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Home My WebLink About3135-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. O~"i~TIF'IO,~TE OF' O00UP,~NOY THIS CERTIFIES that the building located at .~].~...~OP~ggY..~'.q~lt .]~.... Street Map No .... ~ ..... Block No...~ ...... Lot No..~ ..... ~0~.~.~O~{. ~,~.~ ...... conforms substaniially ~o the Applicati.on for Building Permit hereto~m'e filed in this office dated ............. 4~ .... ~7, 19..~ pursuant to which Building Permit No.. 31R~. ~ dated .............. ~ .... 2~ 19. ~, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .occupancy for which this ce~ificate is issued is P~t~t~..0~ .f~i~. ~W~l,~i~g ........................................... ~"~ ~ ~ ~" ' · · .0~.~* ............................. The certificate is issued t.o .. ::,.L J~.,. 9.,~.~:~ ...... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ....... iq.,~ ............................. ...... Building Inspector FO~M NO. 2 TOW~ OF ~O~JTHOLO BUILDING DEPARTMENT TOWN CLE~'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON'THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3135 z Permission is hereby grant.ed toL at premises located at ....~/.~.....~.O.~D~f~... ~.~....~.:~ ................................................. : ........ .................................... ~0~.t,~o2,4~..... ~., .~ ^ .......................................................................................... pursuant to application dated ............................... ~e.....2~. ........... 19..~6., and approved by the Building Inspector Fee $"'~',~ "90 ............ ~'ol~I No. 1 T~WN OF SOUTHOLD BUILDING DEPARTMENT I~OWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ......................................... 19 ........ Permit No. . .~...,....... (Buitdin~ Inspo~tor) .................. g ......... ....................................... UUI'DI a 'URMIV Date .......................... ............... , ....... 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 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 o 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 oil applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if o corporation) Southold, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. ...................................... .A..g.e...n..t 0.£..O.W.~.e~ Nome of owner of premises ....~E;Lli.~...I~..,.,r~.r.r..~ ............................................................................................................. If applicant is o corporate, signature of dulv authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ................... ~:;~:;~ .......... Lot No.: ...... :~Lx~ ........ Street and Number S/.S.....J.ockeT...C~.ee.k..Dr.~ ........ &o~ztho. lcl.~...~.~. ......................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....c~..'l-3,~D.g ............................................................................................................ b. Intended use and occupancy .............. .s...a..m..e....~.~t..,~...a..l'l.....a..d..~.~.%..~.o...~. ................................................................ 4. 5. 6. 10. 11. 12. 13. Nat~Jre of work (check which applicable): New Building .................. Addition .....~ ....... Alteration Rep6ir .................. Removal .................. Demolition .................. Other Work (Describe) Esti~noted Cost ...~30.0.~f).q ........................................ Fee .$....~,,DO I (to be paid on filing this application) If d~'elling, number of dwelling units ..... one ............... Number of dwelling units on each floor if g~rage, number of cars If l~usiness, commercial or mixed occupancy, specify nature and extent of each type of use DiMensions of existing structures, Jf any: Front ............................ Rear ................................ Depth Height ........................ Number of Stories Dir~ensions of same structure with alterations or additions: Front .................................... Rear Dep:h ................................ Height ............................ Number of Stories ................................ Dirr ensions of entire new construction: Front ...]~,0....~ ..................Rear ........... ~,~ ............ Depth ........ ]:'O ....... Hei, lht .................... Number of Stories ..............9.~.~. Size of lot: Front ............................ Rear .................................... Depth ................................ Dar, of Purchase ........................................................ Name of Former Owner Zen or use district in which premises are situated ..... Doe proposed 'construction violate any zoning law, ordinance or regulation? Na ~e of Owner af premises ,-,~'L~£~..,~.,...~.~.~F..Address ........ ~g..~.]~C~.3.~- ................ Phone No. Na ~e of Architect ...................................................... Address ............................................ Phone No. Na~ ~e of Contractor .......se~z~e .................................... Address ............................................ Phone No. Local property I whether ir PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frJJ)m nes. Give street ar block number or description according to deed, and show street names and indicate terior or corner Jot. says that he is the applic STATE OFf NEW YORK, } S S · .J .... T~O~.~'~I. ~, ~]e~.~'.~ ...... be ng duly deposes and (Name of individual signir~g application) sworn, named. of said o~ this applk that the w Swore to k He is the ................. .~.gen¢...o.~...e~e~, ..... (Contractor, agent, corporate officer, etc.) ner or owners, and is duly authorized to perform or have performed the said work and to make and alien; that all statements contained in this application are true to the best ol~ his knowledge and belief; )rk will be peri'armed in the manner set forth in the application filed therewith. afore me this ~.~... day of .................... ,3'.~ .............. , 19.~.. Z/,~ . t/ (~ ~ , ~ '_ ~ ~ fig ~ ~ ' .....~L~.~l, fd:~ff~t.~h~..t~k, .................. .~Y~........~5!~ ....................... ~lic, ./.~,~:f,V,~......(~'~ Coun~ (Signature of appJicanCJ UBliC StaLe oJ New ¥0tR~ //~/ ' Notary Pu