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Home My WebLink About3736-zI~0RiVI 1~0. 4 TOWN OF SOUTHOLD SUILDING DEPARTMENT 'I"OWN CLERK'S OFFICE SOUTHOLD, N. ¥, --,o. Bailie Beach Rd THIS CERTIFIES that the building located at . .p.V.~ .~.,0~.,. ~,~,~ ........... Street Map No...X~. ......... Block No .... ;~X ...... Lot No. 2;~ .... JM.~;.t;:~t~t~k~..~,~ ........ conforms substantially to the Applicati~on for Building Permit heretofore filed in this office dated .............. NOV .... 2]., 19. ~ pursuant to which Building Permit No..~6~.. dated .......... ~ .p~..1.]., 19.~., was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .occupancy ~or which this certificate is issued is ... ~2~Xgg~ .0~. $~m~Y. ~,yell~lg ........................................ The certificate is issued to Hobe2t. A~/6in ...... ~I~e2 ............................. (owner, lessee or tenant) of the ~oresaid building. .Suffolk County Department of Health Approval ..... ~.,.~} ............................... · · · ~ ,.4. . . ~ ' Bufid~ng Inspector f FOl~ NO. 2 TOWN OF $OUTHOLD BUILDING D~PARTMEh~T TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT/~UsT BE KEPTbN:TiL1EYREMISES UNTIE FULL' COMPLE:flON OF' THE WORK AUTHORIZED) , ' ' N? 3736 Z t Permission is hereby granted' to: ~iatt:Ituek~ I~,Y. pursucm( tO application' dated ................................ .~..?..~.~...~.....:....., 19..~..?..., and approved by the Building Inspector. .......... :::::..:.(....,.. ................. Building Inspector [ FORM NO. 1 'TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:FICE SOUTHO/D, N. Y. Examined .....~fr~.....: ............................. , Approved ........................ .~..k. ........... , 19....?... Permit No...~....~ APPLICATION FOR BUILDING'PERMIT Date ....... ~.. ,~/.../..'., ..'?'~ '/' ....................... , 1 .9~...Z ..... INSTRUCTIONS a.- This appli'cation must' be completely 'filled in by typewr'iter 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 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 port 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 oil applicable laws, ordinances, building code and regulations. .................... ......... . (Signature of applicant, or name, if a corporation) ..................... ............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, generql contractor, electrician, plumber or builder. .................. ..................................................... Name of owner of premises ........ . '~..~{~,~,~...'..~..~...~....~./.../../.:. ............................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work w'll be done. Mop No.: .,~.~./~.;.. ~/.//...~'z.~.7~/Lot No.: ................ .,. ...... Street and Number ~ ~ ~]~ .... d ............ Municipality 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 ............ ~.~...~ .......................................................................................... 3. Nature of work (check which applicable): New Bcilding .................. Addition ~' Alteration ~k..~..'~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........ ...~.......¢~.Z~..L'~}...d'?.t~2. ................ Fee ............................................................................... i .......... (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 .................................................................................................................................. i ............ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. ' ........... 7. Dimensions of e,x)sting structures, if any: Front ..¢¢.~1...~,l/./, ........ Rear ....~..~.~..Z ...........Depth Height ..../~.,~.~.././. Number of Stories ...... ~?.Z~.,~ ........................... ~ ............................................................ . ' ] / ...~....~.;....[~ ........ Number of Stories ....£~..~...~ ........... Depth ......('~.,"~..-::~.~. ..... Height ~ ' ~ 8. Dimensions of entire new construction: Front ....~..~..~)~ ............. Rear ....... 2-,~ff~...~.. Depth .~..~...~..ff~.~!~ .... Height ....~./~'..~--:..(.?. ~lumber of Stories ...... ~...~.."~ .......................................... ~ ........ v~ .............................. : ........... 9. Size of lot: Front ....zs,,/.~t~/J~../.-c,¢.:,'~!.~. Rear .......... ¢¢-.~...-~./.~'.2L/. ...... Depth ....~..~.~.~..(.?.i. ..... 10. Date of Purchase .~.,~¢~¢~...Z/~.<:..../...~.,-~?~.. .................. Name of Former Owne~.-z~'.~.4~2~..~:~/c~...ZZ.....' ........... 1 1. Zone or use district in which premises are situated .......................................................................................... . ........... 12. Does proposed construction vj,¢ate any zoning law, ordinance or regulation? ........................................ ~1......[ ............ . . '. , /,,' ., .2/, - 13. Name of Owner of prem.se~...~Z.~.,.~.~,~..Z'./..~..Address/.~....~..:..~.~:....*..:..~.'~. Phone Name o¢ Architect ......... / .................................. :, ........ ..Address ............................................ Phone No ...................... Name of Contractor .~..~.,/.,~.~.~.~.~./../~..~f2.~..~...Address...Z~...~..'..,~..~/~./~.~.?..Y.C~. ..... Phc~,~h~.".~..~.~.~:~/' ' ...... ' PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensio.~s from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................................ ,f · ~2Z2 xC,.,,.,.,¢.-,..,....~.....¢.,, ................................. being duly sworn, deposes and says that he is the applicant (Name of individual ........................................................... signing application) ~'"'~2Z~..,2~..~.,z~. .............................................. ' above, named. He is the ¢.;.~.-~'..~-~Z,,~.. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ¢.nd fil~ 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 performed in the manner set fo~h in the application filed therewith. Sworn to~fore me this ..... ...... .. ..... ' .... ,,,'h ?,0, ]96