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Home My WebLink About3438-zFORM NO. ~. : TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI'CE SOUTHOLD, N. Y. B£1~TIFIP. ATE BF OP. EIUPANP. Y No. Z. ~,.2[~.. Date ................ ~B~2t, - -~' 19. T~tIS CERTIFIES that the building located at .I~/8. · .St~.~S-lk~d .... ..... Street Map No..XX ..... Block No .... ~ ....... Lot No. ~.. ~t~' ~[l~l~.Otli' ~'¢Yi ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... &pl~..1- .... l~ 19.. 67pursuant to which Building Permit No...3~38 .Z dated ........... &t~:~l.. ~,7.., 19.~., 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 l~,~Va2e..o~e. £a~;Ly..d~e2~n¢..: ..................................... The certificate is issued to .-Ch~,[t,e~. ~.F¢'a~ees..1~-8~;t;~ ....... .~'l~'$ ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... ~B,: .............. · .......... ' "~ Buil~tin~ ~nspe~or FORM.NO~ 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERNUT N? (THIS PERMIT. MUST BE KEPT ON THE,PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHOP~IZED) Permission is hereby granted to: .......~.~...~.:., ~.~ ....... ~..; ...... : ...... at premises located at ..~, ./..i~.....~,.~.~.,~(.,~[. ............................... ;' ............... : ................ , .......... i ............... ................................................ ,li~.t, .,~,.~ ........ ~'.o. ....... i ............... . ............ ;...;,...:....:.: ............ pursuan¢ to application dated J~11~i[ ~ I.~ and appi;oved by the Building Inspector. Fee $;.~ ..................... FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ' / ' Approved ........................................ , 19 ........ Permit No ................................. D~sapproved a c ~ (B tar) · APPLICATION FOR BUILDING PERMIT Application No. ~ ~.. ~ ~.. Date ~i~)ri] 11 19 ~? ...... INSTRUCTIONS o. 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 propertymust 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 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 o 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. (Signature of opplic~nt, or nome~ if ~ corporotion) 235 ~'f~ ~richola~ Strafer .............. ]~l.c~iX.l .o.,..~... Z... 3.1.~.0~ ..................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general 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) Title ~12L~-5961 lq. ecorc]e~ ztnc~er 1. Location of land on which proposed work will be done. Map No: L~l~er.........:.,~.....~.....;.,~.................c~?~ P~e L./~8 Lot No: .................... by Clerk of S~ffolk Oounty~ Street and Number ..... ~fi~.~..~].,..~f.~..~'~.~.~.9~.~...~,...~, ...................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin~ use and occupancy ~ ~ur~r~r home ' b. Intended use and occupancy 'B~...~H~.~j~..`b.~`~.9~.~$.~.J~...~..~$~..~.~.~.~9~J.~.r~;.)~.9~.-~.~[Z.~ ............. Parc}~ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost .......... .$.?..0.:. ........................................ Fee .......................................................................................... 1 ,qtot~, frame (to be paid on filing this application) 5. If dwelling, number of dwelling units ...~.0.t.t,.e~';e. ........... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................ ~t6'f; ......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ~e>,>}.i.e~b]:e ........... 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ............................ Height ............................Number o~ Stories ,..,2..,~,~,~...~..)~flW ........................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ..~:..~.~...~.~.~..~2~2~.~.~... 8. Dimensions of entire new construction: Front ............................ Rear ............................Depth ............................ Height ............................ Number of Stories ]~Torth s~e 13~,.90 feet 10. Date of Purchase ............ ~;~15/'.6!~ ............................ Name of Former ~ner t~iaaalim~..D~.rak .......................... 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed constructiop violate any zoning law, ordinance or regulation? ..~}~..~...!S~}P.}~..2~'. ....................... 13. Name of ~ner of premises ........................................ Address .;fi.e;:~vf:q.~:ey..N;.~;;...~:hSolPhone No. 5~95 ............ Name of Architect ...................................................... Address ............................................ ~one No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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. JOSEPH ~. RAVESE STATE OF NEW yORK,, , w 1[c¢ NOTARYH]~LIP,,$TAT[~OFN~WYORA 'No. O2.BS03525 Ou'Lin BtonxCo. COUN~ OF ..~..~0.~ ........ ~ o.o. ,~ ..... ~ ~:,, '>,t e~,,,,:~ Cb~q.e~ F, & Frrmce~ l~. Fetten ..................................................................................... w...v....~eing duly sworq, deposes and says that he is the applicant (Nome of individual signing application) Owner~ above named. He is the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly quthorlzed to perform or have performed the said work and to make and file th s 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 ~pplication file~ ~h~r~with. Sworn to before me this ~~~ ........... Z ............. day of ....~.gS~h..r~5~ ................... , 19...../.. ~) ~, ,~ ,~ k /- . ........ ....................................