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Home My WebLink About3987-zFOIl, WI i'~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N. Y. ~-E:F~TIFIGATE: OF OOP. UPANOY THIS CERTIFIES that the building located at I~a~oau.rotn~ .had ......... Street Map ~o:::~..r.o..~..t. f~ ~o.~. ........... Lot No..,28 ..... ¢,tO~*~-.."..~. ..... conforms substantially to the Applicati, on for Building Permit hereto£o~e filed in this office dated .......... ~'~g"'9 ...... 1968. pursuant to which Building Permit No. ~ .~. dated .......... &~l~ .... ¶~ .... , 19.~.~, was issued, and conforms to all of the require- ments .of the applicable provisi.ons of the la w. The .occupancy for which this certificate is issued is {P~,~'&~e..oFle .~m~:[.~.~. dve']']:tl~lg ........................................... The certificate is issued ~,o '" {{tanle~"lYJ. eFendul~owner' ......................... lesseeO~l~ant) of the aforesaid building. Suffolk County Department of Health Approval .... FORM NO. 2 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) N? 3987 Z Dote .............................. &U~......12 ...... ,19..f~. Permission is hereby granted to: ...~... Ah3,e~,~.... A/O .....8.tan3.e~..ILta~m~n'f pursuan,t to application dated ...................... .A..~ ......... .~ ................... , 19...~.~., and approved by the Building Inspector. Fee $..~.QA.~ ........... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Date January 7, 1969 Bldg. Permit No. 3987Z TO WHOM IT HAY at CONCERN: The sewage disposal facilities Nassau Point Rd. for a structure located (Give deed location) Cutcho~ue ~ Southold have been inspected by this department and found to be satisfactory. District Engineer APPLICATION FOR BUILDING PERMIT ~_. c~,/~-~,ex,,t./~ *~ at. .......... ........ .......................... ,NSTRUCT,ONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this application.-Xj 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 pa rt 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 lows, ordinances, building code and regula~or~. ......... '{'~i'~'~' .......... ;;i'j';';'/~'~;;"~'~';'~g~;gii;;~i", ....... ......................... of ....... 'q' ............ State whether applicant is owner, lessee, agent, architect, eng~~l contractor, electrician, plumber or builder. Name of owner of premises ................=,.~.~,~..-..-~;~ .......... ..~.~-~,-.-.--.-.~-. ................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) lan on whmh rosed work wdl be don Ma NO ............... ~..~..vt~t No ./.~..~. .... 1. Location of d ' pop ' '~a-°n" 'P?°~ ' '.".''''-'"-A''~,~?,.Z .~...." ....... ."". ......... i..ii'. ......... 77/- '73 ~o ..~ M,?,.~,~ty /0~ ~'~- ~' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................. ~ ..................... ,,~;. .................................................................................... b. Intended use and occupancy ....4~..........~.~........~..'.~ .......................................................................................... 3. Nature of work (check which applicable): New Building ~/ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 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 ~- 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ..........................Rear .......................... Depth ............................ Height ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions: Front ....... ~.~ ............. Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ · ~ '~~' . .~.. ' .~' 8. Dimensions of entire new construction: Front ......... .,~.~..~..~'..'.: .... Rear ........... ~ .............. Depth - . ....... Height ............. ~..~ ........ Number of Stories ........... /.~ .......... Z9 9. Size of lot: Front ........ ./..~..~ ............ Rear ............. .~'.(~. ......... Depth ............. ~ ............. 10. Date of Purchase ........................................................ Name of Former Owner ...~'.~.~.....~.~.~.~.. ............... 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ...~..~. ......................................... 13. Name of Owner of premises.......~. ~.. ...~r.~.~ ~.e.£.~.. . .. . Address .......2.~-.....~.~.~.. .~......~..9.~%a~n~e No. .................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ........................ Address No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or comer lot. ~V~,~c~ ~ ~ STATE OF NEW v-~ · ~ ~. ) ~'(2 OF S.S. .................................~? -~,~,..JJ.~ ...... ~ ............. being duly sworn, deposes and says that he s the applicont (Name of individuc~signing application) /,~ .'~ above named. He is the ................................................................... ~..~..~/. ............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du'ly authorized to perform or have performed the said work and to make and file this application; that all statements contained Jn this application a.re true to the best of his knowledge and belief; and that the work will be performed in the mann?? set .forth ~n the application filed therewith. Sworn to before me this ....................... .......... : .......... Notary Public, . ............................................. ~ ............. County (~nature of applicant)