The URL can be used to link to this page

Home My WebLink About3023-zTOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I~I:'I~TII:'IP. AT£ BI= ~IiII~UPANI~¥ THIS CERTIFIES that the building located at ...tteabe. I):r£~O .............. Street 14oose Cove Map No ............. Block No ..... ~ ...... Lot No.19.~.... ~.gt....C.~.~..e.b..o.g¢..e.,..~.,..~.~.... conl~orms substantially to the Application for Building Permit heretof, ove filed in this office dated ............ .it.ar.e.g.. ~.., 19.~.~. pursuant to which Building Permit No. ~IQ~ .$. dated ............ ~{tJ[:~t%...~ 19.~.~.., was issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The .occupancy ~or which this certificate is issued is . .P. ~.v.~.~.0. PX~0..~J~l~'..qll~'.o. lli:I3~g ......................................... The certificate is issued to .... .Bg.b.0~'.~.. ~.~.h~.o,~...d.o. lp ................................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval 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? 3023 z Permission is hereby granted to: at premises located at 4~O~'""'~'~'""~OOB~"~e':-? .............. ?'..".: ................. ; ............. t ................ ............................. ~/~:.....~*,~b,..~r,;..; Cu~h*~a~,.....~.Z~ ...... :: ...... pursuant to application dated .,; ........ ,;.: ....... ',,..-'..,,:.~.a~,Oh.,~,~.~;..., 19~ ..... and approved by the Building inspectoF Fee $..~.O,O0......Z.. .......~..~ .f.~.';~...~ ..z~,..~:.:.;:. r. ..................... .,4, ........ ............... ; · Building Inspector Slr~FOLK COUNT~ DEPAgrMENT OF HEALT~ Date TO WHoM IT MAY CONCERN: The sewage disposal facilities for a structure located at - (G~ve de~d locaSion) ~ have been inepeoted by this Department and found to be satisfac%ory. District Engineer District Engineer FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Exami,ed Approved ........................................ , 19 ........ Permit No. O . (Building Inspel;tor) Applicmion No. ~ APPLICATION FOR BUILDING PE~,MIT Date .......................................... , t9 ............ 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 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. ........ i'~i '~ 'r; 'c~"~ '~~:' '~ ~' ~~ 'r'l~'~ 'r'~'(i'~'~i ......... ~ (Address of appli~'"'~' State whether applicant is owner, lessee, agent, architect, engine,e~ general contractor, electrician, plumber or builder. Name of owner of premises .................~.~.~..~ ............ ~~.F. ....................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed wor, k will be done..Map No.: ...~......~..~..,, ..... Lot No.: ..:....~..~?. ............ Street and Number .:...~...'=~.¢. ,.~-:7F)¢ ......................................... ...~..~..~ Municipally,' ..................................... 2.State existing use end occupancy of premises and intended¥~s.e and occupancy of proposed construction: b. Intended use and occupancy ................................................................................................................................. 3. Noblre of work (check which applicable): New Building .................. Addition .................. Alteration Rep( ir .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Esti ~ated Cast ..................... ./..'~..~.~ ........................... Fee .......................................................................................... (to be paid on filing this application) 5. If d'vel[ing, number of dwelling units .................. ~ ....... Number of dwelling units on each floor ' If gTrage, number of cars ............................................................................................................................... ! ............. 6. If b[usiness,·commercial or mixed occupancy, specify nature and extent of each type of use .............. ; ............. 7. Dim~ensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .......... ~ ......... Hei~hth ........................ Number af Stories ..................................................................................................... .= ............. Dimensions of same structure with alterations or additions: Front ....................................Rear .............. , ............. Depth ................................ Height ............................ Number of Stories ................................ / ?/ / /? 8. Dir~ msions of entire new construction: Front ......... ~..~....~. .......... Rear .....~.~..~......~ ......... Depth Hei ht ........ ./..~. ........ Number of Stories ................... ./. ........................................................................ 9. Size of lot: Front ......... /.~.(~. ............. Rear ............ /.~.~... .............. Depth ................................ 10. Dot of Purchase ........................................................ Nome of Former Owner ....... ....... f ............. 11. Zor , or use district in which premises are situated ..................................................................................................... 12. Doe proposed construction violat,~a9)f zo,qin, g law/~ordinance or regulation? ........ ~ ............................... L ............. 13. Nar',e of Owner of premises ......~_~..~.'~..Addres, .~...~...~Phone No ....... ~ ............. Namle/ of Architect .......................... ~/~,1///.~'4 ........................ Address ................/'"// ~//~, ......x~....¢-.~..~ ...... Phone No Nar~e of Contractor ,~,~.x,~....~...~ ..................... Address .~..~.....~...~....~.~....'~ Phone No ....... : .............. / I PLOT DIAGRAM L.ocat~ clearly and distinctly all buildings whether existing or proposed, and indicate all set-back dimensions from property li'nes. Give street and block number descriptio~ a~ccording to deed and show street names andl indicate whether in~erior or corner at. ~-~--~-~ / STATE Of NEW~ORI~,/ COUNTY OF ................... )' .... ..... j.~.-......~ .................................... bei~ duly sworn, deposes and says that he isthe.applicant I(Name 6f individual signing application) abow~ nar~ed. He is the .......................................... ~~ ........................................................................ ~ .............. (Contractor, agent, corporate officer, etc.)~ of said ay ner or owners, and is duly authorized to perform or have performed the said work and to make] and file this applk arian; that all statements contained in this application are ~rue to the best of his knowledge and bblief; and that the ~)rk will be performed in the manner set forth in the application filed therewith. Sworn to ~ef~e this ....... , ....... ........... , ............................... ......... Notary P~blic~~.~.Z~ C~nt~ / ~ ~ (Signatur~of applicant)