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Home My WebLink About3752-zFO~H NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No~. 3~.{]~ ...... Date ............. l~e~ ..'16 ....... , 19 THIS CERTIFIES that the building located at . S/S .. ~fiddle. R~ ......... Street Map No. ~;X ......... Block No.. X,X ...... Lot No..XX ........ Pe~.or~i¢ .... ~,~,. .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Dee .... ~.3.., 19 6~[. pursuant to which Building Permit No.. dated ......... DeC ..... 23'", 19.~., 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 ... P~$vat~ -e~le..f. alu~ty, d~.ellilag ............. (.F.~'e.d.d.i .e.s.) ............. The certificate is issued to . .Helmut. Has~ ..... 0w~el' .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Jm~..28-.'~9~8- .by. I~,. '/ilia .... .... ' :" ' :t ......... Building Inspector / FORM NO. ~ TOWN OF, $O0~HOLD BUILDING DEP~RTMEI, iT TOWN CLERKfS OFFICE SOUTHOLD, N. ¥. .UlLDING pEP~41T ~' ; !THIS pERMIT MUST BEK£PT ONTHE PREMISES UNTIL FUUL cOMPLETION OF THE ~ DRI~ AUTHORIZED} 3752 'Z Dote ..., ...... :.,?.~: ............................. Permission is he,[eby gr~anted ....~,m~.~...~.~.~. ........... ~..: ......... ;.i ......... ............. to . .~:**o.~... ~p....~.~$.~.T.~.~..:'~w~I. ~.~,r:~...~.~..:~e~...:L~f~ :Lp.~ ...................... · ........ , ..................... pbrsuon¢ to ,application dated ............................. .~.gP~.....~* ............. , 19.~'..., and approved by the Building Inspector. . Fee :~ ........................ FOF~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19....!... Permit No. ~ Z .~...~L'- ~ Disapproved~ ............................... APPLICATION FOR BUILDING PERMIT Date Dec. 23 19 6~ 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 adjoining premises 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 issucnce of Building Permit. d. Upon appFoval 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 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 (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, en.a, ineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... I'~],~l%lt,...l~,s,~. .................................................................................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: .......... ~ ......................... Lot No.: ...... ~-~-:~ .......... Street and Number ~...~...~g.~..~g.Q~ ....... .~.,.~.~ .......................................................................... Munici~lity 2. State existing use and occupancy of premises and intended use and ~cupancy of propos~ construction: a. Existing use and occupancy ........ .~.~.~...~ ............................................................................................... b. Intended use and occupancy ....~e~&~e~.e..~...b~es~...~e...ez~$~..~~ .................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe)................,....Move Existin[ .......... .....d.~] 4. Estimated Cost ............................................................ Fee ten (10.00) (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... QD,~. ............ 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 .....L}2 ................... Rear ........ .l+~ ................... Depth ~..~..-.9.../.....~9-% Height ........................ Number of Stories .............f}~e ............................................................................................. Dimensions of same structure with alterations 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 ....1...0...0. ................. Rear ............ ],.QQ....' ............. Depth ............ ~3.'~.../....if~9 10. Date of Purchase ............~1.c.:.:3.~..~. ................................... Name of Former Owner ....... ~,,....~.~.e. ................................ 11. Zone or use district in w~hich premises are situated ...... .~. ....... .~.~.~ ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............... ..n..o.. ....................................... 13. Name of Owner of premises ....... ~,...H~S$ ................ Address .....R~.~ltb.~.].d. .................... Phone No ..................... Name of Architect ................................ i ..................... Address ............................................ Phone No ..................... same Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number pr description according to deed, and show street names and indicate whether interior or corner lot. ~ ~ , , .1~0, , , ,~, ........ STATE OF NEW YORK, ~ ~. COUNTY OF ..... ~,f f.Q 1.1~ .......... ~' a'a' ................................. l~e].~)~.J~..~s ..................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......... ~.~t¢.....-....9..O.~r...~.c..t...O..~. .................................................................................................... (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 knowledge and belief; and that the work will be performed in the manner set forth in the application,filed therewith. ~ Sworn to before me this ~ ~ / /~ __ ~ // ..... ....... , t Pu , ........ ....................... No ary bi'c, r...v./.Ce~c.~.....~..:..~..~..~.. County (Signature of applicant) L. UARfON A. ~EG~NT ~1o. 52-3233120 Su[iolk Counh, :Term [xpires rvtarch 30, 19,~.~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities at S~ Middle Road for a structure located (Give deed location) Peconic~ Southold have been inspected by this department and found to be satisfactory. Distric~ Eugineer TOWN O F S O UTH D LD OFFICE DF BUILDING INSPECTOR TOWN CLERK'S OFFICE Date December 13, 1967 Comm'issioner of PuNic Works Suffol~ \ County Yapha~k~i Ave., Yaphank, N. Y. Dear Si~r: In accordance with Section 239K of the General Municipal Low of the con~olidd?d Laws of the State of New York, this is to notify the Commis- sioaer of Public Works of the County of Suffolk that ...................................... 'i'Ielmut Hass (0~,:ner~Builder) North ~oad ......... .~ .o. ~?.;?..z..~..~...~:!.:~.!~:.: ............................................................................. ha~ applied to the Town of Southold for a permit to construct a building $/s nlc:~ll~. Eoad (C,R.27) Peconic~ as shown on the attached plot plan, submitted in triplicate, doted ................ A~g. 2~, t967 ~ of !~nd surveyed fo~ Heimut Hass ............................................ and titled b~'D '~' ~" P'~ >~/~i'i'~ '"" ~';;~ ;' ..................... We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. 12/1~/87 - Approved ~o the Town of Sou~hold, pursuant to ~.;ection 239K of Very truly yours, the Gen. Municipal. Law; a permit ~dem See. lB6 is required to Co.Rd. 27. SUFFOLK CO~ DEFI'. PUBLIC WO[~ R. M. ~RER, C0~ISSIONER Chief Engineer Building Inspector Town of Southold, N. Y. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal (Give deed location) "/ facilities for a structure located have been inspected by this department and found to be satisfactory. District Engineer District Engineer f'vl I~ERMIT REQUIRED UNDER S2CT~ON 136 H'WAY LAW FOR ACCE~ Z toc