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Home My WebLink About5188-zFOI~M ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ZI~6t~ .... Date ........ DsO. · 1. , THIS CERTIFIES that the building located at Bo~od' ~ .......... Street Map No~!~, ~S. Block No...I~ .... Lot No. ~ ...... ~tl~k. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... Na~. ~ , 19. ~ pursuant to which Building Permit No. dated ........ ~a~ a9 ., 197% , was issued, ~d conforms to all of the require- merits of ~e applicable provisions of the law. The occupancy for which this certificate is issued is . P~i~o. ~ .fa~ly ff~l~ ................................... The certificate is ~sued to .N~ ;~ 'B~ld~g' ~or~ ' ' '~e~ ......... (owner, lessee or tenant) of the alores~d buildmg. Suffolk Cowry Department of Health Approval ' ~Pg ' aS' t~i ' ' ~' R~ Vil~a · · · Underwater, Cer,. ~ N8~16 ~ C ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV~I CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 5188 Z Permission is hereby granted to: to ...~..~jJ'~ ..~-.:~t~a~. ,~ ..a~,Jg,..:l,.~ ................................................................................. at premises located at ........... ~"JJ~""~J~llW'J~"JtJ~lgl~t~'"J~ ............................................. ................................. ~.,.-I~ ......... IKm~lm; ......... tt~ .................................................... pursuc~n~c to application doted ........................ JJ~jj .......j~ ............ , 19~J .... and approved by the Building Inspector. Fee $'jJJ~m4J~J' .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date September 28, 1971 Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Map of Sunset Knolls, Sec. 2, Lot 40, E/S Dogwood Lane, 400' S/O Stanley Road (Give deed locatiou) Mattituck, Town of Southold have been inspected by this department and found to be satisfactory. Chief of General Engineering Services SEP 3 8 1971 INSTRUCTIONS T~is application must be completely fill~ iff by ~ewriter or i~ ink ~nd submitted in ~plicate to the Building Inspector. b. PI~ plan showing I~tiom of Io~ and of buildings on premiss, r~laflonship to adjoini~ premiss or p~lic streets or areas, ~ givi~ a d~oiled descripfi~ of I~out of pro~ must ~ drawn on the ~i~ro~ which is ~ of this GD~icQtio~. c. · The work cover~ by this opplicGtion moy ~ot be commenced b~fore issuance of Building Permit. d. Upon ~Droval of this application, the Building Ins~ctor will issue a ~uilding Pe~it to th. applicant. Such ~rmit shall be kept on the premises QvoilQble for i~s~eCtio~ t~rougHout th~ profess of the work. e. No building s~ll be occupied or used in w~ole or in part for any pu~ose whatever until a Ce~ificate of ~c~ncy sholl ~e been gronted by the ~uildin~ Insp~tor. 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 alte~atLons, or for removal or ,demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinanc6s, building code, housing code, o~,~ regulations. · ' ....... i'~i;;;~;'r; '~¥'~'~'~*ican";:~'"~;';;';~a~;; ,f. ........ co~.~tio''~'- ":";'i ........ ...... (Address of applicant) //7~'~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ~L ~./.E:./.~ . . Name of owner of premises ......... ...~..,..~.:...7~.......~...~.../...~'..~/.~.......~..'.~...' ~ .........................................................................................~ If applican~isl~co~o~e, s~nature of ~ly authorized officer. .............. ................... 1. L~ation of land on Which pr~osed work will be done. Map No.:-,~,...~.....~...~. Lot No.: ........................ Sire. and N~er ..~4.5....~0~,,~....~ ................................ ~r~¢~ . ............................. Munici~li~ 2. State existing use and ~cu~ncy of promises and intended use and occupancy of prop~ construction: a. ~isting use and ~cupancy ................ ~. ....................................................................................................... b. Intended use and ~cupanc, ............. ~¢~(~[¢ ...................................................................................... :...._.~ 3. Nature of work (check which applicable): New Building ~......~... ...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .............../.~..!.~...~. ....................... , ....... Fee ..l..0..:....a~.. ............................................................................ (to be paid on fi~ing 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 wlth alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ...~. ....................... Nurgber of Stories ................................ 8. Dimensions of entire new construction. Front ............ ~...~.~. ........Rear ....... ;.~.~.. ........... Depth ...... ..~.~.. ............. Height .....~...~.. ........ Number of Stories ......... ./..../'~.. ............................ ;. ........................................................... 9. $~ze of ~ot: F~t ............ /~ ......... Rear ............ /.~..o. ................. Depth .:~.,~,~.:~, ......... 10. Date of Purchase ........................................................ Name of Former ~r ............................................... ! 1. Zone or use district In which orem ses are s tuated .... ~ · ~ ...... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... ..~...0.: ............ ~ ............. 13. Name of Owner of premises ...,~.:.J'.~ ~/~.~. .... Add~ .~Z^ /~,,~-JL, ~ '~'~;,~'~',~" .......... ~, ~ ~. · 7" .. ~'~ ~r~A~ ..'Phone No ..................... Name of Architect ..... .~.:~....~..~.~../.~ ........... ~cldre~ .....-~.......~.~.....~...~.: Name of Contractor . ~.~.'~ ' ................... ~ ..................... .... ...... No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from pw~et~rt~,r li. ne.s. Give street .and block number or description according to deed, and ~how street names and Indicate STATE OF NEW YOI~K, COUNTY OF ./~..~....: ......... ,~..~"~ · ~'i~l~~:~._.-~ ................. being duly sworn, depaees and say~ that he Is the applicant above named. He is the ....... ~, ,~.,.~.,,~., ......... .. (Contractor, agent, corporate officer, etc.) ~l~i_sa_icl_D~c~n~r or.,ow.ner.s., and. Is du. ly aut. h.orlz.~, to. perform or have performed the said work and to make and file ~ app ,cra,on; mar au sraremenrs conrainea in thll apl) Icatlon are true to the belt of hll knowledge and belief; and ~mth~oT~reWlLbe~l~:rformecl in the manner set forth In the application filed therewith. · ..... ....... ........ ............ ................ ................ /6' ~ /7. .4TM tZ-O __ ,2 4~0 " T C h'~ Z £ F-,q f~ I~ FtO b ' S E [