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Home My WebLink About3057-zFORM NO. 4- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFIP, ATE ElF EIP. P. UPANBY No. 2~ .2839 .... Date ............ SeloterabeI'.. 8., 19. t57 THIS CERTIFIES that the buildin~ located at .~./$. ¢~ .Un. d..D~,$~¢~ ......... Street lV~ E~S%e:en Shoz'e~lock .... ap t~o ........... - No ..... 8e¢..~.V.Lot No. ~1,0.¢ ..... O .e.e. nl Oa ,.~t.,.y,. conforms substantially to the Applieation for Building Permit heretofore filed in this office dated ........ Ap~i%.. :[8..., 19.66. pursuant to which Building Permit No..30~7. 2g dated ......... .April.. 16..., 19.66, 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 Private, one. £amily..dwelling ........................................ The certificate is issued to . .I%i.e..l~.a¢~ ........ 0~rttel~ .................. .. .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ~.epg. 20,. 19.66. b7 .It,..V.&lla. Building Inspector / FO~FI ~0. ~ 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? 3057 z Permission is hereby granted to: ~a.~...&.,.~.£¢~ez.~a~.....~/~-..-~.l.~,.-~.ae.~ & Wi~ e ................... Doan, ho .]._d .......................................... to ~tl.i ~4... ~e,~...oz~e.. ~. ~r~3~...d~'~- t.3.i~.~.~ ..................................... at premises located at ....~,t]...]:gi~.,...~..~P ...... .]~,'~l~..~.~f~D,.~).,.GDe~.1~.Op.~ ................. .......................................... ~/. ~ .... ~ m~,~l ..D~e...~4 .,lar.~...~ ........................................................... ......................................................... · k'~ ~'~,:, .................... : ................... t""' ....................... pursuant to application dated ................................ Z~]:':[.- ....... ~8'", 19.,~(~., and apprbved by the Building Inspector Fee $..1.0.,,0.~' .......... Building Inspector ~ FOEM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. Examined .....~ ............... ,I 9.~..~. Approved ........................................ , Ic) ..... Permit No .......................... Application No. ';~ O ~'~ ~ Disapproved a/c .............................................................................................. ........................... ............................... (Building Inspectorj~ APPLICATION FOR BUILDING PERMIT Date .................... ..,~.....~..../~.....(.....~.... ............ , 19.(~.~ ...... 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 adjbining premises or punic 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 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, Suffolk County, New York, and other applicable Laws, Ordinances or Regular OhS, 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 reg.ulations. (Signature of applicant, or name, if a corporation) State whether applicant is o?ner, lessee, agent, architect, engi,neer, general contractor, electrician, plumber or builder. ...................... .z¢.. ............................................................................................................................................... Name of owner of premises ...... .f...4../. -4z- ,....~4'...~...~.~ .............................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title af corporate officer) 1. Location of land on which proposed work will be done. Map No.: ~....'f/~....~...~..~...~.....~./~/...~.~.~.~Lot No.: .~.~.~ ........... Street and Number ..................... ~~.~.~ ....................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of propos~ construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ......... ~...~.~.~....~./.~.~.~.~ ................................................. 3. Natur~ of work (check which applicable): New Building ,.....~.... ........ Addition .................. Alteration Repai~ .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4, Est' m~ted Cost ........... ..~....,~)..~ ............................ Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~.. ............... Number of dwelling units on each floor ................. ~ .......... Ifg j~g : ar e, number of cars ............................................................................................................................................. 6. If buiiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................... 7. ) me~s ons of existing structures, if any: Front ............................ Rear ................................ Depth ............. ' ....... Height ........................ Number of Stories ................................................................................................................. Dime. tsions of same structure with alterations or additions: Front .................................... Rear ................. ; ........... Deptrl ................................ Height ....................... ~N. umber of Stories ........ .~..~, .................. 8. Dimensions of entire new construction: Front ..... ¢.~....~...'..3....). .......... Rear ...~;=.~..~/..~..../.... Depth ...dc....~..../..' ........... I-leigk[t ...../..~.. ........ Number of Stories ........ ./. ............................................................................................... ~ ........... 9. Size ~f lot. Front ..Z.~..~...~..~!~.?.~..~.~Rear ..../..~.~../..~..'Y~J,~,~;.~,..~ Depth '~..~ ~' 10. Date of Purchase ............~. ....... ~ ............................... Name of Former Owner ..../?.:..T..'.S....Z...~..u..?...~./~..~.~...~.e~L~. .... 11. Zone or use district in which premises are situated ...... Z~....~...~./.'..~.....~..~t..7'...q...,:~_...~.. .......................................... ; ........... 12. Does proposed ~onsfruction violate any zoning law, ordinance or regulation? ..... Z'Z.~.. ................................... 13. Nam,, of Owner of premises .'..~..{z../...~......./d~...~...~...5.., ....... Address .......... J'N(.~....~z:.....: ............... Phone No. ' Nom~ of Architect ,.~.,.~,...~...~..d..~......~.~.~..q..~.../.~.Z4~..~..Address ........... Z~l.../~....cr.....: ............. Phone No. .................... I',lam~ of Contractor. ,/~.~...~....~...~..~....'~/..E.,/,x'~../.~.-f..~..;~...Address ....~..~..u...-~.(..~..f...Z....~....../.~.~... Phone No. PLOT DIAGRAM Locate Icle~orly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ~rom property linJ~s. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF qEW YQRK,, /. , / COUNTY F ..:~~.J~'~' ~/t/~-./. J'-¢ ..~..'4''/ .... being ....... ..~..~'.,,~'......?...~......'f~'./. ..................................................... duly sworn, deposes and says that he is the applicant '(',~"ame of individual signing application) above named. He is the ......................................................................................................................................... ~ ............ ' (Contractor, agent, corporate officer, etc.) of said owrier or owners, and is duly authorized to perform or have performed the said work and to make and file this applicc~tion; that all statements contained In this application are true to the best of his knowledge and belief and that the woi'k will be performed in the manner set forth in the application filed therewith. Sworn to be~ore me this , .............. ......... ............. Notary Pub;lic~....h,c~......;.....x~Z.~~ (Signature of applicant) C/ JUDITH T. BOI(~N / ~' Corniness!on Exl,i~cs M~r~h 30, t~ ~ 'k MAD~ DF< 0 ?: , ' ,: -: SI:MMI B RI SII)I N{ I F()B 5IB. MBS. ILII Il{AIlS .i' 3' ItL 1 . . Z 5- Z',P:,,, - ir L 7925 ~ X Lb 0 ' 0 0 {Il q.l~.lOIt. EodE~..,p. CLOdE ~ALL~ ~ALL ~UI~ ~P~M,~LU ~EE.m 0F ~L ¢~ SCLo~U j B Il ... /_ LAZEC:, ~klIC l~L~I. ~A~c ?L~ ~o, ~ FLo,~.6 6TAlOCth ~A~W4 A~s, ' s,~ te TO ~ LEFT ~.u~:A¢ OF ~. ~.~ L%,,~ ¢ oF ,j j,., .... ] \~A.L b~ F~PIL~' I PLAN 7925 e) : I FLA~'141 7925 PlIZ 4 t4~6 ILIF \L/ACS ALT~:I~N Al'~ D"~ "/'" ~% pF~-¢ U f~: ~ ToP ~C~r- OF r/_'~FZ¢ T. · To? oF ~ cm~''~ '~ I -LI '1 1 ,,. ', ¢_ I I 7925 'I EPrcTAI L A 7925 ,/ ..~ - ?.t!x y/)' IMI" 7925 S~CTION 7~25