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Home My WebLink About2915-z TOWN OF SOUTHOLD BUILDING DEPARTMENT Town CLERK'S OFFICE SOUTHOLD, N. O£1~TI~IOAT£ OF' O00UPANOY THIS CERTIFIES that t~ buildint Eastern ~ho~'es B~oOcOk~o ..... Map 'No ............. located at .... ~/.~...I.~9.o.r. 9.s...L.a. ........ Street ..... Lot No.9.3.,. .... 9.~.~.?~.p.?~.~.~...N.: .~.~ ......... conforms substantially ~o tt~/e Applicati,,On for Building Permit heretofore filed in this office dated .............. 0¢.ti../'.,~,~: .2~ 19. pursuant, to which Building Permit No..~9~.[..~. dated ............... 0eg.¢'20~, 10.'.6~ was issuea, and conforms to all of the require- ments ,of the applicable Cro.mmons of the ~aw. The occupancy issued is ... ~a~O -O~. ~'~7' ~W0~[~.~g ........................................ The certificate is issued ~) .;.~.0~.~g~ / . '[ (owner, lessee or tenant) of the afore.smd building./ .Suffolk County D?artm~.t of~}Health Approval .... ~ R, Villa by FOI~M 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? 2915 z Dote ................... Oo.t~01;~.....~9 .............. , 19.6~.. Permission is hereby granted to: O~r.~e..,&h3~ers ................................................ ............ · g~h~g+~e .............................................. to ....... l~$.~..t~e~..one"£~q'y'"dwe'~']:~.~g ................................................................................ et premises located at .....].O~,,...93. ....... s~o~".%"'"'Eg$'~rrl-'~hore~ .................................... .................................... Neo~,~ s...I~ ................... 0/reenpor~ ............................................................... pursuant to application doted ............................. ~O~;. ...... .~.~ ............. 1~O~'", and approved by the Building Inspector Fee $...].~).m~)O ......... TO WHOM IT MAY CONCEI{N: SUFFOLK COI3NI~ DEPA~aI~ENT OF HEAL~ Date ~d~. ~e~_~t .o.?~ The sewage disposal facilities for a structure located at ~Oive de~d location) / have been inspected by this Department and found to be satisfactory, District Engineer DistriCt Engin~e~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined (.~c~ ~ ~ 19 ~ Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ............ ~ ............ ~~:.:~r~ ~~ ................... .................. .................................. 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 pa rt For any purpose whatever until a Certificate of Occupancy shall have been granted by the Building.lnsp,ector. 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, building code and reguJatio~s../~ ....: ....... · '"'~"~~:~ii~:~" or name, if a ~';~;ro;i;~),' ' State whether applicant is owner, lessee, ~gent, a~h~ect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. .................................................................................................(Name and title of corporate officer) ~''~''I'~'~'~ .~ ~ tO0 ... 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: ......... Street and Number .......... ~.~..~...u..~ ........ .~,. ................... '...i ...................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ................................................. ~.'i ............................................................................ Intended use and occupancy ........................... V 3. Nature of work (check which applicable): New Building ...... .~.......... Addition .................. Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ................................... 4. Estimated Cost ........~,.~...7..~ ............................... 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 additions: Front ................................ Rear ............................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... ~.,.~'.L....~...~.. Rear ........ .~...~...~.. ...... Depth ....... ~.~.. .......... Height ......... /..~...~ ........... Number of Stories / 9. Size of lot: Front ...... ~.L.O.. ............... Rear ......... .J./:..~.. ............ Depth ....../..~..~.~ .................. / ~:~" -' ' c ' 10. Date of Purchase ...... .~....C~... ............. ~ ..................... Name of Former Owner ..... ~/~...c~$../.C(.~......~..J')..q.~...<~: .... ] ], Zon,e or use district in which premises are situated ............................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... 13. Name of Owner of premises ...~...¢.~Z~...c.......~.~./C.f.~.Address ~..~..~.~. ..... Phone No ................... Name of Arch,tact .......................... './...~ ............ ~..~. ........ Address ......?.....I: ....... ?.... ...... ~J ........ Phone No. Name of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property li~es. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. STA'r'E Ol NEW YORK } ¢ ¢ COUNTY ;OF ................................ ~" ~°;q ' ,,~ ...... ~ .......................... being duly sworn, deposes and says that he is the appli, .............. (~rr~e of indi((Jdual signing application) _ ~ above named. He'.s 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 this appli(~ation; that all statements contained in this application are true to the best of his knowledge and be and that the work will be performed in the manner set forth ',in the application filed therewith. Sworn to befgJ'e me this ,,~ ~ ' ~ ~, ,~,~ -~ day of .....~ ....... , 19....~..~.. .......... ;'~ . x- x~) -- ~ ................ ~,~....~'...~..],~- ........ '~.4/..,.v...:.T..:..~...'~.,';'. ................. J~ .... k'-t--' n':~lic/.~.~J'~gft ~('.~'~~?&'~vr'~r~'tT (Sj/cjnature of app icant) J , ~/ ¢10. 52-3233120 Suffolk County ~ Term Expiraa March ~0, 19_~.7