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Home My WebLink About3141-z· ~. FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPAINCY No..Z...2921 .Z Date .......... t~etober...~1 .... , 19.67. THIS CERTIFIES that the building located at . N/S ·. 1.ialn. H,-~:~cl .......... Street Map No.. ;Kxx ..... Block No...:K~ ...... Lot No. xxx. · .8ot~thetd~ -I~,-Y-, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... J.~me...29 ..... , 19.66 ~0ursuant to which Building Permit No. 31h-t .Z. dated ......... June · · .~0 .....,19.66, 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 .. L-usi~Le~s. huildJ, ng .... ol'£1/~e .®t,~ ................. ................ The certificate is issued to . Alfred..Gold ~m.~.th .... o,~,r,o~ .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... 0of,...~O..1~)~.,7...~y..ti.. V.~.lla Building Inspector FO~M NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, Iq. Y. BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3141 z Permission is hereby granted to: &~..~.~.~.~ ~;Ld.~r~.¢~ ........................... ............ 8~tL~Z~&~....~..~, ................................ to .~[~t,3,r~..ne~...b~L~e.~..,bt~:.~.:L,~g .......................................................................................... at premises located ~/.~.....~.D~..~C[...J~).....~G~iGA~.F....,.~.~.'~.~ .................. ;..~.~,...~ ............. ~, ............... ; ........... ~.... ............... ................. : .................................................... pursuant to'opplicotic~n dot~ .,~.i..~....'...,.i,..i .......... ,~.~.:...~,¢~ ....... 19.J~6.., and approved by the Building Inspector Building Inspector/ TOWN OF SOUTHOLD BUILDING DEPARTME~I'T 'I~'OWi~ CLERK'S OFFICt~ SOUTHOLD. N. Y. OERTIFI~ATE OF OBaUi~ANgY No..Z. 26.?.h:.... Date ........ .D.~.o. ,m~.o..I'...i. 3 ........ THIS CERTIFIES that the building located at .E/.~., .l~[t,il~. [tOi~d, ........... Street Map No.. ~X ........ Block No ..... ~ ...... Lot No. lt;}g .... .~.011th0~cl .................. conforms substantially to the Applicati,on for Building Permit heretofore filed in this office dated ............ ,J'll~ao...~9..., 19~6. pursuant to which Building Permit No...3..~?.]:...~ dated ............. ~l'lllqO., .30.., 19.6.6, 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 ...businas~..bui,:k~t.~ig .... ~.~f f.le~¢..ere ) .................................. The certificate is issued ~o ... Aif~.0~l..Gol~-l~l~til;h .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Appr,oval ...... }..~.o~.¢.~.i.rlg .......................... Building Inspector ',, S~FFOLK cou~rrT DEP~'.f~T~f OF HEALTH Riverhead, New York Building Pe~t No, ~ 1 41 .'~ Health Pertinent ~an No, ~[,~. . ~ Application, for Approva~. ,~$~:~ia~ Sewage ~isposal.,,System TO: The Suffolk County Department of Health Date _~/)/. ~ Application for approval of commercial sewage disposal system is hereby requested. (Name'and side Of street, and name and disthnce te hearest in~ersecting Street) Village I hereby certify that this commercial sewage disposal system has been con- etructed in accordance with plans approved by the Suffolk County Department of Health on (date) .... and with all the requirements of the latest bulletins on sewage disposal of the Suffolk County Department of Health. (Builder - O~ner) ' ......... 2eady for inspection ~ I FC~ ~SE OF,,HE~LTH DEPA,RTMER~,,,,ONLY Inst~ation satisfacto~ - Yes .~ ~: ~ed on the i~o~tion s~ted hereon by the a~licant ~ other i~or~on ~de av~lable, it is t~ opi~on of this Department that t~s ~stem with proper aainte~oe ca~ be expected to ~ct~n sat~faCtorily and is not like~ to cause ~ nuis~ce, provided designed sewage flow is not exceeded. Structur~ feature ~re not included. Date 'SCHD - S-13 6/ 8 .~_ Distriot Lng~neer FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ..~.~.....~.~.~...O.., 19........ ~ ~ Approved ........................................ , ]9 ........ Permit No ............................. D' pp d / ~ ................................................. --~ isa rove a c .......................................... ............................... ................................. Application No. ~i /~ I APPLICATION FOR BUILDING PIeR.IT Date ............ .~..~..J~/~ ............ .~. .................... 19. ~': .~- ..... INSTRUCTIONS a. This applicolion 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 premi.ses 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 a Building Permit to the applicant. Such per,re,it 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 Occuparicy 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 o corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ...... /1~ ~.