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Home My WebLink About3445-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P. ERTIFIGATE E)F I-IE:I~.UPANI~Y No. z 2796 Date ......... A.~/~t...e ......... TH~S CERTIFIES that the building located at .... Ge~[a~ K~d .D~. ..... Street capt. Kidd Map No.. Est, .... Block No ..... ~... Lot No..15~ .......... Ha~t~tu~,~. ~. conforms substantially ~o the Application for Building Permit heretofore filed in ~his office dated .~P~. 2~ ........ , 19..6~ pursuan~ to which Bui~din~ Permi~ No.344~Z. dated . ~1..24, ............ , ~9.6~., was issued, and conforms to all of the ments of the applicable provisions of the law. The occupancy for which this certificate issued i~ne. ~1~ .~n~ .~ .addition. ................................. The certificate is issued to .Oeor~e. ~,..~t~2e~. a~d .~, .......................... (owner, lessee or ~enant) of the aforesaid building. Suffolk County Department of Health App~val ....... ~ ................ Building Ins~e~o~ ~ORlV[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 34~5 z D~e .............................. ~ ........... .............. , 19 ........ Permission is hereby granted to Building Inspector. ,Fe; $,.~,...~..~ ............ at premises located at ................... .................. ~...~.) ................ ~ ................. . ......... , · ............ ............. i: ..... ~.~:.~..~......: ....... ~~.: ...... :.: ....... i'..~..,i~::~.:,;. :: ..: . A~; ~ ~: ic~ and'approved'by the pul;suan~ 'to application dated .............. ................. ;........ ...... .~ ........... ~,.., -. _...,,.,.., ..... .:i .... ~ ................ : ..... ~ Building Inspector : FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ...... Application No. 3 Disapproved a/c ..y.~;.~;,..mT:;;~.:/2 .................. ~ .............. ::~:. .................... ........ (Building Inspector) APPLICATION FO, BU"DING PE,MIT Date ...... .A. ................................... , 19.6. Z ....... INSTRUCTIONS a. This application must be completelyr 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 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 sba be kept on the premises availab e 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 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 ~egulatloos. 185 O~g&~l~ ~1~ 3~l~e ............................ ~.~.?~g.~.:...B.B...;L~.gAg .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... g. flg~j].e...~T.,...~q..~J~.~.~.gc...~.]~.(;t,..~,~'.~,~'.~....Cj.~.~3.g.~ .................................................................. 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. Mop No.C.a~.%.....Z~£cl&..]3AJ;~:e. Lot No.: ..~.~. ............... Street and Number ..... J~J~JSBJ J J~l~'~J I '~'$~ ............................................................... ~ .................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... '])t~'e'~.]-.~.~ ......................................................................................................... b. Intended use and occupancy ........................ '.~fe..~.~.i.~...~f,~,~,~..8,Tt..~,dcl, iJ~.io~. ............................................ · . XXXX ' 3. Nature of work (check which applicable): New Building .................. Add~hon .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ ~..8..0..0. ....................................... Fee ~,00 (to be paid on filing this application) 5. ff dwelling, number of dwelling units ..... c~;0,~ ................ Number of dwelling 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with a.lterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8, Dimensions of entire new construction: Front ~45'; ........................... Rear ....~..,¢.~4 ............. Depth ..~.,8.....~..~..~ .......... Height .................... Number of Stories .9.~.e. ............................................................................................................. 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated A res±cte~ti~:L 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~O .................................................. Name of Architect ...................................................... 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 indicate whether i'nterior or corner lot. .......................... /~ STATE OF NEW YORK, ~ ¢ c COUNTY OF ...S.u~'2. olk; ........... ~ .... Grace J. Sti£ter ................................................................................................. being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) obow~ named. He is the ....... ~¢...~.~..~,~e9 ................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that afl statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewit~ Sworn to before me this ....... ............. ............ ..................... Notary Public, (..'.t~¢,~.~b..~.u.~C4..~.,k4C.. County MARION A. ~[GENT ~ ~OTARY PUBLIC, State al ~0 52-~233120 Suffolk C0tln[~ ~rm [xptres M. arch ~0,