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Home My WebLink About8239-z FORM NO. . TOWN OF SOUTHOLD BillLDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.68:12...... Date ............. PE!l; . . .1.5.' . . . . . ., 19. 7.'5. THIS CERTIFIES that the building located at . hri.gantine. .Dr. . .. .. . . ... Street Map No.lkri....qr. Lts Block No. ......... .Lot No. .33..... .Southold.............. conforms substantially to the Application for Building Permit heretofore filed in this office dated.......... .$€l;,t.. .29.., 19.7.5. pursuant to which Building Permit No. . .8239Z dated.......... .Oct.. .1.4...., 19.75., 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 ... Pr.:!. V<l:t~. .QUfJ. .f:ar,lily. dw.e. Umg. :with. .addition. (garage), . . . . . . . . The certificate is issued to . . .<:i~J.iam. . .J.. .0 1.~onneJ.l . . . . . . . . . .":wner. . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval F~lf................................. . .~...~ UNDERWRITERS CERTIFICATE No.N.~Il.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER.. 3.95........ Street.. . Br.1gan.tinEl. Drive.................... ................................................1.........[i.f........... .....N~UJ,~ l..c~vl.... Building Inspector FOE~V~ NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8239 Z Dote ........................................................ , ] 9 ........ Permission is hereby granted to: at premises located at ............................................................................................................................ pursuant to application doted ........................................................ , 19 ..., and approved by the Building Inspector. Fee $...!...~.. ............... Building Inspector TOWN CLERK'S OFFICE $OUTHOLD, FI. Y. 19 ........ ................................... "fi' Approved ................... .C~.... .......... , 19 ........ Permit No ...... (Building Inspector) Application No. APPLICATION FOR BUILDING PERMIT Date ........ /... .................................... , 19 .......... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. eb~ oPnl~ta~nn Shao~it2 ~c~C~teisOcnr,o~ o~Ont ~afn,d of buildings on premi.ses,,relodonship to adjoining premises or public streets o,~'~ or s I i , u g p o ~ayout orproperty must be arawn on 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 a Building Permit to the applicant. Such permit~ shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any pm'pose whatever until a Certificate of Occupancy,c/ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the/4 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app cab e 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, and admit authorized inspectors on premises and in~ buildings for necessaFy insp~ections. , 4 (S gnature of app i~t'"~'me, ifa corporation) ......... ......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. marne or owner o1' prem ses , © ,t//~' ¢ ~L If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ ~..,~?....,./~....-~. ................. lumbers License No ................................................. 4t If'. Electrician's License No ............................................. Other Trade's License No ............................................... ~ .~ (~ 0/~ 3 5 Location of land on whLch proposed worKwill be done. t~ap No.: ......................................... Lot.No Street and Number !~!! /..~. ~.,a~.. ~1,6'~ t)~t='t~/¢ ~ J/~ ~l~¢E{ ~,~/.. ~ ,~ ~.~g'~';,' ......... Municipality State existing use and occupancy of premises og.d intend.ed use or, d accupancy of proposed construction: a Exist ng use and occupancy .................................. [. .................... ¢ .................................................................... b. Intended use and occupancy ................................................................................................................. 3. Nature of work (check which oppllcab[e): New Building~ · ................. Addition ......... Alterat on ................ Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... (Description) 4. Estimated Cost ...:; ........... ~ .......................................... Fee /..~ ....................................................... (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 ~ C ~ ~ ...~',.~ ................... Rear .,e....;..:. .................... Depth ~.,~./...k~'. ....... Height ', ~. ' /~ ) ..~,,., ................. Number of Stories ..~..~ ........ .;/,. ........................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................. Dimensions of entire new construction: Front ........ /.,~ ....................... Rear ...... (.:.~.'...' .............. Depth ~ Height ./...~.'. ........... Number of Stories ..... ? ............................................................................................................. ,- ............. 9. Size of lot: Front .....~'.~L,.¥., ........................................ Rear .../f?../ .............................. Depth ..iC 10. Date of Purchase ........................................................ Name of Former Owner ...;;;:;.: .............................................. 1 1. Zone or use district in which premises are situated ....7::.7~ .......................................................... ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .....~.:.'~ff{ ............................................ 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ~) No 14. Name of Owner of premises Address ./(~.l(.y,¢.~ ............. .J)~Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... of Contractor ....................... Address . i ...r. ............ ........ PLOT DIAGRAM ~,,~r~/~ 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, end show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ( ¢ c COUNTY OF ................................ .................................................................... being duly sworn, deposes end soys that he is the applicant (Name of individual signing contraef) above named. He is the ................................................................................................................................................................................. (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 stQtements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ Notary Public,. ................................................... County ............................. . ...........,..~ ....~...~--.......... ............................. ( signc~e c~PPliCOnt) NO'[E: Lo/ . :MONU,VEN'r FOUND ~ o: PiPE FOOND' . ~ ~ SU'BDIVtSION MAP FILED IN THE OFFIC~ OF THE CLERK OF SUFFOLK.COUNTY ON JUNE 8', 1965 AS MAP NO. 4~6Z. .- 3 U R~' E--Y .FOR -WI.LLIAM ':J.~-~;)QNNELL OF LOT 33 "HARBOR L GHTS ESTATES, SECTION O TOWN, OF SOUTHOLD~ SU FF.~COL, N.Y. SCALE~ I"- ~0' SOUTHOLD SAVINGS BAN~ MAY 2, 1966 m~. ~ ~ ~ PROF'ESS~[ ENG~EER AND~ ~; LAND SURVEYOR N~Y,S, LIC NO, 2845 :' ~ RIV~RHEAD N.Y. ',~':f' '