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Home My WebLink About1901-z FOI~M NO. ~ 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 1901, Z Date ...................... O~ 1; O]:)~1~......i_ (% ......... 19..0~. Permission is hereby granted to: · ~nl~arlar~.. Aa~oe.$a.t,e~...:]:no ................... ...... H~t~..-Road- .................................................... ......... ~o~e~l.t......~;..i.~ ............................................ to ...... ]~$.l<~..r~ew-.-ot~e ...~aml.:ly.. ~ve:}..1.~:n.~ ................................................................................ at premises located at ...N/~.....l/~.p.'t~..,~i...o~..~/~.....(}~,all~..~.¥e. ..................................... .......................................................... Hat.~it, u~k ................................................................................ pursuant to application dated ............................... .:~er ............. ~.~' 19 ~., and approved by the Building Inspector Fee $.lO.O0...pd .... SCHD SUFFOLK COUNTY DEPART~NT OF HEALTH Date 10~17/62 Building Permit No, 1901 TO WHOM IT MAY CONC]~?d~. The sewage dispos~0fa~%liti~s for a structure located at N/S MAPLE / ..... AVENUE E/' GR. AN~ AVENUE M2TTITUCK . ~_Qiz.e__d. eed location) ~ N~:W YOFd% have been ihspected by this Department and found to be satisfactory. TIMBERLAND ASSOC INC MOTT ROAD CORAM NY ~A¥ ~ ? 1964 District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No.../.~..~.~.../ ............. INSTRUCTIONS o. 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 promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of thi~ applica- tion. 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 opplica'nt. 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 pa rt for any purpose whatever until a Certificate of Occupancy 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 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. : ..... :"'"'""'"'""'"(S /gnature of applicant, or name, if a, corporation) ....... (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician., p~.umber or builder. ....................... ....... .6,: c .............................. Name of owner of premises ....... .~......~.....~k~. ...... .kl~...~...~,...~...~....~..~ ........ ./~...~..~..O...: ........ ~..*.~...f......~ ................................. If ap~lSecmt is a corporate, sianature of duly authorized officer. ..........: 1. Location of land on which proposed work will be done. Map No.: t/...~....5...c...e.~.i./.~.?..~....<" '" ~ Lot No.: ......... ...................... Street and Number ...~.)...~.~../...~.....~..~..,. ............ ,,J:.C...~.4~./.J.,.~'..~......,~l/.£....../....~.,.~.~.~,..'~...~.~..f..~.t .................. Municipality 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 ~ f, ~5 .~ ~...f....,.W... .A.Z:{..~.. ........... . ............. 3. Nature of work (check which applicable): New Building ..... ~....~..~. ..... Addition .................. Alteration .................. Repair .................. Remora! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ...... l..~.t.m~..~, ......................................... 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 occupa,ncy, specify nature ,and extent of each type af use .................................... 7. Dimensions of existing structures, if any: Front ............................ 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 ....... .'.~i.'.~.'.'.~.'.i~.';;.'.'.'.";~'~'h ...... ,2_.1~..~.~., ..... Height ...... .'~..~....~...~.a,.. Number of Stories ..... 0...~...%...¥....[~/~.{,~: 9. Size of lot: Front ............. l..~..c~...('.,.~.*, Rear ......... ~.~....~...~..,....'X'... Depth ..... ..?~..~.~....('7..~7,.?. 10. Date of Purchase ..... ~..,~..k~..~ ............ )..¢L.(m.% ............... Neme of Former Owner ....].:.....t~.~.~..~./¢..~,.~.%~'..~. ............ 11. Zone or use district in which premises are situated ............... ./~. ....... ,('lm..k..~..Ls2.~.,..~i....~..!...,fl...t,,~ ........................... 12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ............ . . 13. Name of Owner of premises .~..~/¢fZdg&..~.~Z2...~.9...o..:.. Address ....~..~.~.,+....~..~./t.~9.~;,~'~'.'.~"~'~"~'; ~'~"~"-"f~'~' Name of Architect .................................................... Address ...................................Phone No ................... Nome of Contractor ................~....ot.....L.. .................. Address , ..~./'.5).,...~... ~Z , Phone No, ..)..,~..~.,E... PLOT DIAGRAM Locate clearly and distinctly ali 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 NEW. Y~,~R~, ~/ ) ,.~ ~' (Name ofk~ndivid~al signing application) above named. He is the ......................... ~ ........ ..~...~ .. U (Contrctct~r, agent, corporate officer, ~}r~i ........ 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 statement,s contained in this application are true to the best of his knowledge a,nd belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befor~ me this / ............ ..~..,~.,..-r.,t4' day of ....;,~ ....... , 19.~..~ Notary Pub ic C/~"¢5~'~';~.. - ' t ......... ~~"'"~i'"'~-~'~"~'~ ....... y~/."'~-cr~,,...~~?,~....../.,~zCp~n y (S~nature~/of applica,nt) , 's t~arc~l 30, 19~ ~