The URL can be used to link to this page

Home My WebLink About3182-z~OR~I ~0. 4 '~OWI~ OF ~OU?HOLD ~UILDI~G D~PARTM~--NT 'I'OWI~ CL~RK*S OFFICE SOUTI-IOLD, 1~. r.I~RTIFll]ATE: OF' I]I]IgUPANO¥ No....~...2.6.4.1.. Date ........... t~ttl~llOry. 3], ...... , 1~?.. THIS CERTIFIES that the buiiding located at ........ I~l. la..iRO~t ........... Street Map No.. ~ ...... Block No ...... ~... Lot No .... ~ .......... I~tl~:oho~lle ...... conforms substantially go the Applicati, on for Building Permit heretofore filed in this office dated ........ J~llcJtlilt:..9 ....... 1956.. pursuant to which Building Permit No.:~tS.2. 'Z'' dated ........ l~UtJtlSt;. 9. ....... 19~6., 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 ...... t~1t~, l~.~l&l, clSn~ ....................................................... , The certificate is issued t,o .... ~,~ll~lal. ~.&Vl~81~i ........................................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ......................................... Building InspecT- FO~M Nfl. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOO~HOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3182 Z Permission is hereby granted to: Midgley & ..Ho~ ~z~ ..J~.0.....A~.~am..,%~wo ak.~L ................. ........... ~te~o~.e ............................................... to ....~ail.d .. an.. ~dA ~.t le~n.. ~ ..~r~ ..b;~.~ ................................................................................. at premises located at ....~.~....~.~:~...~O-~...0~,,...,~%~L.,~!9'~ ........................................................ ................................................. 4]~t~¢~:~o~.....N.,.%, .......................................................................... pursuant to application dated ................................ .~.Uf>~AD.~.....~ ....... 19..~.., and approved by the Building Inspector Fee $..~,.~0 ............. FO~M NO. 1 TOWN OF SOUTHOLD BU!LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .............................................................................................. . ........................... ................................. APPLICATION FOR BUILDING PERMIT Date ..~p,~.a,~.~.....c). ....................................... , 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 drown on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuence 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 o 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. ordinances, building code and regulations. The applicant agrees to comply with all applicable laws, (Signature o applicant,,~r name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ...0...o. ...................................................................................................................................................................... Nome of owner of premises ........ .~.~f~.,,~,,~,~,J-~.~', .............................................................................................................. If applicjant is,~ corj)orate, sigJ~atu~,~ of duly authorized officer. ....... .................... (Name and ~e ~ ~orporate officer) 1. Location of land on which proposed work wiJJ be done. Map No.: ........................................ Lot No.: ........................ Street and Number ....~..~.~.~.Q.~g~Q~.~ .................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and ~cupancy ...~ ...................................................................................................................... b. Intended use ond occuponcy ........................................................... ~. ................................................................... 4. 5. 6. 10. 11. 12. 13. Locat property I whether in Nat ire of work (check which applicable): New Building .................. Addition .......~. ........ Alteration Rep~ir .................. Removal .................. Demolition .................. Other Work (Describe) EsH~ated Cost ..~.~..,.9..0...0..'. .......................................... Fee ...~.~.,..0..g. (to be paid on filing this application) If d~velling, number of dwelling units ............................ Number of dwelling units on each floor If g~3rage, number of cars If J~usiness, commercial or mixed occupancy, specify nature and extent of each type of use Di~'ensions~ of existing structures, if any: Front ....7.~.I .................. Rear ....~.~.~. ...................... Depth ..../,I,.~.! ......... 2 r Hei~lht ....&. ................... Number of Stories ...2. ................................................................................ Dim'ensions'l of same structure with alterations or additions: Front ....... 1.28! ..................... Rear .1.2~t Dep!h ........ J~..! ................. Height .......... 24,?. ........... Number of Stories ....... £ ...................... D~rrlens~ons of entire new construction: Front ...... ~. ........................... Rear ....... .~.0 ................. Depth ...... j~.Q.t. ...... Hei~lht .~..0..~ .............. Number of Stories ............ .~. Size[ of lot: Front ....~.~.]. ............... Rear ....... .'? ........................... Depth .¢0...oz'....~D..,~,oZ'.e,~ Dat~ of Purchase ......... ~-.9.~.~. ..................................... Name of Former Owner ................... q-~.e.~_~b_.], .......... Zone or use district in which premises are situated ........ Doe~ proposed construction violete any zoning law, ordinance or regulation? Name of Owner of premises ,&,,..~fl. ff. fl~,~J, ................ Address C~D~Lt~a. ...................... Phone No. Na~e of Architect ...................................................... Address ............................................ Phone No. Na~ ne of Contractor i.V-r..J,~;~.9.E...~...~g,~.~.O,~, ............. Address g.~.~.¢.~O~lJ,O ....................... Phone 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 or corner lot. STA'I"E OP~ NEW YORK, COUNTY ,OF ................................. ................. ~ ................................................................................ being duly sworn, deposes and says that he is the applic i(Name of individual signing application) above nar~ed. He is the ~j (Contractor, agent, corporate officer, etc.) of said o her or owners, and is duly authorized to perform or h(~ve performed the said work and to make oad this applicjation; that all statements contained in this application ore true to the best of his knowledge and belief; that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn toJ~efgre me this . ~ day of . ............. ...... : ..... ;; ...... Notary Public, 2.~~Z~_g~y~T (Signature of ~erm ~xpires