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Home My WebLink About4624-zFOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~.2~9 ...... Date J.~n$ ' 7 ,19 71 E,/B West Mill PA THIS CERTIFIES that the building located at B,0,W. off Frilled' R,0,W~Street Map No. ~. Block No.. ~ Lot No. ~ ~ttit~k conforms substantially to ~he Application for Bufldin~ Permit heretofore filed in this office dated . J~ ~ , 19 ~0 p~suant to which Building Permit No.. ~2~Z dated .. F~b 2~ , 19 ~0, was issued, and conforms to all of the requffe- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P~V~$$. ~. f~tly..~O~g .................... The certificate ~ issued to ~tl~!~ ~~ . .0~ .......... (owner, lessee or tenant) of the aforesaid b~ding. Suffolk County Department of Health Approval · ~y . 1~. ~971 .... ~. R. ~tlla . Building Inspector ~OI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMiT (THIS PERMIT MUST BE KEPT ON THE PREMISES~UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o ~1624 Z Permission is hereby granted to: .... ~.....m....,.~.e..~..,.....~.....~s~...~m~e~ ...~.....~.~.~ ................................... ~ ......... ~'.. ~ ........ ]f~..Ze~ ........ .W.~.....to~.... ..... ~ ....... to ........ ~..~..~......~...~,..,~....~...L...l...~~..,.e.~.~.~t~j:..te...l~. ....... ..~~..~...~~...~.t.~.,.~..~.~...~.~...~~'~) ................ ,....'. .... at premises located at ....... ~,?....~.,?.?.?..~..?....~..-.~.,..~...~.~.~..~....~..~.. ........................... ,,..;,. .................................. ~..*.~ ....... ~.-.~.....,...~.,.~.*. ......................................... ; ....... ~ .......... '. .......... ~.. pursuan¢ ,o application dated .................... :..~-..J... ...... ...J~. .................. , 19..~..~., and approved by the S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (~ive deed loc~/n> ~' have been inspected by t is department and found to be satisfactory. Chief of General Engineering Services APPLICATION FOI BUlLDIHG PIRMI'~ Date Jaz~uaxTy 2~ 19...7..0. ...... INSTRUCTIONS 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 property must 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 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 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, ordinances, building code, housing code, and regulations. ]~i~3pgtur~.of ~opli~:ant c~r name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. architect . Name of owner of premises ........... ..?,,l.,1.1. i....a~......B....x~...c....k~...e.,,r. .................................................................................................. 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.: ...~. ................... and Number ..~...~.v...e:..t..e...~...~...t of W..~. e/s W. Mill Ro~d, ..~....t..t.~.tuck Street ,~/- /~..~ . · ~ · ~ ~.~. ~ ......~.... ~ ~. ....... ~;;i~:';l~,i~' ...................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacation house Vacation house b. Intended use and occupancy ...................................................................................... ~ .......................................... 3. Nature of work (check which ap ble): New :Building ........Z. ......... Addi .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost J; 16sOOO ~ Fee (to be paid on filing this application)~ .5. If dwelling, number of dwelling units .......... .]:'....i ...... i;....Number of dwelling units on each floor ............................ If garage, number of ca,rs ............................................................................................................................. 6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... i. Rear ' Depth .................... Height Number of Stories The ez~,..~..~n~..e~'~cture w~11 be demolished. Dimensions of same structure with alterations or additions: Front Rear ............................ Depth ................................ Height ............................ Number Stpries ................................ 8. Dimensions of entire new construction: Front .......... .2.~...t~.1;.~ ............ Rear ....... ~...~..'~.9 ....... Depth ...... .~..~...~..~.~ .... Height ....~2.~......~.~.?.. Number of Stories ................ r · ........... [ 9. Size of lot: Front ..... ..~.~...~..'I; ........... Rear ....~.~..t...~.c~........~..t;.. ............. Depth .,...3..3..g..~..3..4.../..,.8..8...6.,91 ft. Uarch 15, ~968 10. Date of Purchase ........................................................ Nome of Former Owner ..... ~.~...~[L....]:.~.e..?. ......................... I 1.Zone or use district in which premises are situated ... w.A?t D~LaI:Z'[C.~ , .... . ................................... ,[~.~ii~Z. · ~,614 · ~/.~j..~ ~~ ............. 12. Does proposed construction violate any zoning law, ordinance or regulation? ":~e.-elt~]J.~J~lJd ................................ 13. Name of Owner of premises ...J[..~..~..]-..~..~J.....~..T~..¢...J~.~.~.Address ....7.~...~.~l;~...~..~.TL~.~.t~ ..... Phone No. ~.2..,2..-.~.~.~..8.. ' ~' ok Nome of Architect ...~...a.?..~..,~.....U..t.....~.....q..J~...~..]....~.~.. ...... Address .~...~,~e.o...~r~(~ ..... Phone No. ]~..~.-..~[[~. Name of Contractor .................................................... 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. 1 A.P~BOXItetA,TF_ I.O~&TION / ~ L., I r ...... 0 ', I i · "! ' T" · Z STATE OF NEW YORK, ~ e e COUNTY OF ................................ $~'~' ,- '~'"'Z~""~'].'t~"......~...i'-.~.~:~...~...~...~.-~.-~.~.,~:~ ........................ being duly sworn, deposes and says t~t he is t~ applicant (Name of indigidual signing application) above named. He is the .................................. ; ................. ~.~.~.L~.~ ................................................................... (Contractor, agent, co~orate officer, ~c.) of said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to ~ke ~d file this application; that all statement~ contained in this application am tree to the best of his knowledge and belief; and that the work will be perfor~n t~ manner set fo~h in the applicati~, fil~ therew th Sworn to before me this ~ )~ .' ,~ ...... ~day 0f-:...~~ 19 ~ ~ [~ ' ~ ~ ~ ~ . .... ....... .............. v -----" 'No. 60-1358278 ~ir~ March 30, 1971 F__L.F-V~.TI ON ¢._ ,.~ ,,lI PLAN -. LO~VEI~ LEVEL I-IO_US~ lin MATTITUC~, L.I., N.Y. FOR MR. 'W'ILLIA, M BDUC~NI:::i~. PL~.N- UPP~I~! LF--V~.L F__/kST F_.LF_V&TI ON _ j~ F L_IVIN (~ / L~V~L '-',-- ~- L .t C .~ O LI Tlg II