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Home My WebLink About3022-zFOEiVl lVO. 4 TOWN OF SOUTHOLD BUILDING DEPAHTMENT '1"OWN CLERK'S OFFICE SOUTHOLD, N. E:EI~TIFIP. ATE OF E}E:P. UPANP. Y No. Z..2b~.~ .... Date .................. J[llgtlg~. 3'"" 19'66 THIS CERTIFIES that the building located at ~/~ .~tR;~;~.Ba3 .]~/V~ .... Street lVi~91~.~...l~.~.gl~..~.$..Ig~ock No ............. Lot No. '33~ ...... $ou~;hol~ll~. :}~,.Y., ....... conforms substantially to the Applicati, on for Building Permit heretofore filed in this office dated ........... ~l'¢h...J~8.., 19~.. pursuant to which Building Permit No. 30p.. dated ............ ~lr'~h.2~-., 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 .. PI:i~ra*,e..olle.. fa~i~r, d,.tel~Allg ......................................... The certificate is issued t,o ...W~.l].i011t. ~ .(~l[Dolll~e..t.~l ........ Olelt/~.., .............. (owner, lessee or tenant) of the afores~aid building. .Suffolk County Department of Health Approval .. Allg{i[l~..~. '1~(3~'' 'b~t. '/rl~' ~i~.'~' · · · ....'. ...... :1 ........... Building 'Inspector~ FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTfiOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3022 z Permission is hereby granted to: to .~.~ .d....~..e.w....o.~.~.. ~ ~m~ ~Z..dw~.~,~L~: .................................................................................... at premises located at ...~.~...~,.....~a~'.hoz:..~g1:~tS ............................................ ' .......................... . .. ~ ~.~ a~..~m.e...?~,~.~ .......... ~.m~.t,h o,~.~ ......................... ] ............................ .,. pursuant to application dated ................................ ~,~.I.¢~ ........ m8 ..... 19..~-.., and approved by the Building Inspector O. O0 Fee ~,~ ...................... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. 3 t9¢ TO WHOM IT MAY CONCERN: at The sewage dispos.al facilities for a structure located ~ (Give deed location) ~z' have been inspected by this department and found to be satisfactory. District Englnee~ ~ District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Exam,ned ...... Approved ........................................ , 19 ........ Permit No ................................. Application No ............................. Disapproved o/c ......................... ;~.~ .............................................................. Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS , o. 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 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 o 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. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations./9. . ~' (Signatu~re of applicant, or name, if a corporation) ............. .................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) h se k '~ ~-~ 1. Location of land on which__propo d war will be done...~Map .No: ............................................ Lot No: ................. Street and Number ..... ~..~~.........~....~.'~ V Municipality ..... 2. State existing use and occupancy of pr~s and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ,,~...~ ..................................................................................... b. Intended use and occupancy ......... ~..-~... ........................................................................ 10. 11. 12. 13. Nat re of work (check which applicable): New Building ...... Addition .................. Alteration RepAir .................... Rernc~t~ .................... Demolition .......... ~ ....... Other Work (Describe) ........................ i ............. Es&ated Cost ................. l...¢.., ................................ Fee ...................................................... , ............. j ,/ (to be paid on filing this application), If i . d~welhng, number of dwelling units ...... ~.. .................. Number of dwelling units on each floor .............. i ............. If g~rage, number of cars .................~...~......¢.V....~., if I:jusiness,/ commercial or mixed occupancy, specify nature and extent of each type of use .................. i ............. Dimbnsions of existing structures, if any: Front ......'~. ................... Rear .......................... Depth .............. i ............. Heilht ............................ Number of Stories .................................................................................................. i ............. Dim~ensions of same structure with alterations or odditi6ns: Front ................................ Rear .................. ~ ............. Dep[h,~t .............................. Height .............................. Number of Stories ........................................ D.m~ns.ons of ent,re new construct.on. Front..~....~... ................ Rear ...~,~.....~.. ...... Depth ....... .~.......~... ........ Hei~lht ...,.7~. ................. Number of Stories .... ~.. .................... Sizelof lot: Front ..... [i..'~..~ ........ Rear ...~ ........... Depth ..ff....~....O. .................... DatA of Purchase .....~...~-~,~¢;...:....~....~.. ....................... Name of Former Owner ..'~.~...~...~.....~........~..4.~....~ ........... Zone or use d~str'c~t in which premises are situated ....~..-. ................................................ Doe Nar Nar Na~ proposed construction violate,,~nv zoning lawz~ordinance or regulation? ....~......,~ .......... ,,~..~.,..,~...~ ............ e of Owner of premises~ .~....'~... Addres~~-~2 ~ one , ~e of Architect ......................... ~ ........ .~...x....Address ..... .~..%' ................... ---'--.....Jl ...... Phone No .......i......~'x. ...... ,e of Contractor .~.~..~~.....Address ~~..~. ...... Phone No. ~...i...~...~. ................................................... ............................................. being ,duly sworn, deposes and says that he is the applicant qame of individual signing application) , above nor ed. He is the ........................................................................................................................................... i ............. (Contractor, agent, corporate officer, etc.) ; of said owoer or owners and is duly authorized to perform or have performed the said work and to make Jand file this applic~?tion; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wilt be performed in the manner set forth in/}he application filed therewith. Sworn ~b~fore me this-'-x ~ I/ , ' , ~, ,~ // ..... c~ ....... '~"~"'j..,Z_.,,wq /,7, ,_~,.~ ~, ,9 ~,___1 ......... day of ........~... ~b,,-.~ ............... , 19.~.~. ,~~~ .&.~ Notary ,S,gnature of opp,,cont) I 'J ~0. 52-3233120 Suf;d'4 [ ~Irrrl ~Expires Marcl~ 30, lr~'''1 STATE OF COUNTY NEW YORK, 1 S.S. DF ................................ PLOT DIAGRAM Locat clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensibns from prope~]ty liges. Give street and block numbers or description according to deed, and show street names and indicate whether in!erJor or corner lot,