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Home My WebLink About3064-zTOWN' OF SOUTHOLD BUILDING DEPARTMENT '~'OWN CLERK'S OFFICE SOUTHOLD. N. ¥. P.E::RTIFIBATE: DF BI:P-UI::'ANBY No. Z...12.t~..~.2. .... Date ............... A,~g~J~.t .... 2 ..... 19.66. THIS CERTIFIES that the building located at 8~...8~g .~r.~V0 ......... Street Ca~t, Kidd E~tate~ Map No ............. Block No ............. Lot No. ~...I~a.tti~uek~. E~. ......... conforms substantially to the Application for Building Permit hereto~e filed in this office dated ......... .4P~$ .... ~.., 19.~. pursuant to whi~ Building Permit No. dated ......... Apri~.. 2~ .... , 19~., was issued, and conforms to all of the require- me.nts ,of the applicable provisions of the ~ w. The .occupancy ~or which this ce~ificate is issued is . .P~Va.t~, ~e..fm~ily..dW~!l!~g ......................................... The certificate is issued t,o AI~'OASO...Go~f~ede ........ ~R ....................... (owner, lessee or tenant) o~ the aforesaid building. .Suffolk County Department of Health Approval ....................................... FORM NO. 2 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~CE SOUTHOLD, N. BUILDING PErMiT (THIS PERMIT MUST BE KEPT OH THE PREMISES UHTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 306 z Date ..................... .A..~ZL~L.1 ....... ~.~. ............. , 19.66_ Permission is hereby granted to: ............ i~t~i~ck ............................................. to .....bl~ll~.. ~te~.. e~le.-.~, e~ti.]:y.-.d,~9 ~.i'ii~ .................................................................................. ct premises located at .......i~¢..~.t.....~a.l)~d4L.~8.~ ............... , ................................................... ................................................... ~...D~i~.e ~ .......... ~.ti~uek ................................................ pursuant to application' doted ............................. .~!p:~.i~ ....... ~.~ ........ 196~...~ and approved by the Building Inspector Fee $l.0~ Ol~ ........... Building Inspector J~ l~Ol~M NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No .......................... Disapproved a/c~~ (Building I/~spector)~ Application No....?..~.....~....~.~ ......... APPLICATION FOR BUILDING PERMIT Date ............................ .~. ~.~ ~..~. ....... ~.~ ........ , 19~..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 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 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 comp y with all appl cable laws, ordinances, building code and regular ans. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, 'general contractor, electrician, plumber or builder. Contrao tot Name of owner of premises ..~.~.,f..o~so...G~.~..~..r. ec.1..e ............................................................................................................ 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.: ....~ap~..~,d.~..~s.¢,.... bat No.: ...8.bt ................. Street and Number ..~,...~'~;k.~..~.:R;L¥.e. ........................ ~,~,~.J..~.g.a~...~[,Z ........................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .'¢..~g...~..~.~...~.~.~ .............................................................................................. b. Intended use and occupancy ...... O.T~....~.~:~....Cl,~.~.~Lt9~, ............................................................................. 3. Nat4re of work (check which applicable): New Building ....... ~.... Addition .................. Alteration Rep:~Jr .................. Removal .................. Demolition .................. Other Work (Describe) 4. Esti rated Cost .......... ~.Q~..Q.O..O._.~./..~. .......................... Fee ....~..0.. ~ (to be paid on filing this application) 5. If d~welling, number of dwelling units ............................ r~umaer or dwelling units on each floor tf gbrage, number of c~rs ...........,2...C:~Z~. .................... 6. IF ,usiness, commercial or mixed occupancy, specify nature and extent of each type of use 7~ Din ensions of existing structures, if any: Front ............................ Rear ................................ Depth Hei ht ........................ Number of Stories Dirt ;nsions of same structure with a.lterations or additions: Front .................................... Rear De~ th ................................ Height ............................ Number of Stories ................................ 8~ Din ensions of entire new construction: Front ............... ~.~. ................ Rear ........ .~.~ ............... Depth ........ 26. ...... Hei iht .................... Number of Stories ....f~;Qe 9. Siz~ of lot: Front .......... ~.OO. .......... Rear .................................... Depth ....... 2.O0...~./.~ ........ 10. Dot~e of Purchase ........................................................ Name of Former Owner ...... ~..~w~n Estates 1. zode or use district in which premises ore situated 1 12. Doe~ proposed construction violate any zoning Iow, ordinance or regulation? .......... .~.~. ............. 13. Na~e of Owner of premises ..Alf.Q~.O...~.:~'.e.f~.~:~ddress ............................................ Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Nar~e of Contractor ..A,...~.~.:[L..],.]-~...~..~..O..~..s....~..~..e...Address ....... ~.~.~.~.t~.q~. ............... Phone No. PLOT DIAGRAM kocot.le clear y and distinctly al buildings, whether existing or proposed, and indicate all set-back dimensions fr property I nes. Give street and block number or description according to deed, and show street n~mes and indic whether in}erior or corner lot. STATE O~ NEW YORK, }c ¢ COUNTY [OF ....... ~t~.£o.],~C ....... J .... ................. [ ................. ~,.,...~.~.$~.],~. ......................................... being duly sworn, deposes and says that he is the applic [(Name of individual signing application) above narhed. He is the Contractor (Contractor, agent, corporate officer, etc.)' of said o)~lner or owners, and is duly authorized to perform or have performed the said work and to make: and this application; that all statements contained in this application are true to the best of his knowledge and belief; that the ~ork will be performed in the manner set forth in the application filed therewith. Sworn to ~efore me this .............. ..... of ................. ............ , Notary Pu~blicl .~.l.~....~.m..~..~,6~ County (Signoture ~,icant) /f MARION A. REGENT ~OTAR¥ PUBLIC, State oi Ilcw Yor~ ~o. 52-3233120 Suffolk Comity [i'_erm J~xpires M~rch 30, 19J~.'~