~.~.f~ ~ ~. ~.~.'~?M~3~ ~,,:.~k.. I~ J~.~. .................................. If applicant is a corporate, signature of du~,_~,uthorized of.ficer. '2fi ' e and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.' ........................................Lot No.: ........................ Municipality 2. State existi.ng use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... [%.~/.~.iqL(.~'. ........................................................................................................... b. Intended use and occupancy ....~-~ ......... .~.~.C:t~:~..%...~.t~¢.~ .................................................................................. / 3. Nat~)re of work (check which applicable): New Building .?....,t~ ........ Addition .................. Alteration ["~...... / RepcJir .................. Removal .................. Demolition .................. Other Work (Describe) ........................... * ......... / 4. Estin~ated Cost .............. .~....~'...qZ/~..,.~'.~ .................. Fee ....... .~...1..O..'...~.'..~. ................................................... i ......... (to be paid on filing this application) 5. If d~relling, number of dwelling units ..'.'. ........................ Number of dwelling units on each floor ......................... If gc rage, number of cars .......................................................................................................................................... 6. If bJsiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dim,~nsions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Hei~mt ........................ Number of Stories .............................................................................................................. Dim~,nsions of same structure with a.lterations or additions: Front .................................... Rear ......................... Deplh ................................ Height ............................ Number of Stories ................................ 8. Dim, ~ns OhS of entire new construction: Front ........ :.~L.~ ...................... Rear ...... ;~.~. ................ Depth ...'.~ ............. Height ...... fl..Q/ .......... Number of Stories .................................................................. ; .............................................. 9. Size 3f lot: Front ..... ,~O.'): .............. Rear ............ ~..~. .................. Depth ........ ~.~?.o....~ ......... 10. Date of Purchase ..... ~17t~..i?.~.~ ......... .~..~.~.~. ................... Nome of Forme, r Owner ..~/~P,,.t.~..~.t ....... 1 1. Zone, or use district in which premises are situated .....'.~..~z..l~.~.~.i~.~...~...~.:.~.. ......................................................... 12. Does~ proposed const-ruction violate any zoning law, ordinance or regulation? ........ j~..o. ......................................... 13. Nar~e of Owner of premises .l~.,~.¢~b,O.~...16~...~'.~ ....... Address ..,.'~'.~.'i?l'~.~f) .................. Phone No. Narde of Architect ...................................................... Address ............................................ Phone No Na le/of Contractor .~'~'z~,O.~.~.~.~....~'~.~.~...~'~,ddress ...,:~.C'~.'.t~.~O.~.O. ...............Phone No. J~.?..~..~.'/.~.. / ~ PLOT DIAGRAM Locat~ clear y and distinctly al buildings, whether existing or proposed, and indicate all set-back dimensions fr~ property h~es. G~ve street and block number or description according to deed and show street names and indi~ whether interior or corner lot. STAT[" OF COUNTY NEW YORK, ~cc )F ................................ f .... ~..~..?..~.r....~. ~..~.....G¢..~..~..-,~'~.¢.-/~ ..................... being duly sworn, deposes and says that he is the applic above na.n of said ow~ this applic~ lhat the wc Sworn to b~ fore me this ...... ........ Notary Pu~ .i~~~ .......... Co~ .~ MARION A. I'(~,TARY PUBLIC, State of N · 'No. 52-3233120 Suffolk County Term Expires March 30, I9~,~ Name of individual signing application) , '~d. He ',s the ...~,..,~.. ....... .~.~..Z..~.~-.~.~: ...................................................................................................... (Contractor, agent, corporate officer, etc.) ~er or owners, and is duly authorized to perform or have performed the said work and to make and ~tion; that all statements cont.ained in this application are true tO the best of his knowledge and belief; rk will be performed in the manner set forth' irrthe application filed therewith. (Signature of applicant)