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Home My WebLink About5303-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..z...~.3,2. .... Date .... ~tober.... 8, .......... , 19.8.1. THIS.~I~.E§ t~e building located at ~/8. ~erm~.~; '. $. ~ond. L~ne Street 8ubd~v~s Ion Map No ............. Block No..~ ..... Lot No. l... Natti.tucko. ~I.Y ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... 1~.... ~L.7.0 ......, 19.71. pursuant to which Building Permit No..5303..Z dated ...... .~. y.....~.7.,. ...... , 19..7.1., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which tJ~is certificate is issued is .. P~.v..a.t.e...o.n.e.. ~.~.~,¥. ~.e~,l;Lng ...................................... The certificate is issued to . .J,. ~¢. g.~Y ........................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Oq.t.o..~.~..8.°...3..9.7.1. ~..11.o..bq.r.t..~.....V.~..1.1~* Building Inspector 495 Bennett's Pond Lane TOWN OF SOUTHOLD ' BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5303 Z Permission is hereby granted to: ................ J~.t~,~uoie ........................ .................. to · ~*~.6J' · '~,e~"' ~ · ' ~U it? · ' ~t/~']:~B~' ....................... : .......................................................... at premises located at ............ ']:e,~"~"~*-"~e*'~J~%'~"~e~'" ......................................................... ................................................... :~mee¢.~*..Pol~...~ .............. ~a~: t,~,u~l~ .................................... pursuon¢ to application dated ........................... ~ ...........'j.~. ........... , 19..~J.., and approved by the Building Inspector. .Fee $.-$J~,Og .......... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.zl~307 ....... Date ............ A~ ....... 9 ...., lg?l.. THIS CERTIFIES that the building located at . B~l~t. l~d- ~. ..... S~eet Map No. ~tt. ~lock No ........... Lot No.. 2 ......... ~tt~ek.. ~ .Y.... confo~ subst~ti~y to the Application for B~lding Pemit heretofore filed ~ this office dated ........ ~.~ ..... $7'", 19.7~. p~su~t to w~ch B~ld~g Pemit No..530~Z.. dated ......... ~ay ..... ~7"" 19'7~" was issued, ~d conforms to ~ of the req~ ments of the applicable pro~sio~ of the law. The occup~cy for which this ce~icate is issued ~ .. Pr.~vate..one..~y. ~o~g ...................................... The certificate ~ issued to ~es .&. ~$la. · .~e~ .... ~ers .................... (o~er, lessee or ten,t) of the ~ores~d b~ldMg. S~olk Co~ty Dep~ment of He~th Approval - -. PE~ ~, NG ......................... B~d~g I~pe~tor S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date 00TS 1971 Bldg, Permit No. 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. Chief of General t~gfneering Ssrvico~ 197~ AAoroved' ''~ t~' 19.."'..'.... Permit No. ,~'",,~ O~ ~ TOWN m sOUTH°LD BUILDING D .,ARTMEN'r"'J,'~-~ ~'~ ~.~' TOWN CL.K ~li~ti~ NO. Di~appraved a/c ................................................................................... " ............................ ............................... APPLICATION FOR BUILDING I)ERMI1' ~ Date .............................. ~,~r.,....~.2 ............. , 19...~.'J. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector, b. PI.at plan showing location of lot and of bu.ildings on premises, relationship to adjoining premlees or I~ubllc streets or areas, aha giving a amalled description of layout at pmparty must be drown on the diagram whlch Is part of thio 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 a Building 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 purpaee 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 I.awl, Ordinances or Regulations, for the construction of buildings, additions or alterations, or ,for removal or demolition, al herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and ragulatlons. A. Reilly &Sens Ine (Signature cf applicant, or name, If a cml~ratlon) ........... ~at .t~L~ck ............................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................. ....................................................................................................................... Name of owner of premise~ ....... ,.T~m$,..~..L~:t~a.....~mlfs~. .......................................................................................... ~~ If applicant is a corporate, signature of duly authorized officer. ;~ .................. ................... 1. L,~cation of land on whlck propped work will be dane, ~op No,: ,,,~P~'~,~,+.,,~,~I:I~, ........ Lot No,: ,,,~, .................. E S Bennett Pend La Mat r Street and Number ........ ~..E./~. ............................................................ ~.:~.~.I~.~ Municipality 2.State existing use and occupancy of premises and intended use and occupapcy of pmpaeed comtructlon: a. Existing use and occupancy .....v. Ag~.~ ..................................................................................... Intended use and occupan? . ............... arm...ff~l.y...d~el.t~l~ ................................................................... 3. Nature of walk {ch~eck which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ............. ~.1....~0 .............................. Fee ...'J.~).k~).0. ........................................................................... (to be paid on filing this application) S. If dwelling, number of dwelling units ...... ..O..~..,.e. .............. 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 entlm new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ......... ]~,~ ............ Rear ............ ................ Depth ........ ~:)8 ................. 10. Date of Purchase ........................................................ Nome of Former Owner ....... ]~e~e...]~'~s ......................... 11. Zone or use district in which premises are situated ........... /~.IT...~].:TL.i~~. ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~e ................................................. 13. Name of Owner of premises ~T~.Ile~S..~CJC~. ............ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~.....~,e~:L].l~...~..i~ .................... Address ....... _,M~.~:L:L~,lClr .............. Phone No .................... PLOT DIAGRAM Locate clearly and distinctly oil 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 lot. STATE OF NEW YORK, COUNTY OF ...,~l,l~Z'.e~lr.. ............ .................................... J~l:l'ili~...]~l~:l.~l~ ............................. being duly sworn, deposes and says t~t he is the applicant (Name of individual signing applicati~) a~ve named. He is the .......................... ~.e~=~C~a~. ............................................ .J, ....................................................... (~ntractor, ag~t, co~orate officer, ~c.) of said owner or owners, and is duly authorized to pedorm or have perfo~ed the said work and to ~ke ~d file this application; that alt statements contained in this application am tree to the best of his knowl~ge a~ belief; and that the work will be performed in the manner set fo~h in the application filed ther~ith. Swam to ~mme this ~2.~y 19...~. of ~11. ~.~1 ~ I1 '1~ ...... j.l..~.~ ...... ~.~...~~ .............. hloto~ Publi~~ ......... C~ ~j~ (S gna~re ~pplicant) / ........ [ ~ ~I~B~H ANN N~ ' ~ ~ARY PUBLIC, ~ate ~ ~ York No. 52-81~58~, ~ffolk ~un~ ' Term Expires MircW 30, 1~