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Home My WebLink About5102-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~1,221~ ....... Date ........... &pl*[]. ....~ ..... , 19. ~¶ THIS CERTIFIES that the building located at . B/S' t~,. A~'e ............. S~eet Map No.. ~ ........ Block No .... ~ .... Lot No ...... ~. · · C~eh~ .... ],Y,. · conforms subst~ti~y to the Application for B~ld~g Permit heretofore filed ~ ~ office dated ........ D~e.. ~. ...... , 19.~0. p~su~t to which B~l~g Permit No...~1~ dat~ ............ De~, ·. ~. ·., 19. ~0, was issued, ~d confoms to ~1 of the requ~ ments of ~e applicable pro~sions of ~e law. The occup~cy for which ~s ce~ifieate is issu~ is -p~vate .aee~ssery .b~.~d~ ........................................ The certificate is ~su~ to .... ~' 8te~b~; &' ~ ..... ~ '. k ......... [owner, lessee or ~en~t) of the afores~d b~l~g. Suffolk Co~ty Dep~tment of Heal~ Approv~ ....... ~*~*. ........................ ......... B~d~g Insp~tor [ 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? 5102 Z Permission is hereby granted to: at premises located at ........... ~J-'JJ~'"IU~FI~ ......................................................... ~ ........................... ............................................................ ~telmS~ ...... ]I.Z~ ............................. ., ................................ pursuant to application dated ................................... ]JJ~lJ ....... .~...., 19~J~.., and approved by the Building Inspector. reNO. I 'toWN OF souTHO D BUILDING DEPARTMENT TOWN CL~RK'S OFFICE ~OUTHOLD, N. Y. Approved .................... I..i ................. , 19....~.f.. Permit No. '~' ~) .1- Z~ Di~ppnwod al-. .............................................. APPLICATION FOR EUILDING PIRMII' Application No.......~...~....G...~.....~L December 7, t970 Date ........................................................... , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted In duplicate to the Building.``( Inspector. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining pmml~al or public streets or,,~ areas, and giving a deeolled description of layout of property must be drown on the diagram whlch Is part of ~hJe al:~llcation. c. The work covered by this appli.~cation may not be commenced before issuance of Building Permit. ~. Upon approval of this appllcafioD~, the Building Inspector will Issue a Building Permit to the al~llcant. Such permit she I be kept on the pram sas ava labia 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 a Cwtlflcato 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 pumuant to the RBUildlng Zone Ordinance of the Town of Southold, Suffolk County, New York ~nd other al~llc~ble Lawl, Ordinances or egu ations, for the construction of buildings, additions or al.terations, or for removal or demolition, al herein deecrlbed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, If a corporation) Bay Avenue, Cutchogue, N.Y. 11955 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. owt'!.er Name of owner of premlse~ ~,~.ul ~.o,~.l:e~.b.v~.~ a~d ~.,£fe 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.: ..' Cut cho&ue Street and Number ..~fl~...~,~lt~ .......................................................................................................................... 2. State existing use and OCcupancy of premises and Intended use and OCcupancy of prapaeed comtmction: a. Existing use and OCcupancy ........ .~.g...L~...~..~.g..d. ....................................................................................................... b. Intended use and occupan:', To&l and hay shack 3. Nature of work (check which applicable): New Building ' Acldition .................. Alteration .~ ........... Repair .................. Removal .................. Demolition .................. Other Work (Describe) .. ,~..j..,v.?.~ ..(.~.: ............. 4. Estimated Cost ..... .~.~.~.~ .............................................. Fee ......................................................................................... (to be paid on fi~ing this application) 5. If dwe[llng, 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 ...... .2..0..~ ................ Rear .....~ ...................... Depth ..~.0 ! Height 10 1 Number of Stories [ Dimensions of same structure with alterations or additions: :lf=~/re~,P/,-l~.....~...a~...?. ....................... Rear ........................... Depth ................................ Height ............................ Number of Sfories ................................ 8. Dimensions of entire new construction: ~rq~RaJ~J~..~.D.~ ....................... Rear ............................ Depth ........................ Height ..................... Number of Stories ...................................................................................................................... 9. Size o~: lot: ~,~a~..~.o.~.~...~t~X'.~jll~r~ .................................. Depth ................................ 1967 ., . ...................................................... 10. Date of Purchase ........................................................ marne of Former C~vner W:Ln:l. fred B:Lll&rd ] 1. Zone or use district in which premises are situated .......... .~...a:...~... ................................................................................. 12. Does proposed constructlon violate any zoning law, ordinance or regulation.;> ...D,D~I~ ................................................ ]3. Name of Owner of p rem se~ .~.?...[.....S..~...°..1~. ~, ,~.~b..t~..~..~ .~lcJress ~...a.~....~..v..e..~ .)....~.~ Phone No. ~.~.~.~ ~.. none Name of Architect ...................................................... Address ............................................ Phone No .................... Nome of Contractor &one .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM L~cate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property Jines. Give street and block number or description according to deed, and show street names and indicate whether interiororcorner Jot. ~h~.s w&B en old sp~o~ house on &dam Do~osk£~ ~&~m t:~ ~as moved Co ~h£s.propeF~y.~~ be used f r hay s~oraae ~or our horse.,' Bu£[d~n$ was ~o~aerLy L/~ m£~e up ~e ro&d on N~y Avenue. Proper=y loca=£on N-W£nifeed H. Bill&rd E.Win£fred H. B£1lard S-F~ora Luce& Ano W-P S=ou~enbursh Jr STATE OF NEW YOP4~ .... t ~ COUNTY OF ........... ~% .u..z. ~..o....h~.... j. ~.~. ......................................................... .. ...................................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above named. He is the ..... ~ .................. .~tl, tl~r.. .......................................................... .'~ ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rn~ke and file this application; that oil statements contained in this application ore true to the best of his knowledge and belief: that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this /~ ~ ,, ~----~... ............. ...... ................... - ...... ................... - [ ! M; ON A. REGENT %/ NOTARY PUBLIC. St~te of Hew York No. 52-3233120 Suffolk Count.[y Term Expires Marcb 30