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Home My WebLink About11146-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12928 Date .. October .24 ..... 19.8. q THIS CERTIFIES that ' ' Addition the buridmg ................................................ Location of Property .2.7. 5..CAp. cj ~,p.a,],. Pr.l.v. ~ .......................... ~[g ~ .t~_.~.tl¢ g .... House No. Street Hamlet County Tax Map No. 1000 Section ... ~. ! .5 ...... Block ...... .06 .Lot 010 Subdivision .... N.a..~.~.l.~.u. 9.k' .g.s..t.a.~.e.s. ....... Filed Map No..4.4.5.3....Lot No....6 .......... conforms substantially to the Application for Building Permit heretofore fried in this office dated .... .H.ay.c..h..1.1 ......... 19.8.1. pursuant to which Building Permit No..1.1. ~ .4.6.Z. ............. dated .... .N.a.y.. ! .3 ................. 19 .8 J., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One family residence wzth addition . The certificate is issued to Mary E. Raynor (owner, ~t~ ~e~X X X X X of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ...... N/A Rev. 1/81 Building Inspector FORK NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH-OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N . 111.46 Z Date .....f.!'1.�y.........1 a� ................... 19. O Permission is hereby granted to: ......................... to ... r.......�„1tip!!.G�C,i....1o. .... :' f1 Zk .. at premises located.at 1�?. . 5 ........ � Y ................................................................................................................................................................ A,6/ K c� .....��.4.7a:Z� ........ .. - ........................If .. '.'.: ................ County Tax Map No. 1000 Section ... �........... Block ....C}. .......... Lot No. .......... pursuant-to application dated .......1/...................... 195�, and approved by the Building Inspector. 1 Fee ...................... . ....................... .. ......................... Building Inspector Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 5..., ..?/ ^pplication ........... )isapproved a/c ........ --.-...-...~. .......... .~ ........ ., ~.~ ~' ' (Building Inspector) " APPLICATION FOR BUILDING PERMIT' INSTRUCTIONS a. This application must be completely filled in by typewriter or~i.n ink and submitted in triplicate to the Building nspector, with 3 sets of plans, accurate plot plan to scale. Fee according ~o schedule. b. Plot plan showing location of tot and of buildings on premises, lelationship to adjoining premises or public streets .)r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- .~ation. 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 per, nit ,hall 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 purpose whatever until a Certificate of Occupancy ;hall 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 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 alteratigns, or for removal or demolition, as herein described. rhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, an~d reg~atious, and to admit authorized inspectors on premises and in buildings for necessary inspections. -- - ..... . ....~m~...~...4...c..~oww..~.. ................. (Sigr~ature of applicant, or name, if a corporation) 5.. (Maihng address of applicant) gtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electfician, plumber or builder. Nmne of owner of premises ...... ~ .h., .~.x.( .~ ~._.t34~ rq. 0 .Y~.~.. ............................................ ~ (as on the tax roll or latest deed) tf applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~/':a/~.~:'7.....~.~.' .'~'.~.~.~.. i... Plumber's License No ......................... Electrician's License No. '.~. 4 q,?f-.~, f. ff ('. i ........ Other Trade's License No ...................... 1. Location of land on which proposed work will be done. · .............. ............ ............. House Number Street tlamlet County Tax Map No. 1000 Section ... !./..~..~ ......... Block . O fo Lot. (~'O Subdivision .[~..~. J./.~ ......./~ ~ T-/aC'~--~'~ Filed Map No...'~.<f. 5.-.~. ...... Lot ............ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ./.-'~.. ~ .'52..~..~. (~..'~. ~..~. ?....~ ................................ b. Intended use and occupancy ~x .~-..~. ~..b. E'-w . ~.'~., ). t. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... I~- Fee/~.~. ~' (Description) Estimated Cost .... ./..~/~ e .a. I ............................. , (to be paid on filing this application) ' 1 If dwelling, number of dwelling Units ...... , ........ Number of dwelling units on each floor ................ If garage, number of cars ..... ~ .................. ~; ............................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. Dimensions of existing structures, if any: Front ..... .U-..G. ...... Rear .... / .~] ~. ...... Depth....q. Q f.'....... ...... Height ............. Number of Stories... .I ............... ~ ..................... ~ ......... Dimensions of sa~e structure wi!th alterations or addi[ions: Front ..... .~. (~ .........Rear .... .~. Depth ..... ~q P'~ ....... ~t' i.-c HeightF! ...... ~k~'.., ............ Num!~.e~' o,f Stories. ~e' j ...... ! ~-]" ....... Dimensions of~nt're new c ru tion: rent ..... Lo. ........ Rear .....~tm.... ...... pth .... t .......... Height ....).g. ......... Numlber of Stories ......... ~. ............................ ~ ........... Size oflot: Front )..(~.S-7~. .... Rear . ."2..O ........ Depth iil..c~..~i~".'.} ......... Date of Purchase ........... i .................. Name of Former Owner ............................. Zone or use district in which pr~mises are situated ...... ~ ............................................. Does proposed construction violate any zoning law, ordinance or regulation: ..../~ .O ...... . .............. Will lot be regraded ....... JS}. O ................. Will excess fill be removed from premises: Yes Name of Owner of premises b3.~( .~..~ .~ .~.~ ~ ;.. Address .~r/~.q~.. t.T't~ .... Phone No..~..o~.~: ~.,,.5.'. Nme of Architect ...... -.-4 '! ................. Address ................... Phone No ............... Name of Contractor . .~....'¢. ~.~.,r~,~.,~ ............ Address . .~Y~..& .~'..~ '?..%~-J%... Phone No..~..q ~.-: .~q Locate clearly and distinctly all :operty lines. Give street and block ~__~n.~r corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from lumber or description according to deed, and show street names and indicate whether \ rATE OF NEW YORK, OUNTY OF ................. .& .... ~?.) .A.~..~.... ~. .... ~ ¥ ~rq ~ ................. being duly sworn, deposes and says thane is the applicant (Name of individual sig~ing Contract) ~ove named. (Contractor, agent, corporate officer, etc.) said owner or ownem, ~d is du~y authorized to perform or have performed the said work and to m~e ~d file this 9plication; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the ,ork will be perfomed in the m~ngr set forth in the application filed therewith. worn to befo~ me this ~ignature of apphcant) [ Quohhed m Su~folk/¢,archCOunt? ~Comml~ion Exp*tes ~~ ' 320 LOVE LANE MATTITUCK, L.I. NEW YORK 11952 (516) 298-8420 , 0 SERVING YOUR NEEDS SINCE 7923 1 FIELD iN~F~LW[iON 1. FOUNDATION ( FOUNDATION ( 2. ROUGH FRAME & PLUMBING INSULATION PER STATE ENERGY FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 examined 19 Application . . . . . . . . . . . 'approved . . . . . . . .. 194�. Permit No. )isapproved a/c . . . . . . . . . . . . . . . . . . . ... . . . . . . . 01 (Building Inspector) APPLICATION-FOR BUILDING PERMIT - Date . . . 19 V INSTRUCTIONS a. This application must be completely, filled in by typewriterorin ink and submitted in triplicate to the Building ,nspector,with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ,ation. c. The work covered by this application may not'be conitnenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant..Such permit ;hall 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 purpose whatever until a Certificate of Occupancy ;hall 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 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 alterations, or for removal or demolition, as herein described. the applicant agrees to comply with all applicable laws, ordifiances, building code, housing code, and re ations, and to admit authorized inspectors on premises and in buildings for necessary inspections. . . . . . . ; . . . . . . . . . . . . . . . . . . . . . . (Sig riure of applic nt, or name, if a corporation). . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde'r',.,-,, . . . ... . . . . . . . . . . . . . . . . a__.ey.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . .. Name of owner of premises . . . . . .�n AI�Ng,QSQ-1 ni 0Y�. . . .I. . .. . . . . . . . . . . ... . . . . . . . . . . ... . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is,a corporation,signature of duly authorized officer. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. .67111w . . . . . . . . . . 