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Home My WebLink About5155-zFO~M NO, 4 TO~VN OF SOUTHOLD BUH.BING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~ .~.l+.~O ...... Date ........... ~oveml;er...10.., 19 .?~. THIS CERTIFIES that the building located at .. Loz~g. Croek. D.r. ive ....... Street Map No. ¥.ezm.. Pk.. Block No ...........Lot No..21 .......ff~outhald .... E.Y.~ .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........l:i.~.r.,..~.0..., 197.~.. pursuant to which Building Permit No.. ~J.~.. dated ...........~,:-x....1.0.., 19..71, 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 ...;.ri.v~te. o~e. family..dwel.l, ir~g ..................................... The certificate is issued to .. J~sh..- .Fierer ........... ~wnex' ..................... (owner, lessee or tenant) of the aforesaid bui]dlng. Suffolk County Department of Health Approval ~ouse ~-620 .... J~tp .- 16. · .19?.1. · · b.y..R.. ]/.i. tla ...... /'i!~''? .... ~ .... ....... i' ........... Building Inspectd~ TOWN OF SOUTHOLD BUILDING DEpARTMEHT TO~I CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLEtTION OF THE WORK AUTHORIZED) 5155 Z Permission is hereby granted to: , ...~..t~me~ee~....~. je~..t'~l~-m~ .... ot premise~ lo~t,a at ..........~..~ ....... l~t~l~.~..l~t~i~ ........................................................... pursuc~nt to application dated ............................. ~ .......... ~0'"', 19...~, and approved by the Building Inspector. Building Inspector FORM NO. 4 TOWN OF SOUTHOI.D BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z.I+367 ....... Date ........... .A%lt~ ..... 30 .... , 19. ~.~ THIS CERTIFIES that the building located at Long Cx*eek Dr~v~ .... Street Map No.~e~, ~, Block No ....... Lot No. 2~ ~o1~...~,~, ....... conforms substantially to the Application for Building Permit heretofore filed ~ t~s office dated ......... ~eh . ~., 19 7~ pursuant to which Building Permit No..~ ~.. dated ........ ~ch. tO.. , 19 7t, was issu'ed, and conforms to M1 of the require- ments of the applicable provisions of the law. The occupancy for which th~ certificate is issued is .... ~iVato e~ f~ly. tw~ll~ ................................ The cert~icate is issued to . .Jeah,. F~R .... ~e~ ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk Cowry Dep~tment of Heal~ Approval g~...l~. -$9FI-..~Y. R, .Vt la .... Building Insp~tor S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located /// (Give deed location) t have been inspected by this department and found to be satisfactory. JUL ~I 8 I~7! Chief of General Engineering Services TOWN OF SOuTHOLD BUILDING DEPARTMENT ~,/- --/'-~,~ TOWN CLERK'S OFFI(:E ,._~,~ ~/- ".~/,,~ ,/- /¢- ~ . ~/~ SOUTHOLD, N. y. ......... , Application No ............................. Approved a/c .............................................................. ¢¢ ',( ........................ APPLIC.,ATIOH Date March 10 19 71 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, re at onship to adjoining premises or public streets or areas, and giving a detaUed description of layout of property 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 Perm t d. Upon approval of this application, the Building nspector will issue a Build ng 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. RB APPLICATION IS HEREBY MADE to the Bud ng Department for the issuance of a Building Permit pursuant to the uild!ng Zone. Ordinance of the Town of Southold, Suffo k County, New York, and other applicable Laws, Ordinances or egu~ations, tar the construction of buildings, additions or a terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Lee Kvasneskt (Signature cf applicant, or name, if a corporation) ............. ~exttb. eZA ................................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Centracter Name of owner of premises ....aT..e~L.~.:L41~e.l~ .................................... . .... 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. AAa No 2[ennecett Pk 21 P .: ........................................ Lot No.: ........................ Street and Number .... G/R..~..C,z~Gek..~)&,. ......... E~eGt;~4a.l& .......................................................................... '~j~/- ~ ~ c~ Municipall~ 2. State existing use a?d occuppncy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~a~a~t; ................................................................ b. Intended use and occupant, . .......... 3. Nature of work (check which applicable): New Building ?~al;~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...... .~.~yO~O-..'~' ................................... Fee~...!.~. ................................................................................... (to be paid on fi!lng this application) 5. If dwelllng, number of dwelling units ...... ~ .............. Number of dwelling units on each floor ..... .~. ..................... If garage, number of cars ................... II~....~, ........................................ ~t.~ ................ ; ...... -~-....;..~,.....~ .................... 6. If business, commercial or mixed occuponcy~ 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 ........... .b~. ................... Rear ......... ..~.. ............. Depth ...... ,,~-..0-..8. ....... Height .................... Number of Stories ...~.~.....(.~;L~iL19.G~). ................................................................................. 9. Size of lot: Front ........... .1..~ ....... Rear ........ 1..~.~ ..................... Depth ...... :[.?.0..~.~.. ............. 10. D~te of Purchase ........................................................ N~rne of Former Owner ..... ~).,....q'LI.~L~L1 .......................... 1 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... 21J. ............................................ ;... 13. Name of Owner of premises ...AT..~...~;[~*.~.:~ ............... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~...3~1f~II~RA~ ...................... Address ........ ~.e..~...~.e..~...~. ................ Phone No ..................... PLOT DIAGRAM 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 comer lot. STATE OF COUNTY Of ................................... · ~te..~'~/&~=]l:-'~ .............................. being duly sworn, deposes and says that he applicant (Name of individual signing application) above named. He is the ......................... ~:L~.a~e.t,~ ............................................. .;~ ........................... ~ ........................... (Contractor, agent, corporate offioer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the s~id work and to m~ke end file this application; that oil 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 _ __ ~ ELIZABETH ANN JNEVILLE NOTAJ?Y PUBLIC, ~tate of New York No, 52-8~25850, Suff0[k Cou.qj~ Term Expires March 30,