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Home My WebLink About3046-zFOB~V~ 1~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y, nERTIFIEATE nF Ol3nUPANEY THIS CERTIFIES that the building located at .I~I/l~ .l~get'l. A.V.a ............ Street Map No..XXX ....... Block No. ~ ....... Lot No..XX~ ..... lVla. i;tl.t;ll(~lllt· }~o¥, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... A~r.il...1~ .... 19.66 pursu'ant to which Building Permit No..301~6..7, dated .............. AI>I~ilL..8- 19.66., was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .o.ccupancy for which this certificate is issued is . ?.~lva.'~e. ~e..£aiM'liy. flw~l.]:in'g .......................................... The certificate is issued to ...JOsogh. kli~be~ke ........... 0l;r~e~ .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... ~.,1~1~ ................................ FO~I~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~CE SQUTHOLD, N. Y. N? ' 'r BUILDING PERMIT ,;,;' (THIS/PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL / COMPLETION OF THE WORK AUTHORIZED) Permission i~ ~ereby granted to: pursuant to applicotionl~lated .......................... ~,~.~ ......... 8 ...... ,~., ~..66., and approved by the Building Inspector ~ Fee $..~.,?.~ ............ ; TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~....~...., 19,,,.,,,. Approved ........................................ , 19.~! ..... Permit No ............................. Application No. ~ 6 ~f ~ Disapproved a/c ...................................................................................... ..... : ..................... ................................. APPLICATION FOR BUILDING PERMIT Oote ....................... ....... .8. ............... , ....... 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 opprovat 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 1S 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 rernoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. Irwin Tuthill (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, eng?neer, general contractor, electrician, plumber or builder. ........................................................... .Q~tr. ~c.t. or .............................................................................................................. Name of owner of premises ..... J.c se. k..Wier.be.cke. ........................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which 'proposed work will be done. Map No.: ....Z¥..~-,,_,_,_,_,_,_,~C .............................. Lot No.: .~....~. .................. Street and Number ..... ~e~.~e~....&~.....Ma~.tl.tuc~ ........................................................................................ Municipality 2. State existing use and occupancy of premises ond in~ended use and occupancy of proposed c~nstruction: a. Existing use and occupancy ......... ~,~6.~.~ ....................................................................................................... b. Intended use and occupancy ............... .~.~.~...e.....~..J:...t.~...~p...~..d.~..~.~..o..l~. ................................................................ 3. NatUre of work (check which applicable): New Building .................. Addition .....;x,~... Alteration .....: ............. Repc~ir .................. Removal .................. Demolition .................. Other Work (Describe) ........................... i ............ [ (to be paid on filing this application) 5. If d~velling, number of dwelling units ............ .O,,qf~ ......... Number of dwelling units on each f o~or .............. If g~rage, number of cars ............................................................................................................................... ~ ............. 6. If ~usiness,-I'· commercial or mixed occupancy, specify nature and extent of each type of use .............. , ............. 7, Dimensions of ex st ng structures, if any Front ............................ Rear ................................ Depth .......... i ......... He~g. ht ........................ Number of Stories .................................................................................................... ' ............. Dim.~nsions of same structure with alterations or additions: Front .................................... Rear ............................ DePth ................................ Height ............................ Number of Stories ................................ 8. Dim'ensions of entire new construction: Front ......... ~.0 ...................... Rear ........ 2~). ............... Depth].~,......i ............. Height .................... Number of Stories ..... .QZte. ......................................................................................................... 9. Siz.elof lot: Front ............ ~.~.1~.~ ...... Rear .................................... Depth ................................ 10. Dat~ of Purchase ........................................................ Name of Former Owner .......................................... : ............. 11. Zon,ie or use district in which premises are situated ............ ~.~.A.~.l...d.~.,s.t, ...................................................................... 12. Does proposed consttucbon violate any zoning law, ordinance or regulation? .............. ~. ......................................... 13. Nar~e of Owner of premises~.~...~/;J, ftZ'.~f~.O,k-1. ............ Address ........ H_e.t:.t~J.~zl.a~c .............. Phone No .......i .............. Nar~e of Architect ...................................................... Address ............................................ Phone No ..................... Nar~e of Contractor ...... Zz'.~J~...~.tz~Jt£]..]. .............. Address ........ ~,.'b$.'~tt~ .............. Phone No ..................... I PLOT DIAGRAM ' I.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. ~ive street and block number or description according to deed, and shew street names andI indicate whether in~ erior or corner lot. STATE OF NEW YORK ~SS COUNTY ~OF ....... ~'~._f:.~4)~. ....... .~ ' ' ........... ]~J.~.. Z.Lt.t;hJ..I~ ............ be ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above na~ed. He is the ....... ~.~.~.9.~.9.~ ........................................................................................................... ~ .............. ~ (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make] and file this application; that all statements contained in this application~ true to the best of his knowledge and belief; and that the wprk will be performed in the manner set forth in the application filed therewith. Sworn to ~efore me this ................ ..... of .......................... Notary P~blic, ~~.~.~...~.~.~County, .~ ~ .... (Stgna~re' of a~pliE~t) '