HomeMy WebLinkAbout3063-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
P-E:RTIFICATE: OF OCE:UPANE:Y
No. ~ .~t~].... Date .................
THIS CERTIFIES that the building located at .~.~.~... ~1~...~.m~..~..~.&~.~treet
Map NO..][~[ ....... Block No...1[~ ...... Lot NO....~.. ..... .]~..~.~..i.~...1~..,...~.:.~.~. .....
conforms substantially to the Applicati, on for Building Permit hereto£ore filed in this office
dated .............. ~1~'~[~.. ~,~19..~ pursuant to which Building Permit No..
dated .............. &]]~:~l,..~ 19.(:~, was issued, and conforms to all of the require-
ments .of the applicable provisions of the law. The .occupancy ~or which this certificate is
issued is .... ]~121ill~8S..]~l.t~ding...(~il, y. ~e~. ~t;Qx'e) .........................
The certificate is issued t.o ... ~U. ~'.,. ]~Oh .......... · .~. · .~?. ......................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ....
" " " " pe:mit d~ B3.k)+? bZ Dr', Loon:l.e
........ Building Inspe-tor ~e .....
FOR,M NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFIC~
SOUTHOLO, No Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 3063 Z Date ..................... ~r~ ....... ~'. ............. , ~9.6~..
Permission is hereby granted to;
· . J~m~.~.. O:~....l~)h· .............................................
..... ~ t-.ti.t~e~ .....................................................
to b~i~(.~... ~ew · .~.i. ne~ ~...b~i:l~} ~g ............................................................................................
at premises located at ....~-~.~..~.~.O~..~...~T~(~O~-~r..L~V~ ..................................................................
................................................. ~ ~.ti.~uek~,..... ~ ,. ~.. ............................................................................
pursuant to application doted ....................... 'A~[')~'~']~ .......... '~'~ ...........19~..., and approved by the
Building Inspector
Fee $..10..0Q .........
FOEM NO. 1
TOWN OF SouTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ........................................ , 19 ........ Permit No .............................
APPLICATION FOR BUILDING PERMIT
Date .................................. .A...P..r..i..~....~.~..M..., 19...6...6. .....
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 deta led description of layout of property mdst be'drawn on the diagram which is port 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 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 a corporation)
Camp ~ineo].a Road, ~,~attLtuck~ N. Y.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder.
Owner
James J. ~reh
Name of owner of premises ....................................................................................................................................................
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.: ........................................Lot No.: ........................
N. Y. S. Route 25 and Factory Avenue~ t~attituc~f, N. Y.
Street and Number .....................................................................................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...................................................................................................................................
b. Intended use and occupancy ,,,B,,u,,?,~,,n.,e,?,.,s,,.,U,.,,.D.~.~.~-Y....~-?.-e:~,,n.,,,,B,,a,.,r, ................................................................
3. Nat~ re of work (check which applicable): New Building ....... .X. ......... Addition .................. Alteration
Rep~ ..................Removal .................. Demolition .................. Other Work (Describe)
4. Estir ated Cost ............. '. .............................................. Fee
~, (to be paid on filing this application)
5. If d'?elling, number of dwelling units ............................ Number of dwelling units on each floor
If g~ rage, number of cars.
6. If b~s,ness, commercial or mixed occupancy, specify nature and extent of each type of use ~.ei,ail Bus
/
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth
Height ........................ Number of Stories ..............................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear
Dep{h ................................ Height ............................ Number of Stories ................................
8. Dim.,nsions of entire new construction: Front ~0 ft. 20 fi,. 5~ fi,.
.................................... Rear ............................ Depth
Hei ht 19 fi,'Number of Stories
9. Size of lot: Front 55.,~7' Rear $1.88' ~. ., ~o?,(^ve~e)
Deaembe~ ]7, 1965 ,. Yvonne Clark
10. Dat~ of Purchase ........................................................ name of Former Owner
11. Zon,' or use district in which premises ore situated Business
12. Doe! proposed construction violate any zoning law, ordinance or regulation? No
Gordon Ah]ers *~ Jamesport, N.Y.
Narfie of Architect .......................... ; ........................... t~aafess ............................................ Phone No. JA~-5~
i Thos .Wern ~ kowsk
No 'e of Contractor .................................................... Address /~quebogue, N.Y. Phone No. PAT-o0!
PLOT DIAGRAM
Locat~cleorly and distinctly all buildings, whether existing or proposed, and indicate ail set-back dimensions fr
property lihes. Give street and block number or description according to deed, and show street names and!
whether in~erior or corner lot.
ST^'r OFi YORX,, c '1..
COUNTY DF ................ {~..u...f..f..9..]. Jf / ....
James J. Kreh
................................................................................................ being duly sworn, deposes and says that he is the applic
[Name of individual signing application)
above narred. He is the
(Contractor, agent, corporate officer, etc.)
of said o¥ ~er or owners, and Js duly authorized to perform or have performed the said work and to make. and
this opp[k ~tJon; that all statements contained Jn this application are true to the best of hfs knowledge and b~lJef;
that the ~ ,rk will be performed in the manner set forth Jn the application flied therewith.
Swam to k ~fore me this
....... of ..... ................... ,
[ lerm [xpires ~Brch 30,
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