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HomeMy WebLinkAbout2893-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C~JERK'S OFFICE SOUTHOLD, N. %'. OERTIFll]ATE OF I~II~I~UI~ANOY No.. ~..~i.I'23... Date ............... i~F .... 3Z ....... 19.66 TH~S C~,RT~F~ES ti~at the building located at . .:C~V,~--R,O,W.,..EtS.~?.~'9'~3's?. Map No .... Y~KX ..... Block No.. ~ ...... Lot No.. 0~Y~.. ..... ~OUt;hOl~.~. -!~.,.Y~ ...... conforms substantially to the Application for Building Permit heretof, ore filed in this office dated .......... Oe.tobe~...~.., lff~.~., pursuant to which Building Permit No. '2~9,~ '~ dated ............ 0O. tOh~;'..~., 196~., was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The o.ccupancy f. or which this certificate is issued is . .. P~.i¥~%e. -~1~ · f~mi.l.y.d.~'ei.ting ........................................ The certificate is issued to . ~Ob~t..Ya,. ~tO~t ........... 0%~:teTe ....: ...... : .......... (owner, lessee or tenant) of the afore.said building. .Suffolk County Department of Health Approval . .I~ty.. '2?¥ '1966'' 'by' 'R;' 'ViZla ..... Building Inspector\ FORI~ 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? 2893 z Permission is hereby gronted to: ~,w.~..~..~.....~..~.....~..~,.,.~.~g~t Southold to ....... ,B~l].cl..ne.~..~e...£am/,~....d.~e]J,;l,r~ ............................................................................... et premises located at ..... ~./~.....]~.~,~'.lRd,~.~...~.~,.~.~,,.~. ...................................................................... .......................................................... .~.o.~.tho~d.,...~/,.~f., ...................................................................... pursuant to application dated ................................ .O.c..t.o.~.q.Z'.. ....... .~..., 19.....6.~.., and approved by the Building Inspector Fee $....~t..(~. ........ .................... ~,';ii;Ji~;~ 'lnspecto; ....... t ............... S-9 SUFFOLK COUIVrf DEPAE['MENT OF HEALTH Date MAY 2 ~ 19t;~; B'l_d~. Permi~ No. ,,, TO MOM IT MAY CONCE~.. The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer' i'ct gi ..... " ' ' Distr En neet l;tO~tM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. om,ned ....... .......... , Approved ........................................ ~ 19...J....Permit No .............................. Application No. 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 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 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, ordinan~s and regulations.,// (Si~J'ture~f applicant, or name, if o corporation) ( ddress of applicant) ~/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p]urnber or builder. Name of owner of premises ...~.~..~....~ .............................................................................. If applicant is a, corporate, sigr~6ture of d,91y authorized officer. (Name and itle of corporate of~er) 1. Location of land on which proposed work wile be done. Map No.: ........................................Lot No.: ...................... 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 .~....~ ...... b. Intended use and occupancy ...... .//....~~ ............................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................. Alteration .................. Repair .................. Removal ................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........ ¢/. -'~-~,..~.. ....................................... Fee ........................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ,,ff. ................... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupa,ncy, 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 additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ,~.~ ................ Rear ...,~....~. .................... Depth ..: .......................... Height ...../.~'...../. ............... Number of Stories ../...~..--~,~. ................. 9. Size of lot: Front ..../.~ .-~... ........... Rear ..../...'..2~..~ .............. Depth .....,.'-~1~'~...o...~ ............. 10. Date of Purchase .......................................................... No,me of Former Owner ....~.~ 1 1. Zone or use district in which premises are situated ..... ~ ............. (/ . ....... 12. Does proposed construction violate any zoning law, ordinance or~,~_ulation? ...~ .................................................... 13. Name of Owner of premises4~.,.~.~./~ .......... Address .,r,~-.~ ............... Phone No ................... Name of Architect ..................... ,///.~~.~.~ .......................... Address i:~iii:i::ii Phone No ................... Name of Contractor~/....~-.~.... Address Phone No .................. PLOT DIAGRAM kocoCe clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions from prop,erty line~.Give street and block numbers or description according to deed, and show street names and indicate (~*me of individuol si~nin~pplicotion) is the ~bove homed. He is the (Controctor, o~ont, co~orote offic*r, otc.) of said owner or owners, ~nd is du~y outhorizod to perform or have performed the said work ond to m~ke ~nd fife 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 therew th. ~ Sworn to before me this m ~ // Pu' V '/ .... .........