HomeMy WebLinkAbout2650-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
'I'OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
13£RTIF'iCIATI~ OP QOr. I_I;~ANr. y
No. ~ 21+7{] Date
THIS CERTIFIES that the building located at . ..~I/.l~l.. ~iIl~.Fet~d. ......... Street
Map No..:~I:. ........ Block No .... :l~ ...... Lot No..-:l~..]~;t;.i-~_._a~ll~i~. ~,~.,, ........
conforms substantially to the Applicati.on for Building Permit heretofore filed in this office
dated ............ ]IO~'f~llbl~'. ~19.1~ pursuant to which Building Permit No.
dated ............. ~0~..27. .... 19~br., 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 ... ~I~K~. ~tlt~_~,!13~ .~,..~P.~.~ .~ .Of~ie~8 ............................
The certificate is issued to . ~.q~.ilh. F.O~K .L~lllnv. ~o~/x.../)wne~ ...................
(owner, lessee or tenant)
of the aforesaid building. ( app~o~'~d bit Bd
Suffolk County Department of Health Approval ....~/. ~t~/ ~d~..b~..P~..¥~, ........
.........
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? 2650 z
Permission is hereby granted to:
l~ec 1~elaus..1~1~ ~ ~r~.... ~fC.... Nmr.tk..Fc~k., ~,~m~...Oorp
.............. ~att£tu~ct ..... ~.X. ...........................
to .... R~_,'~ ~,d.. ~.. :bu~b~e~ ..l~tldln~ .....................................................................................
at premises Jocoted of ........ ,~.-'-~'-];J~9.~J: ............................................................................
................................................. II~t~L.t~, ..... 1I..~. ........................................................................
~a~rtse ~a~e~ 1 196~.
pursuant to application doted ............................ ~Jjlflrj~J:~'..~J~/. ...... 1-9..J~.., and approved by the
Building Inspector ~I P~i~ ~ss~e~ to replace J 2~91~ ~*ub~ee% to f~ltng
ammended b~,.~.~dlng p!an~.
Fee $..1~ ............
Building Inspector!
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? 2591 z
Permission is hereby granted to:
.. B.t. an~e~...li~a~.s .........................................
.......... ~t~uc~ ................................................
to .... .l~..ae,~..eae...~t,~i,~..~cm~..l~..1~[ ...............................................................
at premises located at .... ~L....~[,Et~I'I..-~O~L ......................................................................................
........................................... ~,t:~ ..............................................................................................
pursuant to application dated .......................... ~m~'"'.~ ...... 19..(~., (:nd approved by the
approved ~y ~M~ Appeals
Budding Inspector
Fee $]~I.DO ............
Building Inspector
B,,~ding Permit No..
Sb~VFOLK COUNTY BEPARTMENT OF HEALTH
Riverhead~ New York
TYPE OR P~I~ LEG _i~Y 1~ INK
Health Department Plan No. _. ~-~ .....
Application for Approval of Commercial Sewage Di,.sp0sal SFst~.m
TO: The Suffolk County Departmnt of Health Date ~ .....
Application for approval of con~mercial sewage disposal system is hereby
requested.
Location:
(Name and Side ~of str~t, and name and 6~stance to n~arest intersecting-street)
I~ame~_ /~I~,,~ /F'~'~ . ~/1~'~-~ ,. _~?'/~. Z,~.~ .................
I~mlet
V~i!t~ge
I hereby certify that this con~uercial sewage disposal system has been con-
structed in accordance with plans apf~roved by the Suffolk County Department of
Health on (date) ~ ~ /~ ~__and with all the req,~!rements of the latest
bulletins on sewage disposal ~f the Suffolk County Department of Health.
Address ..~M~-
~eaay Zor ins~ection. ......... ! ~../~.~/~¢ . .
FOR USE OF HEALTH DEPARTMENT ONLY
by ,:, ..............
Installation satisfactory - Yes ; No .....
Based on the information stated hereon by the applicant and other info~mation
made available, it is the opinion of this Department that this system with proper
maintenance can be expected to function satisfactorily and is not likely to cause
a nuisance, provided designed sewage flow is not exceeded. Structural features
are not included.
