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Home My WebLink About3421-z FORM NO.4 " ....... 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z ~89fJ . Date .October 2.0 .. . .,1961 THIS CERTIFIES that the building located at Private aight of ~ay Street Map No. XXX Block No. XXX Lot No. ;mac . Baa=t Har.i1,)\l~N-o'Y'" . conforms substantially to the Application for Building Permit heretofore filed in this office dated !1arch 31 , 19 67 pursuant to which Building Permit No. 34021 z. dated Ap:ril. 1 ,19 6.1, was lssued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Que family..dwelling.with .additiOn. ...................... . The certificate is issued to 'J;anC:is A... .Beroy. ._.~mer.. .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..At. ...... ............ /In --. (il .. UO-k~.. U4.;Joo.. . ..... Buil ing Inspec r .. . '" FORM NO.2 ^ 7 TovtN 9F .~qUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH OLD, N. Y. BUILpING PERM~l' . (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORk AUTHORIZED) , . !-< .. - " . . . , . , N'! 3421 ,bate, .....................:.~U....l............., 196'.~. ,-, Z . . .. . ' . > . - ~".;: j' Permission is hereby granted to: " ...........b.e4...~ton...I./.QJ'J:o.qct...'1Ie~. , , .. ' , .................. b~n........................................ . .. , . ...10.............................,................................................ . I to ...Iu.:1.1d...aa..a4d.1~..&..Ka.k.....J.~r.at1~..4m..M..H!.t:1.atS.-dwl;U..,...... ......... ..... ......... .................. ..... ..... ............... .....~. ..... ..... ..... ...... ........... ........... ................ .... ............ .... .... .......... at premises located at ..Y.n'.... . a.O'.w....(.1.U&&:1d...3:..il'l.:a...)...&/-S-..Bcrt:7..,A"I.......... ........ ... . .........................,,..If.a2/';t:~nf....~................ ... .....................:....................................................... ................................................................................................................................................................. pursuant to application dated ..........................H....._....,.l.., 19".., and approved by the . Building Inspector. . Fee $.,....00............. , , . b.R , , . ... ". ......................... ................ ....................... Building Inspector . c. , , 'I, , , " J . . , ' FORM NO.1 .4 G, VrJr;, ~ .~ I ~. "".1iJ"1 . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ SOUTH OLD, H. Y. , , '7 Application No. .~..'1.~.!.......... Examined ........... . ..................l......, 19........ l\, t. :?L(~{Z-- Approved ........................................, 19........Permit No. ................................ APPLICATION FOR BUILDING PERMIT Date ...'{:o..e.G.~...8.......??!................, 1 h..Z.. INSTRUCTIONS a ThiS application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b Plot plan shOWing location of lot and of buildings on premises, relationship to adjOining premises or public streets, areas, and giVing a detailed deSCription of layout of propertymust be drawn on the diagram which is part of this applicatio c. The work covered by thiS application may not be commenced before Issuance of Budding Permit. d Upon approval of this applicatlan, the BUilding Inspector wdl Issue a Building Permit to the applicant. Su, permit sholl be kept on the premises available for inspection throughout the progress of the work. e No budding sholl be occupied or used in whole or In part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Deportment for the Issuance of a Budding Permit pursuant to tl 'wldlog Zone Oroloooce of the T~ of Southold, Sollolk C~o", New Yo,k, ood mh" oPP~ loW', O,dloooce' Regulations, for the construction of buildings, additions or alterations, or for removal or dem Ii ion, as herein describe The applicant agrees to comply with all applicable .':ws, ord n es, building co a~ a i s. -1 --;;--->.... ................................:................~.......... , '; f - -' ...,.."~::~~:~~~i~:::~:::,,~). (Address of applica ) ~::~h~t~~~\~~~~{?I~:~:~=~t:.::~I::.::,~~~:~~::..::=:~::~::.,:'=:::':::...'~:~::,::.b:n~: Name of owner of premises ~.A...........l.s;......A..,......... ...................{................................................................. 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 ~.\.~.f.Cr.~..=-.. ~~....Q&......f3..~.~t.9QE..:.....~...f.t$(...ry].0@!.. Munrcipa ity 2. State existing use and occupancy of premises and Intended~e and ~ccupanc.y of proposed construction: a. Existing use and occupancy ...~~..ffi.m..S@.:-.. .........'?':'?.-..\..!).~.~.I:::"....................................... b Intended use and occupancy. .. ........~~~..m..c- .................................................................................. 3. Nature of work (check which applicable): New Budding .................. Addition ....~ Alteration ................ ....,,/ .- Repair ...........~. Removal .................... Demolition............~. O-!!2.er Work (Descnbe) .................................... 4. Estl mated Cost .. ....?3..~. 2.:.. 9.??.. ..... .... ......... .Fee ..............~.:...9..9........... ........................................... ... { (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 ....../8............. Rear .....1..$.............. Depth ...P.<:?............ Height .....L9..~............. Number of Stories ..........I.....~7.Q.f!;;..\4..................................................................... Dimensions of same structure with alterations or additions: Front .l....~.~................ Rear ......./.8................. Depth ......3.'=.............. HeIght .......IQ................Number of Stories ........../............................. 8. Dimensions of entire new construction: Front ....~.~............. Rear ....../fl.............. Depth ....3.'=-............. Height .. ....JS~... .......... Number of Stones ........1.................. I 9. Size of lot. Front .....'3..9............... Rear .......7.Q............. Depth ....l9.9.................. 10. Date of Purchase ........................ ...............................Name of Former Owner ....................................................., 11. Zone or use dlstnct in which premises are situated............................................................................................." 12. Does proposed constructio~IU ~ny zoning law, ordlnancl~~la.t)~;> ~..O..I.................................. 13. Name of Owner of premlses't:.........~.~9.:.:1-............Address Uu;..<$:7J.V..L~~..~I.'1 Phone No. ................. Nome of Architect ......................................................Address ............................................ Phone No. ................. Nome of Contractor+.'....~.t...Bq~~9..~.J.!........Address .~.(M2~if?~.~...:... Phone NI!l.~lf?.lJ.! PLOT DIAGRAM Locate clearly and distinctly all buildings, whether eXisting or proposed, and indicate all set-back dimensions fro property lines Give street and block numbers or description according to deed, and show street names and indica whether Intenor or corner lot. 'rJUlCIOQuJU' I \3 /8' I ~ prz.F-$i3. ;?of ----+ I <I~ I --r ',J.- '\<1f1\J\:>t+L.L I 1(..' ~3:2 r I JiletV fJ-=j $R.\vPr'(~ '2of'tO. Ie:. ~ I I '-r _~,~tk~ .5 . d.wtf€. I -1-_ I ss VI~\U\~IC kOlA") COUNTY OF . ... \ . .....~~. ..~...~...............belng duly sworn, deposes and says that he is the applic (Name of individual signing application) above named He is the .......~:....................................................................................................................... (Contractor, agent, corporate officer, etc.) of SOld owner or owners, and is duly authorized to perform or have performed the said work and to make and thiS application; that all statements contained In this application ore true to the best 0 his knowledge and bel and that the work will be performed in the manner set forth I the application fded t It . Sworn to before me this --tt I Jl .................<2...r d9Y of ./I..{.... ....................., ihrrli:;6.~, .{: lr" G / 1~ Notary Publlc~tu.L.. . .t-.~:t/~~~~li~I:.CO~(1)Y ::'...\S.i.g.~~t.~.~~..~i.~;;pii~~.~t)....................... CommiSSion El<plfes Marco 30, 19..llLf