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Home My WebLink About2926-zFOEi~ 1~0. 4 TOWt~ OF SOUTHOLD BUXLDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. No .... Z..25Lg. Date ............... THIS CERTIFIES that the building located at ./h~'~'~.h..DE.:I.~'e.//Io~14:~h ........ Street Map No. t/loose' 'Ne~Bl°ck No. ~ ...... Lot No. '66' '~ll' conforms substantially to the Applicati, on for Building Permit heretofore filed in this office dated .......... ~v(ar~8~'.10, 19. ~ pursuant to which Building Permit No. '~6. dated .......... N~V~..~0-, 19..(~ 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 ......... ~'~. O1~..~'t~:t].F.. ~1 ~-l~J ....................................... The certificate is issued to ...RO]~t. H~:l,~/r,o~ ..................................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ...,~ ~./~. 2.,.. 1~65..' .................. Building Inspector ~,.~ ..... -- FORM NO. 2 TOWN OF $OUTHOLD 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.o 2926 z Date ..................... ][~l'~lt]~l'..... ].i~ ......... , 196~... Permission is hereby granted to: ......... C,~t~hel~e ................................................. to ]t.~],d .. ~ue.~ ..or~ ..f~¥...d~m 3,1t~[ ........................................................................................ at premises located at ...~o.t,~-(~:~.&-~'.....G~e*.*N~k...]~&.~'~ ............................................. ..................................... ~lm~ th..Dr.X~e.. South, ....... Bouthe:l~, ...................................................... pursuant to application dated ......................... ][O~'mb$1?.....1-q ....... l~:...., and approved by the Building Inspector Fee ~J~. C~O ............. SuFFOL~ COUNTY DEPAEI~IENT OF HEALTH Bldg. Permit NOe~ TO WHOM IT NAY CONCE~: The sewage disposal facilities for a structure located at (Giv deed location have been inspected by this Department a~d found to ~e satisfactory. District Engineer Distri'ct Engineer" TOWN OF $OUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. Examined ........................................ , 19 ' :) Approved i t~ ', C.~ ? ~-C;' ~ 19 ........ Permit No. Disapproved a/c ...... ..... ;>~,~;;~,~.C.,~,,:L:Z,;~.~L:~:::~:~ ....... ~;~%~L:~-~ (Building APPLICATION FOR B'UILDING PERMIT Application No. '~' ~ '~- ~ 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 part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA.DB 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 Lows, Ordinances or Regulations for the construction oF buildings, additions, alterations, or for removal or demolition, as herein described. ordinances and regp, lations The applicant agrees to comply with all applicable laws, , . (Signature of applicant, or name,'''if a corporation) ..... .................. (Address of appJicant~/;~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p]Lumber or builder. ... .u..'.z..],.a...e..z:. .......................................................................................................................................................................... Name of owner of premises ..... t?,O.b.O.r.J~....l:~.fl4g.$3~.~..c?~ .......................................................................................................... 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.C~f)~fl..J.~T~.0.1C ............... Lot No.: ~.~.c%.f.7. .......... Street and Number .S...m..i..~..17.....D..r...i,y..q..~'.3..o...u.~.b... ......... .-..~....~.i.~.YL...~.O.~.qhO.].d ...................................................... 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 ...1-.i...S...%,g.~...9~.e...:~%ffti~Lz...t1.D.D. SD. .................................................................. 3. Nature of work (check which applicable): New Building ....... ~ .......... Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. (to be paid on filing this application) 5. If d~/e lng, 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 Haig. hr ............................ Number of Stories ................ Dimensions of same structure with alterations oe additions: Front i ................................ Rear Depth .......................... Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front _..;3.~. ...................... Rear ....... ].~ ................... Depth ......&.0. Height ..2,~. ....................... Number of Stories ...... 3,.~ ................... 9. Size of lot: Front -~-O0t Rear ...... ~(,}.0. ................... Depth ....... ~.~.0. ............... 10. Date of Purchase .......................................................... Na'm~ of Former Owner l 1. Zone, or use district in which premises are situated ........ 12. Doe~ proposed construction violate any zoninn low ord nonce or renu at onP Name of Arch tect ' Address~lU-BJO-±JO.g~ ~OW ......................... . ........................................................................... rnone rqo .............. Il .... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names and whether i6terior or corner lot. STATIE OF!NEW YORK, ) SS COUNTY OF, .~,~....ff.:..,~,~..) '. ~ (Nome of individual ,,sJ,qning app. lication) above named. He is the ......... ..~.~...~ i ........ idZ;3b g;:.: ....................... of said owfier or owners, and is duly authorized to perform or have 3erfo~med the said work and to make and file application; lhat all statements contained in this application ore true to the best of h s knowledge and .belief; that the w(~rk will be pe,r,f~Lrrped ,Lp_the rAanj~r set forth in the application filed therewith. Sworn to b,efore me this~X~..~..._~,~'_. &x,_ ~,x//~,~, _ / ......... ...... . ,.--- No.52-8~g6350 ..... ~.~< ....4<~..~.~..... ~..~ ...... Z~". ~.. ,,~ ~..~.. ~ 1'1 ............. Notary Pu~blic ............... ~i~'e'i'n's'ow'c,l,~'P~AIH~' .......... County (Signature of appJicont) ] Commission: EXpires March 30, 196 ~'