The URL can be used to link to this page

Home My WebLink About3313-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P. ERTIFIP. ATE E)F OE:P. UPANP. Y No. Z 2879 Date .. OCto)~er 20 ,, 196.7.. THIS CERTIFIES that the building located at ~Ynlet Drive .& Central D~treet Map No. Ca~:-Ki~fock No. , 7C~X Lot No. 90 ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV..en~...~. I5, 19 66 pursuant to which Building Permit No. .3313[ Z dated Nov..emb~.r 15.., 19.6.6 , was ~ssued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is , . addition to. one./~amily, d~®lllnq ....................... The certificate is issued to . Sot:.e.r..i~., .AB~t~.~,s[$..-..!~]/1~ ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~.~. .................... TO~N 01: $OGTHOLD BUILDIN6 DIPARTMENT TOWN CL£RIC$ OFFICE SOUTHOLD, N. Y. N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3313 Z D~e ............................... ~...~.~..~,~...~ Permission is hereby granted to: .............. ~.~e..~;..~l~l..t .~a~.~ ..... ........................ ~u~.~,.~ ..,~..C~.. t~ ............. ................................... .~.~.t.~ ...................... ~ ~ addition on an at premises Io~ated -at ...~O.t,.....~..~,~..~Ll~..~l~l[~ll .................................................... ; ..... ....................... · ~,.~...~.. ~e~.. P:~..~ ...... ...~.~.~,t~,O~ ................................................ ~. ......... pursuant to application dated ....................... ~r.~l~]~Ul'.....~. ......., 19..~g~., and ap~pro~_,~ the Building Inspector. J:ee $ ..... ~.~ .~. ......... Buildin~ Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~...~.....~.. ..... 19..f...~. Approved ~'~C-'~'v'~="'~' ~ '~"'~ / :~ ~ ....................................... , 19 ........ Permit No ................................. Disapproved a/c .~ .......................... ^. LIC^TION FOR BU,LDIN Date.. I'L / INSTRUCTIONS o. This application must be completely filled m by typewriter or m ink and submitted in duplicate to the Buddin Inspector. b Plot plan showing location of lot and of buddings on premises, relationship to adjo,nmg premises or public streets areas, and gwmg 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 th~s apphcation, the Building Inspector wdl issue a Buzldmg Permit to the applicant. Suc permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or m part for any purpose whatever unhl a Certificate of Occupan, shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to fi Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, add~tzons or alterahons, or for removal or demolition, as herein descnbe~ The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. (S~gnature of applicant, or name, if a corporation) (Address of applicant) /7,1/)2'£/7'~&~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises .... ..~..~..~.~...~..../.~.....~d.~..q~.d~.~.......~....~..~...~..~..~...~..~ ...................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and t~tle of corporate officer) 1. Location of land on which proposed work will be done. Map No ............................................ Lot No: .....~..~.. ...... Street and Number .... .~..~..~.[......~/~..~. ....... ~ ."z,/.z'.~ ...... /'...~.. ................. Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Ex~sting use and occupancy ......... ~....~...~...~ ...... (...~:~...f/...~..~.F.~.~,&...~...~.~:~,~ .................................... .......... '' -- - .................................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Budding .................. Addihon ..1~,...... ....... Alteration ................. Repair .................... Removal .................... Demolihon .................... Other Work (Describe) ..................................... 4. Estimated Cost ...................... ..6...~.,:....-~.. .................... Fee ......................................................................................... (to be paid on fihng 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 ~pe of use ............................... 7. D~mens~ons of existing structures, if any: Front ..... ~ ................ Rear .......................... Depth ........................... ~9 ~~.: ............... Number of Stones ..~.~..~.~'__.L.~~ ~ ~. ......................................................... D~mens~ons of same structure w~th alterahons or additions- · Front ................................ Rear ............................... / ~ e Depth .~,~ ......~.~ .... He~t .........~. ................ N~ ~ of Stodes ........................................ ~ O~me~o~ of e~e ~ew co~s~chom ~o~t ............................ ~e~ ............................ Dep~ ........................... Height ..I~...~ ...... Number of Stor,es 9 S~ze of lot: Front ............................ Rear ..................... Depth ............................ 10 Date of Purchase ...... ~.~.~.~. ...............Name of Former ~ner .~.~...~.~.~.~.~ ......... 11. Zone or use district m whi~ premises are s~tuated ..... ~....L ............................................................................. 12. Does proposed construction wolate any zomng law, ordinance or regulation? ....... N~me ~[ Architect ...................................................... Address ............................................ Phone No ................... Name ~[ Contractor .................................................... Add~ess ............................................ ~hone No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, 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 names and ind~cat whether interior or corner lot. ~10;- 0 ;~ STATE OF NEW Yf~/-.,~,,.~'..~. 1 S S COUNTY OF ......... / '- ...................... ~..~~ ................ being duly sworn, deposes and says that he ~s the applio (Name of individual signing application) above homed. He is the ............... ~. ;: ....................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s apphcation, that all statements contained in this applicahon ore true to the best of his knowledge and bali and that the work w~ll be performed in the manner set forth in the apphcation filed therewith. Sworntobeforemeth,s /~/~'~ ~:~Co .................. ./....~. day of .................................................... . ................... Notary Public, . ........................................................... County (S~gnature of applicant)