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Home My WebLink About3201-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD. N. Y. GEI~T{F'{~T~ ~F' n~.~.U~N~.¥ No. ~ .~ .... Date ................. 0~tO~l" '2~'" 19. ~:~ THIS CERTIFIES that the building located at .]~t.~ .. '~'a~i' '~ee~'Lwne-" Street Map No..;{{3{~ ....... Block No. ~ ....... Lot No. ~ ... ~P0eO{~O{{ · {v4Y~ ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~-ml~3~...2~-, 19. {,~) pursuant to which Building Permit No. '~'2t~)~; '~ dated .............. Am}g~lS-~.~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 . F~ -l{u.l-~e~.i.l~g. ,~. ~'~e..~ag~ -. ............................................. The certificate is issued to . 'JOSept~.& '~[ohl2-'POlT~_r~o'-' '.' ' 0M2~t'S ................ towner, ~essee or tenant) of the aforesaid building, .Suffolk County Department of Health Approval ....... l~,~[4 ............................ FOI~i~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (TH~S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3201 z Permission is hereby gronted to: to .......................... ~O,~tt,$ea · · t,e.. ~m~ .-1~$1~45~ ..................................................................... ..................................................... ~.~,...~.,~,~. .................................................................. ct premises located at .... J~.~...~OJlJj~lJl#..JJJ~..:~-O~ ............................................. pursuant to application dated ............................... ~l~Jt~t,..J~J. ........ 19..~.fJ., and approved by the Building Inspector Fee $....&eJ){~ ......... FOBM NO. 1 I~OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom,ned .......... Approved .......... ~....~.....~......., 19~.... Permit No..~..~..~.~ Disapproved a/c .............................................................................................. (Building Inspector) Application No...~...?.~./.... .... APPLICATION FOR BUILDING PERMIT Dote .............................. , 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 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 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 descr bed. The applicant agrees to comply with all applicable laws, ordinances~ code and reg,~kltions. ........... ............... (Signature of applicant, or name, if a corporation) ................... (Address ~f applicant) ! ......... (Name and title of corporate officer) Location of land on whic~,h proposed work will.be done. Map No,.~, ........................ ,~ ............. Lot No.: ........................ Street and Number ~ ~..~7~..~-- ,.~..~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use end oceuponcy .............................................................................. 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 ...... ~//..J..~ ................................. 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 ........ ..~q......~... ........... Depth ...~.~.....C~... ...... 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 ...... /~..;..~ ........... Depth ..... &....~.;.-./...~,,,~ 10. Date of Purchase .~!..~...~...?..~ ................... N~ame of~ ~9ormer Owner ~:J..~~ ....... 11. Zone or use district in which premises are situated ../~.'....~......~ .............. ; .................................. 12. Does proposed construction violate any zoning law, ordinance or re,~lulation? .u.;.....~....~.. ..................................... 13. Name of Owner of premises(,~j..~:~'.....~..~.~..~ess ..... JJ./.~.;L..~....~....~..:~..:. Phone No ..................... Name of Architect .............~' ................ ,,, .............. ~.....Address ............................................ Phone No ..................... Name of Contractor .C,..~..~.......~.~......Address ...~~.Jm..~)ne 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 .~eet names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ c c (Name above named. He is 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 ~ke and file 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 fo~h in the application filed therewith. Sworn to before me this Nota~ Public,~~~ Count~~~;;f~re of applicant) Commission Expires March 30,