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Home My WebLink About5286-z FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy ~qo...~..~Y. tt .... Date ...... ..... D.~.~.e..~:D.e%.'.. 9...., 19. THIS CERTIFIES that the building Iocated at . .~y. ~ .............. Street Map No. ae aon, a~a Block No..~ ....... Lot No.. ~ .... 80~O~..~., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .14ay...lO..., 19 .~. pursuant to which Building Permit No..~2~ . dated ........... N.a~....~0..., 19~].., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for Which this certificate issued is P~e. n~e. 2,amPly .d~Z~,~g ........... ............................. The certificate is issued to .N~ehael. & N~aO~e...~~ ...... 0~a¢~$ ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 0~,. ,2~., .~97~...~. R.-Vxll . ' ' 'Building I~spectort / FOI~M NO. Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ('THIS PEI~VIIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5286 z Permission is hereby granted to: ..~ema.~..Canatmmet, Aea..gee~..AJ~,Mt,el~ael Cem~lX~ & Ytfe ...f~f~....s,-~ee..a~ .................................... .......... II~FXALIe ............ Il,X, ............................. to ~BI3.1,1.L z[e,~., ml~ .. f~ I~ ..~i~i~ g. ................................................................................... at premises located at ......... ~'~B...~I,~" '[~a~ ................. ~..~,~1~..~ ............................... ................................................. · ~t~o~t ............ s..x~...i .................................................................. pursuc~t to opplicotion doted ......................... ~ ....... ~ .............. , ]~...~., ond opproved by the Building Inspector. Fee $.tO~O, ........... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. ~ermit NO. Cu3, f~Z'-~Z- TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. ?V Chief of General Engineering Sar~Ice~ SUFFOLK COUNTY oF ~P~CATION FOR ~PROVAL TO CO~TRUOT PRIVA~ ~AGE D!SP~ SYS~ Date Approval to const~ct s~d syst~ is r~uested,pe~en% ~data her~th: 2-Det~l~ p~perty ~cation ~ ~, ~y Z~C ~F~o ~t No. 3-Pubic ~ter supp~ n~e Die,ce to nearest ~ ~-~t size: Len~h/m<~ ft. Width ~5-~3ft. (Also enter ~n center plot plan be~w:) 10-Proposed s~t~.Septic t~Precast~Cesspoo~Sh~e~other/ / ~-Septic ~ ~side d~ensions:Vel~e Ga~.Len~h Ft.Width ~.~quid. depth ft. e (zo/6 evis.) PLOT PLAN apacityCGals I ~G.P.M. ~ Test Hole ~d~ ,at · No The Undersigned ~: "0ons~ruotion of au~hori~ed ~st~l~io~ will accor~ce ~th the Suffo~ Co~ty Health Dements' ~rent St~dards,Bu~et~, ~d ~en~ents ~here~o~cover~ Private S~ge ~is~sal 5~t~". -- ~ ~ B~lder F~ ~LTH ~~ USE O~Y. ~ed on the ~nfo~tion presented her~ith,it~ option of the H~lth Depar~%,that ~ ad~uate ~d s~tisfac%o~ S~age Disposal System c~ be ~sta~ed on this P~t. BUILDING D~AILI~iNT / ~ ..... ,-- ~ "~:..'"{,:-/-~-'/~ ~z" + ~"*~'-°'"~: _< Application No ............................. INSTRUCTIONS' a. This ap licatlon must be cOmpletely filled In by typawriter or in ink und submitted In duplicm m the Building Impactor. , b. Plot plan showing location of lot and of buildings an premMs, relationship to adjoining premiere m' m~bllc ~eats or areas, and giving a detailed description of layout of pmparty mu~' be drawn on the diagram` ~ b:pm¢ of Jl~i~ al~ldication.-"~' c. The work covered by this application may not be commenced before i~uance of Building I~mft. d. Upon approval of this application, the Building Impactor will I#ua a Building permit to the a~llc~nt. Such permit shall be kept on the premises available for Im~oectton throughout the pragre~ of the work. , .~_ e. No building ~all he occupied or used In whole or In part for any purpa~ whatever until a Ce~zte 0f Occulx~'~ ~ shall have been granted by the Building Inspector. ~. _./---~_. . .A..P. PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit I~mluant to the Budding Zone Ordinance of the Town of Southold, Suffolk Count, New York, and other al~l~dige ~ ~dlnmmm ar Regulations, for the construction of bulldin~, additions or alterations, or for removal or demoilflon, el I,m~in dlcrlbed. The applicant agrees to comply with all applicable laws, ordinances, building cade, housing cade, and regulations. (Signature cf applicant, or name, If a o"-~,o~ ...~,.; ,' ~<.,..,,/.,/,,, ................................... ~.