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Home My WebLink About5563-zTOWN OF SOUTHOI.D BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupancy No. Z6~66 ..... Date ............. J~..16 ..... ,197.5. THIS CERTIFIES that the building located at . Heuxy~.s. Lane ........... Street Map No. Poc., .~m~o. Block No .......... Lot No, 9.- .Pec.onie...N,Y., ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Oct...8..., 19.7I. pursuant to which B-~lding Permit No.. dated .......... QTS...1~ .... , 19.7.~., was issued, and conforms to ~11 of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr.~.vate. one..S~ml,~.~ .dwelling. with. a.n .add. it~on ................. The certificate is issued to . .Eu~en®. & .Ss]:~:ie. gaic s~k ..... O~ners ............... (owner, lessee or tenant) of the aforesaid b,,~lding. Suffolk County Department of Health Approval .N, 1~. .............................. UNDERWRITERS CERTIFICATE No. pend.~nj~ .................................... HOUSE NUMBER .... 99.~. ..... Street ... He,~'F.'.s. Lane ........................ ........... ......... FOF~[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOVt~ CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5563 Z Permission is hereby granted to: .......... :....;~ne..~..~a~;~.....0~l~ ...... to ~.~.au..J~l~t~ _~_. at premises located at ..... ~J~l[.~t...~.....?..~l~l~_~.~ ..~.1t ................................................................. ................................................ ltam~...;an~ ......... ~t~....~l..~. .............................................. pursuant to application dated .................................. .J~....~ ........... , 19....~J, and approved by the Building Inspector. Fee $..~.Q~ ............ Builcfing Inspector BUILDING DEPARTMENT T~N CLmC'S OmCE ~-~ SOUTHOLD, N. Y. E×om,ned ..... ......... ,9.Z./.. ^pp,,cotion ........... ........................................ ' ............................ :'"-':'::- /~'/F Disapproved .............................................. : ...................................... : ................................... -- .................... ........................... _ ' APPLICATION FOR BUILDING pERMiT~'~ Date .:.....QC.tO~ ........ ~4 ............., 19....~.~ .... I a. This opp icotion 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 ofproperty must be drown on the diagram which is part of t~iS Opplicotion. c. The work covered by this application may nat be commenced before issuance of Building Permit. d, Upon approval of this application, the Building inspector will issue a Building Permit to the Gppliccmt Such pe~mlt shall be kept on the premises available for inspection throughout the pro~ress 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 o 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. (Signature of applicant, or name, if a corporation) Sallie Cs icsak .P..O....Bnm..G.,...PacnniCo...He~..~rk.... ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~=gene..&..~allie..~s/~sak ...................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Peconic Homes, 1. Location of land on which proposed work will be done. ~op No.: ..~.¢~...~E.....~...~11~3,...~. Lot No ......... Street and Number ....... gg5..,~z,..t:~'.'..s..T.ane.,...]Pa¢c~J.ce..~1'e.~..~ork .............. ........~ ...................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...D~.~.~l:~..gJ~..J~,ll~;L,~....~,l~.,~l~ ........................................................... b. Intended use and occupancy ...~une...~J.th..a~l~i~.~on ..................................................... i, ,~. Nafb~'~ o"~'work .(qheck wh ch applicable): New Building 4. 5. .................. Addition .,~ ......... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ Estimated Cost ~......~.~.,.5.Q~).+.-. ..................................... Fee ..... ~.Q.Q.....~ .................................................................... (to be paid on filing this application) If dwelling, number of dWelling units ........... ~, ............... 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 s~me structure with alterations or additions: Front .................................... Rear ............................ Depth ............... ~ ................ Height ............................ Number of Stories ................................ 8. Dimensions of en, tire new construction: Front .................................... Rear ............................ Depth ........................ Height ............... ' ..... Number of Stories ...................................................................................................................... 9. Size of lot,: Fro,nt,.......l-ZS.! ............. Rear ..... 12.5.,19 ................. Depth ~.2~..3~..&...].83...21 10. Date of Purchase ..7.~..Q~..Q ..................................... Name of Former Owner ..~,J;tg~...~,a~S~.~l~. ...................... 1 I. Zone or use district in which premises are situated " 12. Does praposed construchon violate any zoning law, ordinance or regulation? ...... ~Q ..................... T3~;=$~.'2 ........ 13. Name of armor of premises ~,~T/,~,.C.&~ ........ Address ~t:ti~Y'.~..s..~J3.e,...]~.e.~... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor -qt:~_~,[e~'...SP,~.Q .................... 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. STATE OF NEW YORK, ' tS.S COUNTY OF ..... ~.1,1 f.:~O.l.~ .......... ................... ~.I~.~.~_..C.~.~L~.~c~I~ ............................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named.~He is the ............................ ~e~. ................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe~'form 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 ...... ,J~.'J;.~ ......... ._.day of ...l~g.~-~.~.JJ~...,w._ ................... , .................................... County fo~' S~EEO[]~ (Signature of applicant) £LIZAB£TH ANN/N£WLL£ NOTARy PUBLIC, State of New York No. 52-8125850 Suffolk Cou Te~m ~Xpres March 30,