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Home My WebLink About3012-zFOI~M ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. 1:3£1:tTIFICATE 13F rlI:3C3UI=ANI::3¥ No. 'Z' ~'~'" Date ........... ~Op~ ...... 26 ........ 1966. THIS CERTIFIES that the building located at ~,~Cr~2t011 ']~,~ '&' 'JelYl~!gS' 1~'' Street ~ap0~li ~. Kc../.~.3~oc~ No .... ~<X ...... Lot No.. ~¥.. '~ou~ho~'~' '~'~'~ ......... · conforms substantially ?0o the Applicati, on for Building Permit heretof,~-e filed in this office dated ............ ){r~:~' '"~20' 19.~. pu.rsuaut to which Building Permit No. ~'02.2 '~' dated ............ }4a'~'0t.1...19 ', 19. (2~, was issued, and conforms to all of the require- me,nts ,of the applicable provisi, ons of the law. The ,occupancy for which this certificate is issued is ~'iw~te' .One · fc~:mi~:)] d~4e~-~kir:c~' ........................................... The certificate is issued t,o ' '~ohZz" 'S~acchig ...... /'"~yrlel' ...... .":':.:.: .......... [owner, lessee or ~enanz~ of the aforesaid building. .Suffolk County Department of Health Approval .t~e~Yq~. '26y '1966'' 'by' 'R~' 'Vii'la ..... ' ~ ~ufld]ng Inspector FOI~M 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? 3012 z Date F~tre~ ].0 19 1~6 Permission is hereby granted to: ~o,ee~.¢.~...~.~$~.~.~...Z~e.....A/~.....~T~.~m~eeh~,a ........ ~.e..~..o..~.~.~ ................................................ at premises located at ]0~; ~..~...~.~:?~,~g~.i][J,~LI~..~.~Z~..., .' ....... ......... :.i ....... ............... ,i .......... : .... ........................ ~.e.~...~..~..a,~.~o~..~.......i. ~.,~ia,....:...~....:...; ..... ...: ...... pursuant to application da~ed Z,.i. .......L,i......~i.:.~.~J~.:,vi~.~ili.,., 19~.6,~,'.,' and Ot~Proyed b~ .the. Building Inspector J: j ' :, ~ ' . ~ io. oo__ - s-9 SUFFOLK COUNTY DEPAEI~ENT OF HEALTH :~EP 2 6 '~9~ Date Bldg, Permi% No. TO WHOM IT MAY CONCERN: The sewage dis~. osal facilities for a structure located at ~ ~Give deec~ location) ' have been inspected by this Department amd found to be satisfactory. District En~ineew District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. ,~ o ( L-- Approved ................................. :x......, 19..:~.... Permit No .......................... Disapproved a/c ~ ~~ .................. ................................ (Building Inspectort 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 property must 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 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 Regu arians, 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. ...Home...C.t.e.s.t...B.u J. ld e~. s... Inc ..................................... (Signature of applicant, or name, if a corporation) ...... 8.CL....G .bb.$... P.o~cl .. Ho 2.d, ...N.e.s o.Qrt,~,~ ................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ....... J.ohtz..~.ac.ch±a .............................................................................................................. 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.: ..Da~.i~.ge...H£1].$.... Lot No.: ...~ ................... Street and Number ..g..e..n..n...t..n..g..s....g.o..~.d...A..~p..v..t..o..n....~..q.e. .......... ~.~.~,.t..h..o...Z..c! ..................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .v..c,.c.a~t;..~.a~d ................................................................................................... b. Intended use and occupancy ........... .O.~.e....~.'.~$~.y.....ct,~.6..~$T~ ........................................................................ 3. Nat re of work (check which applicable): New Building .... ~,~¢.... Addition ..................Alteration .....i ............. Repcjir .................. Removal .................. Demolition ............ : ..... Other Work (Describe) ........................... ; ............. 4. Estin~ated Cost .....i~.QQQ...~./.~v~ .............................. Fee ........ ~LQ .............................................................................. | (to be paid on filing this application) 5. If d~elling, number of dwelling units ...Or~ ..................Numl~er of dwelling units on each floor .............. ~ ............. If g.~rage, number of cars .......... ~ ....... .~. ............................................................................................ ~ .............. 6. ff ~usiness, commercial or mixed oCcupancy~ specify nature and extent of each type of use .............. ~ ............. 7. Dim ensions of existing structures, if any: Front ............................ Rear ................................ Depth .......... ~ ......... Hei ht ........................ Number of Stories ................................................................................................... Dim msions of same structure with alterations or additions: Front .................................... Rear .............. ~ ............. Dep h ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~ ............................. Rear ........ 6~ ............... Depth ..~J..~ ....... He~lht .................... Number of Stories ...... o~e ....................................................................................................... 9. Size of lot: Front ..&~3 .............. Rear ........ ~.,.~ ................ Depth ...... &~.~[..&2.~ ...... 10. Dar. of Purchase .......... ~9~.~ .................................... Name of Former Owner ...O.~.fd.~e...}[~l~.S ................... 1 1. Zon ~ or use district in which premises are situated ..~A~L....~.es ............................................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ....~ ................................................... ]3. Na~e of Owner of premises .,Zo~n..~a~ee.hi~ ....... Address .b.¢=2~.....216...8~..B~s~e No .................... Na~e of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM : L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensibns from property Ii ~es. Give street and block number or description according to deed and show street names and~ indicate whether in~erior or ca er ~.~t. --~-~ STATE OF NEW YORK, ~ c c ..~~ ................................... being duly sworn, deposes and says that he is the ~pplicant ~ lame of individual signing application) (Contractor, agent, corporate officer, etc.) of said owher or owners and is duly authorized to perform or have performed the said. work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and bJief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to b ~fore me this ture o{ opplic~nt) JUDITH T, BOKEfl