The URL can be used to link to this page

Home My WebLink About3299-zFOEM N/). 4 TOWN OF SOUTHOLD BUILDING DEPAtlTMENT TOWN CLEHK'S OFFICE $OUTHOLD, N. Y. 5E:RTIFIE:ATE: I-IF EiI:P-UPANCY No. Z...2.6.73 .... Date ................. atP-J1 .... Ibc..., 19.67. i~HIS CERTIFIES that the building located at .~//.~...~.e..a.d.o.¥...~ .............. Street attituck Estates Map No ............. Block No ............. Lot No..~.~...&..1~.0....~.~..~.t.~.~.~.~.~j...N.,.~.:.. conforms substantially to the Application for Building Permit heretof.~re filed in this office dated ......... ~Olr~I~bHX'...~L., 19.(:~ pursuant to which Building Permit No. dated .......... t~l/~¥-~-. {~ ...... 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 ....P?.~.Ir.~.~..e..0..l~.e...f..8~1. i..~X..d.~.~.~.itat[ ........................................ The certificate is issued to .F.l~ec~x,/Lak.& H~-e,L.I~l'ch~, ......... ~e. lVs .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ~II~h ·-2 .... ~L¢ ~.~..b~. Building Inspector FORM 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? 3299 Z Dote ......................... N.c,ra~rhe z'..... 2 ...., ~ 9..6~.. Permission is hereby granted to: ..... F~<~.../l~l.~ .. ~3,c,.... A/.~ .. Fze.de~.lck.. &.. Helen ILtrehe ................. l~ti.g~;ok ......................................... to ~t¢.:l=d. · .ney. - erie - · ~am~,. -.. ~re t.l.~g ................................................................................. at premises located at ....~4~.t,......~.9..~;..~'...~O.t....l~att£tucl~.Eatatea ................................... ............................................. l~a4o~..l~n®~ ....... 14a t;t ~.~ue3%...]l.o.¥, ........................................... pursuan,t to application dated ............................ ~O.~.O1l~8~.....~,....., 19..~, and approved by the Building Inspector. Fee $...1-(J,e J~ ......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. ~_~ .~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. District Engineer District Engineer FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved r 19 ........ Permit No D~sapproved a/c ............................................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcotion must be completely filled in by typewriter or in ink and submitted in duplicate to the BuHdin. Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and g~ving a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatio, 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. Suc 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 Occupanc shall have been granted by the Buildmg Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of o Duildmg Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcable Laws, Ordinances , Regulations, for the construction of buildings, addihons or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, buil~ code and regulations. (Signature of applicant, or name, ~f a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or bu~Ide ~o]a~:3~&~ter ...................... Name of owner of premises ~..'~..~.~..~.'~.'~..~...~.~..r.~..c~.'~%~..~`..~R.~:~.H.~.~..~.~.~. .................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer} 1. Locat,on of land on which proposed work will be done. Map No 1~.~...~..~.~...~..~..~.~..~..... Lot No: ..4...D....~..~..~ Street and Number ..... ~L~i~.&I~:~..Li~ .................................................................................................................... Mumc~pality 2. State ex~sting use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Ex~sting use and occupancy ..... .~...~..~...~..~...t.,..~...a:..~...~. ................................................................................................ b Intended use and occupancy ....0..~..?.....~..~..~.~......¢~..~.~..~.~.~..~.~ .......................................................................... 3. Nature of work (check which applicable). New Building ....... X ........ Addition .................. Alteration ................. Repair .................... Removal .................... Demolihon .................... Other Work (Describe) ..................................... 4. Estimated Cost ................ ~..2...2.~...5..0..Q ........................... Fee .............. .~3d0.o.f).(I ............................................................ (to be pa~d on filing th~s application) 5. If dwelhng, number of dwelling units ...... .~. ................... 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 ............................... 7. D~mensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones D~mens~ons of same structure wzth alterations or additions' Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mensions of entire new construction: Front ...... ~6.: ............... Rear ........ .56.: ............. Depth ......32.: ............... Height ....... ..]..~. ................ Number of Stones ........................... 9. S,ze of lot: Front .....~..5...0..~. ............... Rear ..... .~..-~.~. ................ Depth ....... ~:.Q~I. ................. 10. Date of Purchase .... ...O~...~..:.....3.~.~....3....g..6...6. .................... Name of Former Owner .... ~.~..~.~..~.t/.~.~...~l.~g.t;,.qNI. ........ 11 Zone or use d~stnct in which premises are s~tuated ................ .~..~.~ ........................................................................ 12. Does proposed construction wolate any zo~mg law, ordinance or regulation;> ................... ~[~ .......................... 13 Name of Owner of premises [,.~,...~,I~rX~ ............. Address {~.Q:~.0...[t~..~&~el..~.C)la.~one No ................... Name of Arch,tect ...................................................... Address ......... ..w..u...°...~'....~..v...~..~./.....~..:..z.;Phone No ................... Name of Contractor ....l{..c~.,....~.~,.~,~ ......................... Address ....... l~l{l~t;;I.:~tt¢,~ ............... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and indicate all set-back dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street homes and md~cal whether interior or co~ ncr STATE OF NEW ~ORK, ~ COUNTY OF ....... .~.~.~.0.,1,~ ........ f S.S ........................ ~.~]i~,X~.~,t~, ........................................... being duly sworn, deposes and says that he ~s the applic. (Name of ind~vidua{ signing application) above named. He is the ............ .(2{3~n~.~t~:~ ............................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and th~s application; that all statements contained m this apphcat~on are true to the best of his knowledge and bel and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this z,,,: day of. ........ , .... / ....................... ..... ..... :: ...... . .......... ...................... Notary Public,/./.~....f.~/. ............. }/}Aq~U~n~C.E;iT (S,gnature of ap/;fficant) ~./ NOTARY PU~LI3, S'~ ~ of [.~','~ York No 52 3233[20 Su{,~l,(Count), Term Expires March 30, 19~r,z~