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Home My WebLink About3490-zFORM NO. 4 TOWN OF SOUTHOLD BU~,r~IN(; DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy B/~ ~pa~rd THIS CERTIFIES that the building located at R.D. aWo. {P.~t. 1~I .l~) ....... Street Map No...~ ........ Block No. xXx~ .....Lot No,.. x~cx~... 2asr, ~arion ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .........May.. h~ ...., 19 ~. pursuant to which Building Permit No. 3.~.~05.. dated .......... l~,ay.. L:% .... , 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 .P. ri.vate, nne. fnmil¥. Awe; ~ng.. & Acce.~sory..~uil~l~g, ............ The certificate is issued to Latu~aae. - Geeghegam ...... O~ner .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .i..ug...2.?...1.9.7.~.....b~..R.....V.t:.l..l.a.. UNDERWRITERS CERTIFICATE No .... pel~,41r~& ................................ HOUSE NUMBER ..... ~ ..... Street .. PrATe.re..t~ia~ .~. 7. .... .E.a.# .t..!~..r..$9.n.,, Building Inspector / FO]~[ NO. 2 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) Permission is hereby granted to: ........ ~.~...~.~ .~,,,~ ................... ~.' ........ ...... ~t~a~:~.;:.~ ............................ to ............. pursua,¢ to application' dated ..... .. ........... ~ ........ ,~......;...,c~ ........... , 19..~,, and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT./ TOWN CLERK'S OFFICE ~/~/~ SOUTHOLD, N~ Y. ...... ...... , Approved ........................... ~ ............ 19 ........ Permit ~o.~..~.~..~...~. ................................................................. .............. ........................ APPLICATION FOR BUILDING PERMIT Date ...~..¢/.~/.....4.¢ ..................................... , 19...~.~'.'~.~.... INSTRUCTIONS o. 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 propertymust be drown on the diagram which is port of this application**. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approvo[ 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 port For any purpose whatever until o Certificate of Occupon'cy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE t'o the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Cbunty, New York, and'other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterationS, or for removal or, demolition, os herein described. The opplicon, t agrees to comply with oil applicable lows, ordinances, building code and regulations. ..x.., ................... (Signature of opplicontt/c~j/nor~//if a corporation) '-'"' ?" (Address of applicant) c:~2_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .¢.. ....... ~d£ ~ ~~ ~ O ~/Y~ Name of owner of premises ..................................................................... ~L'~ ....................... ~ ...................... ~ .......................... 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: Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ...... ..~.../~...~.../~,.. ............................................................................................................. b. Intended use and occupancy ................... ~ ....... ~ ...................................................................................... 3. Nature of work (check which applicable): New Building V"' Addition Alteration Repair ........... ~,......~emoval .................... 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 ............................ 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 ...Z.~..~..~.. ............ Depth .~,Z~.~ .................. Height ....{~,~.~....~. .......... Number of Stories ....... /... ................ 9. Size of lot: Front ....~.~..~...~..:..~...'.'. ...... Rear ...2.~.~..~ ...... ~.. Depth .............................. 10. Date of Purchase ....(IZ~t~...?.r.~,...../...Z..~.../.. ............... Name__ ~.,~ ..~ __ ,~__ ,z ~°f Former Owner ........... 11. Zone or use district in which premises are situ~ted~Z~.~:~.~..~.~.~./{~./`~..f..~.~.:~c`.~..(.~;.'~..'~d~.'~(~ ............... 12. ' .... ~ Does proposed construct*on wolate, any zoning law, ordinance or regulahon? ....... .//../..(-; ...................................... 13. Name of Owner of premises .,*¢~..:~..~'l~["~/~',~:~,d~.....Address ./...~/..~.~..,~..,.~.~'./.r~4~/.'././~.' ./' Phone No~.../...~..~.~....-.¢~....~ Name of Architect ........... ~.,~/~...~..~...~¢/~...~fc/~...Address ..... ./../. ........... ,/..'. .......... ~......~ Phone No ......../.~ .......... Name of Contractor .................................................... Address ...... ~./. ........... ./../. ........... .?. ..... Phone No ..................... PLOT DIAGRAM ~///~ Locate clearly and distinctly all buildings, whether existing or proposed, ar~ indicate all set-back dimensions from · property lines. Give street and block numbers or description according to de~, and show street names and indicate whether interior or corner Jot. / S'rA 'E OF S S .. ~ ...: ................. ".~...c.....~j....;.......:; ...... being duly sworn, deposes and says that he is the appllcant ..... (Nome of individual signing app icati6'n) above named. He is the (~-c~-,---~ - (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 therewitJ?. Sworn to before me this .............. ..~,,..~..... day of ........ ...'~¢~.~1 ..................... , 19..(,."".,~. ~ ~ ' (J ~0T~RY pUBLIC, ~'La',o ~o. 52-3233120 Su[JoJ~ Co~l~t_y~ Te~'m Expires ~arch 30, ~ ~ j FO~,¢'~ ~TO. 1 Examined ......................................... 19 ........ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. Approved ......................................... 