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Home My WebLink About2877-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFIP. ATE OF E)r':.P. UPANP. Y No. Z. 280~. .... Date ............. A~;;t .... ~t,~ -, 19.6~ THIS CERTIFIES that the building located at . 8/8- Oak. D~iVe ........... Street ~ap ~d0~. ~h0~ock No ............. Lot No. k3 .~ .... Sm~old,.:~:~, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... 8op~-. ~k" , 19. '6[ pursuant to which Building Permit No. 28~'~ dated .......... 8opg' ' '27 .... , 19 6~" was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~iw~te- ~n~' i'~ity '~t~zo~:~:i~,g ...................................... The certificate is issued to . ~.. g.,&. Viola. G~°~b~.m .......... ~'a~a~ .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...Al~:g .lk~¥' 't~6¢' 'by' '~' V~i~' ' Building Inspeetor~ FOItM 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? 2877 Z Permission is hereby granted to: ~Lt:L3. ~ ,~,, ..,L,...Ox.._-_~.~. _ .. &..l~.~e .................... ........... ~3Y...alh~.l~..~J~ .............................. ............. .~sxh~m~i;,....L ~ I.~ ........................... to ...... B1/~l O,./I~.W.. ~P.e.. £am~ ] ,y... ~%/el I~TI~ ................................................................................. at premises located at ....].O.~...lf,~..~:...L~ ....... Keydon..Shor. e~ ......................................................... ............................................. O~.Drl~m ................... aouthnl~..lq.2[. .......................................... pursuant to application dated .............................. ..~..e.~..~.. ....... ..~... ......... 19.....~.~,, and approved by the Building Inspector Fee $....30...(XI ....... S~TOLK COUNTY DEPAF~NT OF v~.aLTH AU6 1 ~ 1967 Date Bldg, Pernti% No, ,,, TO ~OM IT NAY The sewage dispesal facilities for a structure located at ~ive deed Iocation) have been inspected by this Depa.~en$ and found to he satisfactory. ~ g3.nee TOWN OF SOUTHOLD BUILDING I~F'ARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .......... .,9.? Approved ........................................ , ]9 ........ Permit No ....................... Disapproved a/c~ ............................. ............ ......................... Application No .................. ..~. ....... I ¸mr APPLICATION FOR BUILDING PERMIT · Date .......... ~ ..................................... ~ ]9 ...... 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 drown 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 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 I~EREBY MADE to the Building Department for the issuance of a Bui d ng 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 regulation~, f (S'g oture of app/E/aBt, or name, Jfa corporation;)" 435 Albem rle Rdad, Cedarhurst, N.Y. 11516 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ownez' Viola M. amd ~Llliam J. ~raha~ Name of owner of prem ses ................................................................................................................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. n~ap rna.: ........................................ Lot Ho.: ................ ~ ..... Location of land on wh~sed~ .wiJ. I .b: done.'''' 631 Map Re~doa Shores..` 43 amd 44 Street and Number ................ .~ ................................................. ~. ~ .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy norm b. Intended use and occupancy 1 family residence ! 3. Nature of work (check which applicable): New Building .................... Addition .................. Alteration .................. Repair .................. Remova! ............... Demolition .................. Other Work (Describe) .................. 4. Estimated Cost $].3s500.' " 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 2 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................................... 7. Dimensions of existing structures, if a~y: 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 .............................. Rea~' .............................. Depth Height ]J4t Number of Stories 9. Size of lot: Front .............................. Rear .................................. Depth .............................. 10. Date of Purchase .......... .~.:...~....0...; ............................... Nome of Former Owner ~[az'.~.oz'~Le E. OSagE ...................................................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. aa Does proposed construction~.ioLate ar~v zonina Ictw ordinance or reoulation;~ .... v~.oJ.a ~ ~ d, ~z'a~'a~ 435 ~t~ema~'].~"~,~' ........................... ;~";~"X~'"" 13. Name of Owner of prem ses Address '.C[e~.~,~.s~, t~ ,r ~>~,~ Name of Architect .................................................... Address ................................................ Phone No ................... Name of Contractor ....... .,~'..~...t~...~.--.. ...................... 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. STATE OF NE~/~ORK, ) COUNTY OF ~/'~~.,) S.S. (Name of individual signl g~pplication) c~ove named. He is the ........ .o.~.e..~. ........................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 know[edaa_a*~d bel el; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befcu'e me this~ ,,-~/'~:~."~,~-~.~.~c. ....... ........................ ........ ( -. L · (/ , / .......