The URL can be used to link to this page

Home My WebLink About3177-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CEERK'S OFFICE SOUTHOLD, N. Y. P. EI~TIFIrI. ATI~ rIF rlr:~UPAN~¥ No.. ~. 2~2.. Date ............ Saptembel?.. 30.. 19.66 THIS CERTIFIES that the building loc,areal at ~/~..~ySh~r~ .Roa~ ....... Street ~ P~onte Bay Estatea~ammende~ ma~ A.~ ap 1~o ............. ~lOC~ ~o ............. ~o~o..~6 ........ 6~eenpo~t~..N.X, .... conforms substantially ~o the Applicatl,on for Building Permit hereto~e fil~ in this office dated .......... ~.... ~9..', 19.66 pursuant to which Building Permit No..~.~.~..~ dated ........... ~.... ~9.., 19.66., was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .occupancy ~or which this ce~ificate is issued is . P~vg~e..o~e..fam~. d~eZ~g .......................................... The certificate is issued ~o . .go.aeph-.. ~og~g .......... ~e~ ..................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ...... ~9R, ............................. Building Inspector FO]~F~ ~0~ 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH CLERK'S OFFICE SOUTHOLD, N. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 3177 Z Date ............................... 4. ....... ¢~:.z.-' ......... , Permission is hereby granted to: ............. , .................. ~O¢.O~:I~L~ ~.....E.o.~-,*, .................. , .......... at premises'located at ..le~' ..~.S~'"-~]eeC~e-'.Z~a~-"'~]~aCes'".~'~mate-~d~d.-~m~"-~%tt*~. ................ ............ '.. :..... ....... .... ~e..~.~ ~.e., ~o~ ~ ........... ~e~.~o~.¢.,... ~: ~.. ................................................. pursuantrto application dated ............................. .~T..g.~k,~......~..~,~...].~o.~, 19 ........ , and approved by the Building In§pector Fee $ ~..~ O.O .............. FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .~.~......~.....(. ........ , 19~ ........ ~ Approved ~ ........... ! ......... :.'. ............ ,19 ........ Permit No...~.:.....:.:.:.....:...~ (Building Insl~ector) APPLICATION FOR BUILDING PERMIT Date ..~,,~ .......... .~.....~.. ................... , 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, b~lding code and re~¥/atio~ ........ ~;~~~ "' .L~ ......... ~.~ t 'g ure at ap{)iicant, or name, if ~ corporation) ..... ........................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. .................... ............................................................................................ If applicant isa corporlte, '~:'"'~' 'gn~r~~i'~'orJ~ze~ o'~ 'c'e'r.~':' ................................................................... (Name and title of corporate officer) 1. Location of bnd on which proposed work wild, be done. Mgp No.' .~.....~..~....~ ................ Lot No' Street and Number ......... .~....~. ~.j ........... ..~-.~t~..~.....(~....~...~ ......... b. Untended use and occupancy ...... ~~~ ........ ~ ........................................................................... 4. 5. 6. NatUre of work (check which applicable): New Building .................. Addition .~.. Alteration Rep6ir .................. Removal .................. Demolition.. ................ Other Work (Describe) [stir ~ated Cost .......... ~.(~..0 ................. ~ ......... Fee (to be poid on filing this opplicotion) If d. velling~ number of dwelling units ............................ Number of dwelling units on eoch flaor If g~ rage, number of cars ........ If b~usiness, commercial or mixed occupancy, specify nature and extent of each type of use Dimlensions of existing structures, if any: Front ....... .............. Rear ......... ...............Depth Height' ..... .~...~. ............ Number of Stories ......... / D~mens~ons of same structure with alterations or additions: Front .............................. Rear DiMensions of entire new construction: Front .................................... Rear ............................ Depth Height .................... Number of Stories Datb of Purchase ........................................................ Name of Former Owner Zon[e or use district in which premises are situated Doe~ proposed construction any zoni~ ordinance or Nar~e of Owner No. / No, ne of Architect ~ ............ No. Na~qe of Contractor No. PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr nes. Give street and block number or description according to deed, and show street names and indic !erior r corner lot. 10. 11, t2, 13. Locot property 1 whether in STAI-r: OF[ NE'~ fO~t(/. COUNTY !OF .: ~..~: ....... ~ ~'~' C abow~ no~ed. He is the ............... of said o~ner or owners, and is duly authorized to perform or hove this appliCation; that oil statements contained in this application are that the ~ork will be performed in the manner set forth in the appJicat] Sworn to I me this Notary P~blic, Yor~ duly sworn, )oses and says that he is the applic (Contractor, agent, corporate officer, etc.) · formed the said work and to make and to the best of his knowledge and belief; therewit ignature of applicant)