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Home My WebLink About1124-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. r. ERTIFIr. ATE DF E]P.E:UPANP. Y TH, IS CER[~IFIES that the building located at ]~/.8. Smith. D.I~lve..8ouih.. Street uoose ~eek Estat;es Map No ........ Block No ............. Lot No. ~{~97~0...~.o.u.%h.Old. ~. R,.Y. :... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... J~:lrie. 2~.. , 19 k0. pursuant to which Building Permit No. ll2[L 2[. dated ............. Jl~e.. 28., 19 60., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .?~'$~a~..e. ~n.e.. ?.a. La:~.ly..c~¥.e.l.~lr~g ...................................... The certificate is issued to ...~lt ~T.,2~'akas .... 0wlle.~ ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....I~.~.. ........................... ,,.~z .... t .......... Building Inspector ~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:FICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote ........................... ~.~.... 28 ......... :.. 19_60. Permission is hereby granted to: Wes Bedno ekt.. ~fC.. :~ ,.,T.,~.lka~ ................................. ........ ~0%lthOl~.....~..~... .............. ~ .................. to ...... ]Su~.l~...~...a~d.t.t.len..~..$~....~.X.~t.i~.:~et.l.~ ................................................. ' at premises located at ...~,Ot~...~...~.~:.,..(~).....l~O.gO:..~t]~, ................. i ................... 8~nt.th.. ~.tv,~../~ou~,,h,. ....... :Sou/;h. oitd ,.....l/, ir, ................................... pursuant to application dated ............................ :.dm~t~.-....~.~.....~.: ...... 19...60, and approved by the Building Inspector : Building Inspector FORI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... ~/..-. .......................... 1 c) ........ Approved ........................................ 19 ........ Permit No ............................... Application No. ! j~ ~' ~ APPLICATION FOR BUILDING PERMIT 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 cov, ered 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 purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE tb 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, ordinances and regulatior~s. (Address of applicant) ~ State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. .. ............................................................................................................. Name of owner of premises,..,/i.-.,....~- ........... ~~---'~,,-. .................................................................... If applicant is a corporate, signature of duly authorized officer. .................... ................... ~/.~ ~U~z ~ ) '/ ''p 2. Stot~ ex[stinO use ond occuponcg o{ pr,em[ses ond intondod use ond occuponcy of proposed construction: ~. [xistin0 use ond occupancy ..................................................................................................................................... b. Intended use and occupancy.....~ ............ ~ .......................................... 3. Nature of work (check which applicable): New Build'ng .................... Add' 'on .................... Alteration .................... Repair .................... Removal .................... Demolition ............ .~....Ot_h~ Work (Describe) Estimated Cost ....... ,¢.~.0..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 ........ '~..~. .............. Rear ............................ Depth ....¢~..~. .................. Height ......... .~..I .............. Number of Stories ............. ../. ............................................................................................. Dimensions of same structure with alterations or additions: Front ....:.~.~.:. .................. Rear ....... ..~...~...: ................ Depth ........ .~.:.~.~} ........... Height ........... ~.. ................ Number of Stories .........../. .................... 8. Dimensions of entire new cons~raction: Front ......... Z'..~. .............. Rear ............................ Depth .... Height ........ .~..~. ............... Number of Stories ........ ./. .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use dtstr~ct in which premises are s~tuated .................................... ..~..~..~ ................................................ 12. Does proposed construction .....v~olate any zoning law, ordinance or regulat~on~ ........ .7.~...~. .................................... 13. Name of Owner of premises.../..f~.,....~..~..LT'..~..$. ............ Address ......~.~..o.~/~..~..(¢~. ................. Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor....~....e~.....~....e.~-'~.o..E .~.~. ............... Address .....~.O..O.~.O../~. ................... Phone NO.~.~.:~.?..~...~..~..J.: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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 NEW YORK, ) S S. COUNTY OF ............................ ) above named~ ................. &. ............................................................................................................. (Contractor, agent, corl~orate off{car, 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 w{{I be performed }n the manner set forth in the application filed therewith. Sworn to before, me this ........... · . