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HomeMy WebLinkAbout3203-zTOWN OF SOUTHOLD BUILDING DEPARTMENT '~'OWN CLERK'S OFFICE SOUTHOLD, N. Y. 1:3E:RTIFIGATE: 13F 13P. P. IJPANBY No. Z. 26~8.. · Date ............... ~arlllal,:y.. 26 .... 191~7. THIS CERTIFLES that the building located at }~/,q .P~billsori .P~ ........... Street Paradise Point Map INo ............. Block No .... ~ ...... Lot No. 10, .... 8olltho.ld~..~.Y, ......... conforms substantially to the Applicati. on for Building Permit heretofore filed in this office dated ............ AII4~tA~;.. 23, 1965. pursuant to which Building Permit No. ~}h~-.~;. dated ................. Atlg '30' 19(~.., was issued, and conforms to all of the require- ments .of the applicable provisions of the la w. The occupancy f. or which this certificate is issued is . P. rt~.ate .one. faml. ly. dw~ll~ng ......................................... The certificate is issued t.o .J01911. A1dell ...... OWl~e~. ................................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ~a~,. 23, · 1967 . by. Ro · ~rilla ..... ............ ...... FO~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? 3203 z Permission is hereby granted to: .~/~.~..~.oim..~,~ .......... at premises iocated at ............................................................................................................................ ......................... ~A,.~.~ ..1~o... ~lCh.. ]l.eM...Ye;~ ........................................................ pursuant to application dated ...................................... ~...,~.~...2...~, 19.~,~..., and approved by the Building Inspector Fee $....~.0.~..~. ,0. ........ $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date JAN 2 3 1967 Bldg. Permit No. .320.32 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Robinson Road (Give deed location) Southold have been inspected by this department and found to be satisfactory. Builder George Ahlers Owner: John Alden District Engineer District Engineer I~OEM NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~'~' '~"-?'~19 ' ' '~"~ ' '~'/J,~/~J-~ ~/~z~ /,~/~ No....~..~""~ C~) ~.. ~ Approved .......... =...~..7~,......~.~ ....., 19.~...y~ Permit .......... .... ............................... ................................. Application No. ~ ..... APPLICATION FOR BUILDING PERMIT Date ................ .C~..~.....,~,,~ .................. , 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 p~,rt 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 shell 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 described. The applicant agrees to comply with all applicable laws, ordinances, building..code and regulations.j'/x (Signature of appl~lant, or name, if a corporgtion) ................... ....... ~J (Address of applicant)L/ State whether applicant is owner, lessee, agent,~architect, er?~i/9~er, general contractor, electrician, plumber or builder. blame of owner of premises ........................................................ ~ ............................................................................ If applicant is a corporate, signature '~F duly authorized officer. 1. Locat on of land on whLch propose~ wo, l~ ' · P .: ...................................... ~,v .: ..................... ./..~... Stree~ and Number . ............................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. I:xisting use and occupancy .............................................. ;'~1 ................................................................................. 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 ............... ~ ........ 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 olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ ~S-d '~, · ' 8. Dimensions of entire new construction: Front ...... :...~ .............. ; ........ Rear ....... ~...~....~.. .......... Depth Height /6"~ Number of Stories / 9. Size of lot: Front ...... .~../.~:.~..,~ ......... Rear ....... /.,~.i~.-...~..~ .......... Depth ...... ../.~..~. ........... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 ]. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any Toping law, ordinance or regulation? ........... ~! ....... 13. Name of Owner of prem ses~ ~.~...~... Address ~<~;~-~¢T~ ~-5 Phon ~ ' ................... c/ ..................................... .?j .......................... e ..................... Name of Architect ..... ~..21 ........ '.'5;~'~2'2 ..................... Address ............................................ Phone No ..................... Name of Contractor ..~:.....C~...~ .................. Address .~_.:...~...~....~. Phone 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 descriotion according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ ¢ ¢ COUNTY OF ................................ ~4...,j.~ C~....~."..~(,/~)iff' ben dui sworn ................................. :~ ......... ................................................. ' g y , deposes and says that he s the applicant (Name of i~Jiividua, signing application) above named. He is the .................................................... ~,,~...~?..Y. .................. :. .................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to ma: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 forth in the application filed therewith. Sworn to b~fore me this Notary lic,. ...... ~¥ ........................