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Home My WebLink About5183-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z~..933 ....... Date ............ De~... ~. ....... , 19.72. THIS CERTIFIES that the building located at R,0.,W,. Bailey .Beaoh. Ikl. Street Map No....x~.. ....... Block NO....x~. ...... Lot No...x~......~..t.% .i.t.u.~.k.. }~;Y.; ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Ma~.. ~6 .... , 19.7.1. pursuant to which Building Permit No. ~.183Z.. dated ........ ~4am... 26. ......, 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 ....P?.t.v..a.t.e..o..rip..f.a..m.:t.ly...d.w.e.l.l..~.g ..................................... The certificate is issued to .L.; ~: .P.e.~.k ..... . .OwD.e.r. ................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~.,t~, ............................... UNDERWRITERS CERTIFICATE No..I~. ;.R.. ............................................ HOUSE NUMBER..780...B. a~l~a~e~e&~h. Road ...................................... Building Inspector FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No. Z~+~28 ...... Date ............. Al~r'~.l - -. 27. ·., 19.71. THIS CERTIFIES that the building located at . .N/3 -2at.ley Beach. Re&cl. Street Map No.. XX ........ Block No... za[ ..... Lot No. -xX.. Natt.i. tuek...1~o3~., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Mar .... 26 ...., 1971.. pursuant to which Building Permit No....~8.3Z dated .......... Na.z,..26 ..... , 19.-71, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...Fr~vete. erie. family, dwet.t~g ..................................... The certificate is issued to ....L,-Peek ...... Owner ................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~euse ~ 780 FOP.~X NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5183 Z Permission is hereby granted to: at premises located at .... ~0.~[~...,.¢~*~...~.......~t,.~......~.....~....~......~... .......................................... .............................................................. l~att:Ltuel~....~.:l · ................................................. ._ ............ pursuan¢ to application dated ............................... ~J~ ....... ~1~.,.., 19...~.~, and approved by the Building Inspector. ]:ee $.5#J~0 ............. '~Building nspector ~ TOWN Of SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OIIIIIC! SOUTHOLD, No ¥o Approved ........................................ , 19.....L.~ Permit No .......... Application No......~.../....~....~. ........... (Building Insp~tor) APPLICATION FOR BUILDING PERMIT ................... .................. ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plat 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 of property must be drawn an 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 o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No ~:)uilding 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 a Building Permit pureuant 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. ..... ...................... i ........................ (Signature cf applicant, or name, if a corporation) . .... ................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ame of owner of premMs ~L.~...:......~.~..~ ............................................................................................................. If applicant is a corporate, signature of duly authorized officer. ~ .................. ................... · ' "-" ' "' -'~ '~ ' '"~9 ....... ~'~'T""~'~"~'"'~'" - ........................ Street and Number ....... ~..~.-../-.~,,..,,,,~, ....... I;..~. ............... ~...~.~~.-. ....................................... Municipality 2. State existing use a.nd occupancy of Pr~i~and intended use and occupancy of proposed construction: b. Intended use and occupancY,'~ ............. ...~.~...~-. ...... ~~." ....................... ' ................... 3. Nature of work (check which applicable): New Building ............ Addition ~ Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost . _~......c;~... ~ ,, ~' ~ (to be paid on fi!lng this application) 5. if dwelling, number of dwelling units ............................ Number of dwe. lling un ts 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 ........ ..~ ........................ 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 district in which.premises are situated ....... ~.1~.~. ............................... ~'~ ............................................... 12. Does proposed construction v.ol~,te any,,,zonirLg law, ordinance or regulation? ....!?.. .......... 13. Name ofOwnerofpremises..~.(~..-..-~.......c?....(Z.~..... Address~.. ~ ..(~..~'~'i ...... i ......... Name of Contractor ...~{,L/~.~..~ ................... Address Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all bui d ngs, 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 indicat'e whether interior or comer lot STATE OF NEW~.~/~ ............................. l.t ............ /,~,,¢/;.;1..~¢,:.~'.~.~.~ ...... being ~ul~ iwom, ~es ~n~ s~vl t~t hi il thl Ii ' (Name ~nndivUu~ ~lgning a~ca~.:'""~'j'' y opp con, a~ve named. He is the (Contractor, ~t, co~rate officer, ~c.) of said owner or owners, and is duly authorized to peHorm or h~e perfo~ed the said work and to ~ke ~d file this application; that all statements contain~ in this application are tree to the ~st of his ~owledge a~ belief; and 'that the work will ~ performed in the manner ~t fo~h n the appllcatl~ filed t~r~lth. Sworn to ~for~ me ~ls ................ ........... . ......... ............................. ..... ' ....... '--7 .......... ~TARY pUBLIC. Sta~ of New York N0. 52-8~25850, Suffolk