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Home My WebLink About3951-zFOI~I NO. 4 TOW~ OF SOUTHOLD BUILDING DEPARTMEI~T ~'OWN CLERK'S OFFICE SOUTHOLD. N. Y. OERTIFII~ATE OF FIP. I]IjPANP. Y No..Z. 3.382 .... Date ....... '.. De.c~eml~.er...17., ..... , 19t8. THIS CERTIFIES that the building located at lla,iri. Roacl ................... Street Map No...P.~.¢.OI}:~.. Block No ............. Lot No....~reenpO~to..~le~. York ........ Bay Estates conforms substantially to the Applicati, on for Building Permit heretof,¢re filed in this office dated ...JLll.~... J,2° ............ 19~8. pursuant to which Building Permit No. 3.951..~. dated ...J.~.l.y...~..2., ............ 19.6~., was issued, and conforms to all of the require- ments ,of the applicable provisions of the Jaw. The .occupancy for which this certificate is issued is .... p.l:.i..v.a.t;~.. ~a. ~:.~g~.. (a.C.C~.~O~:y. bulldlrtg) ............................. The certificate is issued t~o ... ~tla..Ctacta ........... : ............................... (owner, lessee or tenant) of the aforesaid building. ~, .Suffolk County Department of Health Appr. oval ........../~! .... ; .......................... ....... "' '! .......... TOWN OF SOUTHOLD BUILDING DEPART/v~ENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3951 Z Permission is hereby granted to: .......... .~.~,....~... .................................. i ................. ...................... · ~~q~ .......... ; ......... ~ ....... .......................... .....~ ....................... .,..~ .,.. ......... ?..~ .......... ~ ........................ ............................................................ :~,...11,~..~,~t,.::. ....... :i"". ............. : .............. ' ........................ o~ p~mi~es ~o~o,ed o, .......... ~..~..:...L".L..,~..~.~*..~.~ ...~e,,~;~'~ ........ ............................... ~..~4..~..~..~.~....,.....~.....!1.~-.t[~ .............................. pursuant to opplication doted' . . :...-~.-~.. :.:.~.........:.,. 1'9:..'~'~: and approved by the Building Inspector, lrOBJ[ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE .~. SOUTHOLD, N. Y. Examined .. ..L...~....:......, 19.. Approved .................... ..Ct. ................. , 19....~.... Permit No. ~....~......~....(....~'. APPLICATION FOR BUILDING PERMIT ...... ./....z... ........ 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 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 whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY/v~DE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, 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, bu~Jding code, housing~ code, and regulations. -- (Signature of apphcant, or name, tfa corpo' " ' " ration) · ............................. State whether applicant is owner, lessee, agent, architect, ~in~r~general contractor, electrician, plumber or builder. ,ame of owner of premi,es .... ..................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Stre~ and mumDer ................................................................................................................................ , ................... Munici~li~ 2. State existing use and ~cu~ncy of premises and intended use and ~cu~ncy of propo~ constmcti~: O. ~isting use and ~cupancy ...................... ~.~.~4~./..~..~ ......................................................................... ~L~ b. Intended use =nd ~cuponcy ................... .~ ......................................... ~.... ........................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..................................... Fee ....................... O/~! ~ (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, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ............................. ; ............................... .~;.~.., ..................... ~_~.~.4 ......... Dimensions of same structure with alterations or addison: Front .................................... Rear ............................ Depth ................................ Height ......................... ..~.~:l/d~m-~er of Stories .................... r ........... 8. D mens ons of ent re ne~ (~onstruct on: Front ....~... .......................... Rear ...J..~.-~. ............. Depth ........................ Height N~r,,~,~'Oo~' StorJfeC~ ~...~. ................................................................................................................ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which ~pt~'~is~' ~i~uated ~' J~ '~ /~r (~ "~ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. .~...O .................................... Name of Owner of premi~s/J.~....~.~./~ ............. Address ...... ~.~,~.-,~.. .......... Phone No ..................... 13. Name of Architect ...................................................... Address//'~.r~,~...~u.l'.t~.~...~ ...... Phone No ..................... Name of Contractor .................................................... Address .................. [.~ ........................ Phone No ..................... 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 dr corner Jot. ................................................................................................. being duly sworn, (Name of individual signing application) deposes and says that he is the applicant Notary Public, . ........................................................... County (Signature of applicant) above named. He is the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 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 perf°rmed ,i~Kthe manner set forth in the application, filed Sworn to y~.~ me this (~ ~.~ /- ~ therewith. .............. Z..-."?... day of ............ ~/(-..~. ..... .~ ........... , 1~..~..