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Home My WebLink About3435-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I]ERTIFIP. ATE OF oI]rI. UPANI]¥ No. I. l~, ..... Date ........... IIII~IIIblI~..~.., 19.6~. THIS CERTIFIES that the building located at I/tB. iII~l. &~e ............ Street Ma~. ~L~!. ]!~t~I~ No ............. Lot No. ~ ..... Mltt;lt;~i~I:..1~.][:, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... &]~I'~l,...~. , 19 6~- pursuant to which Building Permit No. ~3~' 2. dated ........ &l~='~. ....~.l+ .... ,1967., 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 ...]~31'IW&~I. I. £amll.~ .d~i~l~g ..................................... The certificate is issued to . ~ill~i~e~.ll~d../,~$oet~te~ .IlaI' ....... O~l~®~. ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~el>t- .~7.f .:19~--b~ .]~..~.~,1. Building nspector ~ FOKi~I 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? 3 35 Z Permission is hereby gronted to: ........... '/,Aabez3.aml.. Aaae~t~+,,e~a.. Xm~ ......... to .]~. _~_m~...K~l..~.!l~L.',l'~¢.~]~,.'q~ .................................................................................. at premises located at ~Jlt~....4~O .........j~il~ll..~,~ett..J~8~J~r~8 ........................................................ ..................................... i~eve.....Ave ......... Y~e.~.%~.~um~ ......... I~..Z. ................................................ pursuam to application dated ..................................... .~,,~.~'..~......~....., 19..6.~.., and approved by the Building Inspector. Fee $ ..~(J~.J~l .......... Building Inspector ~L S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da~e Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give/ deed location) / have been inspected by this department and found to be satisfactory. District Engineer C \\ \0 NOTE: m:MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AUG.~,I966 AS MAP N0.4682. SURVEY FOR TIMBERLAND ASSOCIATES OF LOT I0' "SALTAIRE ESTATES" MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. SCALE= 1"=50' MAR. 29, 1967 RIVERHEAD. N,y, FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .....%/.¥,./.l~....../..~../...,(~,~x _ ~ ~ 19 ? ~ 19 ~¢ Approved ........................................ , ........ Permit No ............................. Application No. , . ........... ~..v ..... (Building I nspecto~/V 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, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must 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 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 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 th~ 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, building code and regulations. (Signoturo of opplieont~ or name, if a corporation) ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, enai'neer, general contractor, electrician, plumber or builder. Name of owner of premises ...~...~.~.:....~.:. ........................................................................... If applicant is a corporate, signa3~L~e of duly authorized officer. ............. ( ~" (Nome a~d titlbJof corporate officer) 1. Location of land on which proposed work will be done Map No.: ........................................ Lot No.: .)..~. .................. Street and NumberX~'~,~....'~-~-.'....~~.....~ ....... ~.~(~7.¢-,...,....-~....:.~... Municipality 2. State existing use end 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 Building ..':~ ...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ...~..~.y.~¢::~,..,......~'~ ........................... 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 ...... ..~d~ ....... ~-,,.~X. ............................................................................................................... 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 a.[terations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ , .,. 8. Dimensions of entire new construction: Front ............... .~..0. ............. Rear ......... ~.¢~..../. ....... Depth .....~...O. ........... Height ....~..~.~..../. ..... Number of Stories ........ ~ ................................................................................................ 9. Size of lot: Front ..l..l~ .................. Rear ............ /....fr~¢... ............... Depth ...... ~./..%,~.._...~.~/~ 10. Date of Purchase ......... J..~....G...7. .................................. Name of Former Owner ...,.¢re:~a_~r~...~ ....... ,.:...':r-~..,~" ............. 1 1. 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~..~.~...Address~...%¢~......~.¢, ................. Phone No.~.~ .......... .~..ff. Name of Archite~ ................................................. Address ............................................ Phone No ..................... Name of Contractor~.~ ........... Address ~..~)~ ~.... Phone No.~.~7~Z.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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ c c / ~Yr.2 ! COUNTY OF ................................ ....................... ~.~ .......................... ~.....~ being duly sworn, deposes and says that he is the applicant (Ndme of individual signing application) abow~ named. He is the ............................................................................ ~.,,~.,~ ....................................................... of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make ~nd file 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 forth in the application filed therewith. Sworn to before me this ......... ....... do, o( . _ ....... :.., ......................... Notaw Fublic, /