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Home My WebLink About3770-z~OR~VI ~0. 4 TOWN OF SOUTHOLD BUILDING ~EPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. P. ERTIFIGATE 13F E1P-ELIPANEY No. Z 3107 Date THIS CERTIFIES that the building located at Map No. ~ Block No ............. Lot No. conforms substantially to the Application for Building Permit heretof,o.re filed in this office dated .......... ~b .... ~. ..... , 19. ~ pu.rsuant to which Building Permit No..~ ..... dated ......... .......Feb ........ ][ , ~9...., ~ was issued, and conforms to all of the require- me.nts ,of the applicable provisions of the law. The .occupancy for which this certificate is issued is . .P.~.~.y.~.~..e..o..n.c...f.~.~..~.l.y...d.~.e..~.~.~..B.g .......................................... Joan Marm 0~meI' The certificate is issued t,o ................... ; ....................................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health App,'oval ......................................... Building Inspector FOR~ ~0. ~ TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN CLERK'S OFFICE SouTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL coMpLETION OF THE WORK AUTHORIZED) 3770 Z Permission is hereby gronted to: ....... ~a,. & .~l~s~l~.. ~ .............. to I~I~3~L ..aa.. a~l~.~.~ma ..on..az~ ..u~t ~,a~..aw~ ......................................................... at p~i~ ~t~ ~ ....~..nz..~..~s~e~..~ .......... :........... .......................... : ....... ................................. ~a~'t'"~*J-~ ............................................................................................. pursua~n~ to application dated .......................... ~,.-~. ................... , 19..~, and approv~ by the Buildinq Inspector. ~e~ $...S~a ........... Buildin~ Inspecto;/ FOBM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No. ~ / Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .......................... ....... , j9..6...8. ...... 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 part of thi.s 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 sh.all be occupied or used Jn whole 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, 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, bui ding code, housing code, and regulations. I z"~ , L,/£ (Signature of applicant, or name, if a corporation) ~ .-g , Oakwoqd &r Chi. ist.o.~.her St 8outho.l.d ~,Y. .............................. ............................. State whether applicant is owner lesse~ agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..~*..O.~..?~.a:.~..~.. ............................................................................................................................ 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..~.~':?!~..~.f: .............................. Lot No.: ~ Street and Number ..0..a..l~.o...o..d......~.z....6.',h,.~i..~..qp,..h..~...~ ....... ~.q.u..%..~,.o,..1..d:....N...t,Y..: .................................................. Municipality 2. State existing use and' occupancy of premises and intended use and occupancy of proposed construction: a. I:xisting use and occupancy ...... Q~;~fk..~.~..~.~.~...~.~..~.~l'.%~ ............................................................................... b. intended use and occupancy ......... .s...~...~.e...~.~....~..~...h`~.~..~..~.~..~..~.?.~.~.~.~..~..~.~..'I~.`~..~.~.~..~.~ ....................... Nature of work (check which applicable): New Build'ing .................. ^dclition ..~,]t~ ........ AlteraCJon ,..~g(~ ....... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ Estimated Cost 7~.~:.. .............. : .................................... Fee ..... ~.~..g.O. ................................................................ , .......... (to be paid on filing this application) If dwelling, number of dwelling units ..O~i~ ................... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. If business, commercial or mixed occupancy, specify nQture and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ............. ! ...... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ................. i .......... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .~8 ............................... Rear ....... ,,~J~ ............... Depth o,,,,~, .............. Height .................... Number of Stories ..... D~C, ............................................................................................... ' ........... 9. Size of lot: Front ....~-.~.~ ................. Rear ..... ~.g.~. ........................ Depth ...... ~.~...~ ................... 10. Date of Purchase ........................................................ Name of Former Owner ...~J'10,..~.~.~.~...~O~.~.*. ........ ! .......... ] 1, Zone or use district in which premises are situated .?.l~'~l.l...~].~t ..................................................................... : ........... 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. ~. .............................. ~ .......... 13. Name of Owner of premises .,~.~.O. Fr'.'[J....}:~.0~,[~. ................. Address ......¢.d.f~.~..~,~.O.~..~. ................... Phone No .......... : ........... Name of Architect ...................................................... Address ............................................ Phone No ..................... .... '"'~ Nome 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 ihdicate whether interior or corner lot. (Name of individual signin~l gpplica_tion) (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 s~otements 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. Sworn to before me this 1~,, ~ /? ~' /~) , Notary Public, . ........................................................... County (Signature of applicant) j STATE OF NEV~,,,Y~,~,~, t e c COUNTY OF .ff...u:f:..~.~:..,:~.. .............. fo..,. ~,....~.'....~..~.~..~-.~:..~. .......... ./.~.~. .......... :...~?....~...Z~....~.~ .~..(. ................. being duly sworn, deposes and says that he is the applicant