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Home My WebLink About3086-zFOI~I ~O. 4 TOWN OF gOUTHOLD BUILDING DEPARTMENT ~I"OWN CLERK'S OFFICE SOUTHOLD, N. Y. EI£RTIFIr:ATI~ OF O~I~UPANP.¥ No. -Z..2~.... Date ................. .S0~0.t.. fi ...... 19.66. THIS CERTIFIES that the building located at . S/~..l~i6dle..~acl..(.OR~7). Street 1Vfap No...~X ........ Block No ..... X~ ..... Lot No. ~ ..... ~l~%ti. tut~k~..~dL, ....... conforms substantially to the Applicati,on for Building Permit heretofore filed in this office dated ............ ky.--~2. .... 19.~ pursuant to which Building Permit No. '30~'Z' dated .............. }4~. '~1.'2', 1966', 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 ... Private..on~ .faint:ry. d~eliing ........................................ The certificate is issued ~o .. ~eo .l~Iot{ll[~h ............... (3~t~e~r ...................... (o~vner, lessee or tenant) of the afore.said building. .Suffolk County Department of Health Approval ..... ~$.1{$ ............................... FOP~ ~0. 2 TOWN OF $OUTHOLD 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? 3086 Z Date .............................. ~. ....... ~ .......... , ~9.66... Permission is hereby granted to: .... G.~o.....~¢~ugh ................................................. ................ ,~ld. dZe..},~,d .......................................... .......................... }~ Lti.tu~k ................................ to ........... Build...am.~d£t l~m.o~..a~.. ~i~t ~qg...~.~el~g ............................................... .~ ~ 1 ~-~ at premises located at ........8~.~......~,,~,,,,.~..A~,f~¢1, ............................................................................... Mattituek pursuant to application dated .............................. ~6~y ....... ~.~ ............ 1~.~6.., and approved bythe Building Inspector Fee $ ...... ~...~...(~. ........ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. YS Examined .................. .q ................ · Approved .................................. , ........ it N o.~....~.....~.....~.... ~i Application No. ~ 0 ~-~z~ Disapproved a/c ..;.....~ .................. APPLICATION FOR BUILDING PERMIT Date May 12~ 1966 19 ............ 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. ........ ~.e or.g.e ..P.....~cEugh ................................................. (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect· engi'neer, general contractor, electrician, plumber or builder. ................................... Qw~ar ....................................................................................................................................... Name of owner of premises .....G. eo.e...~e~ugh ........................................................ ' ............................................................. 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.: ....... ,~ ........... Street and Number .... ~./.o.....~,~Jk ....... .~drlle...Raad,~......~v~,t.t~L.C~a} ............................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. ~t.~.e.~-]..J, D4~ ................................................................................................... b. Intended use and occupancy ................ ~j...~...~.~.~,..f~..~,Cl.f]~,~J,q~ .............................................................. 3. Not.'ure of work (check which applicable): New Building .................. Addition ......... ..~.~. Alteration ............. Rephir .................. Removal .................. Demolition .................. Other Work (Describe) ................................... 4. Esh(-nated Cost ............ ~.O.Q..,?~.J?~ ......... ...................... Fee ........ ~ ........................................................................... ! (to be paid on filing this application) 5. If c~welling, number of dwelling units ....... ~,g,~ .............. Number of dwelling units on each floor .............. ........ If gi~rage, number of cars ............................................................................................................... 6. If ~usiness, commercial ar mixed occupancy, specify nature and extent of each type of use ...................... 7. Din ensions of existing structures, if any: Front .......... .2..~. .............. Rear .....2:~ ....................... Depth ....... .6.~. ...... ~ , Hei. ht Number of Stories .......... o....e. ................. Din' msions of same structure with a.lterations or additions: Front .................................... Rear ....................... Del: th ................................ Height ............................ Number of Stories ................................ 8. Din'ensions of entire new construction: Front .......... ~.I' ...................... Rear .......... .2...~. ............. Depth ]_0 Height .................... Number of Stories ........ O,Zl~ ............................................................... 9. Size/of lot: Front ............................ Rear .................................... Depth ................................ 10. DatJ~ of Purchase ........................................................ Name of Former Owner .......................................... ......... 1 1. Zon, ie or use district Jn which premises are situated ..... !!JLIJ...~:J..~:l; ............................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ....... ~.O. ............................................ ]3. Na~e of Owner of premises _~.e..q.,_~_q~.~.g.~ .............. Address}~..~.~,t.,.~.o..~. ....................... Phone No. Norhe of Architect ...................................................... Address ............................................ Phone No Narhe of Contractor ....... C}~as...P,~.~,e.e..&...O~;~ez?Address ............................................ Phone No ................ PLOT DIAGRAM Locot,~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f, property li~es. Give street and block number or description according to deed, and show street names and indic whether in1 erior or corner lot. STATF OFINEW YORK, / t6 CkM COU~-TY ~F ...D,u££.a~.k: ............ /s'S' i Geo. ~cHu~h . . .................. ~ ....................................... .~ ..................................... orang duly sworn, deposes cind says that he is the gpplio (Name of individual signing application) above nambd. He is the (Contractor, agent, corporate officer, etc.) of said ow~er or owners, and is duly authorized to perform or have performed the said work and to make and this applic~tion; that all statements contained in this application are true to the best of his knowledge and belief; that the we rk will be performed in the manner set forth in the application filed therewith. Sworn to b~ fore me this (Signature of apl