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Home My WebLink About5639-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ?+~I#6at~4 Date Mag 2b , 19 "~2 THIS CERTIFIES that the building located at Y~.ctor~.e? 7~ib~rty ha Street Map No. xx Block No. xx .Lot No... . $qy~p~,$ }q,y, conforms substantially to the Application for Building Permit heretofore filed in this office dated ~p~~ 2~ , 19 ~ pursuant to which Building Permit No. ~63gZ dated I~b3)IC 2~ . 19.']1., 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 . •Priva~Ge t~e• tami3y dw~l~~.ng . The certificate is issued to .;l'p~ ~,pn.~ytpp~~ ~ (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . 19?~ R. Vi1~$ UNDERWRITERS CERTIFICATE No . HOUSE NUMBER Street ~'1.~$Op~~y ~ . . ~fl ..L~.berty Building Inspector Folsom xo. x 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) l~~ 5639 Z Hate 19....'~ permission is hereby granted to: . ..........:.~i.'~~tit~.~ to ..~~.,+~..?tAl~?:.s3Xi~F...~'art;1,~.~?..~lx~tl~.~1~ at premises located at .......Yi~,~".~'~.....~..~.~lt~~l~'.~.A..~B! ~~t~~.~!.......~..:~.,~..........,........................................................................ pursuant to application dated .......................~tlt"~'.........,..............., 19..., and approved by the Building Inspector.. ~ r ` - a .Fee ~ t~ ~~13uilding Inspector a S-4 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH f;',, a Date - Bldg. Permit No. -~b ~ ~ Z TO WHOM IT MAY CONCERN: The sewage disposal fac lities for a structure located c 8 t 4. .vti (Give deed location) ~L~~ have been inspected by this department and found to be satisfactory. 1 rp _ Chief o#' G~n~;;,l SAY 26 ~~rz ]POB11i NO. 1 0 Z TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT ~ TOWN .CLERK'S OFFIGE o ~~yy SOUTHOLD, N. Y. ~ Examined ..~w~'......, 19./.~.. / G Application No. v..~.~../.......... Approved 19........ Pemit No.... b Disapproved a/c ......................C~ e~~GGf.. (Building Inspectod APPLICATION FOR BUILDING PERMIT ~ O d d November 23 '71 Date 19............ 1~ ~ ar) y INSTRUCTIONS 0 a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin~ ~ 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 is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. ti d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perm 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 Occupanc~ 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 $outhold, 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. Leo Kwasneski (Signature of applicant, or name, if a corporation) Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C on t r a G.is s7X Nome of owner of premises ...~A~lA...Tr.OS1gdOZ:~kI If applicant is a corporate, signature of duly authorized officer. 'T.> (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.:.........~~ Lot No....~G7G~+............ Street and Number .....Y3ctor3,a.Az...c~c..L3.berty...La.........So~thold 90O LS-0 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .......XtlQfJ.nb...1r'~xld b. Intended use and occupancy ............oT]~..famity..dL[e1.1~.Ag 3. Nature of work (check which applicable): New Building ...X.X7FaG..... Addition Alterotion Repair Removal Demolition................. Ocher Work (Describe) 4. Estimated Cost .29.t.ppp.....~ ......................................Fee 0.00 (to be paid on filing this applicotion) 5. If dwelling, number of dwelling units ....pLte .................Number of dwelling units on each floor If garage, number of cars ....-0rig.........und.eT 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 ..............~tlf,..8............. Rear ........T..*.r..~........... Depth ......~6-a........ Height Number of Stories 9. Size of lot: Front .......x5.0 Rear x.50................ Depth ~.OQ................... 10. Date of Purchase ........................................................Name of Former Owner 11. Zone or use district in which premises are situated nQ.n...d~.S~ 12. Does proposed construction violate any zoning law, ordinance or regulation? ......~p 13. Name of Owner of premises .J•••TvpngbtoS:tL1••.•••••••.•Address .3D...0.~••']•,9St.....J~.CkS01Vh13r~3No Name of Architect ......................................................Address Phone No..................... Name of Controctor .~r...~Swasp,es~~,,,,,,,,,,,,,,,,,,,,,,,Address ..........Southold.......,...... 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 corner lot. ~-~'pi£RZ {.-{1 a~-~ STATE OF NEV~YOJ2K,- 155 COUNTY OF ..........9 ..............J ..........................................ys~o..~4We.Si368~~.......................being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .................................Builekep..:..................................................... (Controctor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 than the work will be performed in the manner set forth in the applicotion filed therewith. ~ Swam to before me this ................a3... of em 19..'J.1.. Notary Public, . County (Signature of applicant) ELIZABETH ANN NE NOTARY PUBLIC, Stale of Ne York , No. 52-8125850, Suitolk County,, Term Expires March 30, 19 ~ ~ ~ ~ ~ . ~ . ~ ~ ~ ,Q a, ~ ~ a` ~ - µ ~ ' ,b yi_ F. , a ~~y 1 a A~{ ~ iS~ ~ ! r.J.....~....~...~` ~ , ~;a ~ t ~ 4 ; ` ~ k~; ~ ~ V s ~ t ~ 4 ~ ~ ~ ~ ~ ~ ~ 'R', N~~ t ~ ~ 9 ! T ~ =~3.__. __4A~ ~ Y ~J 1if ~ Li Z] Y ~ yry ~ r '~y. ~ ~ j~ ~ H, ,F ~ ~ ~ s~ Aga I ~vfr~~»r'Ct 1 ti ~ ~ ~ Cr ~ nz ~ 4 ~ " u ~ , 4 > T : at {~y, 1F .i ~ a ~ + ~ ~ ~ ~r w ! ~ _ t ~ v b ~ ~ ~ ~ ! y Y ~ d ~ i ~ ~ a t v y ~ f. 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