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Home My WebLink About3171-zPOR~I 1~0. 4 TOWN OF SOUTHOLD ]~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OEI~TIFIOATE OF orI. I]UI~ANI]Y No. ii 2598 Date O~tober 28 19 66 THIS CEI~TIFIES that the building located at .~.a.~..k.~.a.y..&...w.o..o.~.e.l~.~. ;I~.~, .... Street Map No.S.O.~..t:.h.v.O.o. ·d. Block NO. ~ ........ Lot No ..... .5.0. ......... S..O.~..t~..O.1.~:. conforms substantially to the Applicati~on for Building Permit heretof, ore filed in this office dated ....... .~..1..y..2..6 ......... , 1~.6.. pursuant to which Building Permit No..3..17.1. ..~. dated ....... ~..Ri.¥..~.6. .......... 19.6.6., was issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The .occupancy f, or xvhich this certificate is addition to OhO family d~elling issued is ............................................................................... The certificate is issued %0 John Rooney (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appr,oval ......................................... Building Inspe?fl; TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLER~('S OFF~CE SOUTHOLD, N. Y. BU~LIDING PEP. MIT (THIS PERMIT MUST BE KEPT OKI THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3171 z Date . .~T~.~. 25, 19....6.~. Permission is hereby granted to: ........ .tV.~.....g~e~...~ve ..................................... ............. ~olt~.....~[ ,Z~ .............................. to ..... J~Zc~..~..~C4~,,~,~c~..~...~4~..~,]L~t,.~ ........................................................... ct premises located at .,~.(~.~,..~.....~...~.~. ~-~1~}'~0~ : ................ pursuant to 6pplication doted ........... 2.1 ........... ~.1~l~1.~. ...... .~..... .......... 19.~.., and approved by the Buildinfl Inspector Fee $-.-..~'e.Ol~ .......... Building Inspector ....... '] FORM NO. 1 'I~OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ~ , ]0.:.: .... Permit No. ,~K../..,../....~,...._~, APPLICATION FOR BUILDING PERMIT Date ......................... ~ ;'i.~.. ~'i.(..~.. ~ ............... , 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 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 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. . . . : Z . . .. ................ "'---'---~/ (Signature of applicant, or name, if a corporation) / ~ . / / , ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, en.qi'neer, ~-~'~r, electrician, plumber or builder. Name of owner of premises .......................................... ~ ................................................................................... If applicant is a corporate, sign6~ure of duly authorized officer. (Name and title of corporate officer) 1. Location of and on wh cb proposed work w be done Map No.' ............. ~ Lot No' ~'~) ;, /, ~' ~ ,' ~ ' /,).' ............. ?\. ........~ ...... ., ................... Street and Number ~'~:~.I..~'[(. ( ~, ]~ ~.~.. ' -~..¢~.~,* ~'. U-4~ ,~'~. !~ ~.- t, ¢,.¢', ,/..~, ~-P..~'~ ' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ .~. ................................ b. Intended use and occupancy ........... ~..~.:~. ~ .................................................................................. Repair .................. Removal .................. Demolition ........... .:.:... Other Work (Describe~ ......... 4. Estimated Cost ................ ~2,~:~..,..~;.0. ..................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~ .......... Number of dwelling units on each floor ............................ If garage, number of cars .......................... ~ ....................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. ~ ......... 7. Dimensions of existing structures, if any: Front ..........~.~. .......... Rear ............... ~..~. .......... Depth ....~...~ .......... Height ....... /..~../. ......... Number of Stories .............~ ........................................................................... .~ ........ Dimensions of same structure with alterations or additions: Front ............... ~....~. ............. Rear ......~...~. ............... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front'~ ........ · .~..'~..~...'.~ .............. Rear ....... .~...~.~...~ ......... Depth ....~',.~..~..O...~. ..... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........... ~,,/~ J"~' .............. Rear .................................... Nome of FormerDepth ...... .c;>,~-~-.i.-~..~i~' ~ 10. Date of Purchase ....... ~w~.,~.~.....~.~,~/.~ ............ Owne~-Z~.~.,'~)~,~~t-~ ........ ] 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction\~ e __ /~.~, z~°late any ~a)ning law, ordinance or reaulation? ............................................................ 13. Name of Owner of premise~~t3t.~-. ....Address ~[~;~01~.~..~/~..(~t/4~... Phone No. .......-~. ............ Name of Architect .~~..^ ......................... Address ................... ~ ........................ o e No ..................... Nome of Contractor .~.~..~Address ...... ~ ....... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. / STATE OF N~ ~K~/ IF /e e // COUNTY OF ...~~.~.~'~' ......................... ~.....being duly sworn, deposes and says t~t he is the applicant above named. He is the ...................... ~.m,~ ......................................................................................... (Contractor, agent, co,orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that oll statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this NOTARY PUBLIC, State of New York ~o. 52-3233~20 Suffolk Coun~