The URL can be used to link to this page

Home My WebLink About3678-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OERTIFIP, ATE I-IF rlEIE:UPANEIY No. Z..3045. .... Date ...... AI~"~Z. 55 ............ , 19 THIS CERTIFIES that the building located at ~lvormoro .Road ......... Street Map No .......... Block No ............. Lot No. 20~L. ~ZOO~Or~L, Zo.,Jg.Y,... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 0Gt,. ;2.3 ........ , 19.6?. pursuant to which Building Permit No. I[. 36.~8 dated ..... (~:,..25 ........... , 19.67., 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 .... PI~iV&~;~J. Ol~e. fai~,],~', f~M~].l:J~g ................................... The certificate is issued to ........... MI~ .&. M~I~,. Bldwelr.d .S&l~h ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ................~ ' ................... Building Inspector 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? 3678 Z Date ........................ .Oc:t, ob~'.... 2~....., 19.6~... Permission is hereby granted to: ]~cl...0o_--,c1~. ~.C.. ~!~..~,Ir- ~j~ ................. ................ .Graenpo~t .......................................... to ltwi,l~l .. ~n.. ed4t~,~oet., eh.. en.- ~.~ et,.i~.. ~r®l.-1- -~.~ ....................................................... at premises located at .~O~..~0...~.~L,...I~I~.~I3,P.Qz'.t,..~O]~es~ ....................................................... .............................. ahozte..~loa~L ...... ~z~eez~parl; ............................................................................. pursuan,t to application dated .............................. ..0.~.....~,,~ ............. , 19~7...., and approved by the Building Inspector. Fee $~.00 .............. FOEM NO. 1 TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~ c~'¢5' 19 ~'/~7 Application No. ".~...~.~.,.~... ......... Approved ........................................ , 19 ........ Permit No ........ Disapproved a/c .....~.~.7~.~~~~'~- .......................... .............................. APPLICATION FOR BUILDING pERMIT 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, relatipnship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust be drown on the diagram which is part 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 issbe a Building Permit to the applicant. Such per,it 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 MADE Ko the Building Department for the: issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New ~ork,. and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolitio~ as herein described. The applicant agrees to comply with all applicable laws, o~k,~..~l:es, building code q~/J r~ ... ..... . (.~.~...ignatuj~e of applico, Jn~or nar~e, if a corporation) ...................... ...... ~ ~J~ddress of applicant) ~,,' State wh~r. J2er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Name of owner of premises .;~0t..~.~~. ........ ...'~..,. .~.. ......... ' .................................... 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: ..... Street and Number ..~.~.b,,,~'~..~..t~.~..~...~.~---......¥.....%~...~.~.~.?~..~..'~....~.~.~.~...~..: .................................. Mupicffpality 2. State existing use and occupancy of premises and. intended use 6nd occupancy of proposed construction: a. Exlst,ng use and occupancy ..... b. Intended use and occupancy ......... .."~.'~.?.:.T~.~..F..!..~,.~.--~ ..................... .......................................................................... 3, Nature of work (check which applicable): New Building .................. Addition ....1~........ ..... Alteration .................. Repair .................... Removal .................... Demolition ........... ..._~.... Other Work (Describe) ...................................... 4, Estimated Cost ...... ~.~-~...~.....~.X...~..~ ....................... Fee ............... ? ...................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ j ................... Number of dweIHng 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 ..... /..O...! .............. Number of Stories ............................................................................................................... / Dimensio,n,s of same structure with alterations or additions: Front ....~.~...~., .............. Rear .(~'~".....~... .................. Depth ....~....~...'~....~. ......... Height .....~. ................. Number of Stories ......... ! .............................. 8, Dimensions of entire new construction: Front .....~.....,'~'... .............. Rear ...~:~.?.~... ............. Depth ..'.~...~.~....~.. ........ Height ....... J. ................... N/umber of Stories ........I ................... ~ 4'~ ! ............................... 9. Size of lot: Front ..... J...;...': .............. Rear ..../..~..1~. ............. Depth 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction vio~te any zon r~g aw, ordinaj;~c~or r~ulatioq? ....~/.~,.~ ..................................... C~ ....... ~ ~t'~ '/I'~ Il ~ ~ ho Name of Architect ..:,:~ ................................................ Address ......... 'f~ ................................ P ne No. "~1 ................ Name of Contracto'r'l[~..:]'.~..,..~q').l~.Z.~.~..~3 .......... Address ..(~..t).~:. ............................ Phone N/Z~.~.../...~..~...~,-' 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~ ~,~-1 ~'i STATE OF NEW YORK, ~ S.S. COUNTY OF ................................ ...................................... be ng duly sworn, deposes and says that he is the applicant ................ i~'~'l~;";~"ii~i~'i'~al signing application) 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 a I statements contained in this application are true to the best o~, his knowledge and belief; and that the work wil] be performed in the manner set forth.in the application filed Sworn to ~e me this / ~ ..... ~ ~ ' ~ ~ ~ ............... __ ....... .........