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Home My WebLink About3032-zFOR1R 1~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~'OWN CLERK'S OFFICE SOUTHOLD, N. Y. E:EN[TIFIP. ATE OF OOP. UPAN[IY No. Z..2632 .... Date .......... THIS CERTIFIES that the building located at t~/~...k~y. Ito~e~ .Road ....... Street Ma~;~O.l?..P.O. .i.l~.t~... Block No ............. Lot No. 1.9. ~...~. {).ll~h.O.~ql4.. ~.,.~., ........... conforms substantially to the Application [or Building Permit heretof, o~e filed in this office dated .......... l~la.y~h... '3'~'", 19~6' pu.rsuant to which Building Permit No. dated ........... l~la~o!~...3~..., 19.66., was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. The .occupancy f. or which this certificate is issued is . .. l~ri.v, ate .or~ · f~ni. ly. ~iwe.~.li. ng ........................................ The certificate is issued t.o ...Bl~ekor. C~r~t~t~¢~c.t~}9, .Co..tho ...... ~r~l, ....... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval .. ~tXg.~.. ~. TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN CLER~('$ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FU~L COMPLETION OF THE WORK AUTHORIZED) N? 3 0 3 2 z Date ......................... .~.~.~ ....... 3.1. .......... , 19_~ Permission is hereby granted to: ........ · 2&....~euCkdo~.,it~ .............................. to .,.~iTd,,,ne~..onw .,~Tiy ..~Tl~n~. ............................................... at premises located at ........5G~..i.~....,~O~]..~l~?.~E...,~.}!~.O~..,~t~ ......................... ...................... ~/~" '" ~y ' '~'~" ~0~ ....... 8'o~h~l~'~"'N~T~ ....................................................... pursuant to application dated .................................. ~a,~.....]~ ..... ]9...~, and approved by the Building Inspector Fee $'"'~)'~-8(~ ........ SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date , , Bldg. Permit No. ~Ck~ 2- TO WHOM IT MAT CONCERN: The sewage disposal facilities for ~a structure located at - -~ ' ~ / ~ve deed i~oation) // have been inspected by this Department and found to be satisfactory. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ......... Approved ~L 19 ........ Permit No. Application No....?..~....~,.., .Z'T~/.. ....... Disapproved a/c ................. ~---~. ........................................................... (Building l~pector) APPLICATION FOR BUILDING PERMIT 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 ~he Building Zone Ordinance of the Town of Sauthold, Suffolk County, New York, and other applicable Laws, Ordinances or Ragu at ons for the construction of buildings additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comp y w th all applicable laws, ordinances, bui ding code and regu arians. (Signature of applicant, or name, if o corporation) ....... 126.....S. authdown..Rd.~..... Huntiag.ton ................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................. .o,,,'o,.~.ac.~ or. .............................................................................................................................. Nome of owner of premises ..... .~...]:.9.e..~...e.~....C..o..~b.'%~.~O..~io;~ C.O. Inf~ .......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Pz'oposed ma]:) of 1. Location of land on which proposed work will be done..Map No.: .~J,.],]...o.w..~.~J, t3.~. .......... Lot No.: ...... ]L~ ............. Street and Number ..~:/~..]~a~...];T.a~a..D.o~d.t.....~o~th~lc~......~T.,.~Z,I ............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .Y. fLO.~Y.:.l;..].a~ ....................................................................................................... b. Intended use and occupancy ....... one..~.amJ~3..~...c~we.13:~ ............................................................................. 3. Not+re of work (check which applicable): New Building ...:Z,lr,~,~ ..... Addition .................. Alteration .................. Repc~ir .................. Removal .................. Demolition .................. Other Work (Describe) ........................... 4. Estir~ated Cost ......I~J~OO..P/~ ............................. Fee .,.,~Q,~. .............................................................................. j (to be paid on filing this application) 5. If d~,elling, number of dwelling units ...~I~ .................Number of dwelling units on each floor If g~. rage, number of cars ............ t,%/~ ............................................................................................................ : ............. 6. If b'uslness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. D re.lens ohs of ex st ng structures, f any Front ............................ Rear ................................ Depth .......... i ......... Height ........................ Number of Stories .................................................................................................................. D~mens~ons of same structure with alterations or additions: Front Rear . . . Depth ................................ Height ............................ Number of Stories ................................ 8. Dim.lensions of entire new construction: Front ...69..-.10 .................... Rear ...... ~,9~i1~ ......... Depth .2.~,~....~..~ Height' .................... Number of Stories .... II:~lt~. ............................................................................................ i .............. 9. Sizejof lot: Front ...12~. ................. Rear .............. I~.O..P/. ....... Depth ..... 12.0/....9.~...1P~... 10. Dat.~ of Purchase .................. 1~5. ........................... Name of Former Owner ...... ..~.~..S.~l....~.?.....~.§.~.~.~...i ............. 11. Zonb or use district in which premises are situated ....".A."....d:~lt, ...................................................................... . ........ 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ........ ~ ................................. 13. NarCo of Owner of premises ....~]-/2f~;~_.(].Ql~.t,....Address ............................................ Phone No .......i .............. Na~e of Architect ...................................................... Address ............................................ Phone No ....... .............. Na~e of Contractor *]'~J~.~,Oh~l~'fl. lll ..................... Address ......... Hl~'~.t,:J.r~lg.t, or~ .......... Phone No ..................... 'PLOT DIAGRAM L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property li~es. Give street and block number Or description according to de~d, and 'show street names andj indicate STATE OFi NEW v, CDRLC...-- '~ c c COUNTY ~DF ...... ~..~..O...~..~. ......... )' ~.~. ................. i .............. n~.~[:..,~,.~,~ ................................. be nD duly sworn, deposes and says that he is the applicant ~Name of individual signing~o~application) , ._J above named. He is the ............ ..................................................................................................... .............. i : (Contractor, agent, corporate officer, etc.) j of said owher or owners, and s duly authorized to perform or have performed the said work and to mokejand file this oppHc~tlon; that all statements contained in this application are true to the best of his knowledge and belief; and that the wgrk will be performed in the manner set forth in the~lication filed therewith, t Sworn to b~fore me this ~ '~ ~ ~ ~ ~ ................ .......... : ......... L I)_ j ('/ .. ~../ ..--- /;~ .,,.' ~ , ........ ~...~.~.~., .............. Notary Pu~lic,/~Z~f;dk~.~.4~:r...:~/;;.~f:~.;:~C~u~ty / I (Signature of applicant) No 2 ~344963 SU lolk gounW~ ~, ' ' j -- ~ ,