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Home My WebLink About3256-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P. ERTIFIP. ATE I-IF OE:P. UPANCY No. Z 2905 . Date . October 20 , 196.~.. THiS CERTIFIES that the building located at Booth Roacl Street Map No. ~ Block No. ~ Lot No. X.X ~ollthold~. N,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated (3¢~ 1+ , 19 65 Dursuant to which Bmlding Permit No. 32~6. Z dated Oct; 8 , 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 Private one- -famil.? .4wel.!il~g. ................................ The certificate is issued to Geol, ge Colr,~ay .... 9wllel' ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Allg 11~ ~,96~ .by. I~..Vt.~.la .... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3256 Z Da~e .............................. 09t~Z'....8.., Permission is hereby granted to: ..... ttJ....ilee be .....Jk/~.....6~o~,g~ .~on~y- .... ............ Ou.~t~er...~v¥, ............................. to ~t.ld. · .New. · One · · fea~:l::t, y · · dw e.l-t ~l:n $ ................................................................................... at premises located at ....i~.&....i~eeth...tJ~ad. ................................................................................... ........................................ g~u. th~l.d.i...~ ~y.~ ...................................................................................... pursuan$ to application dated .......................... 01~.tO~O~....~l ........, 19..(~., and approved by the Building Inspector. Fee $...10.00 ......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Apphcation No. ~:~ ~ ~'~ Approved ........................................ , 19 ........ Permit No ................................ (Building Inspector) / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s application must be completely filled m by typewriter or in ink and submitted in duplicate to the Buildin. Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adjmmng premises or public streets c areas, and giwng a detailed descnption of layout of propertymust be drawn on the d~agram which is part of th~s applicatior c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Bu~lding Inspector w~ll ~ssue o Building Permit to the applicant. Suc permit sholt 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 in pa rt For any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to 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 c Regulations, for the construction of buildings, addmons or alterations, or for removal or demolition, os herein describes The opphcant agrees to comply with all applicable laws, ordinances, b?ding code~,~d regu~j~ns,i (Signature of applicant, or name, if a corporation) (/~ddres~f applicant) State whether applicant is owner,, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work~ill be done. Map No'... ...... , ..... .~....~ ....... ,._ .......... Lot No: ....~.....~... .... Street and Number ....~ ...... ~ ............. Mun.cipohty~"'"""~"'l'~''~ .................................. 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~st~ng use and occupancy .............. ~/~._._._..._..._ ....................................................................... b. Intended use and occupancy .............................................................................................................................. ~ 3. Nature of work (check which apphcable): New Building ..... ./..~ ....... Addition .................. Alteration ............... Repair ................. .;.~/Removal .................... Demolihon .................... Other Work (Describe) .................................... 4 Est,mated Cost ...~.......~h..u./..~ .......................... Fee ........................................................................................ (to be pa~d on fd~ng this application) 5. If dwelhng, number of dwelling units ............................ Number of dwelling umts 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 Dm~ensions of extsting structures, ~f any. Front ..........................Rear .......................... Depth .......................... Hmght ............................ Number of Stones ............................................................................................................. D~mens~ons of same stru'cture w~th alterahons or addmons: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stones .................. I ........ .~....~... ....... Depth ..~...¢~.. ............... 8. D~mensions of entire new construction. Front ........ .~,~..~...: ........ Rear Height ........ ~..'./.....~. .......... Number of Stories ..... ~. .................... 9 Size of lot: Front ....... Z.~.~....:. .... Rear .......... /...~...~..~....: Depth .......... ~.1).....~.....' ....... 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... 11. Zone or use district ~n which premises are situated ............................................................................................... 12 Does proposed construction wolate any zomng law, ordinance or regulation? .................................................... 13 Name of Owner of prem~ses , ddress .................. Phone No ................... Name of Architect ..................................................... Address Phone No ................... Name of Contractor ..~./..~...:..~ ...... Address iiiii~]]i Phone No..~../~.....~.~.. PLOT DIAGRAM Locate clearly and d~stinctly all buddings, whether existing or proposed, and indicate all set-back d~mens~ons froi property hnes G,ve street and block numbers or description according to deed, and show street names and md~ca~ whether interior or corner lot. STATE OF NEW Y~.R..K,, . / '~ COUNTY OF ..~~.~,..( S.S. ..... ....~..../~....?.......'~..)t.:.../(..'~...~/¢~C. ................................................ being duly sworn, deposes and says that he is the applio (Name of individual signing apphcation) above named. He is the ..................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and th~s appitcat~on, that all statements contained m this appli.cat~on are true to the best of his knowledge and bell and that the work wdl be performed in the manner set'f6rth in the apphcation filed therewith. Sworn to before me thisf ' ' .............. .:. ............... :... ....... ; ............................. 6/' /.../../Z. Notar Pubhc,-~. }j.~.4.~',t .(.(...~.~:,,-~/' C:ount ; .......................... ........................ y . . ............................ /../ ................. ~.~. ~,*,ARIS£1 A REGENT ~ m--~- , [/ ~/[tTC~PUZ,-IC, S~'[e of New Yorl~ No 52-3233120 Suflolk County Term Ezp~res March 30, ]9 ~