HomeMy WebLinkAbout3079-zPOi~M l~O. t
?OWI~ OF SOUTHOLD
BUILDING DEPARTMENT
'I"OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
O£1~TIFIOATE OF OI]I]UPANOY
THIS CERTIFIES that the building located at W/.~..I~.t~ .]~B/rl0 ........... Street
Map No .... ~X. ...... Block No ...... ~ .... Lot No.X..Y~.. .... .~.O.g.thq.~.6l.,. ~.,~, ..........
conforms substantially to the Applicati~on for Building Permit heretof, o.re filed in this office
dated ........... .i~.~y ......~. ....19. ~.~. pursuant to which Building Permit No... 3.079..g
dated ............. ~a~:..9 .... , 19..6~ 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 ....P.~..ty.~.e...0.~¢~. $.~i~li~r. .~O~J~g ........................................
The certificate is issued t.o ~ho~las (~o~r~-a~' ~'~.tyt¢~ ........ ; ...........
(owner, lessee or tenant)
of the afore.said building.
.Suffolk County Department of Health App.~oval .. ~0..V.,....3.0.,..1..~.6.6...~.y...0.~...S.m.i..t.h. ....
Building Inspector
FOI~[ NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERk'S
SOUTHOLD, ~. Y.
BUILDIN~ P~RMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 3079 z
Permission is hereby granted to:
John Haponie A/C Thos Conway
S outhold
at premises located at ......~.~,~......~..O..~.?...O..~....~.~? ...................................................................................
.............................................. ~..?~..*.?..~f~.:......!~.~..~.,. ...............................................................................
pursuant to application dated .......................... .~f~. .............. 9 ........... 19...f~6., and approved by the
Building Inspector
Fee $ 10o00 .
FOBM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.
xam,n ......... ·
^pproved ........................... ~ ......... , 19.~ ..... Permit No. 3C-~'~'~'[
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ir~k 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 pub c streets or
areas, and giving a detailed deSCription of layout of property must be drawn on the diagram which is p~rt 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 she. II 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.
......... .o ..Ha oz Le ..........................................................
(Signature of applicant, or name, if a corporation)
Southold
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............................................... .................................................................................................................. .......
Name of owner of premises ..... ,T~/Io.-e..;C. onwa~. ....................................................................................................................
If ~plicant is a co~orate, 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.: ...~ ...............
Stre~ and Number ...~.....[~O~..~..~O=~hO~ ............ ; ......... ~; ...........................................................
Munici~li~
2. State existing use and ~cupancy of premises and intended use and occu~ncy of prop~ construction:
a. ~isting use and ~cupancy ........... ~[..~ ......... ~ ...................................................................................
b. Intended use and ~cupan~ .......... ~.e...~.~[~.~e~[~. .........................................................................
3. Nature of work (check which applicable): New :BuildiHg i......31;;7~... Addition .................. Alteration ..................
Repair .................. Removal .................. 'Demolition.; ................ Other Work (Describe) ........................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ...... .e..~.? ............... Number of dwelling units on each floor ............................
If garage,, number, of cars: ......................................................................... t,9/e ; ...... i ............. ~ .......................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ....... 1.69. ........ ; ......... ;... Rear .....~) ................... Depth ...~.0../.2...~. ........
Height ~ ................... Number of Stories ...Q~ ............................................................................................................
9. Size of lot: Front ...... ~.0...0. .............. Rear ..... ~...0..0. ........................ Depth ..... ..~.~...,0. ...................
1 1. Zone or use district in which premises are situated ....!!JL?....ql,;[~.l; ..............................................................................
12. Does proposed cor{struction violate any zoning law, ordinance or regulation.;> ........... .~..IR. ............................................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .~T~lr~..Z-Z&De~.;Le ...................... Address ........ .~.O...~..t,...h..O...]...~. ................. Phone No .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether 'existing or propoSed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or comer lot.
STATE OF NEW YORK, ~. ~
COUNTY OF ...~tl.'['._f~l~ ........... ?"~'
.................................. ,T..O~TL.~a,13DD.~.13 .................................. being duly sworn, deposes an~ says that he is the applicant
(Name of individual signing application)
above named. He is the ...................... C.o~t,:a.(3.ta32~ ...........................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
this application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be pe[formed in the manner set forth in the application filed therewith.
Sworn to before me this
............... 9. ....... d of ............... ..................... , //_ '
I~ota~y Public, State of New York
No. 52-~344963, Suffolk County
Comms~ !, F · ~ March 30,