~ ............ :~......,~.~.,.~.,.~,..~.~.~ (Address of appflcant) -- State whether applicant is owner, Imee, ag~t, architect, enginelr, genarol contractor, electrician, I)lumber or buill~. .......... ~.~...~. ..................................................................................................................................................... .am.o'..r prem,. ................ .............. ........................ ......................... ........................... If ap~~,s~.~''' I~capt Is a corporate, slgnature....~.~of dulyr, authorized .....°fficer' (Iqame and title :of corporate officer) I. Location of land on which praposed work will be done. Map No.: ........................................ Lot No.: ........................ ~.. and ..robe, ......... :....-.':~..,.~..Z~,~,..,.~...,..,,~.~....~,.~. ..................... 2. State existing use and occupancy of premises and Intended use and occupancy of prppeled cmmemctlon. Cl. Existing uN and occupancy .................................................................................................................................. u, and occur:an=, .....~..e.'.L.e.~..u.~- ................................................................. , ...... :'"'"X: ....... . .... b. Intended 3. Nature of work (check which applicable): New Building ~....~... ......... Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost /~, ~ '~' I:=. (to be paid on filing 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 ........ ...~..?....~..~....~. ......... Rear ...... .'~...?.~..~....~. ..... Depth ......*~.....~./..'~....~...~. Height ..,~./. ........... Number of Stories ......... ~..~....~. .................................................................................................. / 9. Size of lot: Front ........ ./.~........x. ..... Rear .............. /..-~-~..~ ......... Depth ...... /.....~... ................. / 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ !~,: Zone or use district in whi_ch premises are situated ..................................................................................................... 12: Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of pre. mises__ -- ._,/'"/"~':'"'~'"'~'"~"~//'~' ............ Address.~o r~; "~"'~'~"'"~'"Z"'~" '~'"'~"4"~/4F~ Phone No..~...~.o~...-..?..~...~-.~, ,ame of A,ch,t.c, ............ A ress No ..................... Nome of Contractor ...'~-g.t':(/X'.~.~.....~...~-.~x..~'..?~, ...... Address ....-.~'~..~...~.[/./~....../~..~. ...... Phone No.....~..~..'..~..E.~.'~ 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 comer lot. /5-~' STATE OF NEW _YOP~I~, COUNT~j~ OF ...,~.~/,~. .......... J'~'~' ........ /~..~...~, .~y~......,~..c./_/.~,yp~.: ........... , ............................... being duly sworn, depa~ (Name of individual signing application) above named.5~le is the ..... .~..~.~.---~ ................................................................ (Contractor, ag~ ;a~'.I s ys thcrl ~e is the applicant ,nt, 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 term the work will be performed in the manner set forth in the application filed therewith. Swam to [~fore me this , No,a,-, pub,, ........ Coon,,,' ........ ............................. ROTARY PUBUC, State of New York Ne. 52-9705760, Suffolk Count'/ ,i'l~n [xpires March 30, 1972, .~ ~ E. i~O.O0 ,, '~ '~ TE~T NOL~ ~ T TOP~ · .~. x._ ~_ ~ j ~ ~ LO~TiON P~N Ldl' FOP. ~' N $~YVIEW ~D ~T TOWN OF _L_~ _T.;L ~ ~ ~,t .JE~E.U . OCT. ~ ,,~_~ .... ' ~ TIT~c .... . ~ _J "ED'~ (.pp, rv,ATE.~D,.OAj[.)" LOCATION PLAN SCALF:_- I00'. I" J~CJDB$ L^NE (~U&~:&NTEED TO THE SUFFOL_I~ GU~HTE~:~ ~ T'HE HO~E TITLE DV~,ION SUP. VEYE~ ~ - VAN ~UVL~ . i 701.25 _MAP OF PP, OPE!::LTY SURVEVED FOIL MtCkiAEL,,NtCOLE COt"iNOLLY BAYVIEW _.TOw_ N OF SCALES AS SHOVTN D: MOINUMEhiT ' ........ ~,'r~_ co:~-~'t.S-:.-.)4Z4_~-. CaULA r'-, pg4~ 8532 M"' "'~' ' 'i;' , ", , ARK ~,.,ONSTRIJCT O*N ['NC - ~0r ~LINRiSE,HIGH,WAy '-? ', SAY~ILLE; NEW MOR~';i~ 1,7,8~<' - 'LT 9-2020~.,:'i, ' ' iii A%~ lC ,~ FLaiL LEFT' ,/A~i ASP H,AL'T 5 H I'N G L~,'.5 ' ' RIGHT E, LE\ A FI ON _Z . :Z:-_~L_ ./- .LZZTTJ 4" PLATL L~ £F55 FOOL,5 P L d ;v~ ~"" TOMARK STRUCT[ .J 8 t ~l_ I 1'~ Ol F\IP~,O IX3DIv\ ' GL,¸ LI'VIRO ikOD/'¢. O.H, G' 0 G" 171 - (D'~ 1.2~1 ,I $1DE O~",~L'Y OOF-~ I, ALL ~f';°'r~T'' " :~, FLDOIE iN, ATTIC