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ............................... Application No ............................. Disapproved a/c ............. j ....... ~=~. .................. :~; .... <: ............. ~ ............ ...................... ...................................... (Building Inspec~tor) ..%...-' / APPLICATION FOR BUILDING PERMI~'/~f/Y Dote.....~ ..................................................... 19 ............ INSTRUCTIONS o. This opplicotfon must be completely filled in by typewriter or in ink and submitted in duplicote to the Building Inspector. b. Plot plon showing Iocotion of lot end of buildings on premises, relotionship to adjoining premises or public streets or oreos, and giving o detoiled description of [oyout of property must be drown on the diogrom which is part of this location. c. The work covered by this oppHcotion moy not be commenced before issuonce of Buiiding Permit. d. Upon opprovol of this opplication, the Building Inspector will issue o Building Permff to the ~pplic~n~. Such permi~ shell be ke? on the premises ~voiloble for inspection ~hrou~hou~ ~he progress of the work. e. No bui[din~ shell be occupied or used in whole or in por~ for ony purpose who~ever un~i[ o Cer~ificoge of Occuponcy shell hove been ~ronted by ~he Buildin~ Inspector. APPLICATION IS HEREBY MADE ~o ~he Buildin~ Department for ~he issuonce o~ o Bu[Idln~ Permi~ pursuont ~o the Bu~ldin~ Zone Ordinonce of ~he Town of Sou~hold, Suffolk County, New York, end other ~pplic~ble Lows, Ordinonces or Regulations, for the construction o~ buildings, additions or alterations, or for remova~ or demolitlon, os herein described. The applicant agrees to comply with all applicable laws, ordinances, and regulations. ............................................................. .............................. ...... ................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,/'' ("-)'2 - , Nome of owner o~ ~ premises ........ ~.~,~ ....... ,. ~.; ........... ~ .......................... ~ ............................................................................ If applicant is a corporate, signature of duly authorized o~ficer. (Name ond title of corporate officer) 1. Location of land on which proposed w~.~.~ill be done'..Ma: ~~ L°t ~:~'~7~/~ Street and Number /" ) '~'~"~" Municipahty State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ..................................................................................................................................... b. Intended use end o¢cuponcy ....... ,m;<.; -;:...,r:.~,.~.~',~:~.~;;'::'=~.,.~:-..7~y~...~.....; ......... ~. ................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... J Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost....:'~z/.~,~.,~.~ ......................................... Fee ..... ~'~.....~.~n.~:~ .................................................................... (to be paid on filing this application) $. 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 ........ ,~..1~. .............. Rear ............................ Depth ....~)~. .................. Height .......... /. ................ Number of Stories ............ ./. ....................... Dimens~'ons of same structure with alterations or additions: Front ...... .~.; ................... Rear ....... ~'./...~..~ ................ Depth ........ .~..i~4). .......... Height ........... ~ ................ Number of Stories ........../ .................... 8. Dimensions of entire new construction: Front ......... /..~ .............. Rear ............................ Depth .....Z..:~. .................. · tHeight ........ :/.:. ............... Number of Stories ........ /. .................. 9. Size of lot: Front .......... ~..~... ........ Rear .......... (~..5~-.. ........... Depth ....../'...'~.~...~. ..... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........... .,C/.......(.~.:~.X'.:....,.~...;,~M..: .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ z:./..~. .................................... 13. Name of Owner of premises....].:,~3.....~-'...u...x'.~.~ ............ Address .......~?.~t,.X/..,.o..z.r_~. ................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor...(~.¢.~....i.~.~.~.o.~)j~ ............... Address ....~.~.~.~*/~,./¢/. ................... Phone NO.~.~.:.~..~..~'.~.-~..J..~ 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 s~reet names and indicate whether interior or corner lot. STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) / /:".,/ :' -') /} ~/,! ~'~'"'~ be na du v sworn, deposes and says that he s the app cant 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 a)l statements contained in this application are true to the best of his knowledge and belief; and that the work wJll be performed in the manner set forth in the application filed therewith. Sworn to before me this day of ................. ~-~... 19 ........ m. (Sign~re of applicant)