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Home My WebLink About3330-zFORM NO. 4~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFIP. ATE OF EIE:P, LIPANE:Y No. Z 2878 .. Date O~:ol:~. 20 ., 19 6.7. THIS CERTIFIES that the building located at NaSsau I~t & O1~ .~a4~reet Map No. Na~a~ ~lock No. ~ Lot No. 164 . · .Cu~~, · ~..~. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... DeC~ ~ 66 pursuant to which Building Permit No. 3330 'Z dated ~c~ 5 , 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 ..... ad~tion..~. ~. ~tly ~e~1taq ..................... The certificate is issued to ~.~. 8ha~ne~ ............................ (owner, lessee or ten~t) of the aforesmd building. Suffolk County Department of Health Approval ..... ~ .................... Building Inspec~r '~' FO]~I 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? 3330 Z Permission is hereby granted to~. Kander A/C Arthur Sharp .......... ~.?e.,~e.~.L ..~.:..t~.: ................................ to .. ~al~e...al~e~.a.~loA~s...& .~il~t .. wa..add~.~£o~ ..on .. axia ~lng ..d,~elling ............. . lot 16~, Nassau Point Pron at premises located ar ..................................................................... ~. ..................................................... ......... ~.~.~..~.~.~...~.o..~..~..~:..~.e.~..~.~.em..~ .......... ~"~J~.~e ....................................................... pursuance to application dated ........................ ?.?.?.. ....... ~ ................... , 19...6~....., and approved by the Building Inspector. Fee $.....~..*.~.Q ......... Building Inspector J~ FOI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~....~-c....~... .......... 19..~.~.. Approved ........................... ~..~. .......... , 19 ........ Permit No. i'..~....~....~.....~.....~ Disapproved a/c ........................ Application No...~....~.....~.~...~.. .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s applicatzon must be completely filled in by typewriter or m 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 o, areas, and g~wng a detailed descnption of layout of propertymust 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 th~s application, the Building Inspector w~ll ~ssue o Buzlding 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 m part i~or any purpose whatever until a Certificate of Occupanc~ shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th~- Bu,ldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, add~t,ons or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply w~th all apphcable laws, ordinances, building code and regulations. ....... ..................................................... (Signature of opphcant, or name, if a corporation) Riverhead (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builden Contractor Nome of owner of premises ...~.~l.!,tr...~.b. ar.p ..................................................................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Locat,on of land on which proposed work will be done Map No ...... .~...~.?...s.~..?...o.?;.~ ......... Lot No' Street and Number ...~a.~.....~ .... D.l~..~Ze.t'zb.acl.d~n_..~d ............ .C:~¢e~a~.~e ................................................ Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~.'ff...e.~.~ .......................................................................................................... b Intended use and occupancy ...... $.a~e,..~.:L.Y~..~Lt..~.....Ct.~.~bO~ .............................................................. 3 Nature of work (check which applicable): New Building .................. Addition ...~.~..~.. ....... Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ................................... 4. Estimated Cost ....... ~.QQ.0...~..~.~ .............................. Fee ..~. .................................................................... :...; .......... (to be pa~d on filing th~s application) 5. if dwelling, number of dwelling units ..... ~t'ze, ............... Number of dwelling un~ts on each floor ......................... If garage, number of cars ......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................. 7 D,mensions of existing structures, if any: Front .......................... Rear .......................... Depth ......................... Height ............................ Number of Stories ............................................................................................................ D,mens~ons of same structure with alterations or additions. Front ................................ Rear ............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mens~ons of entire new construction: Front ...~ .................... Rear .....]_6 .................. Depth .......... 1D. .......... Height ............................ Number of Stories ..........m~e ........... 9. S~ze of lot: Front ............................ Rear ............................ Depth ................................ 10 Date of Purchase ........................................................ Name of Former Owner ..................................................... 11 Zone or use dmtnct m which premises are situated ...... U. kU...~t.i~t, ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulahon~ ...... BO ........................................ 13. Name of Owner of premises ..~,~.~]g.t~Z'...~aZ'.~ ......... Address ......... C~ke~o~.~e. .............Phone No .................. Name of Architect ...................................................... Address ............................................ Phone No .................. Name of Contractor ...g..t.....~. ~.~. ............................ Address ........... 1~'1 .-¢~e.a~l ........... Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dimensions frc property lines. G~ve street and block numbers or description according to deed, and show street names and md~ce whether interior or corner lot. see plot plan attache~ STATE OF NEV~ COUNTY OF .~..o.~ .............. ~ S.S ........................ ~.]:.~..~.?...~..a..e.....~..~.c~.X~. .................................... being duly sworn, deposes and says that he is the appli. (Name of individual signing application) above named. He is the .................... .0..gnq.l;;.:R. CC.O..t;p~.. ...................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform ar have performed the said work and to make and th~s apphcat~on; that all statements contained in this application are true to the best of his knowledge and and that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me th,s...:. ................. .~. .... day of .. D.e c.e~zh~ez'. ................. , .................. Notary Public, .... ., ......... County '(Signa~re of applicant) No 52 32£2~Z3 $~hclk County l~rm Expires )~arch 30, kg~