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Home My WebLink About3030-z TOWN OF SOUT~OLD BUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N. :ERTIFII::::ATI~ OF DP.P-UPANCY No..~.. ~..~..~ .... Date ................. THIS CERTIFIES that the building located at .~/*S.. lleep .l~o:],~...I)1~ ....... Street Map No...:X~: ....... Block No. ;X~ ......... Lot N~ ..... ~I~;~;~,~;~l~ ................. conforms substantially to the Application for Building I~ermit heretofore filed in this office dated ............. }:{AR0~..~.~., 19. ~6 pu~rsuant to which Building Permit No...~0~0. dated .............. ],~a,Y~lq...2.~ 19.~, 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 .... l~]2~,Va.~e. Ol~e. £e~ly..cl~la~Ll~L~ag. ....................................... The certificate is issued t,o . .~;e.Ol~...OSI~I~O .......... O~P,~ ........... , ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Appv, oval ...~'d~l,~ .... ~].~ .1966...b~.R~ ,Villa, FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLER~('S OFFIC[ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3030 z Permission is hereby granted to: Place As soe~.t e~..A/e,.....~ee~.. C~u.J~.~ ........................ ....... .t t.3 f~..~¢,... ~,~a.S~...~ ¢ .................................... Ri.v*~,~ ~....(.%, ~., ............. to ]~u&t~, ~e~ ~ne .2~.y d~e~..~i~g ................................ at premises located at ...~/.~.....~ee4~&~,.-~.~.~e.¢.....~_e~.~c.~..&.~ ................................................. pursuant to application dated ........................... ]:'~4~¢~ .......~k~ .......... 1¢2~(~..., and approved by the Building Inspector Fee $iO..OD ........... o u ilo i n~.- l¥1~'lbi~ c f~r¢I FOEM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ....... Approved ................... ~...~.,.. ............ , 19...Y.!.. Permit No. ........ ~), ...... 3.............~) Z_,.---- Disapproved a/c ,,-'~"~- ~ ~_~i '~'"~V/~'-- (Bu~ldm Inspector) Application No....'~..~..q~...~ ............ APPLICATION FOR BUILDING PERMIT Date ...... ·., .~., .'~../~-C~.~.~.. ~ · · .~.. ..................... , 19 ~..~. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to thc 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 occ~upied 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. .... ........................... .~. ~....~_~..... ~/~?.~Z¢~'~....~. ~.¢.: (Address of applicant) 7' ........ State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ...... ~./.Z,/~.~~. ................................................................................................................................................................... Name of owner of premises ...~.~..Z../........~...~..~'.~z~;~.~..~..* ..................................................................................................... If a'~DLicant i~s ~:~rp~e, sj~atu~k, of dul/~/uthorized officer. ~ ~ (Name on~it~rP;L~t}°~ficer)~ ]. Location of land on whickered work will be done. Map No.~]~.~~o.: ....~ ............... s~ ~.d .umber .... ~5~./~'~....~' ............... ~.~Z¢~J ...... Z~::~: ................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ...~.,......~-~ .... ............ ,-~.y. ............................................. 10. 11. 12. 13. Na~ Na~ I~ocat property ~ whether in Nat ~re of work (check which applicable): New Building : ................. Addition .................. Alteration ..... ! ............. Rep,~ir .................. ~emoval .................. Demolition .................. Other Work (Describe) ........................... . ............. Estit ~ated Cast ............ ~....~........~...~. ............................. Fee ..... ' ....................................................................... ~ ............. , (fo be paid on filing this application) ff d~ellmo, numbor of dwellino units ........................ ~umbor o~ dwellin~ unit~ on eoch floor .......................... I{ ~roOo, number o{ cots ........... of lot' trent /~ ... Rear ~. Depth Zon, or uso district in which premisos or* situotod ........ ~:~.(~~ ......... ~.} ................................... 1 .............. Do~ proposed construction violoto~ z~_~ ,/~nY zonin0 I~w[ ordinance o[X -~ ~/. /, ~ ~~reOu~°fi°n? ..... ~ ...................... ' .......... " ............. ,e of Architect ~r/~[....~JJ~(~[(~ ............ Address ZZ4~.~.ffJ~Z~(~ ...... Phone N7~(~5 ...... of .......... PLOT DIAGRAM~~ ~ ~ clearly and distinctly all buildings, whether existing or proposed, and Jndicfe all set-back dimensibns from nes. Give street and block number or description according to deed, and show street names and red,cate ~erior or corner lot. STATE OF; NEW. YORJ(,, , } S S COUNTY DF ,J~,../E..J..-.'~f../.b .......... .f '' .~.~..~..~.....~.......L..~...~....~.,4¢)..~ .............................. being duly sworn, deposes and says that he is the bpplicant Name of individual signi~ng application) ~ above nan ed. He is the ............. r~..~..¢.x.t..~.¢.,',., .~.. ...................................................................................... : ........................ (Contractor, agent, corporate officer, etc.) of said o~er or owners, and is duly authorized to perform or have performed the said work and to make: and file this applic ~tion; that all statements contained in this application are true to the best of his knowledge and belief; and that the w, ~rk will be performed in the manner set forth in the applic~ti~' filed ,tl~ermyith. [ Sworn to b ;fore me this _ /// / ,/// ..... ,-,,~....,~.~... day of ..:.~.¢'2..?,,/.42.~.¢~..~. .................... , 19.~."~' '~ E ~/,~ Z-~ ,-,,,/_~-- : i ,q / ...... ............................. ; .............. Notary Public, .~././.~.~...~.../...~..-*~..~! ..............Count rf/,~-/~o ~ / (Signat~a/e of applicant) - · / J'~OTARY pUBLiC, state OJ ~eW .u,~ y..~z/f,~:/,~ ,~/.,.. / t~g p J No. 52.1413725 w-' qu~litJea m Su~ot~ County ,Term Expires March 30, 1~ O= PIPE 300.00! 'TO RICHARD MaP O=STAKE B=MONUMENT OF DEEP HOLE S.30°IV20'E. E N.30°II'20~W. DEEP ' CREEK HOLE ESTATES 72.00; I STORY FRAME H OUS'E 20.00~ ~ d 1,40~ 142~ DRIVE J20.00~ FINAL LOCATION 6 - 22-66 FOUNDATION LOCATION 4 - 16-66 GUARANTEED TO SECURITY NATIONAL BANK GUARANTEED TITLE DIV.-AMERICAN TITLE IN ,~. CO. MAP OF LAND LOCATEDAT MATTITUCK ZEON CZUJ KO '~-'~'"-~u¢~7, ,,~.'1~''!:-~'-~-6. .,, -2D, GEORG~E 4 ...... L~wkJ~