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Home My WebLink About3060-zTOWN OF SOUTHOLD SUILDING DEPARTMENT TOWN CI;ERK'S OFFICE SOUTHOLD, N. ¥. OEETIFIOATE OF' O00UPANOY THIS CERTIFIES that the building located at . 1~I/S..l~Ie~t. l~If:Eolk .tkv. e... Street Map No...:~ ....... Block No .... X~ ...... Lot No.~... 14at.~,ttll~k~..~,.~, ....... conforms substantially to the Applicati.on for Building Permit heretofore filed in this office dated ............ A1~'.:],l...21, 19.6t~ pursuant to which Building Permit No...3(~60. ~ dated ......... .Apr.~,l ....2.~..., 1966., 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 .. P~.lv~,~;e..ga,~agc~ .and. ata~'a~e .bui~,d-i~g. .............................. The certificate is issued to ]gllge. lq~..~][OX'.~;Ol~ .... O~X' ................................ (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Appcoval ......... ~...1~. ......................... FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERg'S OFFICE $OUTHOLD, N. Y. BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 3060 Z Date ............................... Permission is hereby granted to: .... Eugene../~e.~n ............................................ ................. ~D.~.t~l .tuck ......................................... to ....build...p~.~v~..g~ge...(.f.~.~ ~.~ ..b~.~:i~g...er~..lc%.) ............................................... at premises located at ....~i'/.~...,.}]'~.,~.2~]L~,.~.~ ................ : ......................................................... ............................................ ~,~ ¢$ t~.~.....~.0.¥., ................................................................................. pursuant to application dated ,~ ........................... ~L]DL~:~J~..,..~ ......... 19..~., and approved by the Building Inspector Fee $..10,~0 .......... FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~ ........................... , Approved ........................................ , 19 ........ Permit No .......................... Disopproved o/c .......................... ~,.-*.~ ~.x~:..'..~ ................ ~ .................................. (Building In~,~tor) Application N o. '~;~ .~: .r~ ............. 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 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 o 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. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................... O~m~...~..bu£1cl~ ......................................................................................................... Name of owner of premises ..... F.~,~l~"le...~T~I~...~ol% ............................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ............ ~ ....................... Lot No.: ......~ ................ Street and Number ..~/.~.....~[I~.tl~..~.~--~?o~J~-.~¥.e,l~ ....... ,~t'~..~'t.l~ .................................................................. ' ' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use arid occupancy ...... .~..~.~..~.~..i;;.....~...~..~..~.. .................................................... . ........... 'j ................................. b. Intended use and occupancy ...... ..~..~..~..~..~..~....~.~.~.~.~.~...~.~.~..~'Z~.8~..'~t`~.~...Q~.~ .......................... 4. 5. 6. 10. 11. 12. 13. I_ocatff clearly and distinctly all buildings, whether existing or proposed, and indicate all, property lines. Give street and block number or description according to deed, and show,si whether ir ~erior or corner lot ............................. Natbre of work (check which applicable): New Building ..... ~ ..... Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) Estirhated' Cost ............................................................ Fee ..... ~.~. ~. ................................ (to be paid on filing this application) If d~elling, number of dwelling units ...... ~111 ............ Number of dwelling units on each floor If g,~rage, number'of cars If usiness, commercial or mixed occupancy, specify nature and extent of each type of use DJ~r.ensions of existing structures, if any: Front ............................ Rear ................................ Depth He ~, ht ........................ Number of Stories Dim nsions of same structure with alterations or additions: Front .................................... Rear DePl~h ................................ Height ............................ Number of Stories ................................ Din-~nsions of entire new construction: Front ............. ..~.~ ................. Rear ......... ..~.~. .............. Depth ....~..0..I Heil lht .................... Number of Stories ...~1t~. ............................................................... Size of lot: Front ....~,00 ................. Rear .......... 1~10 ................... Depth ..... ~.7~..~.l~ ......... Dot, of Purchase ..................... ],9~. ........................ Name of Former Owner ..... ~',...~l,.~ll~,ll ........................... CA" residential Zon or use district in which premises are situated ........................................................ Doe proposed construction violate any zoning law, ordinance or regulation? ......... Na ~e of Architect ..........~lt~ ................................... Address ....................................... ,:.... Phone No. Na~ ~e of Contractor ............. I!11t. I¢1ti .............................. Address ....................................... /,.~ Phone No. PLOT DIAGRAM et-back dimensions /\ STATE OF~ NEW YORK, ~' S S COUNTY IOF ...llnl'~:o~lr. ........... ~ · · ................. ~ ................. ~,~I~I~I..~[Q:~.~]0 ............................... being duly sworn, deposes and says that he is the ]qppli( i(Name of individual signing application) ~' abow; narfled. He is the ........ ~e~". .........]]t~,J~' ................................................................................... :..q ..... , (Contractor, agent, corporate officer of said owner or owners, and is duly authorized to perform or have performed the said work and to this oppli~ation; that all statements contained in this application are true to the best of his knowledge that the w~_rk will be performed in the manner set forth in the applicatio~ filed therewith. ~ Sworn to ~efore me this )