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Home My WebLink About3968-zFOI~I NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5681:t· ...... Date ............. Dec...'1.0 ...... , 19..73 THIS CERTIFIES that the building located at N~S. 0lc .Jul~ .La .......... Street Map No..xx ......... Block No...xx ...... Lot No.. z~ .... Eat.tAtuck..N,Y. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... - .........Ju~-y...~8 19..68 pursuant to which Building Permit No. -3968F,. dated ............ July ·.. 2~, 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 .Prt.vate. one. famil.y..dwelling, w£th. Addition. on .W/$. ............. The certificate is issued to . .Au$.tin. B.~ .T~thill .... Owner ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County. Department of Health Approval ....NAR. ~. ............................ UNDERWRITERS CERTIFICATE No..penclin£ ................................... HOUSE NUMBER .... 2800 ..... Street .. Ole. Jule. La .......................... , r - Building Inspector ~ FORM ~0, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE 5OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3968 Z Permission is hereby granted to: ........ ]l~...J~mz~..~.....Au~t~.~L~l~S~l.... ............... .~..t.~.~ ........................................... at premises located at ..... L~......~.~..~...~'~J..~. .............................................................................. ........................................... ~ ~ .t...t, ;l,t,'~,,,k ...... ]L...T:,., .............................................................................. pursua:n~' to application dated .......................... .~l~J~ ....... .~. ........... , 19.~..., and approved by the Building Inspector. Fee $.....,,.... :.! .O. ........... Building Inspector ( TOWN OF SOUTHOLD(/'~/l'/*h''' BUILDING DEPAkTMENT~/>~,/~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ~' 19....~.... Permit No. '~ ~ ~ ['- 7-.._ Disapproved a/c ..... ~ ............ ~ ........ L ............ : ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........~.....~....~...~. ............. /....~'......~... ......... , 19.~..~..... ~ ~--. INSTRUCTIONS ! a. This application must be completely filled in by typewriter or in ink and submitted Jn duplicate to the Building~'~ Inspector. ~.1 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 ~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. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy Wl~ e. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant 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, buJ ' g code housing , and regulations. The applicant agrees to comply with all applicable laws, ~, bui/~i~, g cod~e, hous_il g/~__ (Signature of applicant, es-name, if n ,',~ .,~*,~tinrl) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... .......................................................................................................................................................... Name of owner of premises ........ ~..U.."~.Z./.~ .........~..: ...... ...~....~..Z~../..~...L .............................................................. .~ If ~l,cant(~r~~.~l~thor,z:d officer .~ I. L~ation of land on whic~pmposed work will be done. Map No.: ........................................ Lot No.: ........................ Stre~ and Number ~.~..~..r.~t.~....~.~....~..~~....~'.~ 2. State existing use and ~cupancy of promises and intended use and ~cu~ncy of prop~ constmcti~: ,. ,se ...... ............. ,se ....... ............................................................................................ ! 3. Nature of work (check which applicable): New Building .................. Addition .....X .......... Alteration ....~.'~...:.i..~.~.. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... '.. 4. Estimated Cost ......~....~..~..~.......'~.. ........................ Fee '~' (to be paid on filing this application) 5. If dwelling, number of dwelling units .~)~ .~...C~I) ....... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specif~/ nature and extent of each type of use ...... ~ ................ 7. Dimensions of extsting structures, ff any: Front .....3.~,~ ................ Rear ....,-,~.~.. ................... Depth ........~. ......... Height ......J..~.../. ......... Number of Stories .............................................................................. ................................... Dimensions of same structure with olterations or additions: Front ......... ~..,/. .................. Rear ....~..~...~ ............. Depth ........ ..~...~...(. .......... Height ............................ Number of Stories ...~.~..~.~..~'........~...~...~.~../- 8. Dimensions of entire new construction: Front ....... ~T. ......................... Rear ............................ Depth ........................ Height .............. '-'. ..... Number of Stories ...................................................................................................................... 9. Size of lot: Front ....~.O~.t..~ ........ ~. Rear ........ ~/~/...~. ................... Depth ...... ~/.~..~..~ ........... , 10. Date of Purchase .......... ..~1.~...~./~). ....................... Name of Former Owner ....~.~/~.~..~.....~.../...~..~.~L~/.F.~.~... 11. Zone or use district in which premises are situated ......... ~'~..., ................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... T....~......'T ................................... 13. Name of Owner of premises ~..~...~....~...B.:.T/,~/r~.~ddress ~'~.~.~...f.~...~...c~...~..y.... Phone No~:..~..~...-..~...~.~' Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~.~...~.../~..~.~..?......~....~...~'...~'..~.. ............ Address .~.....~....~...~./..~..~..~ ...... Phone No.~.~....~.a~.~ PLOT DIAGRAM Locate clearly and distinctly~ldings, whether 'exis~~icate all set-back dimensions from property lines. Give street and IN,gck number whether interior or corner lot. ~,,., or description according to deed, ~and indicate-'~ ~· IP'I STATE OF N~ ~ORm 1 S S COUN~F .... ~.~~....i ' ' ..... ...... ............ ,worn. ,n, i, ~r(Name of individual signing application) above named. He is the ......... ~.~.~ ............................................................................................................................. (Contractor, og~t, 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 ~ile this application; that oll statements contained in this application are true to the best of his knowledge and belie~; and that the work will be performed in the manner set fo~h in the application' filed therewith.