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Home My WebLink About2060-zFOl%i~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, OEETIFIOATE OF OOOIJPANOY No..~...~.0.~.~.... Date ...... .AI~.I~..i.~....4, ............... , 19.6..8. THIS CERTIFIES that the building located at . h!OOdend Malt ............... Street Map NoBQtl~WOOd. Block No ............. Lot No. 34.. · 8lOtl./:hOl d,. I~. Y..,. ~,¥, .... conforms substantially ~o the Applicati,on for Building Permit heretofore filed in this office dated ..... I41a~..iii. ............ , 19.61t. pursuant to which Building Permit No. ~I~0.60.. dated ..... 14alt. J,l. ............ , 19..63, was issued, and conforms to all of the require- ments ,of the .applicable provisi.ons of the law. The .occupancy for which this certificate is issued is ... p~.:~Vi~,t;O..Ola~..~t!gatl4t, ttvlel, l, ira~ ............................... '... '.: .... The certificate is issued t,o ...... (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval ......................................... ............. ...... '['" FORMt NO. g 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? 2060' Z Date .................... Permission is hereby granted to: · .Ja~c~b..P,..~e!.n~.r. ..................................... ........... ~od'..F_~d.. :~ay ....................................... ...................... ~outh~Id. ....................................... to .....bui. td...a~.-a..di, ti. om..~.. ~a.. ~.l.s%i.ng.- ~wel.lir~ ..................................................... at premises located at ....;3~2...3~....~e~:w~d...A~res ...................................................................... ........................................................... ~o~d~nd.....wa.~ ........................................................................ .......................................................................... ~euthelc~ ................................................................... pursuant to app[Jcotion dated ...................................... M~y""'t]: .........]9.63.., and approved by the Building Inspector Fee $'~, ()O .............. Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ~...~....~...~....:...f..~...,19 ........ (~'~ Approved tx 19 ~ .Permit No. ~ ~'- ~.. ~ Application No ..... ...~....~.....~...0. ..... Disapproved a/c ........................................... ~...~~ 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 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 applica.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 re,,g~lations. ,~ ( o ~ ..~""i~, .......................................................... /c~/ (S'gnature of applicant, or name,, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ome of owner of ..... ........ .............................. If applicant is a, corporate, signature of duly authorized officer. ................................................................................................ ,~ o~ ~ .~ (Nama and title o{ corparata officer) ~I '~ ~ ~. Locatio~ ~ la~d ~ wklck praposad work will ba don~. ~ap No.: ........................................ Lot No.: ...~.~... ..... .............................................. 2.~tata existing us~ and occupancy oE premises an~ i~tendad use ~ occupancy 0~ proposed a. Exisfin9 usa and occupancy b. Intended use and occupancy . ~ . 3. Nat?re of work (check which applicable): New Building ..... ~ ....... Addition .................. Alteration Repciir ................. .c~mOval .................. Demolition .................. Other Work (Describe) .................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ...~..~.~.~..... Number of dwelling units on each floor .. 6. If bu, smess, commercial or mixed occupancy, specify nature and extent of each type of use ,~/c~ 7. Dimensions of existing structures, if any: Front ....... ~../..~.. .............. Rear ........ .~..~/_... ........... Depth " Heig'ht ...... ?..~.. ............... Number of Stories ...... ../.. ...... Dimensions of same structure with alterations or additions: Front ....... .~...~.. ............... Rear ....... ...~....~. .......... Depth ....... ..'~....~... ............... Height ....... Z.~.. ............... Number of Stories ...... ./.. ...................... 8. Dimensions of entire new construction: Front ...... ..~....:~ ............ Rear ....... ~...~ ............ Depth 10. Datel of Purchase .......................................................... Na,m~ of Former Owner Il. Zone or use district in which premises are situated. ~..~.. t2. Does proposed construction violate any zoning law5 ordinance or regulation? .....~....O....,~..~...~....~... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description .according to deed, and show street names and whether idterior or corner lot. STATE! OF .NEW Y/~RK, ,~ ~/)) "S COUNTY OF ....~~' · of individual signin~q application) duly sworn, deposes end says that he is the applica, ; ame above nom~d. 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 application;, that all statements contained in this application are true to the best of his knowledge and belief; at that the work will be performed in the manner set forth in the application filed therewith. Sworn to b~f~r~, me this .- , ~/' ~,o,~r~ , te of New ~ork [ ~ ~. 52;0344963, Suffolk County ~ ' uomm ss,on Expires Uarch 30, 19~4~ FORM NO. 1 Examined ............................ ~.< ......... , 19.....~.. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLEP, K'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No .............................. Disapproved a/c ............................ ............................................................................. ::... (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT Date ................................... , I .7.... 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 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 applica- tion. c. The work covered by this appIication may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applic.a.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 part 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 regjalqtions. __ ,,: ( 'g pp ' t, or am , if ct corporation) ................ .......... ............... ...... " ' (Address of applicant) ~/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pIumber or builder. ....................................................................................................:t! ................................................ Name of owner of premises ..,~¥.....c~:..~:~.6.:~....~~.'~.'...'~..7:~.....:....f..~....~:.::~-~.. .......................... 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.: ~Z.~.~ ......... Lot No.: .....~..~..... Street and Number ..~.~~.~.~ ...... ~'.~.Z~e.~..~ ........ ~..~..~ .......................... 2. Store exist[no use ~nd occuponW of premises ond intendod use ond occuponcy o{ proposod construction. o. Existin~ use ~nd occuponcy ~.~~ b. }ntended use ond occuponcy ..~.. ................................................................................................................... 3. Notgre of work (check which applicable): New Building .................... Addition .................. Alteration Rep6ir .................. ,~mova! .................. Demolition .................. Other Work (Describe) .................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ,,~,?~....'~...../..~.T.. Number of dwelling units on each floor 6. If bgsiness, commercial or mixed occupancy, specify nature ,and extent of each type of use 7. Dimensions of existing structures, if any: Front ..... ¢~. .............. Rear .....~....~. ............. De;~'l~"ii~ ......... Height .....,~..4~. ...............Number of Stories ........ ./. ................................................................................. Dimensions of same structure with alter?,~r additions: Front ...... ..~...~... ............... Rear ...... Depth .~......~... ..................Height ...............~ ........... Number of Stories ...... / ...................... 8. Dimensions of entire new construction: Front ..... .~.......~Zr:%... ............. Rear .......~....~ ........... Depth 9. Size] of / TM ]0. Date of Purchase .......................................................... Nome of Former Owner ................................................... 12. Does proposed construction violate any zoning iow, ordinance or regu at on? ....~...~..~...¥~.~.../~..?...?,'~.;~..~¢~.~ .~.../., Name of Architect X/o,<,, ~ Address ~'¢"~'~ Phone No. PLOT DIAGRAM Loco,Ce clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions f property lines. Give street and block numbers or description according to deed, and show street names and indi, whether i/~terior or corner lot. STATE Oq NEW )~,OP, zl~, ,// 2 ) S S COUNTY ~OF ..~~...) ' ' (?~'ame of individual signing application) a.bow, 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 applic:atio~; that all statements contained in this application are true to the best of his knowledge a.nd belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to be~ me this ~ .. Notary Public .~'~(~..~.:.~.~.,..:¢~bu¢M,~ ',,~,;~] ,,,']:' ;,,~j'~e of ~pp cant) ] JUDIT~ ' ' ,' ' ...... ~ 30,