19 ........ Permit No ................................. Disapproved a/c .~'. .......... ., ....... ::,,~,~. ........ /...~> ................ ........... ~ .............. ................................. ................................. APPLICATION FOR BUILDING PER,MIT ate ..................................... , r 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 propertymust 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 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 and regulations. ....... .......... ......... .............................................................. (Address of applicant) ~:~m//~,, ?. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ........................................................................................ : .................................................................................. Name of owner of premises ...~.~.~/?~..47/~'~. ....... ~..~.~..~.~/.~.'..~..~..~.. ................................................................................ if applicant is a corporate, signature of duly authorized officer. 1 Location of land on wt~h,ptr, g.,~osed ~¢~.rJr4~ill be~e. ~gp~No!~.:~ ............. ~O.....V~w.~,...~,, Lot No: .................... Sfre~f ~nd Number ....................................................................................................................................................... ~unicip~lify 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and oc'cupancy ...... ~ .............................................................................................................. b. Intended use and occupancy ........................... ~ ............................................................................................ 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair ............ .,~..._~emoval .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost'-~.'.Z~?...~.. ........................................ 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 ............................ Height ............................Number of Stories ............................................................................................................... Dimensions of same structure with alterations or aad't'ons Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...~.1~.,'..~. ............ Rear ...~.~...~.. ............ Depth .~?~.e .................. Height ...... ~....~.. ............. Number of Stories ....... 9. Size of lot: Front .....~..~...~..f. ,~..~. ....... Rear ...~..~.~..~.....~..~/. Depth ../...~..~........~. .......... 10. Date of Purchase .~..~.t~....~'....~Z../..~...~.. ~.... Name of Former Owner..~.'....~...~...~.....~..../...~....~m.. ........... 11. Zone or use distri'~"i~",~l~'i'ch p~'i~'~'"are'~'i't'~'~..~..'....~.~-¢~...~.~,~/.~----~...~/~.~. ............... 12. Does proposed construction violate any zoning law, ordinance or regulation ........ ..~....~.. .......................... ~.~ ..... 13. N a m e o f OW n e r o f p remi sos . .~..'..6~r.~--~F.,~.~'~./~.... Add ress ./...~/..:~/.~..,~'..~ .?..J?'.:~'.: ./~/Phone N o~i~ Name of Architect ........... ~J~'.~....~..~...~'.~/..~'.~..~...Address ..... ~ ............ ~.(. .......... .~ ...... ~ Phone No ...... ..~..". .......... Name of Contractor ./..~. I.~ ./.~ .......... Address ~t /' ~' I~one No. ~'~' Locate clearly and distinctly all buildings, whether existing or proposed, ag~ indicate all set-back dimensions from property lines. Give street and ,block numbers or description according to de~, and show street names and indicate whether interior or corner lot. / STATE OF NEW ,A~)R2K,~ COUNTY OF ~pplica, fl~n.~.~; ....... being duly sworn, deposes and says that he is the a~pplicent (Name of individual above named. He is the ............... ~..Z.,,,,~~ ......................................................................................... (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 application ore 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 ........ . .~.....~. ....... dayof ....... .... ,.:k~,.~.¢/ .................. , 19..~.y. ,,~ ~ ~..~..~...~ Notary Pub Jic~...~...~'. ,. .'~ ...... · .~. · · .~ ...~. ,,/~,C~'-~J ~:t ~'~ ~ ~' ' ' '~' ' '('~ i'~lt ~'r ;' ~~ ....................... $CtlD TO WHOM IT SUFFOLK COUNTY DEPARTMENT.OF HEALTH .-- Date MAY CONCERN: 'Bidg. ,Permit, No. The sewage disposal facilities for a structure (Give deed loca~cion) Y /~/ , · / / located hav~--b~en~inspected by this department and found to be satisfactory. 8/11/76_flTHE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY DUPLICATE0F, ti295455 ,~- 85 JOHN STREET, NEW YORK. NEW YORK 10038 C0P~;~CTT0~I o.,,. flu[7 28, ~976 .~..--,;0-~0.0-~,-863782 N 298115 THIS CERTIFIES THAT only the e~al equip~nt ~ ~scd~ ~ a~ int~ by t~ ~l~t ~ on t~ a~ ap~atbn ~m~r in t~ p~mises ~u~ence ~oghegan, P~va~e Rd. e/s Shipyard ~be~ ~s~ .:,,~...~.~do. July 26,1976 ~fou~tobelncompllance.~ththerequl,emenr, ofrhi,~rd. Panels: 1-12, 125amps- FIXTURE ~ ECEPTA LE ~ W T t RXTURES _ 10 I~ 19 12 10 AMT. ! KW / OIL I H.P. GA5 H.P. A~T. .O. A.W.G. ~TRANGE.S.-Kw COOKING DECKS OVENS DISH WASHERS A/4T. K.W. A~T K.W. MT. ~(. W. R V I C CC. CC)ND. t~.OF ill-LEG OF HI.LEG iEXHAUST FANS DIMMERS 07../ Mr. Laurence Geoghegan e/s Shipyard Lane ~ East Marion, L.I. 11939 GENERAL MA~s ~)~ PerPerDD ~ MA~ oF 5U~VEYEg FOR AtN'N~'"rT~ ,rVIVIAN ~4EL. L.Y EAST . TOWN 0~: . T/,, t.,.,, c, ELL ~, R ,a L,,4 ,, I'1 ¢1 ~E A. 12.1 kl6 L,~ T ~F F -- ii I ,-ILo`' ~; Opposl~