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Home My WebLink About3139-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Oit Occupancy No.Z..3~,~ ..... Date ........... ~,... ~: ..... , '19. TI-lIS CERTIFIES that the building located at I1/$. l~/~,-t~I~t~mmel~..~ ....... Street ~bo~ Map ~ ............ ~ck No ........... Lot No. aS ...... 8OU2.OZd ...~.,~, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... l~e .... a~., 19.66. pursuant to which Building Permit No. 3t3~.. · dated ............. J~... 3~ 19.66, was issued, and conforms to all of the require- ments of the applicable provisions o~ the law. The occupancy for which this certificate is issued is .P~age..one. r~l~ ]dvol~$ng ....................................... The certificate is issued to .... ~old..~ee~e ........ ~ ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~[y. ~...1.969...by. ga .V~[I~ ..... " Building Inspector [ ! FORi~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT SOUTHOLD, bi. Y. BUILDING PERMIT. (THIS PERMIT MUST BE KEPT ON THE PRE/v~ SES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3139 Z Permission is hereby grohted to: ......... 8~....8~.~,ae,..IJwy......:..,.,:....:.;.,......:. ......... :. ~y~.~r .:.,~ ~ ~.,, ....... ; ........................ to ....ma~e...alte~a.~.~n~...a~a...eo~:~%~o~..~..~.:e~t~=~...b"~lta:L,~ .......... .......... ( .~o.~er .. to e,z,m-i-t~. · e:c~'~=e~t.) ....... ~ ......................... ,.. ,: ...................................... ~ ................. et premises located at ...... .............................. ~.~c%~ e~e~,..~.~...:.~o~.~ ~.-.~.~ ...... ,.. .................. : ............. ; ........... pursuant to application dated ................................ ~T~.--~e.-.-.~ ......... 19.~.., and approved by the Building Inspector Fee $.lO.e.O..Q..~. ...... ........ ~.. .~:'~¢,.~ ....... :.~ ....... {.. ~.~,..r:~.~ ..................... Building I~spect0r[ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date BldgTP~rmit~No. TO WHOM IT MAY CONCERN: at h% _~ sewage disposal facilities for (Give deed loca~on) a structure located have been inspected by this department and found to be satisfactory. District Engineer District Engineer BUILDING DEPARTMENT TOWN CLERK'S OFFICE Approved ........................................ , 19 ........ Permit No ............................. D~sapproved (Buildin~ Inspector~ APPLICATION FOR BUILDING PERMIT Date .............. Z.~....~..~ ......... ~...~....--.. ........... , 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 issue.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 all applicaNe laws, ordinances, building code and regglatlons. (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. ~..~.~ ...................................................................................................................... Name of owner of premises ..... ~...~..~....~...~...~..~. ........................................... ' ............................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~J'}~.~O~ ~l~}/"S ~7~'7~ 1. Location of land on which proposed work will be done. Map No.: ........................................ Eot No.: ~ ~ ~ ~ ..... ~.~.~1~.%.~ ~.~ ~..~ ~. ............................. ,~.~ ....... ~.~ ........... ~. ~.~ ~ ~ ........ ~ ....... .~:.~..~.~:~..~ ................................................................. b. Intended use ond occupancy ......................................... ~. ........................................................................... 3. NatUre of work (check which applicable): New Building .................. Addition .................. Alteration _.~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) . .... ~'.:~.~..0..?. ....................................... Fee 4. Eshrboted Cost (to be paid on filing this application) 5. If d~velling, number of dwelling units ........ I ................... Number of dwelling units on each floor I If g~rage, number of cars ..................................... 6. f I~csiness, commercial or mixed occupancy, specify nature and extent oftag.h type of use 7. Dirr{ensions of existing structures, if any: Front ..... ~,.~. ................. Rear ._.i~...-! ..................... Depth .I I He~$ht ...... .............. Number of Stories ............. Dim:,ensions of same structure with alterations or additions: Front ......... ~.~...~..~.......1~.~.,.. R,d'. ~.1~.0.~ .~. ......... Depth ................................ Height ............................ Number of Stories ................................ 8. Dirdensions of entire new construction: Front .................................... Rear ............................ Depth Height .................... Number of Stories .................. T 9. SizeI of lot: Front ....... Jl~'..t. ............ Rear ........... L~..O. .................. Depth ......... .~..~.""~....'. ........... 10. Doth of Purchase ........................................................ Nome o.f Former Owner 1 7. ZonJe or use district in which premises are sffuated ......... .r~..~,,~k,~,J,l~.~ .................... 12. Doe proposed construction vi61ate any zoning law, ordinance or regulation? ....~..~. ....... 13. Nat ~e of Owner of premises ...~...~i.~..~..~..~. .............. Address ..~..~..:~;...~..~...~.~L .~.....[~...~t~J~.~Phone Na~ne of Architect ...................................................... Address ............................................ Phone No. Nar ~e of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM Local; clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property nas. Give street and block number or description according to deed, and show street names and indk whether in~erior or corner lot. Lo-r .~a? ,, STATE OH NEW YORK, COUNTY OF ...~S.9.;['~p%~¢ ............... ,f'~'o. .....'i."- -.~.~.~..~.. Rf....~.S..~ ........ be ng du~ydeposes and soys that be ~s the opp~, I(Name of individual signing application) ........ sworn, above narbed. He is the ........ ~.~.~/.~,.~ / (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application ore true to the best of his knowledge and belief; that the w~ork will be performed in the manner set forth in the application filed therewith. Sworn to bjefore me this ....... ....... .......... ...................... .... ' I olk ................................................... Notary Public_, ;,.i,~.~,~Z~..'~.... ............. County ~L"~"~'""(Signature of applicant> i(otalY Pllblic 5 ,t.e,, ,of New No. 52-0508380, .~,.ffolk I~ F,,xpi[es March ~O~