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Home My WebLink About3224-zFOItlVi ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. r.i~ I~TI FI r. ATI~ OF THIS CERTIFIES that the building located at . ~ .Road. I~/~ .Nallgl~a. Dx, Street Map No. ~ ....... Block No.. ~ ....... Lot No. ~ .... ~B~,~l~q~..i~, ....... conforms substantially to the Applicati, on for Building Permit heretofore filed in this office dated .......... A%1t~95.. 2~.., 19.~ pursuant to which Building Permit No..~..2..~...~. dated ............ ~Opi;. "19", 19. ~6 was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The occupancy f. or ;vhich this certificate is issued is . .]Pr&Vl~l;e. o~e..~mil~ .~[w~lt.ing ......................................... The certificate is issued t,o . ANIflOl~-&. BelePA. I~o1~5 ....... Owne~.s .................. (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Appr, oval .~'~ . ~85..19~;...by..R...¥i-qJa ...... Underwriters Cert. 1~ 566~6 .... .~.~.- ........... Building Inspector ~. FORM 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? 3224 Z Date ............................ ae~it~,.....'t~ 19.~:~ Permission is hereby granted to: ]16,m;m, .;l[c~e~.. ;~.... A/C..A~a~I¢I,.. ~;L~ .. & Wife ........ ~-,.~.,~.-'~x-.-~t~r ........................................ ....... ~4&e, ..... ~[.Y. ........................................... to ...]ta~..m..m~e...~.as~l.y..4wet.l.~ll .................................................................................... at prermses located at ..]J~T~.,..~wO,~ ./0~,,..~.....~I1~..]:)~ ............................................... .......................................... ~.t~.~m~.r. ~,~, .............................................................................. pursuant to application dated ............................. ~.....~ ............... 19~.., ond approved by the Build,rig Inspector ~)p3~*OT~([ ~ ]~i. Appeals Fee $ ~.~l,~O~l ........... Building Inspecto~F S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date dAN 1 Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure~located ~ ~(Cive deed lo~a~ion) ~ have been inspected by this department and found to be satisfactory. Distriot Er~ineer District Eng~ne~i~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....... ..... ...... .................................... 1 9 ........ Permit No ................................. D,sapp roved a/c ..~....~....~ ...~.....~.~..: ....... ......... ...... Application No ....................... ¢ .... APPLICATION FOR BUILDING FERMIT INSTRUCTIONS o This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildinc Inspector. b. Plot plan showing location of lot and of buildings on premmes, relationship to adjoimng premises or public streets o areas, and gwing o detailed description of layout of propertymust be drawn on the d~agram which is part of this application c The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of thru application, the Building Inspector will ~ssue a Building Permit to the applicant. Sud permit shall be kept on the premises available for ~nspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part For any purpose whatever until o Cerhficate of Occupanc' shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE ~o the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the censtrucbon of buddings, odd,hans or alterahons, or for removal or demolition, as herein described The apphcant agrees to comply w~th all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether appli~oht is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde~ Name of owner of premises Arliold & Helen Golz If gp_.pl~ant is cXt. orporE._te, signature of duly authorized officer. ........ Described lot 1. Location of land on wh,ch proposed work will be done. Map No' . ........................................... Lot No: .................. Mattituck Street and Number ..................................................................................................................................................... Mumc~pality 2 State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Exishng use and occupancy ....... ~o~e .............................................................................................................. New Home b Intended use and occupancy ............................................................................................................................. Repair ................... Removal .................... Demohhon .................... Other Work (Describe) ..................................... 4. Est,mated Cost .... .~. .3, .~. ,. .0. .0. . .0. ....................................... Fee ......................................................................................... (to be paid on filing thru apphcation) 5. if dwelhng, number of dwelling units ............ ..-~ ............. Number of dwelling units on each floor ........................... If garage, number of cars ......... .~....~...A..~.~.&..o..~.e..~ ............................................................................................... 6. If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D~mens~ons of existing structures, if any. Front .... ~.O,,"~ ............ Rear .......................... Depth ........................... Height ............................ Number of Stories .............................................................................................................. D~mens~ons of same structure w~th alterahons or addmons Front ................................ Rear ...... ~: ....................... Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mens~ons '~f entire new construction: Front 75~":ft~ Rear '/'5~"f+~ Depth Height ....,/.I..~ .................. Number of Stories ........ ~. .................. 9. S~ze of lot: Front ...~.~..~. .................. Rear .~..~. ................... Depth .],.0..0.. ....................... 10. Date of Purchase~..?..Z'...~..]:....]:.~..?...-]=?...6..6. ....................... Name of Former Owner ~.Rg.~J, fLV. fL~U.i];.1.ft~ ............... Re~. ] ]. Zone or use d~str~ct m which premises are situated ............................................................................................... ]2. [Does proposed construction wolate any zoning low, ordnance or regulation? .... .~.e~ ......................................... Al"nold Golz -.. BOX 348 1~1.11 Rd. Phone No Ma.~.-40d 13 Name of Owner of premises ........................................ ^aaressl~lR.~L.~;~..~.;~.~ ............................. Name of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ~4:~,~O~..~o~e,~...[Re,., .............. Address13.~.~D.../$;L..BOX,..lR.G ...... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fror property lines G~ve street and block numbers or description according to deed, and show street names and red,cat whether mterio,~r or corner lot. \ STATE OF NEW YORK, ~. S S. COUNTY OF .............................. ............. .~.~;k~..~,..~o~m~y .............................................. bemg duly sworn, deposes and says that he ,s the applica (Name of in~[qiSuaF signmg app ~cation) above named. He is the ........ O~&~..~&~e~ ..................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and fi th~s applicahon, that all statements cantoned in this application are true to the best of his knowledge and beli~ and that the work wdl be performed in the manner set forth ~n the apphcation filed therewith. Sworn to before me this ~ ~. ....... ~,.~. da~ ............. , 1::~..~:... ~ .............. Notary Public, .~ ............ {~... , Y g ~~¥5-'-~'