The URL can be used to link to this page

Home My WebLink About3099-zFOBM ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~RK'S OFFICE SOUTHOLD. N. ¥. ~I=I~TIFIP. AT£ III:' rlr:.I~UI~ANI~¥ No.Z. 2571 .... Date ............. THIS CERTIFIES that the building located at . $/$., .~.~. ~Oa,~ ........... Street Map No .... ~ ..... Block No ...... ~... Lot No, X]{.. · ~0~:1~$~t~..~e~g, .......... conforms substantially ~o the Application for BuHdlng Permit heretof, ore fried in this office dated ......... Mai'Oh .... ~, ..... 19.6~. pursuant to which Building Permit No...30~). dated ........... .Mla~ .... 2,~ .... 19. (~, was issued, and conforms to all,of the require- ments .of the .applicable prov~sfons of the law. The occupancy for which this certificate is issued is . .N~,(~ .~$~i.Z~.~$..bu':~ldi.~.g..Sea. food .~'ehou~e- ...................... The certificate is issued to .. ~l.',a~:~.. (>y$~ ,~0 ............... ~6'Ae~'~ ............... (owner, lessee or tenant) of the aforesaid' building. .Suffolk County Department of Health Approval .... .~,t~, ............................... FOP~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEP, MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3099 .z Permission is hereby granted to: ~a~...(~t,.e:e.. ~o. ......................................... .. - .............. .~a~.~.o.a& ........................... ......... .0.~t,~hcg.ue.~ ..... ~ ~, ...................... to ....B~l&..~..~dc~J.~&or.~..~..~..~,C...bz~z~,~...~x~d.~,~ .............................................. at premises located at .~'.~ ....... }~8,;[,tl..)?,0~%~ ............................................................. i ....... ................... Cutchogue~ N. ~. pursuant to application dated .......................... ~.C]Z ............ 2 ......... 19..6~., and approved by the Building Inspector ~OT~ Ap'~roved by Bd/Appeal~ Fee $..5,.~0 ............ -- Building Inspector ( FOEM NO. I ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ~Y. ~ Approved ..... ..~...~......~..~.....~.~. ........ , ]9.~.~. Permit No. Disapproved a/c ............................. W .......... t ....... ~ ........= .....~ ............. ................................ ................................. Application No. ~ (5 ~ ~ ct.O_ ~_APPLI~ATION~,~ FOP~ BUILDING PERMIT March 2 19..6...6. ...... 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 application, the Building Inspector will issue o 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 Southoid, 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. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ~) W.lrl ~ .I'. ............................................................................................................................ Name of owner of premises ..~r~,ga~..O.~s.~'....O0 ............................................................................................................. If ~pplicant 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.: ..... ~X ............. Street and Number ....... ~8.....N~l~..~og~, ....... .O~¢eNog. ue. ............................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of' proposed construction: a. Existing use and occupancy ........ ~g....~.e~g...b~.i~.~ ...................................................................... b. lntended use and occupancy ...... ~me..~N..a~..~,~&.¢l.o~. ....................................................................... 3. NatUre of work ( ~licable): New Building .................. ition ....:~X ....... Alteration Repa~ r .................. Removal .................. Demolition ....... ~ .......... Other Work (Describe) 4. Estir~ated Cost ......~Z~..O.Q.O...~./.~ .............................. Fee ..... ~'.,.0.0 ....... ~ (to be paid on filing this application) 5. IF d~velling, number of dwelling units ...~0~ ............... Number of dwelling units on each floor If g~rage, number of cars 6. If ~usiness, commercial or mixed occupancy, specify nature and extent of eachrtype of use 7. D~mPnsions of ex.st~ng structures, if any: Front ........~,.~ ............... Rear ..... .hrS. ...................... Depth ......~'~.-..~ ..... Height ........................ Number of Stories ..... ~-,..~..~, ...... : D~mpns~ons of same structure with alterations or additions: Front ........... 6.~. .................... Rear ..~ Depth ........ ~.~...-..~. ............... Height ....... ~,~..~. ........... Number of Stories ................................ 8. Dim?sions of entire new construction: Front ...... ~.0. ......................... Rear ...... ~. ................ Depth ..... .~.~', ......... Height .................... Number of Stories 9. Size!of bt: Front ............................ Rear .................................... Depth ................................ 10. Dat~ of Purchase ........................................................ Name of Former Owner 11. Zonb or use district in which premises are situated ........ ~.~..~..I.l..,.c]..$~.~. ......... ..-.~./(~....~.~. ......................................... 12. Doei proposed construction violate any zoning law, ordinance or regulation? ............... 13. Nanhe of Owner of premises .,..~.z'~..g~.~..~.~.z'.....g. PAddress .....g.l,l.~.g.~.~. .................. Phone No. Na~e of Architect ...................................................... Address ............................................ Phone No. Na~e of Contractor ..... ~.J~lrp,~ ...................................... Address ....... C~.~aZ~o~.~e ................ Phone No .......~ ......... PLOT DIAGRAM Locot~cleorly ond distinctly oll buildings, whether existing or proposed, ond indicote oll set-bock dimensipns frl property Ii%es. Give street ond block number or description occording to deed, ond show street homes ondi whether in1 erior or corner lot. STATE OF NEW YORK COUNTY OF ...~'~l~.~'~]~ ...................... ~t~/'flfi.~...~Jl~.~ ............................................... ,being ~uly sworn, deposes~and says that he is the (Name of individual signing application) above non'ed. He is the ........ aD~)~,t~...g~.~J~a.e~ ........ of said owner or owners, and is duly authorized to perform this applic~ation; that all statements contained )n this app that the w~rk will be performed in the manner s~t forth Sworn to before me this Notary PuJ~lic, inature of applicant) ~ I~[LDR£D Comm~ss~ol~ Expires /vbrch (Contractor, agent, corporate officer, etc.) have p~eF~orme said work and to make, end are true of his knowledge and belief; ~lication filed ~rewlth.