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Home My WebLink About4448-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. ~'~816' ..... Date ...............Jl~e'' 'Z ..... , 19. ~q) THIS CERTIFIES that the building located at . ~/eLle..A'~e. & 'Peek-Place Street Map No. ltal*weet, ttom~ck No ...........Lot No. q~ ....... lJo~thold...J~oZ., ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........Sept ..... ~..., 19..69 pursuant to which Building Permit No. ¥:~.~.. dated ............. fSept; .... ~, 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 'Pr~.~ate' 'one. famtX3r 'dve~lin~ ....................................... The certificate is issued to . -Frank- Lek~.~ ......... 0VI~A' ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 'May ' '2'/' · .¶9~O · 'b~"-R~. T'~la .... l~ou~e ~ 13~0 Welle Ave 80 Peek PI l~O~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEI~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4445 Z Permission is hereby granted to: ................ ~ z~:..,~,k '-,. ~I~, ................................... .................. ~,e~,~t~.e.'.t 4. .......................................... to .................. i~t~.Z.~i...~e~..ette..~'~J~.~,..eL~e~.~.~,~g .................................................................. at premises located at ................. jj~,~:¥,a~.....lie~e6.....~,..:J......,1.~j...j~ ...................... ~ ............... ............................................ ll~k..P~..&..We1.&.~ ..libra4 ............ ~t.l~ m~4 .......... ~ .......................... pursuane to application dated ........................ J~j)~ ....... ~ ................ , 19...~D9, and approved by the Building Inspector. Fee $..~t)..,J~l .......... Disopprov~d a/c .............................................................................................. Alqq. lCATION FOR BUILDINQ FERMrl ~ Date September 6 0 .......................................................... , ...... INSTRUCTIONS a. This application must be completely filled in by tl~ewriter or in ink and submitted in duplicate to the BuildinJ~~ Inspector. ' b. Plot plan showing location of lot and of buildings on premim, relationship to adjoining premises or public streets areas, and giving a deteUed description of layout at properly must be drawn on the diagram which is part of thle 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 inepectior throughout the progress of the work. e. No building shall be occupied or used In whole or in part for any purpaee 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, ordinances, building code, h.ous~Rg j~odej, croci regulations. (Signature of applicant, or name, if ct corporation) H,,m~el Ave 8outhold (Address of applicant) State whether applicant is owner, lessee, agent, architect~ engineer, general contractor, electrician, plumber or builder. .......................................... ~f'~.q~..-. ................................. ~ ....................................................................................................... Name of owner of premises ....... ~'~.an_lr ....... T.eirlela ........................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Harvest Homes 1 1. Location of land on which proposed work Street and Number ......... ..~./..S..~.~.~.~§:..~.~.~/..~.~?..e.~.~.~:~.~.~.g~9.~g~g~ .................. "....i....' ........ 2. State existing use and occupancy of promises and intended use and occupancy of propaeed comtrUction: a. Ex~sting Use ~lnd occupancy~ ...... .I[.~.1;...~,~.~j ............ , ........................................................... 'ii .................. j .... b. Intended ~Se and'oc~cupancy ...:,: ...... 3. Nature of work (check which applicable): New Building~....Z.B~r..... Ax~lition .;:.~. .............. Alteration .................. Repair .................. Removal .................. Dem~i'ition.....~ .........~.. ~Other Work (Describe) ........................................ 4. Estimated Cost 32~)~C).....~.. .Fee ..... .~,~.(~ ........................................................................... · (to bii paid on filing this application) 5. If dwelling, number of dwelling units (t~. ...'.....;Numbe~elling units on each floor ............................ If garage, number of cars ....2.. ........................... ...~)...~.. ........... ;.,. ............... : ...... : ............................................................. 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 alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~..-.~. ................ Rear ........~'~.-.~. .......... De~th ..32e~ ............ Height .................... Number of Stories ..~f...~ ......................... : 9. Size of lot: Front ...1.3~[ .................. Rear ...........~.5.~ .................. Depth ...... .1.~.~ .................. 10. Date of Purchase .......... .1..~..~. .................................... Nome of Former Owner ..... ..O.~.~g.q~;~,~. ............................... 11. Zone or use district in which premises are sitU°ted ......... ~.......~[~k~..'~. ................................................................ 12. Does proposed construction violate any zoning Iow, ordinance or regulation? ........... 4:~ ........................................... 13. Name of Owner of premises .~.X'A-~-~..~tl~4Ch ......... Address .......... ~Ol~t.~cJ:to.~Cl .............. Phone No ..................... Name of Architect ........... .~.~...~,.~.I~.~X'~ ................... Address ............................................ Phone No ..................... Name of Contractor ...~..~.~....C..Q~,~j.~.:~ ........................ Address ...... ~QTLI~D~;D~, .............. Phone No ..................... PLOT DIAGR~MY[ Locate clearly and distinctly all buildings, whet.her e.x!s, ting or p,.mflo~., .ar~, inai.cat,, all .set .-?ack ciimen_,~i _.o~[cra~e property lines. Give street and block number or aescnpr~on occora~ng ~o aeea, aha snow street names aha ma c= whether interior or corner lot. STATE OF NEW yORK, t S S COUNTY OF ...~lLff'olir ........... )' · ' ]i'z'8-z'~: T~e..~..~.~,.~..,~ ............... being duly sworn, deposes ond says thor he is the applicant (Nome of indiViduol signing application) above named. He is the ............... .(~1~.~.. ......................................................... ~ .................................................................... (Contractor, agent, coq~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have pe[forme?l t,he sal.d .wo,rk a,nd_,to make and file this application; that all stetements contained in this application are true to me ~ at ms w-~wmage and belief; and that the work will be Performed in the manne~ set forth in the application filed therewith. Swam to before me this e~ E ABETH 'A, ' ............. :"~- ..................... S-9 SCHD TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~ ~. ~ ~--~T (Give deed location) have been inspected by this department and found to be satisfactory. ~AY 2 7 1970 District Engineer