7. . . �AAF__S - Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. .. . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111-11-5- ly.,� Y)-) <Z_44z::� P . . . . . . . . . . . . . . . . . �'� . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet 1/ County Tax Map No. 1000 Section . . . f."5 . . . . . . . .. . ....Block C. . . . . . . Lot . . . .00. . . . . . . . . . . . . . . Subdivision t�ft-7—/ ! T?,' . . . . . . . . . . 1_�.k .— 7--t7l . . . . . Filed Map No. .. . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . .R . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . ... . . . . Removal . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other-Work . . . . . . . . . . . . . . . (Description) I. Estimated Cost . . . . I-r-8 a a. . . . . . . . . . . . . . Fee =t (to be paid on filing this application) i. If dwelling,number of dwelling units . . : . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage,number of cars . . . . . . . . . . . . . . . . . . . . . . �;. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . r. . . . . . Rear . . . . l S... . . . . . . Depth . . . .q. . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . .I. . . . . . . . . . . . . / . r . . . ... . . . . Dimensions of same structure with alterations or additions: Front . . . . . . .lo. . . . . . . . . Rear . . . .t . . . . . . . . ... Depth . . . . . .14- ?�.'. . . . . . . . . . . . . Height . . . . . .)41 . . . . . . . . . . . . . . Number of Stories . . . . .I. . . . . .;. . . . . . . 3. Dimensions of entire new construction: Front . . ? I. Rear . . . . . . . . . . . . Depth . . . .1 �. . . . . . . . Height . . . 1� . . . . . . . . . Number of Stories . . . . . . . . .I . . . . . . . . . . . . ). Size of lot: Front . . . . A .. . . . . . . . . . . Rear . . . . . . . .?.C7 . . . . . . ). Date of Purchase . . . . . . . . . . . . ... . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Zone or use district in which premises are situated . . . . . . A . . . . . . . . . . . . . . . . . . . . Z. Does proposed construction violate any zoning law, ordinance or regulation: . . . ./.�! n . . . . . . . . . . . . . . . . . . . . . 3. Will lot be regraded . . . . . .N.0. . . . . . . . . . . . . . :Will excess fill be removed from premises: Yes _ No I. Name of Owner of premiseslbAK( .2. 9 P Y q t . . . Address Y1l�r . . . . . Phone No. I .-S:S. l. . . Name of Architect . . . . . . . . . . . . . . . . . . ... Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . .. . Name of Contractor oVvAr-.-3 . . . .40. . . . Address !':qO T! Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from roperty Lines. Give street and block number or description according to deed, and show street names and indicate whether a ef—nor r corner lot. i 11 f3�f TATE OF NEW YORK, -S.S _ OUNTY OF . . . . . . . . . . . . . . . . . - - !'�1 A .`( lZ iZjTY N q . . . . . . . being duly sworn, deposes and says thaoie is the applicant (Name of individual signing contract) rove named. s�eis the . . . . . . . . . . . . . . . . .. iY.�! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . (Contractor,agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true^to the best of his knowledge and belief;and that the .,ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . . . f,-'IN . . . . . . .day of. . . . . . . . . . . . . .... 19 . . . jotary Public, !,�1. . . . County SKWARA State of New York r1oTAIC X. , .�220"c . . /. . . . . o. 52 4663491 !, Qualified in Suffotk County u Signature of applicant) Commission Expires hAarch 30, 19$ DA'rE- B. : N~:i:IFY BUILDING DEPARTMENT 7&~1~C~ g A~ TO ~ P~ FO~ THE FOLLOW~G INSPECTIONS: FO~ POUR:D coNCRETE 2. ROUGH - FRAMING & PLUMBIN~ 3. INSULA 4. FINAL - COF~STRUCTiON MUST BE COMPLEBE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~ATE ~ONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ~iGB OR COBSTRU~ION ERRQRS. I i is, tn/*L d✓ 40 �i i i u w <,�.��- a, 7 Aid iris •op X of 4 as rt �Sh.�y.,afcF � - rya° 10 Elk 2. sc j f e Do 't h or 4-kit e airy R�� ov aY" f es xx � t CdR ee+�smcA fStwx.r� R. 'rk�� ta� �r `t,It M �' S p.t`'"°Z�f1�'r�c'<< $ Nov �,a,tom. � -zoo" Cpeata W'!I i:vq MAN iIJ o ! C4 pits- /00 C l�R \� p f FAaa r•scco,��Flaur a w�yr SarD � `t f��F,d,'r�NS�,S,reaec7s+w$1>al�ts6+-FC^G'u�s'f:h�N� �•-•- "'^o,,,, �,��•��p�1�i4,r VIA ak 1 � 1)l x e- E ) ^�tJfie Frre 'cl eat RaC I ti d Qr , clasp Kay laa✓'PN1� f y r®� ^f e OAK r z1 r� fi r t 3 j r r &Jtf i pal PJDUL ��I�P, �f fJ