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Home My WebLink About3081-zFOI~ ~0. 4 TOWN OF SOU?HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC~- SOUTHOLD. N. Y. OEI~TIF'Ir. ATE 0~- QOOUI~ANr. Y ~o.Z .2~8: .... r)ate .............. ee~,. ~ ......... THIS CERTIFIES that the building located at .~Itt;~;~ .~)~;~'~..N~h ........ Street ~p ~o ............. ~oc~ ~o ....... ~.. Lot No..2~ .& .~8~... ~UthOla~. ~Y~-. · conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~ .... ~..., 19~. pu.rsuant to which Building Permit No. 3~1..~. dated ........... ~y...1~ ..... 19.66, 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 ~V~0. ~e..fa~l~ .d~l~ ........................................... The certificate is issued ~o . .D~ .~ · ~.~. R~I~ ..... ~e~ .......................... (owner, lessee or tenant) of the afore.said building. .Suffolk County Department of Health App,*oval ......... ~, .......................... Building InspectOr F01~ 1gO. 2 TOWN OF $OL~THOLD BUILDING DEPARTMENT TOWN CLEP, K'$ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHQRIZED) N? 3081 Z Date ................................. ~ ......... ~bO..-., 1966_ Permission is hereby granted to: G .W o S~Lt}l..& ..~m~s....tnc.....~/C.....~...~%...~il~y .............. ~.~t~.o. ld ............................................... to ...~i1~1.. ~n...adz,~.tl~.. ~n...a~..e~i~..~w~l;1.~ ...................................................... ct premises located at ...... ~g~2.~&~`2~j.~e~e~c1~`~t~r~`~.~"~1~i;~ .......... ..................................... ~ ea,;ho ZL~I w ..T,t.,.~:.~ .......................................................................................... pursuant to application dated ................................ 1~}t. ......... .~ .........19.~(~.., and approved by the Building Inspector Fee $..~..QO. ............ Buildlng lrl~pector \[ FOI~M NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................. Disapproved a/c ....................................................................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... ...................... 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 oppllcotion, 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 or alterations, for removal or demolition, as herein described. Regulations, for the construction of buildings, additions or The applicant agrees to comply with all applicable laws, ordinanc,~, building code/nd regulations. (~gna~e of applic,a,~nt, or name, if a corporation) (Address of applic State whether applicant~is owner,,lessee, ag,~/ent, architect, engineer, general contractor, electrician, plumber or builder. If applicon ,, _ thorized office . ' (Name and title of corporate office~ I. Location of land on which p~opose~d wo~will be done. .Map No.~...~..... Lotl~o..~_..~ ......... Street and Number~~~~ ...... ~.....~~.~......~...~..~.. ............ 2. State existing use and occupancy of premis,es and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~.~~ ........................................................................................ b. Intended use and occupancy~~ .............................................................................................. 3. NatUre of work (check which applicable): New Building Addition ................ Alteration Repair .................. Removal .................. Demolition ................ '.. Other Work (Describe) .................................... 4. Estirhated Cost ./...s~...~...~.. .......................................... Fee ....... .'~. ........................................................................... I (to be paid on filing this application) 5. If d~velling, number of dwelling units ............................ Number of dwelling units on each floor ....................... If g~rage, number of cc~rs ................................................................................ ' ....................... : ................................. 6. If Uusiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dim[ens,ons of extst.ng structures, if any: Front ......~......2=.. ............. Rear .....~...~ ................. Depth ...-~....~..! ......... NeiCht ........................ Number of Stories ....~,..=. .................................. , ...................................................... Dimensions of same structure With alterations or additions: Front ...~...~ ....................... Rear ~l--. Depth ..~....~.... .................. Height ....~.. ..................... Number of, Stories ....~ .............. 8. Dimlensions of entire new construction: Front ....... ~..~.. ..................... Rear ..... ./...~... ............... Depth./~... ............. HeR, ht .,x.~ ............ Number of Stories .~,~-,---, ................................................................................................ 9. Size of lot: Front ..,~..,~;~....o. ............. Rear ............ ./...~..'.TR ............. Depth ~-¢ ¢ 10. Dar. of Purchase ........................................................ Name of Former Owner .................................................... ]1. Zon' or use district in which premises are situated ....... ~..~.~....z'~..~.'..~..,~..'?.~...Zrm... ..................................................... 12. Doe~ ~roposed construction violat~ any zoning law, ordinance .............................................. 13. Na~e of Owner of premises .~./,<.':~.....~. ............. Address ~.=~: .~.._r ....... z ............. Phone No Name of Architect .~ ......... .-~7.....i.~,~ ................... Address Phone No ................. Nor~e of Contractor'~..;...~..-..~~..~.....Address .'~J.'iJJ.'i.' Phone No ................ j PLOT DIAGRAM L.ocat~ clearly and dmtmctly all buildings, whether exmt~ng or proposed and ind~cate all set-bock dimensions fr property IFhes. Give street and block number or description according to deed, and show street names and indic, whether in(erior or corner lot. STATE OFINEW ¥~O.P,~,/. ~ ~/ icc above n~m~ed. He is the .................~.....~...:.~.~..~..~c..~ .......................................................................................... , ........ j (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 this apphc~t~on that all statements contained in this application are true to the best of his knowledge and belief; that the wdrk will be performed in t~e manner set forth in the application filed therewith. Sworn to b~fo~e me this __ ~ ............. .......... ............. , // .... i -- _. J , .... Notary PuBlic, ..~~.~..~..~.~~un}y~ ~ ~ (Signature of applicant~ .......