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Home My WebLink About4661-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...~J)..~.~.~. ..... Date .............. ~..~.~ ....2~....., 19 THIS CERTIFIES that the building located at Bray Ave .................. Street Map No.. xx ........ Block No... XX ..... Lot No...lu~ ..... L.~..~.el...I~¥.~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ l~a~o...27, 19.70 pursuant to which Building Permit No. dated .......... ~... ~_~...., 19 T0., 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~.~y.~.~.e...o.b.e...f..m~.~..~'..d.~..e.~.~..~g. ...................................... The certificate is issued to .. ,~oseph .&. Barbra .Z~:~moskt ...... 0~ers ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Jnne.. 22)..1.97.$...by..R.o. .. .9-:'-.. _... ~ ...... Building inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 661 Z Permission is hereby granted to: .............. J.o~..&..~rl~ .~l~mo~l~ ....... ..................... ~.tt&t~ .................................... to ......... 20A,~1,..~'...O~..,f~l~ ~,}~.. ~.W~,~I~$ .......................................................................... at premises located at ......................... ~..~g~..~. ..................................................................... ..................................................................... ~.~e.t ...... ~I,X,, .................... pursua:n¢ to application dated .......................... K~l~h .........~ ......., 19...~., and approved by the Building Inspector. Fee $...l~egf~ ......... Examined .~.,,'~ I~ 7 19 ''~ O Approved tx 19...~.4.. Permit No ........... ........................................ , Disapproved a/c .......................................................... BUILDING DEPARTMENT I,/,/?e ~ ~.~ ~.~' ~ TOWN CLERK'S OFFICE ~ 0 ," ~ ~- Apali~tion No ............................. ~ o/<{C .o , ~ APPLICATION FOR BUILDING PERMIT Date ldarch 27 19 70 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 o 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 port 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 a terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Anne Z~m,~oski Fliss (Signature of applicant, or name, if a corporation) Bray. Ave Laurel (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. A ent o£ 0~ner Name of owner of pram ses ..~.g .s..e.j~..h. ~ ..~..~..~...~..a...~..&..~. ~_.lQ~....o.~..~..~. ................................................................................ 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 Num~e/r .~.~....~...~..........~./..~...~..~.~...~.~...e .......... ...T~....t~...e..~, .............................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy v.a. gant land . b. Intended use and occupancy one fami,l.2' dwelling 3. Nature of work (check which applicable): New Building .,.~ ........ Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ozl. e ............ 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 ............................ Rear Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ..lf~...,,~ ................. Rear ......lf.8.-..J~ ............. Depth ..2.~.-..~....~.-..8 Height .................... Number of Stories ...$~. .............................................................................................................. 9. Size of lot: Front ........... .1.00. ......... Rear ........ 1.0D....'t:'. ................ Depth ...23~../...2.J~.1. ....... 10. Date of Purchase ............... '~9.~-0 ................................ Name of Former Owner ..... ]f.,..Tllth;Lll ........................... 11. Zone or use district in which premises are situated t~., 12. Does proposed construction violate any zoning law, ordinance or regulation? .................. ..-'1.O. .................................... 13. Name of Owner of premises .~TGse. pJl,....~:l.n~:$Address ..... ~nt,~lj.¢ic ................Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~..~..~..e. .......................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. Ave STATE OF NEW' YORK, ~ S S COUNTY OF .~uff. olk .............. J' ' ' Fliss ......................................... Ar~l:le..~mt~n~tri ........................ being duly sworn, deposes and says t~t he is the applicant (Name of individual signing application) above named. He is the ................. ~...Q~..g~.~.~ ...................................................................................................... (Contractor, agent, co,orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~e and file this application; that all statements contained in this application are t~e to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this 22 ~ (Signature of applica~ ' ....... ELIZAB~NN NEVILL~ NOTARY PUBLI0. State of New YO~ Ho. 52-8~25850, Suffolk Ooun~ Term ~pires M~rch 30, ig~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give Ideed location) have been inspected by this department and found to be satisfactory. Chief of General ~nojineerir~g Service~