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Home My WebLink About3720-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~....3....2..4.'.g. ............ Dote ...................... ~U.~ii~.t;..~0., .......... , 19,68... THIS CERTIFIES that the building located at .¢.O~.~¢;l,~g'.~OlL.~,.O.~l, ................................. Street Map No ....................... Block No ....................... Lot conform~ substontiolly to the Appiicotion for Building Permit heretofore filed in this office dated .................... ..N..o...v..e..m..~.e..~...2.4..~ .................. 19..6...9... pursuant to which Building Permit No..3.'Z. 2.Q..~. dated .......... .~..o...~..e...~..~...e..~,....2..~.., ................ , 19...~...?.., was issued, and conforms to all of the requirements of the app]licable provisions of the law. The occupancy for which this certificate is issued is ........ Private one family. ....... The certificate is issued to ......~...=.~.......A..~.e..1......~..o.~....{..~qX1,.~.). ...................................................... (owner, lessee or tenant) of the aforesaid building. Health Del~t. Al~l~roval, August 27, 1968, Robert V~lla TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N?'3720 Z Permission is hereby granted to: ..... ~,,...~.~....~.~....~..~,~..~a~:~ ..... to .,~o.~t~ ..en...e~,a.'c&~..~l.~e:[L~-~...~c~..~a~...:~a~ ~ .................................................... at premises located at .~.~)~.,~q~ ...... .~.~$~k',j~...~....[r-)~,~..~~- ........................................ .......................................... Cttt~ehOg~ ....... ~,.~.,- ............................................................................... pursue:ntt to application dated ,,;'. .................... ~,i.J~Qlt .......... ~. .......... , 19....,~ and oppreved by the Building Inspector. *J.O ................ S-9 SCHD TO WHOM IT MAY SUFFOLK COUNTY DEPARTMENT OF HEALTH Date AuMust 27, 1968 Bldg. Permit No. ~TP0Z at CONCERN: The sewage disposal facilities for a structure South bide of Carrin~ton Rd. Nassau Point (Give deed location) located Cl~tcho~ue, ~outhold have been inspected by this department and found to be satisfactory. DistrieC Engineer District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19...~:.!.. Permit No ........... Application No. '~ 2'~0 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 Jot and of buildings on premises, relationship to adjoining promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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 Permit 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 shall hove 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 lows, ordinances, building code, housing code, and regulations. ''~ ~ (Signatur~of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ........ .......................................................................................................... Name of .......................................... 7' ............................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number .............. ~..~.~..)'.)~.~.g.:~.....[~.~.~,~. ......... ~..~'.~..~....~..C~)~. .......................... / Municipa~ty 2. State exi~ing use and occupancy of premises and intended use and occupancy of proposed construction: oc .pa,c .................. ........................................................................................ b. Intended use and occupancy ........ ~.....~.~m:.:I~~ ........................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. ~'__Rem°val .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ....... ~....,'~..~..¢!..(¢. ................................... 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 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 .................... kleight ........................ Number of Stories ...... ,~ ..................................................................................................... Dimensions of same structure with alterations or additions: Front ........ .~.....~....f~ ............ Rear ..,,~...~...~..¢. ......... Depth ....... .~..,~...~..,.-~,.. ........ Height ............................ Number of Stories ..... ~ ....................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of Io,: Front ......../..~...¢.~.... Rear ...... ./.....¢~.....7..ff'.. ............. Depth ..... ~..~..?,.....~'....; .... 10. [)ate of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district Jn which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ ~ 13. Name of Owner of premises ........ .~....¢....St..))..~..~. ........... Address ./.~.1~.¢,,(..~.~..../~....~.. ............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor l~..~.-~...~,.,~,,~.~...b....~k.. ............... Address ......~..~..'~....c..~...9..~.~.~...~.. ......... Phone No.~.~..~.:t..~...~..¢7:../ PLOT DIAGRAM Locate clearly and distinctly oil 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 corner lot. ................................ ~ .............................. dui sworn de oses and sa ~ that he ~s the a phcant (Name of ~ividual~gnmg apphcahon) ~ __ ~~ (Contractor, ogent, corpo~ote officer, etc.) o~ said owner or owners, a~d is duly outhorJzed to perform or have performed the said work and to make ond this application; that ail statements co,rained in this application are true to the best of his I~nowledge and ~elie~; and that the work wii~ be performed i~ the man,er set forth in the appJJcofion filed therewith. .............. day of ...................... , 19 Notary Public, (.t~ ................................. ouny~ / (Signature of aCplicant) ~ i~OTARY PUBLIC, State 0t New'Y~'¢