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Home My WebLink About1880-z TOWN OF $OUT~IOLD BUILDING 'I"OWN CLERK'S OFFICE SOUTI-IOLD, OERTIFIOATf~ OF' O00UPANOY No..~. ~ .36. Date , ~UI'~. 8 ..... 196~. THIS CERTIFIES that the building located at .~/~.. Kl~tO~,l~ood, ,~ ........ Street Map No.. ~ ........ Block No ...... ~. .... Lot No...~ .... ~$~.~1~. ~ ....... conforms substantially to the Applicati, on for Building Permit hereto~e filed in this office dated ............ ~gg~ .. ~., 19~2. pu.rsu'ant to which Building Permit No.. ~8~. dated ............... ~.~p.~.~, 19.62, w~s issued, and conforms to ali of the require- ments ,of the applicable provisions of the law. The .o.ccupancy ~or which this certificate is issued is . P~i~atO..O~e. ia~i3.y. ~l.*el.~,].Dg .......................................... The certificate is issued t,o . .~le~Bt..T,. Br~ ......... ~a~ ..................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ....... ~,~, ............................. ............. ......... FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1880, Z Date ........................ Permission is hereby granted to: ...(~tement...Br~w~ ............................................. ........ · Enot'l~o~d.'.~a ........................................... .............. Mattitu~k ............................................. to .To..Bu~.l.d...an..add~.ti~..on..an.. wxi. s ting., dwel.~.~.ng ................................................. of premises located et ...S/~.....]I~iO.'[.~A~O0~..~t. ................................................................................. ............................................................... i~t¢~.~'~]~ ........................................................................... pursuant to application dated ............................... ~111:~1~..1~-~1~.....~...196~..., and approved by the Building Inspector Fee $'"'~'~'0~) .......... ' ~ Building Inspector FOI~M NO. TOWN OF SOUT OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. Examined ............................. 19 ........ ~mv~ ........................ ~. ....., ~9 ........ ~r~ ~o ................................. ................ ........ ............... .......................... > ................... Application No, ..l...,~..~? ......... 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 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 purpose whatever until a Certificate of Occupancy shah 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 $outhold, 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 regulations. 'g pp ' , , ' a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................. .~.. ~.b..¢:.C ............................................................................................................................................... Name of owner of premises .~.] .~.'.~..~ ~.~'t] ].Z_] ..... ...~.. :.~...o. ~.o..E~ ........................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... ~ %~, ' ¢,o& Lo._ e ~ 'o - ~v¢~' Gr-a. ~ Street and Number S.O.~; .......... .¢, ...... ~-~.~,Q.i,.~.cf~ ................ v.~ .............. ',~..~..,.,EJ}.; ........ ~,~, ............. ..~.....[~.~/~.,, Municipality 2. State existing use and occupancy of premises and intended use and occupancy oF proposed construction: .......................... b Intended use ~nd occuponcy .~ .................................................. .. 3. Nature of work (check which applicable): New Building .................. Addition .....~ ...... Alteration .................. Repair .................... Remo~al .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ................. '~. ~-, .~..(~ ................................ Fee ......... ................................................................................. (to be paid on filing this apl~lication) 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....'.~...~....fi~ ........ Rear ...... ..~...~.....~?..~.: ..... Depth ...~-~..~.....~.J¢. ........... Height ............................ Number of Stories ...........[ ................................................................................................. Dimensions of same structure with alterations or additions: Front ........ .~)..~...~.R: .......... Rear ..... .~...~...~ ............... Depth ........ 3..IJ...Ii~ ....... Height ................................ Number of Stories ..... ! .................................. 0 ' 8. Dimensions of entire new construction: Front ........ l ...... ~'.~ ............... Rear ....... ~..~....~r., ........ Depth .....~...~....~..~. ............ Height ............................ Number of Stories ........... I ...................... 9. Size of lot: Front .............. J.~....~'.~:.... Rear ............ 1.0..G...~J ...... Depth ......... ~,.~...~..~.....kJ.., ......... 10. Date of Purchase ....................................... /..~.~}~.......Name-- of Former Owner .'~.d~.~..~../T~.....]~...6c,.L'.I¢. .................... 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ..~..Q ............................................. 13. Name of Owner of premises~.~.l~):~..q.f......'~....~.~., .~...~...Address ~0.0J!~.~.~.~.qn~'.;...~..~ki.~ Phone No. ~..~..-....~.l.!cl Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... 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. lifo us es STATE OF NEWc~.~r,/~ ) c COUNTY OF ..~ .~.......Z~....) ................................ being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above homed. 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 th s e.pp cation; that all statements contain,~,l~i~_~i~,l~ol,~cotion are true to the best of his know edge and be ef; and that the work will be performed in the. ~,rt~t~r~lk~'~rl~in the application filed therewith. Sworn to before me this~-. ........................ ........ . ........ .............................. Notary Public,~...~/..'....~~ (S'gnature of applicant) '