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Home My WebLink About3323-zTOWN OF SOUTHOLD BUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD. N. Y. P. ERTIFI~ATE i-iF E} E: E: U PA N P. Y No..4.2~.~... Date ................ THIS CERTIFIES that the building located at ~/J~.. ]~.L~lll;. ~af~e ......... Street Map No. ~ ........ Block No..~ ....... Lot No. :~:g~...~.~;~;l.t;~lc! .. ~,~., ...... conforms substantially ~o the Application for Building Permit heretof, o~e filed in this office dated ............ ~C~,...21..., 19456. pursuant to which Building Permit No. 3~,~3..Z.. dated ............. ~V,...~i..., 19.~, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . A(~¢~9(~Z"~r. 3~l~il.(lir~g..(priva.te..sl;o~age. b.l. dg..~'~l~..~wne~) .......... The certificate is issued to .~',~,. ~aphte. We~l~ ........... Ownel, ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .1~.~]~ ........................... Building Inspector \ FOP, lVl NO. ~ 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? 3323 Z Dine ........................... .Na~ba,T..21., 19..6~. Permission is hereby granted to: ............... ~,r.,s....~.~..h..~ .o....~.e.,~.~. .......................... ............................. ~/a-ttl. tuek ............................. at premises lacated at ..W~.lL..Ji~Zmzt..~l.a~e ................................................................................. .................................................... ~t~ek,..l~.,¥., ....................................................................... pursuant to application dated ............................... ~..0.~,~...~,,], .......... ~,~ 19 ........ , and approved by the Building Inspector. Fee $...~...Q.O. ........... · . b I~O~IV~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~pproved ........................................ , ]9 ........ Per, it ~o ................ D~sop~roved o/c ..~ ........... Application No ........................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o Th~s apphcat~on must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and gwmg a detaded description of layout of propertymust be drawn on the diagram which is part of this application c The work covered by th~s opphcation may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Suci permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used m whole or m part Far any purpose whatever untd a Certificate of Occupanc~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE lo the Budding Department for the issuance of a Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the censtruction of buildings, additions or alterations, or for removal or demolition, as herein described. The opphcant agrees to comply w~th all applicable laws, ordinances, budding code and regulations. Mrs Sophie Wells (Signature of opplic(~nt, or name, if a corporohon) Walnut Place Mattituck (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... .0. ,W.~ .~,~. ............................................ Nome of owner of premises ..}/!..Z'..s.....~..o.~..~..~...e.....~..e...1.~.s. ............................................................................................................. If applicant ~s 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: .......... ..]~.....]~... ........................ Lot No: ....~ .......... Street and Number ~'~,S... ~.a~-~t..P-laq~ .... ~3,~.~.:;J..~f~...~.:~... ........ ] ......................................... Mumcipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ..d..w..e,..]:..1...i..~.~, ........................................................................................ ~ ............. b, Intended use and occupancy ............. ~1~.~:L~`Q.~.~$~Q~.~(~`Q~'S`.t`~Q~.a.~[~e~e'~~ ....... property hnes. Give street whether ~ntenor or _corner 3 Nature of work (check which applicable): New Building ...~ ..... Addition ................. Alteration ................. Repair .................... Removal .................... Dernolit~on .................... Other Work (Describe) ..................................... 4. Estimated Cost .... $,~.QD. .............................................. Fee ..... .~.~0~t .......................................................................... (to be paid on filing th~s application) 5. If dwelhng, number of dwelling units ............................ Number of dwelling units on each floor ........................... If garage, number of cars .......................................................................................................................................... 6. If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D~mens~ons of existing structures, if any. Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure w~th alterations or ad¢itions: Front ................................ Rear ............................... Depth ............................. Height .............................. Number of Stones ........................................ 8. Dimensions of entire new construction: Front ....... cJ.-..6 .............. Rear ............. .9'-~ ....... Depth ....l(~> ............. Height ............................ Number of Stones .... .o...~.~. ................ 9. S~ze of lot' Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ..... ~'~.~;.~.e.¢,..~-~ ..................... 11. Zone or use d~stnct m which premises are s~tuated ......... ~,..cl..~.~.t, ........................................................................ 12 Does proposed construction wolate any zomng law, ordinance or regulahon? .......... :~0 ....................................... 13 Name of Owner of premises .~.q.'p.~,~,~....~ft,~,~& .......... Address .....~,J~.ti.~tc~ ................. Phone No .................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor ..... ~sa~e ................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~stmg or proposed, and indicate all set-back dimensions fror ~nd block numbers or descnptio~ according to deed, and show street names and ind~cat STATE OF NEW ~.ORK, COUNTY OF ...... .~O~J~ ......... 1 S S ............................. ~O~J~..~.eZb].S. .................. : ................ being duly sworn, deposes and says that he is the applica (Name of individual signing app ~cation} above named He is the .................... ..o...~....e.?.. ..................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f th~s apphcat~on; that all statements contained in th~s apphcahon are true to the best of his knowledge and bell: and that the work wdl be performed in the manner set forth ~n the apphcation filed therewith. Sworn tobefore methis ~'~'"~""~ E/ ...~.;~.~ ............... ..2..].. .... day of ................. ,~.~.embe,~ ......., 19....66 '- ~ Notary Pubhc, .. County/~,.~c~ ' (Signature ot appdcant) ¢ommlsslon £xp~re~ ~arc, h ~,0,