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HomeMy WebLinkAbout3869-zTOWN OF ~OUTI-IOLD BUILDING DEPARTMEN~ 'I'OWN CLERK'S OFFICE SOUTHOLD, N. Y. P. Ei~TIFIOAT£ Ol:' Ol]OI~II~ANI]Y No. ~. B.333. .... Date ..... D~e~r..5, ............. 19.68. THIS CERTIFIES that the building located at a/.S. 8t~ca~mo~. lto~d ....... Street Map No .... 3.723 .... Block No ............. Lot No. ~ .., ~a~ ~iOn,. ~e~..~O~k... conforms substantially to the Application for Building P~rmit hm'etofore filed in this office dated ......... .~Z.4~ ......... 19.~8. pursuant to which Building Permit No. dated .......... ~Z.. ~-.O, ..... 19..68, 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 ...... pr. iva.te. ~ne..family .~llin¢ ..... ~ ................................ The certificate is issued t~o .. An~ew..TsavariR ..... : ................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~o~. FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Building Inspector. ~ 19...~ approv~ by the pursuam to application' dated .......................... ~ ................... ,....., .. and S-9 SCHD SUFFOLK COUNTY DEPARTMENT OM HEALTH Date Octob~r 28, 1968 Bldg. Permit No. ~ 3 TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located s/s Strathmo~e Rd, 175' w/o Rocky Point Roa~ E~t Marion (Give deed location) have been inspected by this department and fonnd to be satisfactory. Bu~]der - Inland H om s O~,mer - AMdrew Tsavaris DJ ~tr$ct Enginsez~ District Engineer COLONIAL RANCH CZ FLOOR PLAN · FULL CELLAR · FULLY INSULATED · CUSTOM CABINETS · ATTACHED GARAGE · COPPER PLUMBING · CERAMIC TILE BATH · HOT WATER HEAT · CEDAR SHINGLES · INTERIOR & EXTERIOR PAINTING · 2 CESSPOOLS INLAND ~'~, SE 2-2177 473-7349 432 lqIDDLE COUNTRY ROAD, SELDEN, N. TOWN OF SOUTHOLD TOWN CLERK'S OFFICE Approved ........................................ , 19 ........ Permit No .......... Disapproved APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in idk and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relati6nship to adjoining premises or public streets or areas, and giving a data ed descr pt on of ayout of property must be drawn oh the diagram which is part of this application. c. The work covered by this application may not be commenced before~ssuence of Building Permit. d. Upon approval of th~s apphcot~on, the Budding Inspector wdl ~ssue o 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 sh~ll be occupied or used in whole or in part for any pu(pose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of ~ Building Permit pur~suant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Ybrk, and other applicable Laws, Ordinances or Regulations for the construction of buildings, additions or alterations, or f~r removal ~or demolition, as herein described. The applicant agrees to comply with all app icab eaws, ord nonces, build t~g code, hous ng code, and regular ...................................................... (Signature of applicant, or name, if a corporation) ...... ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractoF, electrician, plumber or builder. ................................... ............................ ......................................................................... Name of owner of premises ...... ~J~Cl,~'.eY/....~.8~kV.~,l~fl...t..~..-...~f.....~../~.~o.t~l~. ,.~Taekao~..~e.~g~,~;~...~. ........ If app~duly authorized officer. ......... off,car) 1. Location of land on which proposed work will be done. Map No.: ..... i).~.~ ......................... Lot No.: ...~ ................... Street and Number ...... .~./.~.~...~.~..~.~.~.~..~.~.~.~.~.~..$.~.~.~.~.~"~k~*~A ...................................................... Municipality 2. State existing use and occupancy of premises and intended use an~ occupancy of proposed construction: a. Existing use and occuponcy ......................................................... i ......................................................................... b. Intended use and occupancy .................. .~. ........................................................................ 3. Nature of work (check which applicable): New Building ..... ,~.-~..~. ..... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ $1~ ,000. O0 4. Estimated Cost ............................................................ 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 ............ ,O.,,~.e.....~...~..~.....~.~.Z'...8.,~,.~ .............................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ ~..~ D~mens~ons of exmtmg structures, ~f any: Front ............................ Rear ................................Depth .................... **'J~jght ........................Number of Stories ................................................................................................................. Dimensions of same structure with a, lterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear............................;~;) I Depth ...~..8..! ................ Height .................... Number of Stories O~E zos, ................... ........................................................... 9. Size of lot: Front ............................ Rear ...............~. ...................p h ............................... 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 1 1. Zone or use district Jn which premises are situated ..................................................................................................... 12. Does proposed construction vi6late any zoning law, ordinance or regulation? ............................................................ ~ .... ~.~ A, Tmava~l~ Address.~.