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Home My WebLink About5000-zFORM NO. 4 TOWN OF SOUTHOLD BIll.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupency No...~.!02. ..... Date ............ ~..a~.... !2 ...... , 197.1.. THIS CERTIFIES that the building located at . ]/B. Gl~a~l~e .Roa~ ........ Street Map No.t~*lll~e~a~, Block No ........... Lot No.. ~. ..... 8011t~o3.~ .... N,~.e ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... OCt .... ~.~...., 19 .~). pursuant to which Building Pemit N~01I~ .... dated ....... 0e~ -.. t~ ..... , 19.70., 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 .. l~$va$~ .o~..family .l~ll~ ...................................... The certificate is issued to Il&vid .Lli~d~ ..... 01~I®F ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval llev . 19.19 fl) -.by .R,. Villa... t~O~ NO. ~ 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? 5000 Permission is hereby granted to: ............. TJ,.~..~,u;~,,~ ...................................... ............... · ~.....~,,~:~..~. ........................................ ...................... ~,~ ....... I,,Z~ ............................ to ........ ;~t~.3.~...~te~.. toe .. ;etai-% ~r...~t,~e ~..~ ~ ............................................................................ at premises located at ................. ~,~,..~ ......... ,.~t.~.~Ia~b~..,l~l~l~e~ .......................................... ................................................ II~ts.....¢~ ~..~,~,. ........... ,~m~.~ .......................................... pursuar~t to application dated ........................ [~ ...... .~..~ .............. , 19......~., and approved by the Building Inspector. Fee $....~,0~i ........ t ' Building Tn~ector I S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date November 10, ~970 Bldg. P~rmit No. 50OOZ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~/~ G~mnge *~oa~ 555' W/O Bayview Road~ Sou~hold (Give deed location) have been inspected by this department and found to be satisfactory. ChIe~ of General Engineering Services District Engineer TOWN OF $OUTHOLD BUILDING DEPARTMENT ' TOWN CLERK'S OFFI "/ Disapproved a/c ....~~ .............................. ~/~ ~.~-~ ........................................... ........... .............. APPLICATION FOR BUILDING PERMIT / ' ~. lhi~ opplicotion mu~t 'b~ compl~t~l~ filled in b~ ~writ~r or in ink ~nd ~ubml~ in d~lic~t~ to th~ Buildin~ In,p~or. b. ~1~ plan ~howino I~ofion o{ lot ~d o{ buildln~ on pmmi~, relationship to ed~oinin~ pmmi,~ or public ~tr~t~ or *ree~, ond Oivi~ ~ d~toiled d~ription o{ Io~o~ o{ pr~mu~t ~ drown ~ th~ diagram ~hi~h ~ p~ o{ thi* application. c. ~ work cowr~d by thi, oppllc~ti~ m~y not b* ~ommene~d b*fo~ issu~nc~ o{ 8uildinfl ~rmi~. d. Hpon opprov~l of thi~ ~pplicotion, th~ 8u[Idin~ In,p~tor will issu~ ~ ~uildin~ ~it to p~rmlt ~holl b~ k~pt on th~ premi~ ~wil~bl~ for in~ection throuohout th~ pr~ress o{ th~ work. e. 'No buildin~ ~holl b~ ~cupied or u~ed in whol~ or in p~ for on~ pu~o~ whot~wr until ~ sholl h~w been Oronted b~ th~ Buildino In*pector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 oil applicable lows, ordinances, building code and regulations. 3 T,ake $~ree~, Islip, ~. Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner ~.T-' - ~ .... -~ If applicant is a corporate, signature of duly authorized officer. , ................ ]. Location of land on which proposed work w be done Mnn No' ..~...0..9..6 ...... . . ,. ? ~'J'_~-~ az;5'6'i;"l 6Com e s°: ................... Street and Number ......~ ~0'""i'::''''~''O'~'~'~'~'{]' ................ ~t~ ........ ~'"'~ .................................................... 2.State existing use and ~cupancy of premises and intended u~ and ~cupancy of pr~os~ constmctlon: a. ~isting use and ~c~an~ vae~ 1 s~or~ ~well~ wl~h a~aohe~ garage b. Intended use end occupancy ................ ~ .................... ~ ................................................... . ........ 10. 11. 12. 3. Nature of work (check which applicable): New Building ..... ..Z. .......... Addition .................. Alteration .................. Repair .i: ................. Removal '. ................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost $22s 835.00 Fee ../. ...................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .1.. .................... Number of dwelling units on each floor ............................ If garage, number of cars 2 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front .....n..o..n...e. ............. Rear .......................... Depth ............................ Height ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or edditions: Front ................................ Rear ................................ Depth .............................. Height ............................... Number of Stories ........................................ 0~ t Dimensions of entire new construction: Front .~. ......................... Rear .....7.Q ................... Depth ...'~...t....~..~.?..~. ..... Height ......... .'l.~. ............... Number of Stories ....... .~. ............. ..... - -~ Size of lot: Front ......... /.~.J~. ......... Rear ........ ,~. .......... Depth ....... /..~.J~ .............. 10/6/69 Rene Gendron Dote of Purchose ........................................................ Nome of Former Owner ........................................................ Zone or use district in which premises ore situated ......................................... "~ .......... ;; ......................................... Does prOPosed construction violate any zoning kl~, oj'dinan~: or regulation?ri..O. ................................................... T ,.~ma3m, r. 81-0.~69 13. Name of Owner of premises~.~.~.~J,.d.....~.....~9.~'.9.1~.~,/%.Acldress ...~..'.~,~r,9....~.~.,.,.~.3,~&~.. Phone No. ~. ............... N~ne of Architect ...................................................... Address .~5~89...~,lb.,~.~§...]~j~f.~ P(~one No ..................... Salt-Alta Enterprises, Ina. N,Y ~...8..8..= .1...8..6. ~ Name of Contractor .................................................... ~oress .~.~m~e ...... , ....... Phane ~o. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and Indlc~.te all set-bock dlmens!o~, s.from property lines. Give street and block numbers or description according to deed, and show street names aha ,naicate whether interior or corner lot. STATE OF NEW YORK, . - - ,,.1 ,.. -. COUNT~ OF ..... .~..f..~..~..': ..~...~....¢~...~ ~"=" , , ............~)...~.....~./.,,~,. ...... ~i .......,.~,...~.....~....~..[.A/,. ...... ..~....~.. ...... be ng duly sworn, depaees and says is the applicant (Name of individual signing opplication) above named. He is the.. .................................................................................................. ...... · .. ... · -.- .. · .. · · ---- -. (Cantrocto~, agent, coq~orate officer, etc.) ~, and is duly authorized to perform or:' _havb.~m~med .the. said ~ a. nd ~ .make ~ .fi~ this application; that all statements cantai~ed in this c~p!!~~ue ..to t~.e ~ m ..,!s K, ow,eage a,a ac.eT, and that the work will be performed ~In the:manner set fo, q~dgL~l~_ '~ik~illcatlan fhea merewrm. Sworn to be~6re me this,~-,~X~ ~~-- ~ ,.~ ~el~al~. , . ........... ....... ....................... ,... FOP. M EI~LY C,P. ANGEE P_OAD MAP OF PP..OPEI~Ty, SLJl2.c..V. EYED FOf2. DAVID R, JP..'*mEP. ESA MA?.t. LUIN,DI ,,,N 'AT 50U'FHOLD TOW~, oF sou'moLP.,r~,Y. SCALES m--,~O~UMF--H.,_ G--I ,r..,~ N E AND HoME TITL,E, DIVI~LQ_~_- CMICA..'~O.. TITLE I l,lStJmAbtC',E CO. ~ov. 30,1970- LOT' mob..~Ho'c-,"rN P...~:_F ~ P.. TO',M. AP._OF COUN_T~,' CLF~W-'.50__~_E. A~ .No,~,0%., ",/AN TUy .L~ SON .... rz_.,. V~,.="F..,,,CZ.. _ L~CENSF;D LAttD t O: "t." -- - I 60 L 0" SALT-AIRE ENTERPRISES, IN 3289 Vebrans ~emorTal RONKONKOMA, N. Y. 588-1864 HOWARD C. PETERSEN ' F CHARES J. IRWIN 1 ~ ~.,~ ,.-,_,, ,. -,_. ,-,:,,:,-,- ,.,~.., --I II I I1 1' I ?~1~ '~/,_'--.=~.,..~--,- ~-o~.,-.,>,,~ L. - ~ II II '---' ~"~' ~'""""""'- '-"' -t- /~ , F¢,,,8',,.,.,,'-,~,,,,.,-,,,~. ' ILJJ. -- ,,-'-.u'~- ~.'.~.. -~4.~-- -~'.,--=---,--k [[ ,.~ ,-,....-,-,.,,-,,. ' I ' ,: " ' ~ " ' ~ ' I' ' ' , , ' II / 1 :~;-,,,,. ,,.' ,-,.,,,.,.':: ~ .. I f I 1/1 / , ~-~, ¢-o,~ , ' ~ I"""----'- ,,~.'.4 .--- ~1 / ~ ~- ~,~ .......... _- = k- -__. ~,1, "~ lllh / I I - -- & ..... ~ ~ ~ iii h .f ] ~. ' I ...... ~ : ........ = :.-:=.- ,, L'---!t ....... ~------- ('t-',~ '-~-1 ...,.__ M ~"' ~t" '- rf SALT-AIRE ENTERPRISES, INI 3289 Vetmns Memorial Hwy. RONKONKOMA, N. Y. 11779 538-1864 HOWARD C. PETERSEN CHARLES J. IRWIN ARcHIrECT ~90 BAYPORT AV~. BAYPORT, N. Y I I J I ENTER?RISES, RONKONKOMA, N. Y. HOWARO C. P~TLI~SF.N CHARLES J, iRWIN