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Home My WebLink About5015-zFORM NO. 4 TOWN OF SOUTHOLD BUrr.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~..~.~0 ...... Date .............. .0.c.~;...1.3 ..... , 19. THIS CERTIFIES that the building located at . E~.$. C~Ld .t/al'.bor. R5 ...... Street Map No...xz ........ Block No .... X~ ..... Lot No... Xx... I{ev. $.uffo~k... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... l~ct.. 2~ ..., 19..?0 pursuant to which Building Permit No...501 dated ......... 0c.t.. 2.1 ......, 19.. 7Q 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.r.~.vate. one. I'~mLLy..dwe.l. lSng ...................................... The certificate is issued to . ~:~z&beth .~hel~n ..... Owner ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval House # 11)+~' old hbr rd Building Inspector FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLE~RK'S OFFICE ~ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 5015 Z Permission is hereby granted to: to ........ ~.. ~..~...~...~ ............................................................................ at premises located'at ......... ~.~,O~..~ff..~,..~..~.....~ .............................. ............................................. ~..~ ...... ~,~.~ ............. : ......................................................... pursuan¢ to application dated ........................ ~ ......... ~.~ ........ ~....., 19...~, and approv~ by the Building Inspector. ......... ~.~..~ ...................................... r~ ................... Building Inspector t S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date O~T ~ ~07~ Bldg. Permit No, TO at WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ' /~ ~ /eGive z~eed location) ' have been inspected by this department and f~und to be satisfactory. Chief of : ' G~neral Engineer~ng Servioe2 APPLICATION FOR BUILDING PERMI'T INSTRUCTIONS ng~ a. This application must be completely filled in by typewriter or in ink und submitted in c~pltcate to the Buildi Inspector. streets or b. Plat plan showing location of lat and of buildings on premises, relationship to adjalnlng premleec or public areas, and g!ying a detailed description of layout of properly must be drawn on the diagram ~ le paff, of:.~leal~!!cation. c~ covered by this al~licatlon may not be commenced before iseuanc~ of Building Permlt~ .. d. Upon c~ppraval of this application, the Building Inspector will Issue a Building Permit to the applicant:: SUch ~rmlt shall be kept ai~ 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 I~reuant to the Building Zone Ordinance of the Town of Southo~l., Suffolk ~ounty, New~f. er4~,~d other aPPlicable I.awl, Ordinances or Regulations, for the construction of buildings, additions or ;~Iterations, 6~for rem~l~or demolition, al ha'rein de~crlbed.~ The applicant agrees to comply with all applicable laws, ordi~co/de,/~bslng ~d regulations. ....................... u ~----'~----~~ applicant, or name, If a c~i"l:mratlon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general cant.rector, electrician, plumber or builder. ............... ~..e..n.,e.~.~...Z....q .o..n..~.~ ~ ~.o.~ ....................................................................................................................................... Name of owner of premise~ Elizabeth F. Whelan ~ If applicant is a corporate, signature of duly authorized officer. 1 Location of land on which 'ro asa- work will be done Ma No ...... ~ ............ ' '" ~ · p P ~ , p ......... ~..~.. ......... ~.~ ~...,~ ....... ~ ............ ~ ................... , ...... .., ...................... o. ~isting u~a and occuponc~ .,,~.~,.,m,~.E,°.Y,~,,~,~,°,~,~,~,~, ......................................................... ~ ................ b. ~ntendad use and occupon? .~19.~...~.~...~.~ ...................... ...................... ~ .................... ,, ......... ~.,.. 3. Nature of wo~k (check which applicable): New Building ...~ ............. ,Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 2 ,ooo.oo .l .0. 4. Estimated Cost ........................................................ Fee (to be paid on fi:lng this application) 5. If dwelllng, number of dwelling units ..... ~ ................... Number of dwelling units on each floor ..~ .f].o.O.r ......... If garage, number of cars 2 6. If business, commercial or mixed occupar~y, 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 ..~./~.~ ............... i ' Height ......3. ........... Number of Stories ....].. ................................................................................................................ 9. Size of lot: Front 100' Rear 135'-+ Depth.~/~...~.'~.~..*..-+......S/8 182':[' 10. Date of Purchase ....'~..~'-~.~..rcl~...t..[.~.~. ........................ Nome of Former Owner ...... .~..t.~,~...~..!.'~.. .............. : ............... ! 1. Zone or use district in which premises are situated .......... '.'..A..."....D...~..~..~..e. ...................................................................... 12. Does proposed construction viol~.te any zoning law, etd nance4~' ~ec~ulat on~ ............................. ~-o -~a~evlew Ave ............ Elizabeth Whelan M v 13. Name of Owner of premises ........................................ Address .a.]~...e.T~D.~.,...~..e.w...~..gz'.]~.. Phone No. ~.~..-.~.9.9 · ~a~t~ood Drive Name of Architect ..~..~,~..J~,~Ztft.9~'. ................... Addressb:LL~tA~.,...~l. et~/...~.9.T:}~ Phone No..7.,3.~...-..~0.0.7. Nome of Contractor Same .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior Or comer lot. I STATE OF NEWt~R~y . ~, t. ~ COUNTY OF ..~.~....j-a,a.. ............ J~..~..~~~~ ..,(.C ~L:L ....................... b'~ (Name &f individdal signing application) duly sworn, says that he is the applicant 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 all statements contained Jn this application tha~ the work will be performed in the manner set forth in the appI Swam to b~fore me this ~ .... x;:~)./.~......, day Of .....~...~ .......... : ........ , 19~..~_ U ~ OTR HEyU ~?~. ASNtiNt e N~NLeLwE Yet k No. 52-8125850, Suffolk County Tarm Expires March 30, Lf his knowledge and belief; and (Signature of applicant) 0/.o PL,~N OF ,~ u R.V l:r¥ ED JAMES C. NEW Fo~ WHELAN OTI'O V',/, V~N 'Fo~L ~