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Home My WebLink About3275-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, ¥, BI:'RTIFIr. ATE DF rlP. r. UPANI2Y THIS CERTIFIES that the building located a.t B~/~.~ '~.]~g~" ~i//~ ............ Street Map l~gl~ ~ ~S~;~No . Lot No. "3/; ....... t :itu k .......... conforms substantially to the Applicati. on for Building Permit heretofore filed in this office dated ......... ~t; .... 8 ...... 19.~ pursuant to which Building Permit No. dated ........ 0t~"'~ ......... 19. ~, was issued, and conforms to all of the require- merits ,of the applicable provisions of the la w. The occupancy for which this certificate is issued is ....PR. SYSCO..q~e..l~m$1~.. I~ltl lt~.~ ....................................... The certificate is issued to .. ~'i~be~I'a~d' &~soela~;es' 'Ine'" ~nea~t') ........... ~owner, lessee o£ the aforesaid building. Suffolk County Department of Health Approval ...... ~l~l'il'''~' X~67 'b~ 'I~;' Bui ng Inspeet or\ FOH~ NO. :~ TOWN OF SOUTHOLD 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? 3275 Z Permission is hereby granted to: ........... 'ei~b · ~'la~ ..,~a sac/mfrs....1:nc ........ ................ I/a~;.U..~uek .......................................... to ..~:lA..ne~...~n#..~,i~...~l,~al;L~,~ .................................................................................. et premises located ot ...... ],f~.~.. ~,~.l...l~[[..}x~,:r0...~.a~a~e.s .......................................................... .............................. Sa,l.ta ~.e...I/a~. ............ gat.t.ttuekt..]/,Y., ..................................................... pursuan,t to application dated ....................... ~.~.]~.~ ............. ~J ............. , 19..~.., and approved by the Building Inspector. Fee $.. X .0..'..(~... ......... S-9 ~oT ~ ('' SUFFOLE COUNTY DEPAE~MENT OF HEALTH Date Bldg. Permit No. TO WHOM 1T MAY CONCERN: The sewage disposal facilities for a structure located at (Give deed location)' ... ;-,~. ,, .. . /~?~ 77 ~77 ~,, ? ~<'~ 43. have been inspected by this Department and fouad to be satisfactory. ' ' Dis%r~'ct 'Engineer NOTE m= MONUMENT SUBDIVISION PLAN FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AUG. $,1966 AS MAP NO. 4682. SURVEY FOR TIMBERLAND ASSOCIATES LOT "SALTA I RE ESTATES" MATT 1TUCK TOWN OF SOUTHOLD SUFF CO., N.Y. SCALE: I "= 40' AUG. 29, 1966 dAN. 17, 1967 PROFESSIO'N:~I[~ ENC~NEER AND LAND SURVEYOR, NF~.Y.S. LIC. NO. 12845 RIVERHEAD, N.Y FOR~ ~1'0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE souT,oLD, N. am,ned ........ ...... Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c~~ ...... .................... .......................... ~ u~ mg nspec or)/ / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and giwng a detaded descnpt,on of layout of propertymust be drawn on the dmgram which is part of this applicatior c. The work covered by this application may not be commenced before msuance of Buildmg Permit. d. Upon approval of th:s application, the Buddmg Inspector wdl issue a Building Permit to the applicant. Suc permit shall be kept on the premises available for inspection throughout the progress of the work. e. No buildmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLiCATiON IS HEREBY MADE to the Bud&ng 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 · Regulations, for the construction of buildings, ad&tions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, budding code and regulations. (Signature of applicant, or name, if a corporation) ..... ..... ...... x~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises ..... ~-~..~ I.~f applicant is a corporate, s~qoture ~_.f duly authorized officer. ....... ..... (~) (Name and ti'de of~e/orporate officer) 1. Location of land on which proposed work will be done. Map No' ~t IT-fi , ~ ~ ~ ~ T"??~%Lot No: ~ ~' Street and Number ~ ~O t,t,L..~...,~. ...... ....... ~..O..c.~.f.x....c4....?..',..~.....t~......../7.--~...~...~ .................. ......................................... ~unicipality 2. State existing use and occupancy of premises and mtended use and occupancy of proposed construction: a Existing use and occupancy ................................................................................................................................. b Intended use and occupancy .................... .ff...~...~..~. ............ ~..(.~....~....~ ....................................................... 3. Nature of work (check which applicable): New Budding ...~..?....~..'' ..... Addition .................. Alteration Repair .................... Removal .................... Demoht~on .................... Other Work (Descnb'e) ..................................... 4. Estimated Cost .......j..b).....(...~..~ ................................. Fee (to be paid on fihng th~s apphcat~on) 5. If dwelling, number of dwelling units ..... ~.~ ........... Number of dwelling units on each floor ........................... If garage, number of cars C) ~ ~- 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D~mens~ons of existing structures, ~f any: Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure w~th alterations or additions. Front ................................ Rear ............................... Depth ....~ ................... Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction' Front ......... .'b.....L~..:. ........ Rear ........ :.~...~.fr?.....~. ...... Depth ...../..~...:. ......... He,ght ....... -- '/....~.....z. .......... Number of Stories ..... .()....~...~.: ........ 9. S,ze of lot. Front ..... /....5:...¢.1....f ......... Rear ...... /......¢~...!..../. ...... Depth ......-.-~.....~..~..?....: ......... 10. Date of Purchase .............. .~ ........................................ Name of Former Owner .... ..(-..../~......c~...~....?...~.. ...... 11 Zone or use district ~n which~ premises are 12 Does proposed construction v~,l,a: 13 Name of Owner of premises Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and d~st~nctly all buddings, whether ex~sting or proposed, and indicate all set-back dimensions fron property hnes. G~ve street and block numbers or description according to deed, and show street names and ind~cat~ whether ~ntenor or corner I~t~ STATE OF NEW~F. OR.K~/.~ }. ~ ~ COUNTY OF ..~..'~...q,-~...~ ~ ~ ~ .................. ~.~ ......... .....,.......~...:~ng duly sworn, deposes and says that he is the applicon (Name of individual signing app icat~on) above named. He ~s 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 fil th~s apphcat~on; that all statements contained in this apphcat~on are true to the best of h~s knowledge and behef and that the work wdl be performed in the manner set forth ~n the application filed therewith. Sworn to ~ore me th~s ............... ~. day of ........ ~~ ...... , 19~ Notary Pubhc, . ........................................................... County (Signature of apphcant)