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Home My WebLink About2975-zTOWN OF SOUTHOLD BUILDING DEPARTMENT 'I"OWI~ CLERK'S OFFICE SOUTHOLD, N. Y. 12EI:?TiFIOATE OF O[:OIJPANIgY No. Z~.I{'~.0. ..... Date ................ .i~r.~ ... 31 ..... , 19 THIS CERTIFIES that the building located at . .I~/L~.. l~til~-.Ro~d ........... Street Map No. ~ ......... Block No. ~ ......... Lot No. Y,-X .... S~ll~;l%O."ld.~. 1~.~, .......... conforms substantially ~o the Applicati.on for Building Permit heretofore filed in this office dated ............ ,~I~,..6 ..... , 19~6.. pursuant to which Building Permit No.~9~ .~.. dated ............. ~.~Idl~.-7 ..... 19~6., was issued, and conforms to all of the require- ments .of the .applicable provisi.ons of the law. The .occupancy ~or which, this certificate is issued is ... BIlIB~Ie~.~. ~i]~c~ilrl~ .... ~l*~O~'e ......................................... The certificate is issued t~o . ~.~a1%!4:. 0~li~e~ .............. 0~/1~ ..... .. .... ............. (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval . . l~ay. · .9~. 'l~ ..... ~y' ~ '~'ll'l~ · ' · FO~M~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~CE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2975 z Permission is hereby granted to: ...................... ~T.~espor.t .................................... ........................................ e~--:~-.~i.~.:-~o~,%.-~;.~.-,-~..-.:.....,...,?.,.~..,.,..::..,~:~,..:~..,~.~,.....~ pursuant to opphcat~on dated ............................ ~..~.,,~:.,......::;~, SUFFOLK COUNTY DEPARTMENT OF HEALTH Riverhead, New York ~:U~g Psat No.,,,m F ~ 7 ~- z_ Health Departmant nan Application for Approval of Comme. rcia~..SewaEe .Disposal. System TO: The Suffolk County Department of Health Date ~/ ~ ~..~ ! Application for approval of commercial sewage disposal system is hereby r eque st e d. (Name and side of street, and name and distance to nearest intersecting street ¥illage I hereby c~rtify that this cmmmereial sewage disposal system has been con- structed in accordance with plans approved by the Suffolk~ County Department of Health on (date).. and with all the requirements of the latest bulletins on sewage disposal of the Suffolk County Department of Health. Applicant's Signature ~. Title .... (Builder. Owner) Ready for inspection ......... Inspected by, /,z ,~%, Installation satisfactory Based on the information stated hereon by the applicant and other information made available, it is the opinion of this Department that this system with proper maintenance can be !expected '~to function satisfactorily and is not likely to cause a nuisance, p?~p~v~d~d designed se~age flow is not exceeded. Structural features are not includ~dj~ H~Y 2 ~ 19~6 S~D. S-13 61.58 '5c~ ]~ : .cO' = /" FOI~M NO. ! TOWN OF SOUTHOLD BUI~LD~NG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....8~''~'' 2 19 (~' ~ 19....~'... Permit No ............................. Approved ........................................ , ~ 29 ¢ ~'- ~ Application No. '~ ~ 7S D' sapproved a/c ..............~. ............................................................ ~L;~::..;.~_ ,..~.::~ ...... (Building !~spector) APPLICATION FOR BUILDING PERMIT Date ............................. ~g~.~...... ~ ........, 19.6.6 ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall 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 part for any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. R.~.n.e...~.~.~.O,~.g~q ..................................................................... (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................... ~.or~r.~e.~.~ .............................................................................................................................. Name of owner of premises ....~Z'.9,~'~...0.~k~ ..................................................................................................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ...... ~ .......................... Lot No.: ....... ~ ......... Street and Number N/.8' Nain ~oadt Arshamema~u~t Gz'.ean~oz',t~ N..Y ......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~c~.n.t..]J~.n~L....(.~,z'.t..4)~...La~.o3,1~,..E,~t.) ............................................ b. Intended use and occupancy .~.~S~. ~Ul&~n~.~i~g~.,~D,~,~,). .......................... 3. Nature of work (check which applicable): New Building ...,J~l:~ ....... Addition .................. Alta t n .................. Repair .................. Removal .................. Demolmon .'.. Other Work (Describe) ........... 4. Estimated Cost ../(..~/,~../)...~..~....~... ................................ Fee ..~,O,O0 ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~1~1~.~ ........... 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 'lJ~l~l.~I~J ........ 7. Dimensions of existing structures, Jf~ny: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ' Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ I~umber of Stories ................................ 8. Dimensions of entire new construction: Front ~. O Rear .................................................. ~ ............. ep n ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..~.,,~...tl~...l~l~..:~l~....~.~....~...~.I~l~t~rZ ......... Depth 10. Date of Purchase .............. J~el~....'l.~)6~ .................... Name of Former Owner ..... ~T,~....[~g~'l.,'t&..~l~ ................. 11. Zone or use district in which premises are situated ....~,ll..~t~ .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... 11~ ............................................ 13. Name of Owner of premises ..~:~',ll~...0:J~'tl'~. ........ Address .......... J~t~&$~,t,~ ............ Phone No ..................... Name of Architect ..~['l~..~II/O~ .............................. Address ..~&~l~..~J~ ............ Phone No ..................... Name of Contractor ...J~,.(J~ll~ .................... Address "i ......... ~illl~j'~.t~ ..........Phone No ..................... PLOT DIAGRAM Locate clearl~&~Dd distinctly all buildings, whether existing or prop~)sed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ ¢ ~ ' COUNTY OF ,...l~.o3,k ........... ~ .... ........................... ~Jl~al~...l~Jl~lti~,o~ ........................................ being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ............... ~.~ ................................................................................................................. (Contractor, agent, corporate officer, e~c.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wiJl be performed in the manner set forth in the application filed therewith. Sworn to before me this ........... .~ ........ day of ............ ¥..~,p.~. ............. , 19.6... /'~ ' .~/~ ~ -.~, -,- - ~ n ,9 /t /"~ ~ / ...~.,~r~,~..~..~';'~r~1~f~.¢;....~. ............................. Nota,'y~¢!~:~:..;~..[....,,¢C~-~ount~f~/~ (Signature of applicant) , , '~, , F e O M T H * O F F I C ~ O F~~~ I PLAN NO( I~ ~z% SCALE ,.~.,z ,.= ~L D' SHEET NO. CHARLES iA. WO° P H O N E , ~ A ' ¢ '' ~ a ' 1 ' 0 ' ~ ' -~ ...... , r , ¢ ; ,' SHALL NOT BE DUPLICATED WITHOUT HIS PERMISSION , /,.~ CHARLES A, WOODi R A. ~~*/~X I ' I I P H O N E W A 9 - 4 3 I O ~[~T ~' '~ ~ r ' ' THIS P~N S THE PROPE~Y OF THE ARCHITECT AND '~ , , ' : ~ o '~ PLAN NO. z5~% SCALE. ,~" = ,J:~" SHEET NO. O.D.r.A. A D 18T REV' YORK PLAN SHEET NO. F R 0 M T H E 0 F F I 'C' E 0 F CHARLES A/,WOoD. R. A. A R C H I T E T P A R K ~E R WADING RIVER, PHONE WA 'NE'W YOR'K I~ 9 -4 3, I THIS PI-AN IS THE PROPERTY DF,THE ARCHITECT SHALL NOT BE ,AND DUPLICATED WITHOUT HIS P£RMIS~ION S. HEET NO.