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Home My WebLink About2899-z~OR~ ~0. 4 TOWN OF SOUT~OLD BUILDING DEPARTMENT 'I~OWN CLERK'S OFFICE SOUTI'IOLD, N, Y. BERTIF'IBATE: OF EII~I~UPANr:Y No. ~. 2~0~ .... Date ............... A%t4%q~S.~ ·. 11 ..... 19.66. THIS CERTIFIES that the building located at .~/.8...FO.%l~d£~.~.S..P.a.~,~, ...... Street Founders Estates Map No ............. Block No ..... X~ ...... Lot No. 2.8. ..... S0~.~.O~l%..I~...~.. .......... conforms substantially to the Applicati~on for Building Permit heretof.ore filed in this office dated ......... 0etobe~.. · .'t.l+., 19,6.~. pursuant to which Building Permit No.2;~99. Z.. dated ............ 0..e.g., .... .1!~., 19.6.~.., was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .occupancy got which this certificate is issued is . · · P.I'iV~' o..one · fa.miler · elwet~ing ........................................ The certificate is issued t~o . lg. ote..~.. B0gOll:!,e2el .......... 0W~ION ....................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval .Jl~f..-131.1.96~...b~--R*..Vi~t,l~, ..... Building Inspector 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? 2899 z Permission is hereby granted to: ................. T~upe, r~. ~, ........................................... ........................... ~,~.~...0~'..o..v...e. ............................. to .... Itu~..ae~...o~e.. ~:m~.~... ~/.e.~. ~.;l,r~ .................................................................................. at premises located at ...... ~D.~..~,~.i.....~.~I,.~T~.~...~.I[~.I~.~.e..~ ........................................................... ................................. .~/~.......~.~..~.~....~ ~.t.~., ........ .s...o..u...t.~.o. ~.~.,......~....~... ....................................... pursuant to application dated ............................... .(~.~D.t:)9~.....~.lf..., 19...~., and approved by the Building Inspector ~.0. O0 Fee $ ....................... FOltM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT ........... ............... ,19. .C .... 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 o detailed description of layout of property must be drawn on the diagram which is port 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 o 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 re~neval or demolition as herein described. The applicant agrees to comply with oll applicable laws, ordinances, building~ (S'g e o applicant, or name, if a corl~cation) ...lc'L ............ ................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ~ 'T ~ ~- ~ o C~o ~, ~ ¢ ~ If applicant is a corporate,~ of duly authorized officer. (Name and title of corporate officer) 1. L~ation of land on which proposed work will be done..Map No.: ........................................ Lot No.: ........................ Street and Number OU ~ ~ ~ 0 u old Munici~li~ 2. State existing use and ~cupancy of premises and intended use and ~cupancy of propos~ construction: a. Existing use and ~cupancy ~ ~ ~ ~ .................... b. Intended use and ~cupancy ............ ~.~..~. ......... [~..~ .~ .................................................................................. 3. Nature of work (check which applicable): New Building '.'.......~.. ..... Addition .................. Alteration Repair ............. ,.. Rernova Demo t on Other Work (Describe) ... 4. Estimated Cost .... ..~....S...l..~..: ................................... 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 ..........Z ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...v-..~ ............. Rear ................................ Depth .................... Height ............... ; ........ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ~ Rear 8. DDepthmens .................... OhS of ant re'"'~T"new ....... constructHeight on: ........ Front'"~" .......... ....~'...~.."~'Nu'mber. .......................... of StorieSRear~..L~..~ ................ ~ ............... Depth ....~..i.~...~... Height ~ ~ ~ Number of Stories J 9. Size of lot: Front ......... ~...?. ............ Rear ........ ..~...~'. .................... Depth ........ .(...~..~...i .............. 10. Date of Purchase ........................................................ Name of Former Owner .............. "' e "strct'n'' re e r "u ' ' (~,Ou4,..(,~O(..~ ................. 11. Loneorus a~. i wncnp ms saeslr area ....... .-~. ........................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regu at on? .~....0. ....... ...... k _.. 13. r~ame or uwner or prem,ses ........................................ address',..~ .................. ~..; ................. Phone No ..................... Name of Architect ........ ~ ........................... Address ......... J ........... ' ....................... Phone No .................... Name of ContractorO..~.$.~ ....... ~..~.~..L..n.~.~ .................. Address ~.?.(...~.....L~.....(..,...L...~.....~. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~RK,~ . / t S S COUNTY OF ~.~ ' ' ~ (Name of individ~ signing application) above named. He is the ........ ~~-,~ ........................................................................... ~ ............................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized fo perform or have performed%the said work and to make and file this application; that all statements contained in this application are true to theist of his knawledge and belief; and that the work will be performed in the manRer set fo~h in the applic~filed there~h, n/ / Sworn to befo~ me this, / ~ ~0Jlry Public, State of New York Cmmmssion Expires March ~u. SUTFOLK COUNTY DEPARtmENT OF HEALTH J U L 1 3 1966 Date Bldgo Permit No,. ..... TO WHOM IT MAY CONCE~: The sewage disposal facilities for a structure located at (~ive deed I~ca~on)- " have been inspected by this Department and found to be satisfactory. Dls~rio~ ~nglnee~ , District Engineer~,,