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Home My WebLink About4822-zFOEM NO. 4 TOWN OF $OUTHOLD BUILI~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. ~27~. .... Date ...J..u~lr...2.~. ................. , 19. ?~. THIS CERTIFIES that the building located at . ?.~.Q...B~..~..e~'..A.v..e.a.~.~. ...... Street Map No .... .~.9.8. ..... Block No ........... Lot No...a.~..17.~...a~... ?.~. ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....~.?e...2~ .......... , 19. ?..0 pursuant to which Building Permit No..~.8.22~.. dated ... ~..~.e.. ~ ........... , 19..7.0., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... ..... .P.~.~..~..t.e...0a..e..P..aA~...~...D~..~ ................................ The certificate is issued to .... .~..s. ~...~...~$...~.~....l~... ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~1~..~...~.~.... ~ .~..*..?~..~..a U DERWmTr. s C .RTIFICATE No. laS · HOUSE NUMBER . ~[~. Street .. ~.~]-9~'..~Vg~.q~ ........................ 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) No. 4822 Z Permission is hereby granted to: to ........ ZaLI& .mm..aae...-'maLla..4veLLLI~ ........................................................................... at premises located at ................. ~..~.4~ ......................................................................... pursuant to oppli¢otion dated ............................. 4,?14B~.....~ ........... , 19....~ and opproved by the Building Inspector. Fee $..t/~.t~) ...... ~... Building Inspector TOWN OF soUTHoLD ~.'/< ¥~, "~//e. ~ -~'~ $'~ C~ BUILDING DEPARTMENT ~.~ ~ ~ ,~/~ ~ TOWN CLERK'S OFFICE ~ ~ ~ d ~ r- · ~ .... ~o.~.~.~.~ .......... ~min~.~,~ ..~ ................ .~ .............. , 1~..~ Permit No.' ........... ~ ........ ............... , ........ ........ ,, _ ..... ,, ............. .~.~.,~_~.=.~.~.__~;C~~ ........... ~ .................. ~ ' ~~ APPLICATION FOR BUILDING PERMIT ~ Date ................. . .~..u..n..e...~ .2.f. .......................... , 19..?...0. ...... o INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building ~lJ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and g v ng a detal ed description of ayout of property must be drawn'~on the diagram wh ch s part of thle appl cat on. 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 pur~u.a, nt 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. .- ~,_~_,~,. - :~.~ ~ '. (Signature of applicant, or name, if a corporation) IV",~. ~ ..~..~,..~..~¥..~?.:...~?..?.~t..~...,..,...?. ............................. ~/~'-~ ~'~-~-~ ~ ~ ~ (Address of applicant) State whether applicant is owner, lessee;agent, architect, engineer, general contractor, electrician, plumber or builder. Owne~-o B1sa M, Hand ~ame of owner of premises .................................................................................................................................................... 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.: 298 a 42 and 4'~ ........................................ Lot No..*. .................... ~.. Street and NUmber ..~..a.~.Z..e.~..A..v..e..n..u..e.~ ...... .G...~..e..e.?...t~..?. ...................................... s~nJ ~-- ~'~,~ 0 Municipality 2. State exJ g use a.na occupancy of Premises and intended use and occupancy of proposed construction: Vacant. a. Existing use and occupancy ..................... ~',.~__.~"J,'~l~l.~.:::-_,~./"~. .......................................................... ............................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) t:o move house o.% 4. Estimated Cost .~ 4~000,00 - $ 10,00 (to be paid on fi!lng this application) 5. If dwelling, number of dwelling units one. ............................ 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 ............................ 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 ..... .~..8.." .......................... Rear ...... .3..8.." ................. Depth .....~,~.." .............. Height Z0' Number of Stories ..... 9..n,,e.~ .... .. . 9. Size of Iola Front 80' Rear 80' Depth ....... 7,~.Q ................... 10. Date of Purchase Ma 1970 .......... ~v.t .......................................... Nome of Former Owner ~dwetd Weteoa 11. Zone or use district in which premises are situated "A" Residential 12; Does proposed constr~lction violate any zoning law, ordinance or regulation:~ no 13. Name of Owner of premises .Elsa M H .............. t.....~ .............. Address ...G~ecngg~;.t,..N.,..~'~ ......... Phone No..4.7.7..-.0~9.;~... Name of Architect nOne. ...................................................... Address ............................................ Phone No ..................... Name of Contractor none, .................................................... Address .... ........................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-hock dimensions from property lines. Give street and block number or description according to deed, and show street names and Indicate whether interior or corner lot. /66 ' STATE OF NEW YORK. ! ee COUNTY O,F ..... ............. ' ' ElsaM. Hand , . .......................................................................................... Doing duly sworn, deposes and says th~t~e Is the applicant (Name of individual signing application) above named. ~le is the Owner . (Contractor, agent, co~orate officer, etc.) ~aiaL~mme. m~a~ame~and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application, are'true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the appficatlon flied therewith. Swam to before me this ,o,o':',;;;L o, ..;, ...... , ,f.... .............. .:. ..... : ............................ ~ , ... _......~p/.~a~;...~.~.~,~,.~ ....... ~ounty {blgnature o? applicant) S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date September 4, 1970 Bldg. Permit No. 4822 TO WHOM IT MAY CONCERN: The sewage disposal facilities at Bailey Avenue: Greannort (Give deed location) located have been inspected by this department and found to be satisfactory. Builder-Owner - Elsa Hand SEP - 4 lg70 Dlstrlot ~nglnser District Engineer