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Home My WebLink About3753-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z37 3 ...... Date ..............De~l... :~.6 .... , 19.69. THIS CERTIFIES that the building located at .t]/~...~i~dle. Roa¢~ ........ Street Map No.. XXX ....... Block No... XXX.., Lot No ..... :CXlg .....Pe~Ot~l¢~ .... N~ · .. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Dee. · · 23...., 19.67 pursuant to which Building Permit No. ~7.~]3 iZ. dated ....... Dee .... 2~ ..... , 19..67, 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 .. ,Busi~ess..built%trig...can.vas. ·shop .&. Ca,~-pen.ter. shop. e.t¢~ ........ The certificate is issued to ....Bellailt. Itgas ..... (~lt.el~ ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · ~tme. 28. ~968. · by .R,..iIilla. .... Building Inspectot[ FOI~M NO. 2, ~ TOWN OF $0UTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OuTHOLD, N. Y. · BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3753 Z Permission is hereby granted to: .'....: ....... ~:.~. ....................................... ..................... S~A~I~ ....................................... to mO~.. ~m,:.ez~,at:l~.. ~'~e...t,e. ~e.. :Le~t~Lo~ ........................................ ,. .................. at premises located at .~'2....~..~a~.....(~A) ............................................................... ............ : ............................. ~ee~ ......... ~,~-~..--.:....: ....................................................................... pursgcn~ to application dated ......................... ~..~....~,~ ............... , 19..~.., and approved by the Building Inspector. Fee $..~.*~.~ FOKM NO. 1 TOWN OF SOU'THOLD BUILDING DEPARTMENT TOV~N CLERK'S OFFICE $OUTHOLD, ~. Y. Examined ....... ...~......C:.......~....~. ....... , 19...~.,.~. Approved ......................... ~..¥. ........... , 19...~..~... Permit No....'.~.....~......~....~.....~'"' Disapproved a~ ....... ~..~ ............... (Building Inspec~r) APPLiCATiON J:OR BUiLDiNG PERMIT Date ........................ ............... .2...3. ......... , ]9..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 drown on the diagram which is part of ,hire 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 tho 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 Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sou,hold, 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 cgrees to comply with all applicable laws, ordinances, building code, housing cod~, and regulations. ~'~gnature 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 owner of premises ....... ~f~l~.~,~.,~f~$.S .................................................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name ond title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ............... ~ ................... Lot No.: ..z-~r~ ................. Street and Number ..... ~S/~....~:tcl.cl3,e..~oa,cl ....... .Re~,o~::Lc ........ ~...~ ................................................................. Municipality 2. State exisHng use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ...... .~.~...~ .................................................................................................. b. Intended use and occupancy ..~eS,~g,~..~-~.S..~...~Q~.~,.~S~..~ ....................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) Move exist'lng 4. Estimated Cost .......... 1.0.0.0. ......................................... Fee ...~.,O.Q ...................................... garage (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 ............ 3.~.'.~. ...... Rear ....... '~.~.:~. ............... Depth ..~.0.~.....: ...... Height ........................ Number of Stories ......... .O.b.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 .......... ']..0.Q ........... Rear ............. .1.~.0. ................ Depth ........... .~..~.~....Z....~.~.9 10. Date of Purchase ...... 1..~...6.~. ...................... ................... Name of Former Owner ........ .~..:....O...a...s..e. ............................... 11. Zone or use district in which premises are situated "tB" d::L~t 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ Zl.¢~ ................................ ~ .......... 13. Name of Owner of premises .....~..."..~.~ ...................... Address ......~.o..u...~.~...o..]:..d. ................... Phone No. Name of Architect ...................................................... Address ............................................ Phone No ..................... .................................................... Address ............................................ Phone No ..........~ .......... Name of Contractor ~a~e 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 or description according to deed, and show street names and indicate whether interior or corner lot. See attached plot plan STATE OF NEW ~'O~K, ~, 1. c c COUNTY OF ..... ~.~..z.~.z..o..~. .......... ~.~. ............................................. ~e,.].~"~'~..~D.g~ ......................... being duly sworn, deposes and says that he is the applicant (Name o1: individual signing application) (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 oil statements contained in this applicotion are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applicatioD filed therewith. Sworn to before me this ~ /~ /) / (~ Notary Public,~..~'.(..~:,d',cc~.....~..~..~.C.~County (Signature of applicant) ,No. 52-3233120 S/li~olk ,T~rrrl ~xpires M.,~cll 30, 19~~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal at $~ ~.ddle Road facilities for a structure located (Give deed location) Peconic~ Southold have been inspected by this department and found to be satisfactory. District Engineer TOWN OF SFILITHOLD OFFICE DF BUILDING INBPEE:Tr-IR TOWN [3LERK'S E]F'FIF:E S[~UTHI~LD, N. Y. Date December 13, 1967 Mr. R~ Kammerrer Commiss,oner of Public Works Suffolk\ County Yaphank Ave., Yaphank, N. Y. Dear S~r: In eccordance with Section 239K of the General Municipal Law of the con,olid6ted Laws of the State of New York, this is to notify the Commis- sioh~r of Public Works of the County of Suffolk thor ...................................... Helmut Hass (Owner-Builder) North Road has applied to the Town of Southold for a permit to construct a building on S/S Middle Road (C,Ro27) Peconic~ N,.~., os shown on the attached plot plan, submitted in triplicate, da.ted ................ ....~.~:.~.?....~!?..%....~.?.~? .......... and titled~l'a~ of La,Id Sl~rVe~/oc~ ~0~ t~el~t~t H~SS ;' ..................... We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. 12/15/67 - Approve¢~ to ~he Town of Sou~hold, pursuan~ ~o ~.;eet:[on 2BOK of the Gen. Municipal [[,aw; a permit ~dem Se~. lB6 is required fo~ access to Co.Rd. 27. SUFFOLK CO~ DEPT. PUBLIC R. M. ~RER, CO)~ISSIONER BY. William ~; -gatsunaye,Jv.~ Chief Engineer ~,J Very truly yours, Building Inspector Town of Southold, N. Y. S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Bldg. Permit No. TO ~HOH IT MAY CONCERN: at The sewage disposal facilities for a (give deed location) structure located have been inspected by this department and found to be satisfactory. ..... DistricC Eng:[neez. District Engineer X I~iRMIT REQUIRED ,C c~. ?-'- '~' ' UNDER SECTION 136 H'WAY LAW FOR ACCESS TO COUNTY ROAD ~0