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Home My WebLink About355-z Fo~ I~o. 2 TOWN oJ: SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLk--FION OF THE WORK AUTHORIZED) No. 355, z Date ...............~.I~.~ .~. .................19.~[8... Per'mission is hereby granted to: l~aker & l~Icais~e~ .. A/.~ ...ltar. olzt..tiolmhe~,~ ....... .............. ~;~I~ ...................... .................... ~; ........................................... to..,m~e..an, a~Lter~or~acld~tf~or~..oa, a~,..exi~t~..~wel~Lin~ ............................ at premises located at ..... ~/~...~IT~O~.~tt.. i~.O~,~1.! ..... ~.e~l~;~9~'~,- ~,.~-e ............................ pursuant to application dated ....... ~':g~l~...~L~. .... Budding Inspector Fee $~. 00- .............. ............. 19.~.., and approved by the NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANGY THIS CERTIFIES that the bu,ld,ng Iocated at .l~../..~......1~. ~.t,.h......P~... ............................ Street Map No ..... ~ ................ Block No ........ conforms substantially to the Application for Building Permit heretofore filed ~n th~s office dated ................... ~..u..?...~...2..~. .................. 19 .~..~..., pursuant to wh,ch Building Perm,t No .... ..~...~ ........... , dated ............ ~..1~. 8......2...~' ......... 19...~..~., was issued, and conforms to all of the requirements of the apphcable prows~ons of the law The occupancy for which this certificate ~s issued is ........... ..................................... ...... ............ Zh~s certificate ~s issued to ..................................................................................................... (owner, lessee or tenant) of the aforesaid budding Building Inspector NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL F,le No . Z....3..5'..~ .................................Date ......................... .J.:.J:.~.e.....!...7. ............... 19...~.8.. ...s..o..u. ~. h .o.z. ~ ,...~ ...L ........................... PLEASE TAKE NOTICE that your apphcation dated .... Jltp. e .].7. .............. for permit to construct ...... ~..n....a...d..r!..i..t..$.o..n.. ......... at the prem,ses located at . N/S l~orth Roacl ..(lt~u,~,~ ?.2A) ..G~'.e..e~nl?.o~..¢ ~... N, ~,. .... Street Map .............................. Block ......................................... Lot .......................................... is returned herewith and d~sapproved on the following grounds ~.~;~.ll~?...i..q.~.Ii.~...~..i..qt..e....y..~...d. ...... .... Am~cle. I/It Seation .3Q? ......................................................................... /s/ Howard M. Terry Building Inspector FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ~,.../,.~ .......... 19...~...~, A . ,, O~ .A,¢,-. .. .....~.....~..~.~.... pprovea ........................... ? ............ Iv ........ Ferm~ No. Disapprovedo,c ...... ........ · ........ (Building Inspector) / Application No ..... ..~......~'...~.... APPLICATION FOR BUILDING PERMIT Date .............. ~ ........ L...-f. ....... I~...~.-. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 location. 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 pul'pose whatever until o Certificate of Occupancy shall have been granted by the Buildin~ 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oll applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) .................. ~...~...u...Z....k...~..~...a.. ........... (..v.:.y,..: ................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. ~.~.~.~.~..~. ....... ,O<...o..~.~.~.. ,A...~..~.~...~.~..f; .......................................................................... ·Ll~r~.nlqn~z_ /_ ~-/~C ........................................................... If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map lxJ~.~z~._.z..r..:; .................. Lot No: .....-TZ. ............. Street and Number ~.~(~ ..........~.~...~ !Z~,..~.......~..~~.~...... ,~..r.~...:Municipality ................................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b: Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ......~. ............. Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......... ~....~....O~.. ........................................ 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 ....... ~3.'~...~....~ ........ 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 .... .~...~....~....~. ......... Rear ..../....~..~...f. ........... Depth ...,~.....~....O...~...~..7...~..'~.~ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1]. Zone or use district in which premises are situated ...................... ~;...~ ................................................... 12. Does proposed construction ~inance or regulation? .................................................... 13. Name of Owner of premises..;/ ................... ddress ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor..../~.~..~....c~......~....~....~.L.(.~....Address ........ ~..~ ............ 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~,YOP.~Ig, ,~/J ) S S COUNTY OF ..~m~-:~..~..~ "~--~ .............................. · ~.~..~..~..~"~..b.~..:.,..,., being duly sworn, deposes and soys that he is the applicant (Name of individual signing application)~.~.-~ above named. He s the ........... ~..~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 that the work will be performed in the matin_ ~./~t/~r~Jn in the application_,.filed therewith. Sworn to before me this r"~ ~1!~ ~t~.~_~// ~ .... ~ ~ ........... ..... doyo, .......... ........ Notary PuN,c, ...~-.(-.~~ ....... ~ ~0, ,, -/