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Home My WebLink About5508-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No..z...4.5.~.7 .... Date .... JanuarY... 3., ........... , 19.7.;~. ..... .~ Mac Donald's THIS CERTIFIES that the building located at .~Y.~:. ?.~.; .~.~.-.Croas~ng. ..... Street Map No. ~ge~.. Block No ........... Lot No. l?.t. ,..!2., .1.3.,.~...1.4.,...L.a.u.r.e..~.,. ?....Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated . S.~ptember .... 1~1,..., 19..7:1, pursuant to which Building Permit No. 5..5.0.8...Z. dated . S.~pte~.~r .... ~.4, .... , 19..7.~., 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.~.~.v..a.~.e...o.n.e..~..~.m~l.y..d.w.e..l.l.~.n~. ...................................... The certificate is issued t~o..h.n..K.e..l.ly...-..o.~r)~. ................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .J.a~ .~. .~¥. .3. ,. . .1.9.7. 2. .,..R.o..b.e?.t...V.i.l.~..a. House # 100 Mac Donald*s Crossing (Pvt. Road % 3) 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) N9 5508 Z Permission is hereby granted to: at promises located at ........ .~l~J~..jl~....,{~[~.l....~.~j...~J....,jJJ~~..~..J~ ............................... ................................... P~L~,~..~o~ ......... ~..J.,,IL,. ......................................................... pursuan¢ to application dated ........................................ JJ~l~t....JJ~, 19.....~[~J and approved by the Building Inspector. Fee $...1~,{~ ......... Building Inspector 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 ~/ (Give deed loc~tion) have been inspected by this department and found to be satisfactory. JAN $ '!972 LOT' NUA4BERS R£FER TO ~AP O~ ~ ED~RE PARK~ FILED IN ,OFFIC~ OF TH~ CLERKOFSUFFOLK COUNTY ON JUL Y NO 742. REv'I$tO~I$ YOUNG t~ YOUNG 400 OSTRANDER AV£HU~, R/VERH£AD, H.Y. ALDEN W YOUNG HOWARD ~ YOUtI~ PROFESSIO?t/L EH~IHEEH AHD ''. LAHD SURVEYOR LAND SU~VEYO,?, HYS. LIC. KO I2~S ,, NfS LIC tf~ 43095 SURFEY FOF~ JOHN d HELL Y ~ AN'N LEGGIERO HELL Y AT TO~N O~ SCALE' Approved ........................................ , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFICE SOUTHOLD, N. Y. Application No. '~O(~ Disapproved a/c ............................................................................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by ~pewriter 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/UJ areas, and giving a detailed description of layout ofproperty 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 Jn whole or in part for any purpose whatever until a Certificate of' Occupancy shall have been granted by the Building Inspector. APPLICATION 15 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 Regu at OhS, 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, bui ding code, housing code, and regulations. A. Reilly & Sons Inc (Signature of applicant, or name, if a corporation) Mattituck N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ...~OtlI~.~lLy..&..~a If applicant is a corporate, signature of duly authorized officer. .................. ......... ,., T Y.z_ ]. Location of land on which proposed work will be done· Mop No.: ..... .~..~..e..~...e..~..e.....~...a.?.~ ...... Lot No..~.~...1.~.~.~.~.~ Street and Number ..... gx.~/~;~..~a~'.o££..~/.&..~eee~.~e..~¥...:~.l, vd......~.>e~. ................. .(.~ ........ /~O /~/~'C., ~:fA/',4~_~ C~,,~s'/,~/6~- ~7'~ Municipality ~,~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......V.~c..a.~..~....~...a:..~...~. ................................................................................................. b. Intended use and occupancy ......... ......................................................................... 3. Nature of work (check which applicable): New Building ..Z~C ........ Addition .................. Alteration ............... Repair ........ ~ ......... Removal .................. Demolition .................. Other Work (Describe) ....................... ..~...4, ........ 4. Estimated Cost ........ ,~......~..,,.0~1~. Fee . 1..0......0..0.. .................................................... ...~...t. ........ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..-oPze .................. 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, jf 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 ............................ Depth ........................ Height Number of Stories 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........ .1Dx?.1 ....................................... Name of Former Owner ..... ~].tlchez'. ................................. 11. Zone or use district in which premises are situated "A"dist 12. Does proposed construction violate any zoning law, ordinance or ragu at 13. Name of Owner of premises ...~..O....h~......~..e..~,;],~...~....~.....Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .....A.........~..e.~.~.]:.~.....~.....S. ................. Address ...~.~,~.~.~C.~ ..................Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex st ng or proposed,_and indicate a set-back dimensions from property lines.~ Give street and block number or description according to/e~ee~,,.~qnd show street names and indicate ST^l' N4V , COU N"pi'~OF ...~.'[~; ,0, ~,1~ ............ .t' # .. ELIZABETH ANN ~OTAFty PUDLIC, State ~ New No. 52-8~258~, Suffolk Cou Term Expires Ma~ch 30, ........................................... ~o.~]aa,~..~{e~.]:..].~ ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing applico'fion) above named. He is the ............................ .(~oJ3.t~ac.+,o~ .................................................................................................... (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 in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this