The URL can be used to link to this page

Home My WebLink About2993-z~0B~ ~0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, f3E~TIFII-:.ATE OF or. oU~ANr. Y THIS CERTIFIES that the building located atN./..~...~.t.~.i..~. .R..O.a.~. ............. Street Map No..~ ...... Block ~o ..... Y~i... Lot ~o. X~. .... ~.O.1..4,,..B.,X~ ........ conforms substantially to the Applicati, on for Building Permit heretofore filed in (his office dated ........ ~'[{~1 ..... ].Ii ......19~.6. pursuant to which Building Permit No. ~..~3..~.. dated l~) ]'~ 19~..6 was issued, and conforms to all of the require- me.nts of the applicable provisi.ons of the law. The .occupancy ~or which this ce~ificate is ~ ~. ~..~. $~. ~w~._..(~v~..~.~r~.~ .............. The certificate is issued ~o ~1t~ ~e~ . O~e~ ......... (owner, lessee o~ tenant) of the aforesaid building. FOP,,M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2993 z Date .......... :.,..........~b~t~.y....18. , 19.6.6_ Permission is hereby granted to: .............. Do~tt, ho.Z~} ....... : ...................................... to Bu~.ld...a~.. aad.J.4;.l.o~.-om.* eh., eX.SS '~*~ng' ..d.we'~.~'l. ng ........................................................... at premises located at ....,..~,SL.~.J~a;$Jt..~O~,: ...... ~O~¢~OZ~,, ..~:,.~.,. ......................... pc~?suant t0 Opplicafi~" da~:~d ..J..:...~;i..J.~:~i~...::.~..:.,:~.].~:::.:.:,' 1'~.i.':, and approved by the · Building Inspect0i; Examined Approved TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Permit No .............................. App licat ion N o.~....~...~....~. ................ Disapproved a/c ................................. ~ ....................... :, ......................... (Building Inspfctor) APPLICATION FOR BUILDING PERMIT Date ....],~..~..~--....J...?.. ................................. ,19..~.~... 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 propertymust 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 ~ 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. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name ol~ owner of premises ......~...... .................................................................................................................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) i. Location al~ land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...~~........~...~ ........ .~....~..?.....~. ..................................................................... Municipality 2. State existing use and occupancy of premises and intended, use and occupancy of proposed construction: a. Existing use and occupancy ...... . ~.,~,...V?. ' ................................................................. b. intended use and occupancy .......... '..~...~.~..~,.u....~..,~m ................................................................ 4. 5. 6. 10, 11, 12, 13. Nature f work (check which applicable): New Building .................. Addition ....... ~. ....... Alteration ...,~ ......... Repair "t ................. Removal .................... Demolition .................... Other Work (Describe) ............................... ~i ...... Est~mate~l Cost ............... ~..O..~.¢,,) ............................. Fee ................................................................................... ~ ...... ' (to be paid on filing this application) If dwelh g, number of dwelhng units ............................ Number of dwelling units on each floor .....................! ...... If business, commercial or mixed occup~ncy, specify noture and extent of o,ch type of use ......................... ~ ...... Dimensh[ns of oxistinfl structures~ if ony: Front ........ J~ ...........Ro~r ......... ~r~ ........... Depth ..................... ~ ...... Height . ..~ ................Number of Stories ............. ~ ............................................................................................. Dfmensi~,ns of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............................. Height .............................. Number of Stqries ........................................ Dimensi~,ns of entire new construction: Front ............................ Rear. ........................... Depth ............................ Height .......................... Number of Stories ............................ Size of ~t: Front ....... (~..~ ............... Rear ....... 2,.~..~ .......... Depth ................................ .......... ~..&,.~ .................................... Name of Former Owner ....~'....~D~ .................... Date of Purchase ~ ~ Zone or use district in which premises are situated .......................................................................................... ~ ~ ...... Does pr, ~osed construction violate any zoning law, ordinance or regulation? ........... ~.~ ............................. ~ ...... ) Name Owner of premises .x~y~...~ ........ Address ...~...J~,~ ............. Phone No .................... Name Architect ...................................................... Address ............................................ Phone No .................... Name Contractor ........... '. ........................................ Address ............................................ Phone NO ..................... PLOT DIAG~M ~rly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ~rom Give street and block numbers or description according to deed, and show street names and indicate or corner lot. ~ b b ' ' ' '"' ' ' ~'i~ ................ being duly sworn, deposes ~nd says that he is'the a ca t (Contractor, qgent, corporate officer, etc.) .... i )r owners, ~nd is duly outhodzed 1o perform or have performed the soid work end to m~ko end file ~j thor ~11 statements contoined in this ~pplicotion ~re true to the best of his knowledfle end ark will be performed in the manner set forth in the application filed therewith. me this ~ ~e~m Expires ~arch 30, tg~'~/ property lines. whether interi~ STATE OF NE COUNTY OF (Nan above n~med. of said owner this applicatJa and that the ¥ Sworn to befor Notary Public,