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Home My WebLink About3238-zTOWN OF SOUTHOLD BUILDING DEPARTMENT 'I"OWN CLERK'S OFFICE SOUTHOLD, N. Y. BI:'RTIFII::ATE: ElF EIP. P. UPANP. Y 2'7 68 No..-..'g. Y.;: .... Date 19 B/B Bayshore Road . THY. S ~.C,,ER~FII~IF_~ that.the~.build~n~ located at ............................... Street &mmenaea ~e¢on~c ~ay ~a~es ~0 areenport, ~ap No ............. Block ~o ............. Lot No ..................................... conforms substantiallysepttO the~7 Application66 for Building Permit heretofore filed inthi~' eZ dated .......................... 19 .... pursuant to which Building Permit ~o .......... Sept 27 66 dated .......................... 19 ..... was issued, and conforms to all of the require- ments ,of khe. apRlicable p~ovisions of the law. The occupancy ~or which this certificate is Private one zamily d~elling issued is ................... I~E '&' Tlb~d&' 'C~h'~e ..........~ ................ The ce~ificate is issued t.o ........................................................... (owner, lessee or tenant) of the ~oresaid building. N,R. .Suffolk County Department of Health Approval ..................................... .......................... Building Inspector House FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, FI. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3238 Z Da. ........... i ........... ~.~..~..~ .~.~?...~........~.'..., 19....~.... Pewnission is ~ereby granted ~o: ......................................... l~..abore..Ro~.....(t~emt~'~. ........................................................ pursuant to application dated ........................... ~.~.~jJ~.l~.....~.., 19..~..., and approved by the Building Inspector. Fee $.~..it....~... ............ Building Inspector WILLIAM W. WETMORE Co~rpe~er a~c~ ~B~ilc~er BAYSHORE ROAD GREENPORT, N Y, 11944 /4 p~{:~ X · z~,~Y ii! FOI{,]~ i'~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE N. ','. [xomined Approved ........................................ , 19 ........ Permit No ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Th~s opplicatzon must be completely filled ~n by typewriter or ~n ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adloming premises or public streets areas, and g~ving a detailed description of layout of propertymust be drawn on the d~agram which is port of th~s applicatio, c The work covered by th~s opphcat~on may not be commenced before ~ssuonce of Building Permit. d. Upon approval of this application, the Bu,ldmg Inspector will issue a Budding Permit to the applicant. permit shall be kept on the premises avadable for inspection throughout the progress of the work. e. No building shall be occupied or used ~n whole or m pa rt For any purpose whatever until a Certificate of Occupan, shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of o Building Permit pursuant to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances . Regulotmns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe. The apphcant agrees to comply with all apphcable laws, ordinances, building code and .regulations ....................... r._ ................................ (Signature of apphcant, or name, if a corporation) B~yshore I~oad~ Green,oath: ~, ,,.;;.,l~ , (Address o~ applicant) State whether apphcont is owner, lessee, agent, architect, engineer,~9.?eral contractor, electrician, plumber or build: tktiider lr,~ & F!,~renc,~ Ch Name of owner of premises ................................................................................................................................................ If applicant ~s a corporate, signature of duly authorized officer (Nome and t,tle of corporate officer) 1. Location of land on which proposed work will be done, Map No ............ . :iq ~ ,,: ~,,"> .................. i ~..., ~ '1'1'~ Lot No: ............... 40 Street and Number ....... :.'........:?. .... ' ~' ..... ' ~": ' "~ ' ~ ' '~' , 'u .... : . - .. ~. ......... .,..%" . . ...* - ._... ,, .* -,,. ., - · - Mun,opality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Ex,sting use and occupancy ...... b Inte.ded use and occupancy . Nature of work (check which applicable)' New Budding ............... Addition ......X .......... Alteration ................. Repair .................... Removal .................... Demoht~on .................... Other Work (Describe) .................................... ooo. oo 4 Eshmated Cost ............................................................ Fee ........................................................................................ (to be pa~d on fihng this application) 5. If dwelhng, number of dwelhng umts ............................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].o~lex~sting structures, if any: Front. ............. 32t . ........... Rear .... ~2.I. ............... Depth ..2.t,q-! ................. Height ........................... Number of Stones ......... .q,~f~ ............................................................................................ D~menslo~2c~f same structure w~th alteratmns or addmons' Front ..._~.!. ..................... Rear ...;4~!. .................... Depth .............................. Height ....]:..5...t. .................... Number of Stories ....... D~e ......................... 8. D,mens~o~.ss~f ent,re new construction: Front ...... .......2~'t ..... . ......... Rear ...... R4!. ............... Depth ...l.:2.t ................ Height ............................ Number of Stories ...... ..o..~..e.. .............. 9. Size of lot' Front ...... ~.~..t ................ Rear ....... ~.0...t. .............. Depth ~...3~.7..!. ..... ~...3.9.0.l t0 Date of Purchase ...... .]..,.c)...~.~ ........................................ Name of Former Owner .G~o.~.~...G.,...;c~e~o.:pe ............ 11. Zone or use d~stnct in which premises are situated ..... ~',~J,f[~D.b.$~l, ............................................................... 12 Does proposed construction violate any zomng law, ordinance or regulation? .................................................... 13. Name of Owner of Name of Arch,tect ...................................................... ~aaress ............................................ Phone No ................... W,W. Wet, moz, e Name of Contractor .................................................... AddressB..~.,~),),O~.e...l~ct, .................. Phone PLOT DIAGRAM Locate clearly and dmt~nctly all buildings, whether ex~sting or proposed, and red,cate all set-back dimensions fro~ property hnes. G~ve street and block numbers or description according to deed, and show street names and Jnd~ca whether interior or corner lot STATE OF NEW XOF;K4 , , ~ t c c COUNTY al: ..,,k'.~,Y~./...~. · ........ / °'"' .............. ~.~'.,~{!f.~....i.,c~...~,...~....~....d~r~(. ............... be ng du y ~worn, deposes and says that he s the app cc (Name of ind,vidual s~gn,ng application) above ~med. He is the .............................................. ~.O.~.~..r.~.~.~.M.~ ................................................................ (Contractor, agent, corporate officer, etc.) of sa~d owner or owne~, and is duly authorized to perform or have performed the sa~d work and to make and th~s application, that all statements contained in th~s application are true to the best of his knowledge and beh and that the work w~ll be performed in the manner set forth in the apphcation filed therewith. Sworn to before me this ....... ~.~ ...... x.. day, ~f~,;.. ~....., 19.~.~./ fl ~- ~w~.~~ ~,,,,~,,~,,T ........ ~ ~,,-~, Z~ ~?.:,,;¢ ..................................... Notary Pubi~~t~. ~ _ (Signature of applicant)