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Home My WebLink About3231-zFORM NO. 4- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. EIERTIFIEIATE DF EIEIEIUPANEIY No. Z 2885 Date ...Oc.~.o~be=. 2..0 .... ~1967.. THIS CERTIFIES that the building located at il~l~aterm. Road .. Street Map l~o.l~:cope~c~:tei~toc~: No. x~xx Lot No. 27, 26 Cut:cho~ue~,..~,~.- conforms substantially to the Application for Building Permit heretofore filed in this office dated Sep~e~ 20 , 1966 pursuant to which Building Permit No. 323[ Z dated Se~te~ 20 ,19, 66, 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 .... addison go. one. E~mtl~. ~e[~g ......................... The certificate is issued to · ~a~ .C. · ~gg. ~..~n~ ....................... owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval ~ ................... Building I~ecto~--~" TO~N O~ SOfT, OLD 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 3231 Z Permission is hereby granted to: ...~....~.t...~.~ .......................................... ...... ~~r..~..e....e....:E...s.....~...~...~..,...~ to . ~,q,l,~..~.~...~t~.~.~.~...~..~...~.~ ~.~.~.. ~. .......... pursuan~ to application dated ............................... ...~...~........~... .......... , 19,....~..., and approved by the Building Inspector. Building Inspector' , j FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. 3 .,~ 3 / ~t Disapproved a/c~~ .................... (Building I ns/~ctor) APPLICATION FOR BUILDING PERMIT Date ...... .~...~,.~..,.~..,~...~'...~. ........ ..~....°.....~. ..... , 19..~...~. .... INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ~nk and submitted in duplicate to the Buildin Inspector b Plot plan showing location of lot and of buildings on premises, relahonship to adjoining premises or public streets c areas, and gwmg a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatio~ c. The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Suc permit shall be kept on the premises avadable for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or m pa rt i~or any purpose whatever untda Certificate of Occupanc shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Budding Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for r,,emoval or demolition, as herein descnbec The apphcant agrees to comply with all apphcable laws, oral,nonces, buildir~' code and regul~i,9~. ............. .................... (S~gnature of applicant, or name, lf/aXdorporat-~) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electr,cian, plumber or builde Name of owner of premises ..... ...~...~....~..~...~.~......~..'......~..../...~...~. ................................................................................................ If applicant ~s a corporate, signature of duly authonzed officer. (Nome and t~tle of corporate officer) 1. Location of land on which proposed work will be done. Map No' ......,~...,(....c...e~.../?...../~...~,....~..~..: .... Lot No: .~.ZZ..>....~.. Street and Number .............. ~.~..~.~..~.~..~.~..~....~.~.~.;~...~.~...~..~'.~.~'~..~/..~...~..~...~...~.'~[~>~~(~~ -- --Mumcipality 2 State ex~sting use and occupancy of prem*ses and intended use and occupancy of proposed construction: a Existing use and occupancy ..~...~./.~..~..~..'?.~ ~.~...4.~..~..~.~....~(~.~?...6;...~.-....~.~..~.~..~...`s].~'.~'..~.~./~.~.'.~'r b. Intended use and occupancy ......................................... , ................................................ x~'~'4~Zr~';,t~-~' ........ 3 Nature of work (check which applicable): New Building .................. Addition Repair .............. ~,.. Removal .................... Demohtian ................ ;,~Other Work (Describe) 4. Estimated Cost ~.:~.~...:./~,~..~...~. .............................. Fee ........ ..~......~....~..~.~.. ...................................................... ~ ....... (to be pa~d on fihng th~s application) 5. If dwelhng, number of dwelhng 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 D,mens,ons of existing structures, if any. Front ........ .?...~.. ........... Rear .....?....~. .............. Depth ..?....~. ................... He,ght /....~'...~....~. ........... Number of Stories .............. ..~....~..~ ..................................................................................... D~mens~ons of same structure w~th alterations or additions' Front ..... ~...~....~...~ ............. Rear ..... .~....~.....~....~'.. .......... Depth ~..~...~..~?...~.~'.~.~.-'..".~..~.. Height /~¢"'~'~" " ' '~ ~'~' .............................. r~umDer of Storms ........................................ 8 Dimensions of ent,re new construction. Front ~' ~ ........................... Rear -~ ~ Depth~'~ ~ ~'~: ~ Height ....../....~...~....~. .......... Number of Stories .... ..~...~...~. ............. 9. S~ze of lot: Front .... /.....~..~....~....~.. ...... Rear ..... ../...~....o..~ .......... Depth ?~'~ ~ 10. Date of Purchase ............/.~....~..~'.. ............................... N a me of ,~rmer Owner ~..~...~...~..~..~...~J~.....~..~...~...~..<.. 11. Zone or use d~str,ct in which premises are s~tuated .............. ~.x ............................................................................. t2 Does proposed construction violate any zoning law, ordinance or regulation~ ...~...~ 13. Name of Owner of premises .............. Address .,('~....//..~.~.e'.,~./.~.~...~..~..'.~..r~e.. Phone N .o~.-~..:...~.?..~..~..~. Name of Architect .................. ..4(.~..,~....~.. ....................... Address ............................................ Phone No ................... Name of Contractor .................................................... Address :..~.~. ' .. ..~,.~.,,...~'..........~ ,~,.,d Phone No ................... PLOT DIAGRAM Locate clearly and d~shnctly oil buddings, whether ex~sting or proposed, and indicate all set-bock dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street names and ind~cot whether interior or corner lot I I I I I I I I i l I I I i I i t STATE OF NEW YORK, ~ S.S. COUNTY OF ............................... ................................................................................................. being duly sworn, deposes and says that he is the applica (Name of individual signing application) above named He is the ..................................................................................................................................................... (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 f th~s apphcat~on, that all statements contained m this a.pplicat~on are true to tj~e best of his knowledge and beh- and that the work wdl be performed in the manner set torth ~n the apphcatioj~"fded therewith. Sworn to b?fore me this ~ ./N ~ ................ ............. .......... , (, .........................