Permission is hereby granted to: ........ ~m~.,.ge~ .............................. ~ .................. ............. ~.e ~'g,~b_ ..&:~ze ..................... ! .................. .................... ,g.,~t~ ................... ~ .................. to ............. .t~.~ ~.q...~e~..,o~.e..,tt.~;t~,~:...~,~,~.,'L.t~ ~ ....... .(~.q~.~g...~.o.,~.e..). ................................ at premises located at ............................... .~.....P.e.q~tash..~ve ...................................................... .............................................. ~-*U.t,~ ~.0 ~:O.e ....... ~ ,~ E.,~ ........................................................................... pursuant' to application dated ................................ ~T:t~,~ ....... ~J~,...., 19.~.,, and approved by the Building Inspector. / / ~?-~ .......... ~,,.~: ................................. .~ ............ ~ Building Inspector / SCHD SUFFOLK COUNTY DEPARTMENT DF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Gi~ deed~catio~) ~ have been inspected by this department and f'ound to be satisfactory. District Engineer Disapproved a/c ........................................................ APPLICATION FOR ~ PEP. Mn INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.~in c~pllcate to the Building Inspector. b. PIo, t .pi.an sho~. ir~ I,oc.ation. o..f lot a.nd of bu.ildi ~ngs on pre_rnise~, relationship to adjoining premisee or public streets or areas, aha giving a ama.ea aescnptlon of layout of prapem/must be ~ on the diagram which is port of this application. c. The work!covered I~y this. application may not be commenced before issuance of Building Permit. d.., ,. U,p~I~. ~..~ of: .this..applicationr .the Building Inspector will issue a Building Permit to the applicant. Such permit sna ce Kept on me prom ses available for inspection throughout the pragress of the work. e. No building shall be occupied or used in whole or in part for any puq~ose whatever until a Certificate of Occapanc¥ shall have been granted by the Building Inspector. ge.A..P. PLI ~CATIO~N ,!S HEREBY. MA~DE to the Building Department for the issuance of a Building Permit pursuant to the u,a!n.g. Lone. urn. inance or .m.e ~own .of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ulat~.o, ns, tot the construch.on of buildings, additio~s or alterations, or for removal or demolition, as herein described. · applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address ~f applicant) State whether applicant is owner, lessee, agent, architect, eagi~er, general contractor, electrician, plumber or builder. .......................... ,0.. ............................. Name of owner of premises ....... .~........'~....~...~.. ....... ..~...~...~. ............................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which p~ work will be done. Map No.: .......... ~ ........................ Lat No.: ..... ,.....~"-~ ............ Street and Numl~e~r ...~.:.......~....2: ............... ~.. .......... 'v ............................................ ~.., ......... ~ ............................. 2, State existing use and occupancy of premises ond int~ecl use and occupancy of proposed construction: V o. Existing me and occupancy ............... ~.'.'~,, ....................................................................................... 3. Nature of work (check which applicable): New Building ,..~..... ...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .............. .... Other Work (Describe) ........................................ 4. Estimated Cost .... ..~....~)....~..~..~..'~. ............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~ .~....~.....e~....~...~....Number of dwelling units on each floor ............................ tf 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 af same structure with a.lterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... /...?~..~. ..................... Rear ...... /.....a: ............... Depth .....~....0. .............. / Height ~'...c~..; ...... Number of Stories 9. Size of lot'. Front '"' '~"q"~. __ ~,r~Rear ................... Depth ...'.~....~...', ............. -- 10. Date of Purchase .... .~...¢~....~......../.,~.j.~...Z..(..~. ....... Name of Former Owner i/~'..('..~..'..~.,.~..~...../.:...Z~...°...~...J,../.~...~... ..... 11. Zone or use district in which premises'are-- situated ........ ~.~... ......." .~....~,..~.~.~..D.......I~..~.~ .~..~...c...:; .............................. 12. Does proposed construction violate any zoning law; ordinance or regulation? ......... ,~.....~.. ........................................ 13. Name of Owner of premises ..~.....,,:!d...g~.....x:~....,....~g.~...Address ...,,t~.c~.~.T.,...~:.~...i ....... Phone Name of Architect ......................~i: .............................. Address ............................................ Phone No ..................... Name of Contractor ............. ~:'::; ........................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street end block number or description according to deed, and show street names and indicate ~vhether interior or corner lot. STATE OF NEW yORK~ ~, . ~ ¢ ¢ couNrr OF ................... ~..~.~ ........... ~.r...~ ........................... being duly sworn, d~oses and says t~t he is the applicant (Nome of individual signing application) 0 above nomed.~He is the ......................... ~.~......~ ...................................................................................................... (Contractor, agent, co~orate officer, etc.) ~~, and is duly authorized to perform or have perform~ the said work and to ~ke ~d file this application; that alt statements contained in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the applicatim filed therewith. Swam t~ore me this j /q . Y J .... , _ ........ ~..~4 ...... ~..~ ............................. N~ ~c,. ............. ~~ ........... ~ ,-.~St,,e o{ ~.~' (Signature of applicant) ?.t~.O · G. lB K n U14 So,o FLE[T'$ N~CK ROI~D KHO~VN RS SCI3L[~. ~50'. I" 19 = /AONU~LNT IJURVEY£1~ . JULY il. 19&9 YG~ TUYL at LICENfEO LIINP 6URVr:YOKS GREE:NPAKT , NI.~/ YOKK 5U~VEYEn FOI~, ~. R R~UI4 5.4.~' ~' ~ 50.0 N. 4.B' 2~' O0 ' W. I:'L[: IT'S Nr. CKROI:ID i~NOWN SCEILF=. ~{}'-I"