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Home My WebLink About3121-zTOWN OF SOUTHOLD ]~UILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTHOLD. N. Y. P. ERTIFIE:ATE {3F EIE:P. UPANP-Y No. ~-. 2;+95 .... Date .................. A%l~ttS.t~ · - 9", 19.66. THIS CERTIFIES that tile building located at ]~S' 8o~l~h' Oak%~oO~l' '~Ve' Street conforms substantially %o the Application for Building Permit heretof~e fil~ in this office dated ............ ~..~.3.., 19.66 pursu'ant to which Building Permit No. dated ......... ~e~' '1~" 19. ~& was issued, and conforms to all of the require- ments of the applicable provisions of the law. The ~occupancy ~gr which this certificate is issued is . .. P~ivate..erie. fami1.y · 4we].-ling ........................................ The certificate is issued ~o ...Mrs 'Elizabe~'C~;~ ~;'~i) ........... of the aforesaid building. .Suffolk County Depa~ment of Health Approval ..... ~,R, ............................... Building Inspector 1~01~1~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3121 Z Dote'. ............................. ~:~ ....... ?1.~ ......... 19..66. Permission is hereby granted to: ............. ~.~.t~,~ ..................... ~ ....................... to .bnild,. mn..ac~di~i~n,,.or~..a~a.. ~i~ Mug...dx !1 ing ......................................................... Gt premises located at .,.~L~; ........................... ~t~.~1...~.~r.~ .............................................................. ....................................... &o.~..O~I~,~...-.d~ive .......... .t~t~l .................................................. pursuant to application dated ................................ ~.~TI~ ....... ],..~ ....... 19.~,., and approved by the Building Inspector Fee $....~.~..00. .......... ........ f~;~.~.-~. .................... ,.- .......... t ....................... Bui ding nspector ~ FO~M NO. I ?OWN OF SOUTHOLD ~BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... ...~....., 19: ..~.. Approved ........................................ ,19 ........ Permit No. ~'~..L...c~....l'....~.. Application No.....~..~...~'...l ........... !B g Inspector) APPLICATION FOR BUILDING PERMIT Date J~rze :L,~ 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 punic 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, 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, engi'neer, general contractor, electrician, plumber or builder. ........................................................... ,C c~n.~, r,a¢.'~,~ ............................................................................................................. Nome of owner of premises .......... ~TL~...E~.~.~a.~o.a~..C.on~o~ ....................................................................................... 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.: ........ La~cc.e~L..~..a~.k ..... Lot No.: / '~ ~ Street and Number ,,.S,.,,,,fla~zw...aoct,.,D~i~e .......... I~tzz~.el ................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... .C~.~/.~.].~L..~T~ .................................................................................................... b. Intended use and occupancy ............ ~.~.~...,~.~...~l~...~-,q]~%.t~.',i,~.~ .................................................................. 4. Estir 5. If d If g~ Nat~re of work (check which applicable): New Building .................. Addition Z~ ........ Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ~ated Cost .............. .3.OO...~/J~{ ............................. Fee .......... ~'.~.0.0. (to be paid on filing this application) veiling, number of dwelling units ....... Q~e, .............. Number of dwelling units on each floor ~rage, number of cars., Jsiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dim,msions of existing structures, if any: Front ............................ Rear ................................ Depth Hei 'hr ........................ Number of Stories Dim ;nsions of same structure with alterations or additions: Front .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions/ of entire new construction: Front ............ 2.0." ................... Rear ....... ..~.0. ................ Depth Hei~/ht .................... Number of Stories .......... ,(?..aD ........ 9. Size[ of lot: Front ............................ Rear .................................... Depth ................................ 10. Dot~ of Purchase ........................................................ Name of Former Owner 1 1. Zon~ or use district in which premises are situated ....!.LA!.L..d.:LS.~, ........................................................................ 121 Doe~ proposed'construction violate any zoning law, ordinance or regulation? ................ ,g,O ..... 13. Na+e of Owner of premises ...~.,...C.O~DO~L~t ............ Address ........ ,~,ID;'.F,~ ..................... Phone No. Narpe/ of Architect ...................................................... Address ............................................ Phone No. Name~ of Contractor ..];:~.~$~..~.g,J~J.:b], ................... Address ......... V/~t.t,'t,,zL.tu~,~ .............. Phone No. PLOT DIAGRAM Locat9 clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property li'n,e,s. Give street and block number o~ description according to deed, and show street names and whether in ,rior or corner lot. STATE OF COUNTY NEW ~ORK, t ¢c DF ....~.u.t'.£ o:L~ ........... ~' ~'~' I this opplic that the w, Sworn to ....................................... · ].'~'.]_.n...~.'bh.:b']'..]-. ......................... being duly sworn, deposes and says that he is the Name of individual signing application) above nan~ed. He is the .............................. g. QD..~.cA~.l;.qZ.. (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 ~tion; that all statements contained in this application an rue to the best of his knowledge and belief; ~rk will be performed in the manner set forth in the filed therewith. Notary Pu! ;fore me this :~.... day. of ........................ .Z.?~.~.~ ......... , 19..~.. ~ 5Z(Jo~~'~ ,- 30, qature