-~6 7~$h., .,S~._,__Phone No. 13. Name of Owner ,~, ~ ................................................. ~tl~O~..j~.~l~;.gl~,~i~f¥..~ .................... Name of Architect ...................................................... Address ............................................ Phone No ..................... .. . . I~iand Home~ vno,, _.. z~2 ~liddle Oou~=.~ ~. N?~2-2177 ... Name of ~,ontrac~or .................................................... /~aaress ...~O~.~...j~i~..~.~l.~...~[L~ r'none .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from properly lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. J STATE OF NEW Y,C)RI~, .. ~ S S COUNTY OF ...... ..~..l~..~..~[..O..J:..~.. ........ ,f . . ..... ~...g.~.~..~..~....H.......,H...~..]....~..z. ....................................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing applicaHon) above named. He is the ..~..0..1~.:~.~..~.$....¢~...~.~..8~,¢]....~.O~.1[I.~..,~g..~., ......................................... · (Contractor, agent, corporate officer, etc.) "~ of said owner or owners, and is duly authorized to perform or have performed the said work and to m~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; anti that the work will be performed in the manner set forth in the application filed therewith. SworrKtobefore me this · fi .... .............................. Notary Public ../.~..%~..~lm,.~!~-~mf~k/;~N~?.~.. ..... County - (Signature 6f appli~,¢nt) Examined ............... ,....~.. ............... , ........ Approved ........................................ , 19 ........ Permit No ....................... Disapproved a/c -7 ................................................ hJ~ 4~t/ ~1- ~ ................................................................................... .. ................... ,. .... . ,...~ .J APPLI~TI~ FOR BUILDING PE~IT ........................ , ........... 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 pub c streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which ~s port 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 whoie 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, Ordnances 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, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... ``'~d~4~:~1K~.~&~[~.~.~.~.`~4`~1~4~4T&~r"~~.G~..j~`~ ....... If app~duly authorized officer. I. Location of land on which proposed work will be done. Map No.: ..... ,~'~ ......................... Lot No.: ...1~ ................... Street and Number ...... ~l./.~...~.~l~.~,¢~.ll..~,l~,~s..~l~...]~.ll~.~l~l..jr~.~ ...................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupanc~ .................................................................................................................................. b. Intended use and occupancy .................. 3. Nature of work (check which applicable): New Building ..... ~ ...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost S[~iOOOeO0 Fee (to be paid on filing this ~pplication) 5. If dwelling, number of dwelling units ..... ?..~..?. ................ Number of dwelling units on each floor ............................ ~ .... W a, IL~ ~e . .... If garage, number v. ,~. .......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ :~J~l~)imensions of existing structures, if any: Front ............................ Rear ................................ Dep h .................... ~¥~... ~l~j~'~J~ht ........................ Number of Stories ......................................................................... ~ ....................................... Dimensions of same structure with alterations or additions: Front ................................... ; Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Dimensionsof. entire new construction: Front ......~..~..!. ........................ Rear .....~.~.~. ................. Depth ...~..~...I. ............... 8.' Height .................... ]l~s Number of Stories ~ - .............. : .......... . ~ . 1LO~' Rear '"~'~ ....................... ~ ...... '.~i~ ....................... 9. Size of az: ~ron~ ................................................................ De~th ............; ............... t0. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12~ Does prop6sed construction ~i61ate any zoning law, ordinance or regulation? .......................................... ~ ................. 13. Name of Owner of premises .~...*.....~...~...?.~....~.....~. ............. Address.~l'~w..~-~..~..*.]~Phone NO ..................... Name of Architect ...................................................... Address ..................... ....................... Phone No ..................... Name of L.ont'rac~or .~ ................................................. ~oaress "~Oll~'~'"~lX~il~l.'~'"lr~"~ . .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing Or proposed, and indicate all set-back dimensions from property lines. Give street end block number or description according to deed, and show street names and indicate whether interior or corner lot. I I 11111 I r STATE Of NEW Y. DR.I~ .. ~ COUNTY Of ...... ~.~.~ ........ $~'~' .,'" ..... ~g.l~.~j..~......~.~..~..:.... ;.... ~ .................... being duly s~f~ deposes and says that he is the applicant (Name of individual signing aPplicatiOn) /' above named. He is the .~.~.l~,.~l~".~...~ld[Ikl~l~.~.~.]ll~ll.~T~.~'e'a'";a ...................................................... i..~..~ ........ ~ .... (Contractor, agent, corporate officer, etc.) ~ of said owner or owners, and is duly authorized to perforr/or have performed the said Work and to make and file this application; that all 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 forth in the application filed therewith.