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Home My WebLink About3110-zTOWN OF f~OUTHOLD BUILDING DEPARTMENT 'I"OVffN CLERK'S OFFICE SOUT~'IOLD, 1~. Y, r. ERTIFIOAT~- QF O00UPANO¥ · No .... .~. ,2, .5.1.5.. Date Septembe~ ~ 19.66 THIS CERTIFIES that the building located at ~a~ ~ Street Eastern Shores 9 6~een~, ~.Y. Map No. ~..~ .... Block No...~ ...... Lot No ..................................... conforms substantially go the Applicati,on for Building Permit heretofore filed in this office dated ....... ~ .~. .......... , 19..6~ pu.rsuant to whid~ Building Permit No. 3~ dated ~u~e 1 19. ~ 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 r~ olle £~i],y' (~elli~g The certificate is issued to ~O~ ~i~I (owner, lessee or tenant) of the aforesaid building. Augua~ 9, i966 ,Suffolk County Departmen~ of Heahh Approval ......................................... Building Inspecto~ FO~I NO. 2 TOWN OF SOUTHOLD 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? Permission is hereby granted to: , ,~ ..~, ~, ,,r~,~, ~-,~..,~='%'"'.",~"'"'~'..~..'"'"0"~".'~°'~'~-:.~,..,,...:,.:..~ .................. ~.~Len.~.....: .................. ....., ...... ......::... at premises located at .......,l~t~...~,...l~t~4~z~..8~c. ee ............ ~ ......... 12 ........................................... ............................. ~fe.Cl e~'~...:r,~xte......~.....Gzmez~l~.:g ........................................................................ pursuant to application dated ........................... ~ ....... .~], ............... 19.F0~.., and approved by the Building Inspector Fee $.].D,.Cg) ........... SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH AU8 9 19 6 Date Bldg. Permit No. ~//~ TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Gi~e deed location) have been inspected by this department and found to be satisfactory. District Engineer ~ ..... District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ]9 ........ Permit No. Disapproved a/c .................................................................................. (Build~or) 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 issua.nce 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, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code 'and regulations. (S.gnot~'e'~ opphcant, or name, f a corporat on) ........................ ..................... (Address of applicant) (/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~/~.'/..~. ....... ~ .... F~ If applicant is a corporate, signature o7 duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ........................................ Lot No.: ...fi/ ................ Street and Number ...'...~..4.~.¢~.<....~.~..:....~.~....~ .......................... ...~.~...~.'..~.~.~.~..~.:..~.'. ............................... Municij~ality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ..... ......... ~. .......................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .............. Rep ~ir .................. Removal .................. Demolltlan .................. Other Work (Describe) .................................... ....... 4. Esti noted Cost .................................................. Fee ...................................................................................... (to be paid on filing this application) , / 5. If d;Welling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If ~rage, number of cars ......................................................................................................................................... 6. If ,usiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Di ensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... He !iht ........................ Number of Stories ............................................................................................................. Dirr ensions of same structure with alterations or additions: Front .................................... Rear ....................... DaP:th ................................ Height ............................ Number of Stories ................................ · ' .. 8. Din' ensions of entire new construction: Front .......... .~. ....................... Rear ...... .~.'..~.. ............... Depth .':~....g.?.f' ' Hei!lht ....L~..~. ........ Number of Stories ..... [ ......................................................................................................... 9. Siz~ of lot: Front ...... ././....O...'. ........... Rear ......... ./../..?-.~ ................. Depth ..... ./...~....~...~ ............... 10. Dot of Purchase ........................~'.. ............................ Name of Former Owner .~.-"-<~.... 11. Zor e or use district in which premises are situated ...... rf'/~.. JL 12. Doe~ proposed construction violate any zomnfl, law, ordinance or regulahon ...... ~ ........................................... f 13. Narhe of Owner of premLses .../i?r..,~ ;,.,~,~,~ ...........Address ............................................ Phone No .................... Nar~e of Architect ..,d~..¢:.~~...~.. ...... Address .~....~-~.~...~...~:Z.......~.~... Phone No ................... Na e of Contractor ....... .............. Phone I_ocat~ clearly and distinctly all buildings, whether existing or proposed and indicate all set-back dimensions frl~ property lines. Give street and block number or description according to deed, and show street names and' indic~1 whether ntenor o corner lot. I / ~ ~ STATE aFl, NEW YOR~,, . ~ S c I(Name of individual signing application) (Contractor, agent, corporate officer, etc.) of said owllner or owners, and is duly authorized to perform or have performed the said work and to make. and this appli~.ation; that oil statements con'~ained in this application are true to the best of his knowledge and belief; that the Y/ark will be performed in the manner set forth in the application filed therewith. Sworn to I~efore me this Nato y P bi c, County gnature of apphcant) I ~o. $2-7.2~7800 Suffolk ] ~r/ll ~xpires March 30,