Date
JUL 1 2 1966
SCHD - S-13
~/58
Examined ................................... 1¢).. ·
FO~I NO. I
TOWN OF $OUTHOLD
~BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ........................................ , 19 ........ Perm't No .................................
....... 7 ........
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin,
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o,
areas, and giving o detailed descnption 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 w, II issue a Building Permit to the applicant. SucJ
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 ,n part For any purpose whatever until a Certificate of Occupano.
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Budd,ng Department for the issuance of a Building Permit pursuant to th,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described
The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations.
Mike Wini~r. Z..... A/. 0..... ~.tanley...WJ_nia~z ....................................
(Signature of applicant, or name, if a corporat,on)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
.................................... ..........................................................................................................................
Name of owner of premises ..... ~q.~.~.~e~...~J.n.lbar~ ...........................................................................................................
if applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer}
1. Location of land on which proposed work will be done. Map No' . ......... g~ ........................... Lot No: .:~,_~r.~ ..........
Street and Number ..~/....~. ..... ..~. ~...~..,~.9.fLc].~ ..... ~.~.~.$..~.1~.1~]~ .....................................................................................
Mumc,pahty
2 State exzsting use and occupancy of premises and intended use and ~cupancy of proposed construction:
a Existing use and ~cupancy ...~g...~ ...................................................................................................
b. Intended use and occupancy ........ Oge..~g~...g~S~s&..b~~ .....................................................
3. Nature of work (check which applicable). New Building ...3Or'z3Ly,.. Addition .................. Alteration ......... v ......
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................
4. Estimated Cost .... 3,~..~OD..P,g. lV$ ............................ Fee ........ 1,QA.0.Q .....................................................................
(to be paid on filing this application)
5, If dwelhng, number of dwelling units ............................ Number of dwelling units on each flcor ...........................
If garage, number of cars ..........................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... 13.~lsJ.n~.s.s ......
7. D,mensions of existing structures, if any: Front .......................... Rear .......................... Depth ...........................
Height ............................ Number of Stories ..............................................................................................................
D~mens~ons of same structure with alterations or additions: Front ................................ Rear ..............................
Depth .............................. Height .............................. Number of Stories ........................................
8. Dimensions of entire new construction: Front ........ ~,~. ............... Rear ..... ,:].~. .................. Depth ....... .~...0. ..............
Height ............................ Number of Stories ...~)~3~ ..................
9. Size of lot: Front ...~.C},.~P./.]~ .......... Rear ............................ Depth ...~.Q(~..?.~.~ ...........
10. Dote of Purchase ........................................................ Name of Former Owner ......................................................
I1. Zone or use distnct in which premises are situated ........... !!~.!!..~B~.:~k~.E~. .......................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? .... Y..~.~....-:,..~,Dl3.~..q.'Y..,e.~....b.~..~..B..
appe~-s
13. Name of Owner of premises ..~Ita~;L~'...Wil't;l~,r.z. Address .... ~.ti.tuc~ .................. Phone No ...................
Name of Architect ...... .G,..J~!er.$ .......................... Address ....... ~.~Ttfi~.~P~.~ ................ Phone No ...................
Name of Contractor ..xM:i~e..~iD. ia~.Z ..................... Address ........... ~[~.t.+~;~.t,.W,¢~ ........... Phone No ...................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions fro,
property hnes. Give street and block numbers or description according to deed, and show street names and indica~
whether interior or corner lot.
Bee filed plans
STATE OF NEW YORK, ~
COUNTY OF ..... ~.u~o].t~ .......... [ S.S.
................................. ~il~e..~,li~;La~.~ ................................... being duly sworn, deposes and says that he is the applio
(Name of individual signing application)
above named. He is the ......... ,~§~lq¢...O~..(~,z~e:P .........................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or ownem, and is duly authorized to perform or have performed the said work and to make and
th~s application; that all statements containe~u~q~tys~lication are true to the best of his knowledge and bel
and that the work w~ll be performed in th?~p~p~t~['~t~o~ the application filed therewit~
Sworn to before me this
.................. .~Z... day of ..................... ~Q~.~r...., 19..b.~.
~ ~/ ~ ~_ ~ ....... ~_.f.f..i~f..~. ~ ~- ~-~ ,...~
.......... ..........