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Home My WebLink About3218-zI~ORM ~0. 4 TOWN OF -qOUTHOLD BUILDING DEPARTMENT 'I'OWN CL~-RK'S OFFICE SOUTHOLD, N. Y. P.~RTIFIBAT£ DF DBP. UPANBY No..I~..26~.5. · · Date ........... ~t~1~ ..... ~0 ...... 19.({7 Tins CERT~ES that the building locata at. ~.~....~..t ..~.~...0.~.~...~. r.~.vr, meet Map No...11~ ....... Block No... ~ ...... Lot No. XX.. l~e~..l~,l~fO~]C~..}1,,~. ....... conforms substantially to the Application ior Building Permit heretof<)re filed in this office dated ............. .~..~p.~....~.~., 19.~.~. pursuant to which Building Permit No..~218. ~ dated ............ ~.p~ .... ].~., ~9.~ was issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The occupancy ~or which this certificate is issued is ... P~t~ate..O~le .fa~ilLy. d~el.ling ....................................... The certificate is issued t,o . P~l;e.lff.&-.N~']-l. ~1%g16 ..... Owll~l'~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .. Ma~.. ~0~..1967. · '~y. R,,..¥itta - Building InspectOr FO]~I~ 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°' 3 218 Z Date ........................... ~l~l~bl~.~'...~3...., 1 ~...~.... Permission is hereby granted to: ~tuseon..Go~ts4~.z, ue~.~.~e~-t~..~..(~..Pet, e.~..&. Nell Bruno ........ ~v~ ~head.r..~.~ ................................... to ...~.. ~e~..elr;u~.. £am~bl~w~ l&in~ ..................................................................................... ~t premises located at ...R.,~).,.W~ ..... e~...]~./~-.4~t~..~b~-.~a~ ............................................... ..................................... New...8~. ~'e]~.v ...}T~.¥, ............................................................................. pursuant to application dated .............................. t~ep~ ....... '].'J~ .......... 19.66.., and approved by the Building Inspector Fee $. ~1,O~OO .......... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give d~ed location) have been inspected by this department and found to be satisfactory. District Engineer 1~0]1¢~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ...... ~ ..................... Application No ............................ APPLICATION FOR BUILDING PERMIT Sept. 12 66 Date ............................................................ , 19 ........... INSTRUCTIONS a. This application must be completely filled ,n by typewr,ter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showmg location of lot and of buildings on premJses, relationship to adjoimng premises or public streets o areas, and g~wng a detailed description of layout of propertymust be drawn on the diagram which is part of thru application c The work covered by this apphcat~on may not be commenced before ~ssuance of BuHdmg Permit d Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant. Suc! 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 m part i~or any purpose whatever until a Certificate of Occupanc; shall have been granted by the Building Inspector. APPlICATiON IS HEREBY MADE to the 8uHdmg Department for the issuance of a Building Permit pursuant to tht BuHdmg Zone Ordnance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnances o Regulations, for the construction of buildings, add,hans or alterations, or for removal or demolition, as herein described The apphcant agrees to comply w,th all applicable laws, or~ces, building/~.e and ,r~egulat~gj~s. ..... (Si~lnature of appl,c~nt, or nam~-~'a'corp~;~;i~i ........ (Address of apphcant) State whether applicant is owner, lessee, agent, architect, eHg~neer, general contractor, electrician, plumber or builder general Contractor Name of owner of premises .......... ..P..e...t..e..r.....E..,.....a.~..d,...N...e..1..1..._~,...,l~;r.Uia.Q .......................................................................... If apphcant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No ............................................ Lot No' . .................. Street and Number north side Old Harbor Road, New Suffolk, New York Mumc~polity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Ex,st,ng use and occupancy Vacant land b Intended use and occupancy .... .o.,n...e.....f...a~,...i.,1..~......c~....e..1..1...i..n..~. ............................................................................. 3 Nature of work (check which applicable). New Building ....... ~.. ........ Addition .................. Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4 Estimated Cost ..........$..2..2..:..0...0..0. ................................... Fee .............. .~..1..0..: ..0...0. ............................................................ (to be pa~d on filing th~s apphcation) 5. if dwelhng, number of dwelling units ............................ Number of dwelling units on each floor ........................... If garage, number of cars 2 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. D~mens~ons of ex~st~ng structures, if any: Front .......................... Rear .......................... Depth ........................... Height ........................... Number of Stories .............................................................................................................. D~mens~ons of same structure w~th alterations or additions: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stones ........................................ 8. D,mensions of entire new construction: Front ..... ~...5...9..'. ....... Rear ..~....5..9..'. .......... Depth ......... .3..5_: ............ Height ............. .1...6.~ ......... Number of Stories ....... .1...~. ................ 9. S,ze of lot. Front .... ..1..0..0...' ............... Rear ....1..2...5..'. ................ Depth ..2..1...0..'../..1.~..2..'. .......... I0 Date of Purchase ..... .1..9..6...0. ......................................... Name of Former Owner ..J..a..s.....C,.:.....W~....e...1..a...n. ....................... 11. Zone or use d~stnct in which premises are s~tuated "A" 12. Does proposed construction violate any zomng law, ordinance or regulahon? ..................................................... 13. Name of Owner of premises ..P..,..E..~..&...N.,..M..,.....B.~c~.n..9...Address ..~.....M..i...d...d...1..e.....N..e...c..k.~r....R...o..s.-~:~Sne No .................... Name of Architect ....G...o..r...cl:.o..n......Al~....1..e...r..s. .................... Address ....C....a~....e..s.R.o..r...t.~....N..e...w.....Y..°.:ttgfione No .................... Ruscon Cnnstruction _,, Riverhead, New York Name of Contractor .................................................... ~aaress ............................................ Phone No .................... PlOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fron property hnes. Give street and block numbers or description according to deed, and show street names and ~nd~cat. whether ,ntenor or corner lot. STATE OF NEW_YOi I COUNTY OF .... ......... t S.S. ................................. : ...... : ...... , ........ : ............. ;........,.:.u~, ......... being duly sworn, deposes and says that he is the applicon ....... ........ ............ (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 fil th~s application, that all statements contained in this apphcation are true to the best of his knowledge and belief and that the work w~ll be performed in the manner set forth in the apphcation filed therewith. Sworn to bef?,~.e this ........ ,Z/. ~..--,~. d ay o~~~t,~..'"" ....... ............................ No 52 3233120 Sulfo~k CounJy