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Home My WebLink About5595-zFO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ZI~568 ...... Date ..... Feb' '25 . , 19.72 THIS CERTIFIES that the building located at .B/~..Ma.~u R..oa.d. ..... Street Map No.. l~t ...... Block No .... ~.,. Lot No.. ~ ...Orient lq,II, conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... 0C~;. 29 .. , 19 7~ pursuant to which Building Permit No. dated ..... OCt 29 , 19 ~r[, 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~tYa*,o .~to .faln.i. ly. dwell.~g .......................... The certificate is issued to Frederick L .Ter,22r. .0~,:ner ..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .Feb · 22 .~972 · .l~y I~. Villa Building Ina/pector FOIIM NO. ~ TOW14 OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ $OUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N. 5595 Z Permission is hereby granted to: to ...... ~.L~cr -z~," aae'"~--clwe:~l; .............................................................................. at premises located at .......... ~.~..~..~ .................................................................................. ................................................................. C~$e~t ........... .1~,~., ............................................ :. .............. pursuc~¢ to application dated ........................ ~1~:....~ .................. , 19....~.~, and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~ldg, Per,~t No, ,~,~,~ -- TO WMOM IT MAY CONCERN: The sewage disposal facilities for a structure located - ' ' (Give dee~ locatio~) - ' ~' ' have been inspected by this department and found to be satisfactory. Ch~r ~f C ..... 1 ~s~!neerir~ Seza-ices District Engineer FORM NO. I TOWN OF SOuTHOLD 'BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , 19 ........ Pemit No ..................................... Application No. ~'~"~ 5~ Disapproved a/c ............................................................................................ .............. ...... ................................. APPLICATION FOR BUILDING PERMIT 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 ofproperty must be drawn on the diagram which Js 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 permits 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 Jn 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, ordi nances, building code, housing code, and regulations. ......... i~:~r a~,e of ~app icant, or name, it a corporation/ ................. ......... ............................... (Address of appli~'ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .....~.. .... ~ .......... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I ' n hlch osed orkwill be done Mo No Lot No Y~' 1. Location of aha o w ' :n pZ. op w · P .: ...... .~-.-...u .................. ~. ......................... Street and Number .... ~ ...... .~.......~'.. ....................................... ~-.~.-.~- ................................ 3.~Z' ~ 7~2 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...~......~..~....~.....o:~,......~. ................................................................... b. Intended use and occupancy ....~..'. ........................................................................................................... 3. Nature of work (check which applicable): New Building................../'/ Addition .................. Alteration .................. Repair .............. ..~h~Removal .................. Demolitio~ .................. Other Work (Describe) ........................................ ~-tmateJ" t'~'~ ? ~ ~ aa 4. cs a ~.os ........... .~..e .......... /. ............................... tee ...................................................... (to be paid on filing this application) 5. 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 same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of StorieS ................................ 8. Dimensions of entire new construction: Front ..i..?...~....~..~...*.. ............... Rear ....?...~.../...~..~: ....... Depth ~ ~ ' Height .....'./.~....~ ..... Number of Stories ......... ~. .................... 9. Size of lot: Front ........ ./...~'...~...~ ......... Rear .......... /.~...~...../. ............ Depth ......~.....~...~.:..~.~..~. ........ 10. Date of Purchase ........................................................ Name of Former Owner ~..~ ~11. Zone or use distr ct in which prem sas are s tuated ...... ~'~.......~ .................................................... 12. Does proposed construct on v o ate any zon ng aw, ordnance or regu at on> 13. Name of Owner of premises ...~. ............... Address ~ ' ............. ~.. Phone No ............. . .~..~. '/. Name of Architect ......................... ;-.-~. .............Address ............................................ Phone No ..................... Name of Contractor .....~...~,~ ...~..~ ........... Address ...... .~..~ ................ Phone No~...~.. ............. · PLOT DIAGPu~M 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 corner lot. /&O r STATE OF NEW.YORK. ~ S S COUNTY OF .,~.~..,~....~.~../,,~....f ' ..... :.....~.~~: .................................. ~ing duly ~orn, d~es and says t~t he is the applicant (N=m, indi id.= .i p ica above named. He is the ....... ~ .................................................................................................. (~ntmctor, agent, co~orate o~icer, etc.) of said owner or ~ners, end is duly authorized to perform or have performed the said work end to ~ke end file this application; that all statements contained in this application am t~ to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the applic~i~, fil~ therewith· .......... , ....... .......................... MA~ ~ KLOS ~O~ARY ~UBMC, ~TATE ~ N~ YOR~ ~5~-73C6925 SUFFOLK COUN~ ~mi~s~on ~pires March 30~