The URL can be used to link to this page

Home My WebLink About3524-zI~'OEM NO. ~ TOWN OF SOUTHOLD BUILBING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~9 ( replaces ~ Z~290) Date Oct 16 19.73 THIS CERTIFIES that the building located at ...E/.S...G.u.l.l...P.o.n.d...L.a.n.e. .... Street N- F°rd~- Ac. Map _.u .............Block No. .Lot No. 1 ~ Greenoort I~ .Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........J..u~.7...2.6...., 19.6.7.. pursuant to which Building Permit No. 3 521+Z dated June 27 19.6..7 was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for'which this certificate is issued is Private one family dwelling The certificate is issued to ~,~alter Galazzi Owner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Sept 8 19;67 by R. Villa UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER 11+25 Street Gull Pond Lane Building InspeCtOr FORM 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) N? 3524~ Z Permission is hereby granted to: ~ ....... ~ ....... ~e~ ............. ., ............................. Buildir~g Inspector.' .......... at premises located t ~t ~.~.~. ~.?.~ .A.~2~- ~ ~ ../ · pursua:r~t to application dated ........ : .................. ~..1~,....~[~ .............. , 19,..~.~.'::,, and'a~proved by the ..... :..; ................... Building lnspeTr NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~290 ...... Date .............. ffu~y.. ,20..., 19.71. THIS CERTIFIES that the building located at . E,/S. Gull. Po~ad. Lane· · . Street Map No.I,]ordhara. Ae..Block No .... I ...... Lot No.. 1 ~. ..... G~ee~.portr .L.I...~ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Jame.. 26.., 19~ 67 pursuant to which Building Permit No.. dated ............. J~e...27, 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 ... Private..one..famil. y .~we. tling ..................................... The certificate is issued to . ~alte2 .¢alazzi ...... .awner .......................... (owner, lessee or tenanO of the aforesaid building. Suffolk CounW Department of Health Approval . ~ept..8.. 1~.67.. by.R.,..~llka .... ............... ~nilding Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da~e ~ 3~ /~ Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal (~ive dee~ location) facilities for a structure located dF have been inspected by this department and found to be satisfactory. District Engineer District Engineer FO~M NO. 1~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ............................ ~ 19...~..Z Application '1~1o ................. ........................................ , 1c) ........ Permit No ................................. Disapproved o/ .......... ....................................................... ~,.....; ........................................................... · '-,:::!....: ...... ............. ' ~ (Building Ij~pector) ...... -/ · APPLICATION FOR BUILDING INSTRUCTIONS i/ ,1.o.~ c./r._ ,~' ~ 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 ~ntil 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, ordin~nees, building code and reaulsltions. {Signature of applicant, or name, if a corporation) .......-- ~lAddre' of app,ca ~l~l' ~" ' ' ' '~' '"~'i .......... ~ .................... State whether applicaDL~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................... ..................................................................... i ............................................... Nome of owner of premises ......~....~.~..~..~.~....~........~.....~....L~..~..'~.....'~.....I ................................................................... 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 ..~bd.J~,~,,. .~t~.l~ ...... L...~.~.~ ............~.'~...~....~ ................................... Municipality 2. State existing use and ~cupan~ of promises ond intended use and ~cupancy of pr~os~ const~ction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ..... ~..~...I..D.~.~..~ ................................................................................... 3. Nature of work (check which applicable): New Building ..... ~.. ...... Addition .................. Alteration .......... t, ....... Repair ............ ..~... R_e~noval .................... Demolition ........... .~,~.. Other Work (Describe) ...................................... 4. Estimated Cost'~......L..~'~.{~.l~.,~J~.-- ''' ...................... Fee ......~.......L~.I:..{~..~. ........................................................... (to be paid on filing this application) 5. ~lf dwelling, number of dwelling units .......................... Number of dwelling unit~ on each floor ............................ If garage, number of cars ............................................. .~.l~.,~.~r~l~,. .............................................................. 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 .............................. h~umber, of Stories ............... $. Dimensions of eotJre new construction: Front .....~..f..,.'~....-/~... ...... Rear ........ Depth .................. Height .... Nu~nber of Stories ."...T....4. ............ ~., .-. Date of Purchase ........................................................ N~e of F, ormer Owner ........................................................ Name of Owner of premises~.*...~..~...~..~t.{ ......... Address .~~..~?n_e .......................................... No ..................... Name of Architect ...................................................... Address .; .............................. :a.. e No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back din~ensions from property lines. Give street and blOCk numbers or description ling to and show street names' and indicate whether interior or corner lot. according to ~eed, STATE OF NEW YORK, ' ~, S.S. ~'~ COUNTY OF; ............................... .......................................................................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......................................................................................................................................................... (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 a I 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 therew~h. Sworn to before me this ,~ si I ~ -- ~-~ ~'1 ~ ~ ' ........ ......... dayof ..... ............ Public..'~j~.~......(.~.../.~~0~^. ,~H.'[ (Signature of applicant) Notary ' ~''~-- "~ '""~' (J NOTARY PuBUC, St~te..ot.?~e~w..,~.\" v NA ~2-3233].20 SUIIOIK ~u~ ~ *'~:e~'l~ ~pires Ntarch 30, l~JIg-!