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Home My WebLink About3106-zIe0BM ~0. 4 ?OWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD. N. ¥. E:ERTIFIP. ATE FIF E]J~F:.IJPANP. Y THIS CERTIFIES that the building located at .~..o.h.Q~'..L.t~t~.O...(~.~.~.). ........ Street Harbor L~ght,~ lg~ . Map No ............. Block No.. ~ ....... Lot No. 1~$ .... ~.011.~.J)9ld,. ~.*.~.~ ........ conforms substantially to the Application for Building Permit hereto~e filed in this office dated ........ ~Y. ..... 2~. ..... 1~.. pursu'ant to which Building Permit No..~[06. ~ dated ......... ~.~ ..... ~. .... 19.~., Was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .occupancy ~or which this certificate is issued is .. ~FA$O..Og~..fgtg$~. ([}{eil~g ..................................... ~I · · · The certificate is issued t,o CB0~go. ~.~e.~0~ ...... ~=~ ............... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval .. ~'~.. 2~..196~. · .bT. ~- .~llla Building Inspector' ' 'l. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH CLERK'S OFFIC£ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? .:3106 Z Permission is hereby granted to: ...6~'ge...Baue~. ................................................ .............. · ~,.~..- ..1~ .....i.d,.t ¢,~.e.,.tq~k...~k.~r~r..... ...................... ~X~;.~:I~..~.....~X. .............. to ..l~uild...n~.w..o~..£A~il.y..~.~3.1&a~g...[ ...................... . .......................................................... at premises located at ..~D.'h..,~-~'. ...... ~e.r..b.o.~',.~i,~h.%~L.~si~..~t ...................................................... .... i ................................... ~,~,t~....~ne.... ....... g~uChot.~t...~, ................................................... pursuant 'to application dated .;; ...... :.....i,;;.~..,....~t~... ....... ,~,~....:.;..., 19~..., ~nd opbroved by the Building Inspector . ' · · Fee $.. '10.~.0,0 ......... .... .~, : ........... ._..ii.:in.~...i_.___.._.r....~ ................... ~u d(nspecto~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. JAN 2 5 19~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed locatio~n) ~ have been inspected by this department and found to be satisfactory. District Engineer iq 6.4°0!''' ~ ~,0 ,¢ t00,0 FORM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. Examined .......... ~..,.~.........~.....~., 19...(-?...¢;. Approved ........................................ , 19..~ .... Permit No Application No. '~ ~ ~o Disapproved a/c .............................................................................................. APPLICATION FOR BUILDING PERMIT Date .............................. ~.~.Z ....... ~2 ........... , ] 9...6..6. ..... 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 o detailed description of layout of property must be drawn on the diagram which is pa:rt of this application. c. The work covere~t 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 Deportment for the issuance of a Building Permit pursuant to ~he 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 fo~ removal or demolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances, bui/l~g code and re,~_lations. (Signature of a/~61icant, or name, if a corporation) ....... .br.~.?. 3.8.....lzL~;.¢3, e...Ne, ck..?k~...Li, J:.~,l e...N.e.c k ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................................... O.~/~ .............................................................................................................................. Name of owner of premises ....(..z.~i0,,~.g~...&..G~,zl..C,~.l)~t.e..,l~..'~,ez' .......................................................................................... 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.: ..... ~.O.~...L~..~.~... Lot No.: ....~.~ ............... Street and Number .~o.~D~...La~e.~.....~ozt~o2~...~...~ .................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~.O. fl~ .~fl~ ....................................................... b. Intended use and occupancy ......... ~..~.~.~..~.~le.;~.~ 3. Natqre of work (check which oppllcable): New Building .....~f~....~. ........ Addition .................. Alteration Repair .................. Removal ..................Demolition .................. Other Work (Describe) 4. Esti~atedl Cost ......],~tD. OO.,.t¥.D~ .......... '. ................... Fee ....... ~,..0. / (to be paid on filing this application) 5. If d~elling, number of dwelling units ....O.T~,e .................. Number of dwelling units on each floor ~f g~roge, number of cars ............................... at'La, ................................................................................................... 6. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth Heig~t,i ........................ Number of Stories Dimensions of same structure with alterations ar additions: Front ....................................Rear / Depl~ ................................ Height ............................ Number of Stories ................................ 8. Dim msions of entire new construction: Front .......... .~.~. ..................... Rear ..... ,ZJ~..6..~ .......... Depth ..... ~.~,~ ......... Hei~ ht .................... Number of StorIes ...... 9. Size of lot: Front ..... ~,.(~.0. ............... Rear ........ 3,OD .................... Depth ....... ~.0...0. .................. 10. Dat~ of Purchase ................. 3..c)~.~'. ............................ Name of Former Owner 19ease i 1. Zon or use district in which premises are situated ......... ..A..,.~..,J:.~.~ ................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~O .......................................... 13. Nan of Owner of premises ....~.e. cL.lq~.'~ez' ............... Address ........ .~l.G~,~e-.~f. ee~ ......... Phone No. Nonce of Architect ...................................................... Address ............................................. Phone No. Nar~e of Contractor ...........~.~.~t~ ............................... Address ............................................ Phone No. J PLOT DIAGRAM Lacat~clearty and distinctly all buildings, whether existing ar proposed, and indicate all set-back dimensions property lihes. Give street and block number or description according to deed, and show street names and whether int,~rior or corner lot. STATE OF NEW Y~RK, I e e COUNTY DF ..~.~,~,~'.C)gJ~ ............. ,fo.a. ................. ~ ................. ~flD,~..~.9,,..~.~ ................................. being duly sworn, deposes and says that he is the Name of individual signing application) above na~ed. He is the ......... 0.1gZLflZ'...=...'~tzzL~l~e~'. ............ i (Contractor, agent, corporate officer, etc.) of said ow~qer or owners, and is duly authorized to perform or have performed the said work and to make and this applic'ation; that all statements contained in this application are true to the best of his knowledge and belief; that the w~)rk will be performed in the manner set forth in the application therewith. Sworn to b~fore me this ............... ~.~'..... day of ...... Z ........ ]~'~"~'~ ............ ' 19.(~6.. Notary Public, ..~.~.~/~.~,....~.,...~~unty ~ature of applicant) ' J I NOTARY PUBLIC, State of New Yo~k , k] No. 52-3233120 Suffolk Cou~t~ ~ Term Expires M,m'cB 30. 19J~,7