The URL can be used to link to this page

Home My WebLink About3308-zFOI~ I~TOo 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFIP. ATE: rIF EICP. UI:AN5Y No..Z. 26t[6... Date .......... 1}i~lki,~iX;~r' · · · 23 ..... 19. THIS CERTIFIES that the building located at .. E/S..-]~i].ey-tkve ......... Street Map No.' ~1~t: ........ Block No ...... j~ .... Lot No..~ ..... fil*OOl'llS0~t;~' 'I~;~;, ...... conforms substantially to the Application for Building Permit heretof, ere filed in this office dated ........ l~{rreltrbe~"7"', 1986' pursuant to which Building Permit No. 21308'Z' dated ......... l~o~rellIi0~l*' '10, 19'6~, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The occupancy for which this certificate is issued is P~.'g~e' ~ax'~g~f · ( ~'~c~'~oX*y' ~fx~ ~'tig) ................................ The certificate is issued to F1,~ E.~ 'tI~q. se-JT ...... Owh~ .......................... -- (owner, l~essee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ~t~ ........................... ~Q~'~ Inspector Building 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 T?.E WORK AUTHORIZED) N? 3308 Z Permission is hereby granted to: l~z'ed Hulse I~:~.le,~. Ave ............................... ~r..o.~. ........................... to .... ~.,~l...~r~..~,~l;l,~,~a..oa.. au.. e,x.l,-~ ~tla&..ae.c aa so.~...bu., lzl~u~ .......................... at premises located at ..~. ,/.~.......~....~..]-...e.~'....A..,v.e. ...................................................................... ; ................ .......................................... Gz~eez~p~r~..t..~I. ~ o .................................................................................. pursuant to application dated .............................. ~D.~ZeI~.bP-,.~.....7...., lC~...., and approved by the Building Inspector. Fee ~..?.**.0~., ............... ....... -:~,~..i ; ....... ~...~..~ ......... Building Inspector J FOI~M ~0. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........... ~.....~...?... .... 19...~....~. Approved ........................................ , 19 ........ Permit No .....~....~..~ ~ ~ D~sapp roved a/c .............................................. Application No, ~ ) O ~ APPLICATION FOR BUILDING PERMIT Date ............................... No.v. embe~ .....~.., 19..6~ .... INSTRUCTIONS o. Th~s application must be completely filled m by typewriter or in mk and submitted in duplicate to the Building Inspector. b Plot plan showing location of lot and of buddings on premises, relat,onsh~p to adjoining premises or public streets o, areas, and giwng a detmled descnphon of layout of propertymust be drawn on the d~agram 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 th~s application, the Budding Inspector will issue a Building Permit to the applicant. Suc[ permit shall be kept on the premises ova.laNe for ~nspect~on throughout the progress of the work. e No budding shall be occupied or used in whole or In part For any purpose whatever until a Certificate of Occuponm, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE 1o the Building Department for the fssuance of a Building Permft pursuant to th, Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulotmns, for the construction of buildings, additions or alterot.ons, or for removal or demolition, as herein described The apphcant agrees to comply w~th oil apphcoble laws, ordinances, building code and regulations. (S~gnature of applicant, or name, if a corporation) ..... ~i le.F...A.v.e., ..... .Q~.e~gor.~ ...................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..................................................... g.~.~:....-.., hn_~l ~le r ........................................................................................................ Name of owner of premises ....~...r..e.~....~..:....~...q~.~..e.....~.~ .......................................................................................................... if applicant ~s 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 ..~/.~....J~k~l~.~...~,Tc.e,~ ..... g.~f~.fl~pDZ~.~...~.,.~., .................................................................... Mumc~pa/ity 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ......... D.~e3.~,J~...~...~z.t..g~'~ ................................................................... b Intended use and occupancy ........... ~.~...~..~.~...~P...~ ............................................................... 3. Nature of work (check which applicable). New Building .................. Addition .................. Alteration ................. Repair .................... Removal .................... Demohtion .................... Other Work (Describe) ..................................... 4. Estimated Cost ....... ...~...~.....~.. ................................. Fee ..~....~.~.Q0 ......................................................................... (to be paid on filing this application) 5. If dwelhng, number of dwelling un,ts ............................ Number of dwelling units on each floor ........................... If garage, number of cars ....... o~O...to...¢~O ........................................................................................................... 6, If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. D~mens~ons of ex~sting structures, if any: Front .......................... Rear .......................... Depth ........................... Height .......................... Number of Stories .............................................................................................................. D~mens~ons of same structure w~th alterations or addmons: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mens~ons of entire new construction: Front ............................Rear ............................ Depth ........................... Height ........................... Number of Stories ............................ 9. S~ze of lot. Front ............. ,~.0. .......... Rear .............. ~.0. ......... Depth ....... -'[.l~.0 .................. 10 Dote of Purchase ........................................................ Name of Former Owner ...................................................... 11 Zone or use distr~ct m which premises are s~tuoted ..... ~..c't.J~.~ .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation~ ...... 2ZO ......................................... 13 Name of Owner of premises ..... F.,Z].o~IZ~3.$o...oT.:V ...... Address ....~.~.ezt. p~.i~d; .................. Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ............ $~,mo_, .............................. Address ............................................ I~one No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buddings, whether ex~sting or proposed, and indicate oil set-back d~mens~ons fror property hnes G~ve street and block numbers or description according to deed, and show street names and ,nd~cat whether ~nterior or corner lot. STATE OF NEW YORK, .}~ S.S. COUNTY OF .... ~L~t££ o3~ ........ 12-- ......................... ~'.~f~j:t.,...~l:uTuso...Z~ ...................................... be,ng duly sworn, deposes and says that he is the applic~ (Name of indmdual s~gning application) above named. He is the ................ 0~.ne.~. ..... ~u&.l. cle. z~ ................................................................................................. (Contractor, agent, corporate officer, etc.) of said 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 in this application are true to the best of his knowledge and beh and that the work will be performed in the manner set forth in the apphcat~on filed therewith. Sworn to before me this .................. t...o., day of ............... ......... , ,c, . ,,-- ........ .................................... -7... Notary Pubhc,/.J....)il_~..~0'~......~..:...I.~.. Co,,u?t¥: ~ .':z~;~ . . (S~gnature of applicant) ~ ~ bio. 52-32a~;-~,) Suu,.I~ L'3Lhtd Term Expires ~arch 30,