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Home My WebLink About2556-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. I]EI~TIFIP. ATI~ QF oI]r. lIPANr, y No. ~..21~ .... Date .................. ~T~....31~. .... 19.6.6 THIS CERTIFIES that the building located at . .]~/~.. ~.~ .L~%]~. A~i~cl .... Street Map ~od.a..I". . .~.h...P~okck No .... X~ ...... Lot No..12~-. ~O]%~hQ~[,...~.*X, ....... conforms substantially to the Applicati~on for Building Permit heretofo~-e filed in this office dated ............ .0Ct,.. 16.., 19.~ pursuant to which Building Permit No..2.~6-~ dated ............... Ogi;,. 3,6., 19.6I~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .Px'~va.'~e. o1%(~..f~mil~ .~l%~el]..il~ ......................................... The certificate is issued to . ,Joseph .&. ~a~he~.ine~ .Ba,~l~.li~ ........ ~e~.s ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. J%%~e. ~.-1966...by ~,..~l;L'l.a. . FORM 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.° 2556 Z Dote ............................ O~;gbel~....j6....., Permission is hereby granted to: · · · ~Tese-l~...Bl~J~t,e · .& ..tt/~,£e ......................... ...... I~l.....l~tl~..jkv~ ............................................ ............. Z,...N~.thi~$, ..................................... to .]I~Lt.I~I.. ae'~" one..£em~t~'..d',,e.l.~g ...................................................................................... et premises located at ........ Lot-.-~-P_~.f.....G-~d~t,.*.Beaeh..~ark ....................................................... ................................ ~}/S -... Vest...Lake..Rd i' ....... 6outhotd i" '~'~ :~ i ............................................. pursuant to application dated ....................... O~t, ljlje~.....tl6 ............ 19.(~1~.., and approved by the Building Inspector Fee $.~(~ .......... FOI~i~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .......... ..... Approved ........................................ , 19 ........ Permit No ................................. ..................... ................................. APPLICATION FOR BUILDING PERMIT Date ...... ~~-~..~...~. ........................... , 19 ~[ ~: INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildi Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and g~ving a detailed description of layout of propertymust be drawn on the diagram which is part of th~s applicati, c. The work covered by this application may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Budding Inspector wdl ~ssue a Budding Permit to the applicant. Su 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 Occupar shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to t Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb, The apphcant agrees to comply with oil applicable laws, ordm~:z~es, building code and reg~ations. ' '~'"'~" (Address of applicant)~/ appli~~agent, architect, engineer, general contractor, electrrcian, plumber or built Name of owne'f~'~'~'('~~)'~'""~~II ................. If applicant ,sa c/;~J'r~J~"o~f'~J[f'~' off,ce';i ............................................................................ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No' . ......... ..?...~.. .......................... Lot No' ./...~....~. .... Street and Number ...~.,~,~ ~--~ ~ ../..~..~... .~..~ .~...~. c~7-~/('~' ................................. ~/~'~,c i~li;~"~j~ ........................................................... 2. State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy ......................................... P-7 ............................................................................ b. Intended use and occupancy.....~'~..~.../~J..~...~ ....... ~...'~...~ .................................................................... 3. Nature of work (check which applicable): New Building ...~..~..~. .... Addition .................. Alteration ................. Repair .............. ,~,~...Removal .................... Demohtion .....~ .......... Other Work (Describe) ..................................... 4. Estimated C~.....C.~....~....~..~...~..~. ............................ Fee--~..]Z..~:...~.--~.~. .................................................................... (to be paid on fihng this application) 5. If dwelhng, number of dwelling units .... ..~...~....~. ............ Number of dwelling units on each floor .....~....'~..~ .......... If garage, number of cars .... .~..~....~.. .......................................................................................................................... 6. if bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. DJmensions of ex,sting structures, if any: Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stories .............................................................................................................. Dimensions of some structure with alterations or additions: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8 Dimensions of entire new construction' Front ~'~'~" Rear ,.~.2 ~',F'- Depth ~' ~/~-~'~' .... · ~. ..................... Number of Stories ............................ Height ~ 9. Size of lot: Front .......~....~...o..../],.'..... Rear, ...... ...... Depth .....~...,.~.....~.:....~..,... 10. Date of Purchase ............ ..~../..~...~.....,~/...~....~... ............. Na~l~ of ,~ormer ~ ..... .~.....~//.....~./...~.~/...'. ....... 11. Zone or use d,str,ct in w~,ch premises are s,tuat d ..................... ~ ........................................ ~ ......... .~ ......... 12 Does proposed construction f~olate any,.~pmg Igw, ordinance or regulation? .................................................... 13 Name of Owner of pr~mis~.4.....~_....:...'.~.~..~....~..~...~'...~dress ..~..././.7...~'..~....?..~......~.r...~... ~h~.e~...~....~....~...]~...: Name of Controctor .................................................... Address ............................................ I:hhone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property lines. Give street and block numbers or description according to deed, and show street names and red,cai whether interior or corner lot-. STATE OF NEW Y'C~RK; / ~,~ ) ~ ~ this application; that oil statements contained Jn this application ore true to the best of his knowledge and beli and that the work wdl be performed in the manner set forth ~n the apphcotion filed therewith. Sworn to before me this -- ~ ~ ' *" ................... =... .... . ..................... du,~rY Public, State o~ ~r~ -' No 52 (,~t4963, Suffolk County ~