The URL can be used to link to this page

Home My WebLink About3005-zEUILDII~IG DEPARTMEI~IT ~I"OWN CI~Ei~K'S OFFICE SOI/TI-IOLD, l~I. Y, P.I:'~TII:'IP. ATI:' rIF rII~I~UPANV. Y THIS CERTIFIES that the building located at .E.~[~...R~.~.~,e. ~Ve ............ Street ~a~.~. ~?..~'?..~.~.t.a~ck No ............. ~ot ~o.. ~.~....~a.~.'~,it.~¢k~. ~.,.~, ........ conforms substantially ~o the Applicat~.on for Building Permit heretofore filed in this office dated ............ ~,,~,...~ .... 19~. pursuant to which Building Permit No..-~f)0~-2~ dated ............. I~.~.~...~.., 19.(~, was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .o.ccupancy f~or which this certificate is issued is . ~.ri.v. ate .oreo · £a~ai.l.y. rlwe~,~ing .......................................... The certificate is issued t,o .. 0aSbO~* .~.~a~ ........... 0'~/~6~:P .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~ep~;~..2~..~.~...by..~,V.i. llr:~. ...... ......... - ....... :'. ........ Building Inspector { FOP~M' NO. 2 TOWN OF SOUTHOLD BUILDI~G DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ H. y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3005 Z Permission is hereby granted to: ...... D.~...~ ................................................. at premises located at ..... .~/~.-.--~,~,e~'~...JkV~ ....................................................................... :.;..t...r ..... ..................................................... ~.ti.tu~..... ~. ~ ~ ~ ......................................................... ........... ~.. pursdent to application dared ................................ ~.~b.,.....a],~. ......... 19..(~6.:, and ¢~pprOved by the Building Inspector Fee $ ...... % Q.,.Q..O. ..... NOTE: I = MONUMENT LOT NOS. REFER TO SUBDIVISION MAP OF "$ALTAIRE ESTATES" FILED IN THE OFFICE OF THE CLERK OF SUFF. CO. SURVEY FOR TIMBERLAND ASSOCIATES MATT I TUCK TOWN OF SOUTHOLD SUFE CO., N.Y. SCALE= l" = 40' JAN. 21, 1966 MAY 4, 1966 GUARANTEED TO: GUARANTEED TITLE DIVISION OF AMERICAN TITLE tNSURANCECO, PRO FES$10 I~1[!~ E NGI~L'~[ R AND LAND SURVEYOR ~ N~.S.LIC. N0.128~.5 RIVERHEAD ~ N.Y, $CHD SUFFOLK COUNTY DEPARTMENT OF H~ALTH ~ldg. Permit No. 7~' ('~ ~ -2._ The sewage disposal facilities for a structure located at (Gi~ deed location) have been inspected by this Department and found to be satisfactory. District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , Approved ........................................ , 19.....~...Permit No................................./-L~O O~7~ Disapproved a/c ......... ~~,,7~ ................... ............................... ................................ ............................... (Buildin~ lnsp~ctor~ Application No ............................. APPLICATION FOR BUILDING PERMIT ....... ............................. ..... 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 an 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. ordinances, building code r gulations. t~n h .......... ........ ..... ........ ~ (Address of applic6nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner p .................... .~ .............................. : ................................................................................... 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 ...7. ...................................................................... Municipality ~ .......... : ..................................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. intended use and occupancy / NatUre of work (check which applicable): New Building ,.~.}...~.....~. ..... Addition .................. Alteration .................. Repair ................... .j~gmoval .................... Demolition .................... Other Work (Describe) ...................................... Est' ated Cost ~" 0. , .0,,-¢.' ee .......... ...... ...... l ............... F .......................................................................................... (to be paid on filing this application) ' ' O /L; If d~ielhng, number of dwelling units ................~ .......... Number of dwelling units on each floor ............................ If go, rage, number of cars ............ (~.)...~..{.~, ................................................................................................................. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use ................... i Dim lnsions of existing structures, if any: Front .......................... Rear .......................... Depth ............... Hek. ht ............................ Number of Stories ..............................................................................................,, , , Dim msions of same structure with alterations or additions: Front ........................ ' ....... Rear .......... '....'... Dep .............................. Height .............................. Number of Stories ........................................ 10. Dat~ 11. Zon 12. Doe~ 13. Nan Nan Nan property lit whether Dim ~sions of entire new construction: Pront ............................Rear ............................ Depth ............................ Hei(. ht ............ i..2<..°...~..~. Number of Stories ..... .~'~...~,k%D ......... ' Size,of lot: Front ...... .~.~D ............ Rear ......... ~.~ .......... Depth ......~.~..~.~ .... of Purchase .......... ~...~..~, ....... .~.~ .................. Name of Former ~ner ....~....,.~....~.L ............. or use district in which premises are situated ................................................................................................ proposed construction violate any zoning law, ordinance or regulation? ..................................................... of Owner of premises ..~.~.~.~Q~..~,.Address ....~.~..~..~.,~Phone No.~q.~.J . of Architect ...................................................... Address ............................................ Phone No .................... of Contractor .~...,......,.~.,.......-..;....~...-..;.. ............ Address ~.~.,.~...;.:~..;..,.~,~.Z¢..C;.; P'hone No PLOT DIAG~M ~learly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimens~ens from es. Give street and block numbers or description according to deed, and show street names and lindJcate ~dor or corner lot. . STATE al NEW YORK, ~ S.S, COUNTY )F ................................ ~ '"~'~'~'N~' ~' '~'~i ...... ~ ~ ~ ~. ~) ~ ................ being duly sworn, deposes and says that he is the ,pplicant . . above non ~d. He is the ....................................... :~......~.~..~ .............. r. ............................................................................. (Contractor, agent, corporate officer, etc.) of said ow er or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge an belief; and that t~e work will be performed in the manner set forth in the application filed therewith. Sworn to efore me this Notary Pu )lie, . ........................................ N~~'~~¥~'~ ~pp cant) ....... ~ ~ ~ed in St~o~ Cmm~ F~