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Home My WebLink About3008-zTOWN OF SOUTHOLD BUILDING DEPARTMENT ~'OWN CLERK'S OFFICE SOUTHOLD, N. Y. I~£1~TIFII'I. ATI: OP O00UI~ANr. y NO..Z. 2~'I'.~.9 ... Date ................. Jl~l.~. · .~ ...... 1961~. THIS CERTIFIES that the building located at .~/~.. ']~y'AVe .............. Street Map No .... ~ ...... Block No ....... ~.. Lot No.. ;~X .... ~,t¢~Og~lO~. ~,~ ........ conforms substantially ~o the Application for Building Permit heretofc~e filed in this office dated ............. ~4a~l~. · '3- 19,6~. pu~rsuant to which Building Permit No..~)0~; .~. dated ............. ~4e~:l~..~-., 19~6., was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .occupancy f~or which this certificate is issued is ...P~iva.$e. one..£ag~ity .~tw~5.'l. ing ........................................ The certificate is issued t,o .ROge.X, .~' ........ 0~r~ ............................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ...I~,~ ................................. Building InspectOrl FORM 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? 3008 Z Date ........................ ~h .......... .3 ............ , 19.(~.. Permission is hereby granted to: ................... ff~tct~ag~e ...................... : ................ ct premises located at .~/.~....~a~..A'~ ............................... .....:,...L ........... :.........; ....... ;..........:;: ....... : ......................................................... O.u.~e'ao~ue~.,...,~;I,~:~. ........ :.,...: .:. ...~. ~ ~ : . pursuant to pphcohon dated .:~ ....... ~ ....... :....~'~]a ......... ..~.. ........ .., 19~.. and approved by the Building Inspector ' · ~ ~ "' Fee $...~.OQ ............ '' :' ........ ~5.....~..~,.?....~.~;~:.~?~,__ ....................... . Building inspec,... ~ . FO~ ~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~.. Y. Approved ........................................ , 19 ........ Permit No ............................. Disapproved o/c ....~ ............... ~-~ ~_ ' Date .......................... .tJ~.ar. eb. ......... .3 .......... , 19.66 ...... 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 o~ 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 td the appli~:a~t. 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 Ragu arians for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply w th all applicable laws, ordinances, building code and regulations. .... ~.o.uglas...B~ehe..&..~.o~ ............................................ (Signature of applicant, or name, if a corporation) Cutchogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, ena, ineer, general contractor, electrician, plumber or builder. ...... ~.O.~,t,~. a.e .¢.0~. ............................................................................................................... Nome of owner of premises ...~ge~..]~a]~. .................................................................................................... ~ .............. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: ............................. ' ........... Lot No.: ........................ Street and Number ~.~...~-~..J~.'¢~ ......... .Qlz'c.o og.~e ............................................................................................ Municipality 2. State existing use qnd ~cupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. dM~l~i~0~ ................................................................................................... b. intended use and occupancy ................ ~t~te.,...~.i~,h..a~...aS~l.J..t,:tD~ ............................................................ 4, 5. 6. 10, 11. 12. 13. Lacateiclearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensiol property i~es. Give street and block number or description according to deed, and show street names and whether intErior or corner lot. Na ute of work (check which applicable}: New Building .................. Addition ...... ]~;¢X ..... Alteration .... .............. Rep,~ir .................. Removal .................. Demolition .................. Other Work (Describe) .......................... : ............. EstiMated! Cast ..... ~ t ...O0~1.. '~./~ .............................. Fee ...... ..~.,i ................................................................ : ............. (to be paid on filing this application) If d veiling, number of dwelling units ........ IDZle ............. Number of dwelling units on each floor ............................ If g, lrage, number of cars ............................................................................................................................................. If [:usiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................... Dirt ensions of existing structures, if any: Front ............................ Rear ................................ Depth ................... He !~ht ........................ Number of Stories ................................................................................................................. D m~nsions of same structure with alterations or additions: Front .................................... Rear ............... , ............. Deplih ................................ Height ............................ Number of Stories ................................ Dimensions of entire new construction: Front ............ 32 ............... Rear .......... ~t~, ............ Depth .......... ,.~. ......... He ! ht .................... Number of Stories ...... ~e ........................................................................................... , ............. Size Df lot: Front ............................ Rear .................................... Depth ................................ Dais of Purchase ........................................................ Name of Former Owner Zon( or use district in which premises are situated ..... !.~,~!!.....cl_.J,~.t, .......................................................................... Does' proposed construction violate any zoning law, ordinance or regulation? ....... Z~e ................................... L ........ Nat~e of Owner of premises ....~,...~a.~De~ .............. Address ......g.g..t;.e,~.Q~l, ft ................ Phone No ........~ ............ Nam]e of Architect ...................................................... Address ............................................ Phone No ........i ............ Nora of Contractor ..D.,...Bo~.he..&..~qo3n ................ Address ......... Gl.lg~.hog~u~. ............. Phone No ........~ ............ I PLOT DIAGRAM IS from ndicate ? STATE OF YORK. above named of said owner this applicati( that the work Sworn to beta Notary Publi ........ .~...t..~...~..e.~'....~...e..e..'g..e. ...................................... being duly sworn, deposes and says that he is the applicant ~me of individual signingapplication) He is the ................... ~i.a.,~ ~g..e.?.....o...~....C..g,~,.,~.~g...~.,o.?..,~. .......................................................................... i ......... (Contractor, agent, corporate officer, etc.) ; or owners, and is duly authorized to perform or have performed the said work and to make and file n; that all statements contained in this application are true to the best of his knowledge and belief; ~nd will be performed in the manner set forth in,the application filed therewith. e me this ~ ' · day of .................. ............. , '...~.~ ..~;. ~... County"'"~"'~' 'r""mz'j~'i~';';ture of opp~'~a*nv""-"l'i;'~;~'i ............................. MARION A REGENT IqOTAR¥ I>U'~LIG, State of i'~w No, 52-3233120 Suffolk County T~fm ~xpi~s N~cI~ ~O,