The URL can be used to link to this page

Home My WebLink About2748-zFOI~M N~O. 4 TOWN OF 50UTHOLD $OUTHOLD, N. Y. P.E~TIFIE:ATE ~F {:3~E:UPAN~Y THIS CERTIFIES that the building located at 8UnseX, .I, ane,..o£t~ .B&~F.Vie~S~re~le't Map No..~ ..... Block No...~l~ ..... Lot No ....... ~ .............. ~O~tfcl~O~.d~I~o conforms substantially to the Applicati, on for Building Permit heretofore filed in this office dated ........ ~'ebl~tll~1~r..J. EI .... 19~. pursuant to which Building Permit No.. ~L748..Z dated ....... ~..2[4 ........... 29.t$~, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. Thc occupancy f. or which this certificate is is~uea is ..... n??...o.n..e..~..~..~..i~..~..e.:[..l~n. ~. ........................................... The certificate is issued t.o ..... RO~.~I~.~..0'~ .~.tl:~B.e~ .................................. (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval . .~llgJ~litl.t;. ~.4~. J,~6.6. .................. ............ ~. <~, .~ ~ Building Inspector .. ~ FOEI~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEIqT 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? 2748 z Permission is hereby granted to: ..llober.~..~o...~,.ne3~ ................................ '. ...... ..... 21+1~,..13he:~,.. ~a,~.~e~., t~ ........................... ......... .~t~.d.e~.~,., ,, .~.,.~, ...... : ............ : ............ to ...... ~u~ld..ne~..c~ue..$~..~t~,:t,~ ........... , ............... ; ................................................... , pursuant to application dated ................................. ~b13;V8~.....3-~ 19..~.~., and approved by the Building Inspector, ~0TEI Aeeessoz, y BU:tld[ng ~.ecat;:ton (B)en appl~.eat,:Len ~ill have tO be approved 137 ;Eld/ APpeals. Fee .?~..O..,..O...Q ............ t~ ~.--~. . . .... /,..~.o~&:...::.~x~,~., ...................... ~unamg mspecto~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH AUG Date Bldg. Permit No. TO WHOM IT The MAY CONCERN: sewage disposal facilities for a structure located CGive'deed 16C~ti~r~ have been inspected by this department and found to be satisfactory. District Engineer District Engineer FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ...~....~..~ .............. , I9.~.~. App,,cotion No. '~ ~ ~ ~ Approved....~.~ ....... :..~ ........ , ,,.~.~.Perm,, No. ~.Z.~..~.....~. ~e~/2' ~i~op~owd ~,~ ....~...~..~......~=~... ~ .......... ~.....~:,:., ................... ~..~ .............. .¢ ........................ ....................... ......................................... (Buildino Ingp~etor) 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 propertymust 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 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances ilding cod an (Signature of/O!6pTrcant, or name, if a corporation) .................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, 4~lumber or builder. ..................................... ~.~w.~ ........................................................................................................................................ Name ofowner of premises ....~'~0 ~..~..t / .......................................................................... ~- /q/)~-...~.l'~. / 6-/--'-"~'~/y~...~ .................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~, J rk ,11 e ne Ma o ]'') ~~oi e~-~ 1. Location of land on which proposed wa w' b ,'~Jo . p N : ........... .t... ............................ Lot No: .................... Street and Number '"~":"V'""'~""'"'"~"!'"0'"'O~'"'t'"'"~"~"'"'~"~'"'5'//~" "~'"'"c'~' '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 l../~..~ ......... / 3. Nature of work (check which applicable): New Building .............. Addition .................. Alteration .................. Repair .................... I~emoval .................... Demolition .......... ~ ......Other Work (Describe) ...................................... 4. Es. mated Cost ................................... 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 ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or aad't'ons Front ................................ Rear ................................ D mens ons of ent' e neDepth .............................. Heightonstruction .............................. Front ,~zjNumber of,,Stories ......... 8. rjr' w c : ........... , ............... t~ear .............................. ~, ........................ .~.:.. Height ......~..~).../.l'.~...f'..~,.e. ~'4~umber of Stories ...... ~ ............... _ · /oo /~--~ 9. S~ze of lot: Front ........................... ,--~ ~ _ -Rear . Depth J..~. ..... 10. Date of Purchase .../~).~-..~.....~..~....!..~.~..~.. .................. Name of Former Owner .~o.~..n/...~....~....O..~!..Ul..ff.....!..c~....~....~..~..~ 11. Zone or use district in which premises are situated ....... ~'. ...................................... ~7' ........................................... 12. Does proposed construct on violate any zoning law, ordinance or reaulat[on? ....(..~.~. ...................... ~ ....... 13. Name of Owner of premises ~...~..;.../...~/.~../'x'~x~.....Address .~...~..Z..~.~...~..~//~¢.~ Phone ~.(..:....~.../~ (;. Name of Architect ...................... .................... .....~....~...~.C~.....~......:. Phone No ......./.'. ............ Name of Contractor .................... ~.'. .............................. Address ........~ ...i ................. ~.. ........... Phone No .......~.i ............ 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. STATE OF NEW YORK, ~ c:¢ c~ ? ~ -- - -- COUNTY OF ................................ ..~..~..~...?..~.,.r/........~..: ...... ../'...~'...4~...,~'.~.....: .............................. being duly sworn, deposes and says that he is the applicant -- (Name of individual signin~ app ication) 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 all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the,~application filed therewith. Sworn to before me this / ...... ...... Notary pub I,c~. ~z..~.'..~.......¢o,~¢ ':; .'.; '?!?ii;? ";:;~;~'~';;" g~";;~;~;ii~'~'~;i .............................