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Home My WebLink About5199-zFORM[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Of[ice Southold, N. Y. Certificate Of Occupancy Suffolk County Department of Health Approval No. Z..4332 .... Date . Augus.t, 12, ........... , 1971.. THIS CERTIFIES that the building located at . Mailer Court ...... Street Map No. S4nith~ield Block No ....... Lot No. 27. Southol~, N. T, .......... Park conforms substantially to the Application for Building Permit heretofore filed in this office dated ...Mar. ch.. 30, ..... , 19 71 pursuant to which Building Permit No. §199. Z. dated ...Apt. il .... 1, . .. , 19.7.1 , 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 . private ~ne. family .dwelling ................................. The certificate is issued to .... gdw.a~:d ~ .Ruth .Irene. Houghton.. -. 0w~:s ..... (o%vner, lessee or tenant) of the aforesaid building. Augus.t 9,. ~971~..ROb.er~.V.i.11..a.. House % 240 Mailer Court Building Inspector d" ~' ' FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI, CE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE 'WORK AUTHORIZED) 5199 Z Permission is hereby granted to: at premises located at ............... ~J~J ..................................................................... ............ ~ ................................ llijj~z...l~t ......... ~m~ ......... ll,:Z. ............................................. pursuar~t to application dated .......................... Jl~l~3~. ......... ~) ............ , 19.,.~.J~, and approved by the Building Inspector. Building Inspector J $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date,~ Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Giv~deed location) J ~' have been inspected by this department and found to be satisfactory. AUG 9 1971 Chief o£ General Engineering Services Appraw::l ......................... .(.~ ........... , lg.l.~..... Permit No ............................. Disapproved a/c ...~ ......................... / APPLIC&TIOH FOR IUILDIHa FERMI1 .............. ................. , .... INSTRUCTIONS a. This application must be 'completely filled in by typewriter or in ink' und :SUbmitted in duplicate to the Building~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premleee er public streets or~'~ areas, and giving a detailed description of layout of property must be drawn anthe diagram whlch I! part ~f ~hle eppltcation./~ c. The work covered by this application may not be commenced before iuuonce of Building Permit. d. Upon.~f~mval of tl~ app!i~.at_iqn, the Building, Ipspector will Issue a Building Permit to the agplicant. Such permit shall be kept on the premises available for inspection thl~;~gl, mut~he progra~ ofJ'he ~.~rk. ..~ e. No building shall be ~occupled or used In whole or in part for any purpaee whatever until a Certificate of Occupant shall have been granted by .?e Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit punmant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other al~liceble Lawn, Ordlnance~ Regulations, for, the construction of buildings, additions or alterations, or for removal or demolition, al herein ~Ncrlbed. The applicant a~r.s to comply with all applicabl, lows, ordinancei~lldlng cod., h~u/l..~n~g~, cod., ~nd r~gu~tlons. ' ' { dd is O{ appllc~ ........ 'UJ .............. State whether applicant i.s'~vner,,'lessee, agerJt, archltec~e.n~nNr, gonerol contractor, electrician, plumber or builder. If applica is a corporat nature of duly au (Na~e and title 'of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..... .~. .~..~.. LOt No.: ...'...~.~... ........... ~ C./~) Municipality 2. State existing use and occupancy of pramlses and intended use and occupancy of pmpMed comt~uctlon: aa Existing use and occupancy ................................................................................................................................... ,ntended us. ond occu.n:.. .................................. .................................................................... 3. Nature of work (check which applicable): New Building ................. Addition ................. Alteration ............. Repair ................... Removal .................. Demolition .................. Other Work (Describe) .................................. 4. Estimated Cost .............. .~.....~..).~.:~..~,. ....................... Fee ...................................................................................... (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 with alterations or additions: Front .................................... Rear ......................... Depth ................................ Height .......................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... .~....O. ................... Rear ......... ~...O.'. ............. Depth ....6~..Z.. ............... Height ....... /.~.. ....... Number of Stories ................. ./ .................................................................................................... 9. Size of lot: Front ..... ./..O..O.. ................ Rear .......... ./.7...~,. ................. Depth ........ L.?../ .................. 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated ................ ~.. ................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ~ ........ ...~..~. ............................................ 13. Name of Owl'.er of premises ~...'fff..£~...~......~...~..~9.~....Address*]J2...W~.'...~..~.~./9.'~./~/~.....~...e.!?.L9~Phone No./~...~...~.?4.~.. Name of Architect ...................................................... Address ............................................ Phone No .................... Nome of Contractor .~....~?.,...~..~..J[.~...~...~./e/c..(.~'.n~, ....... Address .[..~..O..~...~.5.....~¢....~...~.,~.?.~.. 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 Jot. ~ ?~. ~ '1. STATE OF NEW Y/~RIC. z ~Z COUNTY OF or ;[*'°' .................. ~f.~ ....... ~ ....................................... beingdu~ sworn, deposes and soys that he is the applicant (Name 6~a individual signing application) (~ above named, He is the ................................................. ~.--m~.....~..zs'~..z ....................... ......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have 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 ti.ar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .,~ ....... ..... d vo, ..... ..................... , No. 52-8125850, Suffolk Cou~ Term Expire~ March 30, 19