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Home My WebLink About3146-z~OI~F~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C/JERK'S OFFICE SOUTHOLD. N. Y. ~£1~TII:'II~ATI~' rIF rIP. I~UPANP.¥ No.Z~6~0. ...... Date ........... D.e, aelabe:t'.... 6 ..... 1966. THIS CERTIFIES that the building located at .]~g*~. ~Or~i~. ~aB~ .......... Street Map No..~ ....... Block No..y~ ....... Lot No. ~ ....~O~t~O~..~,~, ......... con2orms substantially ~o the Application for Building Permit heretofore filed in this office dated ............ ~U.~y...6 ..... 19~6. pu~rsuant to which Building Permit No.. 3~6 .Z dated ........... ~....6 .... 19.~6, was issued, and conforms to all of the require- ments .of the applicable provisions of the 1aw. The .occupancy ~or which this certificate is issued is .... P~lYa'~e' one. '~i~y '~et~ing ....................................... The certificate is issued t,o . .Le~enee'.ttughe~.& .~.~e ....... ~e~.a .............. (Swner, lessee or tenant) of the afore.said building. .Suffolk County Department of Health Approval ...D~.~,..~. ~ .b~ .R*..~ ...... Building Inspector FORM NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC£ SOUTHOJ. D, N. Y. N? 3146 BUILDING PERMIT (THIS PERMIT MUST BE KEPT:ON :FHE PREMISES uNTIL FULL COMPLETION OF THE WORff AUTHORIZED) Permission ,is hereby granted to: . ...... BO.....~b.b~..,P~u~.~..,.., ............. :....: ...... ........ N~s~or~s~t~.~.N.~Y.~...... .............. : ........... ~o....~.z.~...n.,?.t~...~...~.t.,.z.~...~.~.e.~.~.~ ....... . .............. ......:.....i ............................ : .................. at premises located at ..... .~.~J....,~O~"~.:~,t~...~ ......................... : ........................ ~ ....... ~ ................... $outhold~ pursuant to appllcation doted .............................. .~..,,~,..~.. ......... .~. .......... 19.....~..~., and approved by the Building Inspector Fee $.....~...0...,..0...0. ........ 8-9 $CHD SUFFOLK COUNTY DEPARTNENT OF HEALTH Hate Bldg, December Permit TO ~OM IT gAY CONCERN: The sewage disposal facilities for a structure located at. e/s Hor~on lvenue~ 21~ s/o Sound~ie~ A~e~ Southold (Give deed location) have been inspected by this department and found to be satisfactory. Builder John Desiderio Owner Laurance Hughes FOE~ NO,! T~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Application No. APPLICATION FOR BUILDING PERMIT ................................ , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and sub~it~ed 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 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 far inspection throughout the progress of the work. e. No building shall be occupied or used Jn 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 df Southold Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or a terotions, or for removal or demolition, as I~erein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. .... (Signature of applicant, or name, if a corporation) 7: If op~;~j~ca_n~is ~¢-o~,ate, signa~ure~of duly but~rized o f'c . ' ...... .......... ..... " (Name and title of corporate officer) 1. Location of land on which proposed work will be done..~Map No.: ........................................Lot No.:~: ...................... Street and i~umoer ..... ~......~...,.~..I ...................... ~.~. ........ ; ........................... l..: ......... r. ......... t ................................ ~ /~unicipality , 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: e. Existing use and occupancy ........... ~.~ .................................................................................................................. b..,l~'ended use and occupancy .~ ....................................................................................................................... 4, 5. 6, 10. 11. 12, 13. Nature of work (check which applicable): New Building ..... ~kddition .................. Alteration ............... Repe r .............. Cr:~,Removal .................. Demolition .................. Other Work (Describe) ..................................... Estimated Cost :~ ..........'~..1 .............................................................................................................................. ~ / (to be paid on filing this application) ff d~e[linO, number of dwellino units .......................... ~umber of dwellino units on e~ch floor ......................... If 0o'~e, number of c~rs ......... ~ ..................................................................................................................... ' .......... I~ b~siness, commerciol or mixed occupancy~ specify noture end extent of each type of use ......................... D~m{ ns~ons of existin~ structures~ if any: Front ............................ Rear ................................ Depth .................... ~ei ~t ........................ ~umber o{ Stories ............................................................................................................. Dim~ nsions of some structure with oltorotions or odditions: Front ....................................Reef ........................ Dopt ................................ Heioht ............................ Mumber of Stories ................................ Dim, ~sions of entire new construction: Front ....~ ....................... Rear ...... ~...C ............ Depth ..~..',. ........... Haig at ...~ ........ Number of Stories ....... ~ .......... ~;..~ ....... =:.-.., .............................................. t t' Size ~f lot: Front ....t..~.~ ............. Reo~....l ............................ Depth ..l ............................ Dote of Purchase ........................................................ Na~,A ~f Fo~er Owner ...................................................., Zon~ or use district in which premises are situated ........... ~......~ ................. :....' ........................................ 11.. Doe~ proposed constructio~ viol~,ahy zoni"~g law, ordinance or regulation? ..... ~ .................. ~.., ........ ......... Na~e of Owner of~premises~..~~ ........... Addres~:.~.~.....~.~....~n~ ............... NaMe of Architect ................ ~ ..................................... Address ............................................ Phone No ..... ; ........ Nome of Contractor ~~'...,~d~....; ................................. Phone No ................. PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ~es. Give street and block number or description according to deed, and show street names and indic~ erior or corner lot. Locot~ property Ii whether STATE OF qEW )~'ORI(, /~¢ c ~ ...................................................... being duly sworn, deposes end seys thor he is the applic qame of individual signing application) above named. He is the ..................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said ow/per or owners and is duly authorized to perform or have performed the said work and to make end this application that all statements contained in this application are true to the best of his knowledge and belief; that the wqrk will be performed in the manner set forth in the application fi ed therewith. Sworn to b~bfore me this ......... .............. . ......... . (Signature of applicant)