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Home My WebLink About3088-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. THIS CERTIFIES that the building located at ~/.~...~.~.~.e..~,.~.~.~. .......... Street Map No.. ~ ...... Block No..~ ....... Lot No, ~ ..... ~~. ~Y.~ ....... conforms substantially ~o the Applicati,on for Building Permit heretofore filed in this office dated ............ ~y .... l~.., 19.~ p~rsuant to which Building Permit No.~& .~.. dated ............ ~4b.~...~ ..... 19~., was issued; and conforms to all of the require- ments ,of the applicable p~ovisions of the law. The .o~cupancy ~or which this certificate is issued is ... ~9i~e~ .~ld.l~g-. (~t~.%~..g~.~,g .& .p~ki~g) .................. The certificate is issued bo . ~.~(~. ~. ]~.~'~ ....... ~ ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Appzoval ...... ~].,R~ .............................. .... .... :- .... ...{ .......... Building Inspector FOi~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTM[NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 3088 Z Date .............................. Permission is hereby granted to: ..... S~eve.,Do~o~:~ ........................................... ............... ~[i~.d:Le..~o~ ...................................... at premises located at ....~/S.....~¢~d'l'e'"~O~ .......................... So.~hol.~ ~..1%. ........................... ; ...................................... pursuant' to application dated.,. ~' . .}~y, ........ , ~..,.,, , 1L9t~6~.~;,. ,~: and approved by the Building Inspector Fee $-~.~)0 .............. .. L..'~- .x4... ~;. ~ ................. t' · '~'~.~ ~ t "' tt~*'r ................... Building' Inspector L FOE~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~. ...................... Approved .......................... .~.'.' ........... , 19'..! ..... Permit No..?......~....~......~........~- APPLICATION FOR BUILDING PERMIT lvia¥ 16 Date ............................................................ , 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 Pen~it 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. APPblCATION 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. (Signatdre of applicant, 'o'~ name, if d ~zorporation) Southo~ld (Address of opplicant) State whether applicant is owner, I~ssee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. - C Owner o .......................... ~.~.ft.¢ ......................................................................... Name of owner of premises ...~'.te.v.c~r.~.Jor..os.k.l .................................................................................................................. If applicant is a corporate, signature 6f duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: .......................................:;[~ ~c~.:: ~ ....................... Street and Number ...~'~'.....~d~,le...~.aa~, ......... S:o~,th.ol~, ................... ][...'.~.'.'.~: ....... '.~..:~.]..~ ............................ Municipality 2. State existing use and occupancy of premises and Jnt~e~ U~"a~8 ~c~cy of proposed construction: a. Existing use'and occupancy ........... ~-O...~4~B.i~.~...~i.~ ..................................................................... b. Intended use and occupancy .............. ~.~.~...,..~.~...~..~.(~.~.q~ ............................................................. 4. 5. 6. Nat¼re of work (check which applicable): New Building .................. Addition ..... ~..~.~. ..... Alteration ............. Repgir .................. Removal .................. Demolition .................. Other Work (Describe) .......................... i ........ £sti ,~ated Cost ....... 3. ~..0...0..0.....~./.~ ............................... Fee ........ ~ .......................................................................... ~! (to be paid on filing this application) If d,lWelling, number of dwelling units ............................ Number of dwelling units on each floor ....................... If g~3rage, number of cars ........................................................................................................................................ ' bus in e s s If business, commercial or mixed occupancy, specify nature and extent of each type of use Dir~ensions of existing structures, if any: Front ............................ Rear ................................ Depth .......... , ......... Height ........................ Number of Stories ............................................................................................................. Dirr{ensions of same structure with alterations or additions: Front .................................... Rear ....................... Dep~rh ................................ Height ............................ Number of Stories ................................ Dirdensions of entire new construction: Front ................. ,8.Q .............. Rear ........... ~.0.. ............ Depth ....2.,,0. klei~ht .................... Number of Stories ...... .O.~f~ ......................................................................................... ; ......... Size" of lot: Front ............................ Rear .................................... Depth ................................ Dot? of Purchase ........................................................ Name of Former Owner ................................................... Zon[e or use district J9 which premises are situated .......... !!_A.!!....d..~.~ .......... .~..,-..C....,~..s..,e. ........................................ Doei proposed construction violate any zoning law, ordinance or regulation? ............... .~...O. Nar~e of Owner of premises ....~.l:;.e,.-v'..e...D. or.ctflkJ,....Address ....~:Ql&.~..h..9..],~ ..................... Phone No ................ Nar ~e of Architect ...................................................... Address ............................................ Phone No .......: ......... Nar ~e of Contractor ................. ~a.~. ......................... Address ............................................ Phone No ................. PLOT DIAGRAM ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fn ~es. Give street and block number or description according to deed, and show street names and' indic~ erior or corner lot. 10. 13. kocot~ property Ii whether im STATE OFJNEw YORK, ~ c c COUNTY ?F .S'.uf~.o/.k .............. f~'~' / .................. ~ .......... .~.+,,~¥~..,gO~'.QS~f .................................... being duly sworn, deposes ar~d says thaf he is the {Name of individual signing application) above named. He is the ....................Q~..m..~.~iZdo~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ma(e and this application; that all statements contained in this application are true to the best of his knowledge and be ef; that the wdrk will be performed in the manhe'r'set forth"in tee ,licati6h filed therewith. Sworn to b~fore me this .................; F6.. day of ...~Z ......... , 19..~., 3 Notary Public, Jature of applicant)