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Home My WebLink About3247-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. DERTIFIE:ATE OF DP,,P. UPANE:Y No. Z 2903 Date .... o,c~oker 2.0 , 19,67, THIS CERTIFIES that the building located at Oxchal:d Sgxee~: Street Map No. ~ Block No. XX:4 Lot No.. ~ ..... Oz'i~nt-,'l~;Y; .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ~4arch ~(} , 19 63 pursuant to which Building Permit No. 3247 'z dated Sc~p~emi~ax 30 ' , 19 66, was issued, and con£orms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is la~O~ aam.o ~£.~.cll~g- ..................................... The certificate is issued to ..... F,o .Kem-~-~.h. ~a~.~lc ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~. .................... 'B~ildin~' il~specto~.,~'~ FO~ NO. 2 TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT N? 32~7 Permission is hereby granted to: .... ~.....lJ~t..~:a~oF.....A~.~....~emm.t~.Tabor ............... ~t,..~,:~, .................................... CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) '~ J ................... :....t at premises located at ..~Ji~....J~:~..o~*...O,~i:L~i~L.~Lt~ .................................................................. ...................................... ~)~en~..-~.Z. ............................................................................................. pursuan¢ to application dated ................... ~j~ ....... ~0 ................ , 19.~.., and approved by the Building l,nspector. ~pFO~}'t~, b~ ~ &ppe~J.S FOE~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~/~"~ [ 0 , ~ ~ .... ....... ...... ...... .............................................. ...................... ................................. APPLICATION FOR BUILDING PERMIT Date ........................ ~r.~.~ .......~.0.. ........... , 19..0...6... INSTRUCTIONS a. This application must be completely fdled in by typewriter or tn mk and submitted m duphcate to the Buildir Inspector. b. Plot plan showing Iocanon of lot and of buildings on premises, relationship to adjoining premises or pubhc streets, areas, and g~ving a detaded description of layout of property must be drawn on the d~agram which ,s part of this applicat~o, c The work covered by th,s apphcation may not be commenced before issuance of Building Pertain d. Upon approval of th,s apphcat,on, the Building Inspector will ,ssue a Building Permit to the apphcant Such perm 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 part for any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to t} 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 removal or demoht~on, as hereto descnbe, The applicant agrees to comply with all applicable laws, ordinances, budding code and regulations (Signature of applicant, or name, if a corporation) (Address of applicant) State whetherapplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde ................................................. ............................................................................................................................ Name of owner of premises ...~.,...~6~'O.f~.~'t...~.l;lo:~ .................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1 Location of land on which proposed work wdl be done Map No · . ....... ~ .................. Lot No: ....~f.. ............ Street and Number ...~./.J~ ..... g.~.g~B,Z'.d...~J&~ ........ g.~.:L.e, zLl~..~,~ ..................................................................... Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Ex.sting use and occupancy ....... ]~ .~f;1,. ~..~bg~....O.a,~ ................................................................... b. Intended use and occupancy ..,S.~.6~ ..~:L.lz, b....ac].~tzL.~,:I, zzcta~...'lmJ~.]dJ~. ..................................................... Repair .................................... Rej;poval Demolition~z'&L $-t', ~u G' .................. OtherC/l~ ~. ~Work (l~esc ribe)/~b & ./~.9.g..~..~.....j..l..~......~...~ ~ 4. Estimated Cost ............................................................ Fee ...~. .................................................................................. (to be paid on filing this apphcation) 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 existi.ng structures, if any: Front ............................ Rear ................................ Depth ................... Height ........................ Number of Stories ............................................................................................................. Dimensions of same structure with alterahons or add,hans: Front .................................... Rear ........................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of enhre new construction' Front ....... ~ ~ Rear ;~- C~ Depth Height .................... Number of Stories 9. Size of lot: Front ............................ Rear ................................... Depth ............................. 10. Date of Purchase ........................................................ Nome of Former Owner ...................................................... ! 1. Zone or use district in which premises are situated .................................................................................................. 12 Does proposed construction violate any zoning law, ordinance or regulotion~ ......................................................... 13. Name of Owner of premises .....~.:....~.:.....?...~...~,~..~...Address ......... .C)....~....~.~..~.....~. ............ Phone No ................... Name of Architect .................................................... Address ........................................... Phone No ................... Name of Contractor ..............~...../~....~.~. ..................... Address ............................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and mdm~te all set-bQck dimensions fro[ property hnes. Give street and block number or description according to deed, and show street names and indicat whether interior or orner lot. STATE OF NEW YORK. ~.,, COUNTY OF ..... ~.~'.~P.~,~ .......... )' ~'~' ............................. l~.,.,.~ft/gAq,.~.~.~...~l~.~.t~. ............................. be,rig d~ly sworn, d~oses o~d soys that he ~s the opphco (Name of individual signing opplicatioh) above named He is the ................... ~e~,.=...~l~J.[~e~ .............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke end f th~s application; that all statements contained m this applicahon are true to the best of his knowledge and behef; a that the work will be performed in the manner set fonh in the application filed therewith. Sworn to before me this of ................. ....... ~ ............... ~.:.Z, ............................ ~.~ ~ota~ Pull,c, State of New York t',~ ~'2 '~ ,3, Sui[olk County_/ , ;, ~ Msrch 30,