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Home My WebLink About3492-zFORM ~0. 4 TOWN OF SOUTI-~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF DDOUPANOY No. ~.. ~.O~8 ..... Date .... April..4, ................. 19.68. THIS CERTIFIES that the building located at .~/.S...YO~ngS .A~.er~ue ...... Street Map No ............. Block No ............. Lot No. $O~thO].~,..L.,.~.,.,..N.~. ~fOY2k .. conforn:s substantially %o the Applicati.on for Building Permit heretof, oTe file.d in this office dated .... MY. ~;6 .............. 19.67. pursuant to which Building Permit No. dated ... ~I~.~2~ ............. , 19.67, was issued, and conforms to all of the require- ments .of the .applicable provisi.ons of the law. The .occupancy f. or which this certificate is issued is .... ~.,~tt~:~'.i.a~..~.l~t~g .................................................. The certificate is issued %o ..... L£]p~O-,.~,~y. ~=, ................................. (o~vner, l~~t ) of the aforesaid building. .Suffolk County Department of Health Approval .... 'l.<. '. .......................... 'Building Inspector 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? 3492 Z ~Permission is .hereby granted to: L~/.~eO ~* A~//8,~ XZt,13 .............. Xo~..A~ ......................................... ................. ~c~ut~t.d ........................................... at premises I~atod at. ................. ~ .. pursuant {~ ~pplic~lion Building( Inspector. P~E ~VXSE FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved ~ ............................................ (Building ~pector) APPLICATION FOR BUILDING PERMIT Date ................................... ~,y, ...... ~ ...... , 19...6.~. ..... 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 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 o 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. Lipco - Agway Inc (Signature of applicant, or name, if a corporation) /,A//~) U ~' 'f/~ ~ ~ b f~ U / ~- D//k/~'" .... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................... :?....o. .......................................................................................................... Name of owner of premises ..LipP,.a..~....Agway...Izza ......................................................................................................... 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.: ............ .X...X..X. ..................... Lot No.: ..X._Y~... ................ Street and Number ..}?/.~...~;.'..~..~..P:~....~.~,9. .......... .~.g.~..~.o.~.,~. .................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ..b..~..~.~t.~..e..s...s....l~..~..~.l..c],.J~.g .................................................................................... b. Intended use and occupancy same with addition & Alteratio~a XXX XXX 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... ~.~...~.~..0...~./...~. ............................. Fee ..,~.,..0.Q ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... T~.Q:D.¢. ........... 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 ..b...~:~.~.~..a..~.s.. ....... 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ ~mber of Stories ....................... ~ ..... ~LQ- 3.8 8. Dimensions of entire new construction: Front ..2,0 ............................. Rear ........ 20 ................ Depth .. (J ............... Height .................... Number of Stories ..o..~..~ ............................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...~u.,.~.,,,P...~.~..~....QQ ........................ 11. Zone or use district in which premises are situated ..... '.'.~.[[..~..~.~.9..t}.?..$fl..3: ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~.O. .............................................. 13. Name of Owner of premises .~,~.9..q....-...~*gk¢.~. ....... Address ......~.0.~,.t;~.~¢t, ................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...°.~.e.?.....Z....b.~..];.~..r.-. .............. Address ......... .S..O.~.~...O.?r~. ................ 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, COUNTY OF ...... ~.~.~ f..o. ~ ......... ..................................................................... ;:.~ .................... b_' ~ duly sworn, ~ ~~ e,nn deposes and says tha¢ he is the applicant (Name of individual signing application) abow~ named. He is the ..... ~...9~...9~.~ .................................................................................................................. (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 all statements contained in this application are true to the best of his knowledgff and belief; and that the work will be performed Jn the manner set forth in the application filed therewith. Sworn to before me this ................. Z6.. day of ,...; .............. ~y. ................ , 19.6.~.. z/ Nota~ PubJi~/~~...~~ ........ Cou?y F'-' ~(~afure/of applic~) ~o. 52-3233120 Su~oJk FORM NO.I Examined ...................... T~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No....;;,~.~;/..~..~ ....... a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. Il;. b. Plot plan showing Ioca~i0n of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed d~Scription of layout of property mUSt be drawn on the diagram which is part of this application. c. The work covered by t~is application may not be commenced before issuance of Building Permit. d. Upon approval of this Ippplicotion, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises ~vailable 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 theiBuilding Inspector. : APPLICATION IS HEREBY M"A, DE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the'1'own 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 ~ith all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ,~ '~ ',~ (Address of applicant) State whether applicant is o~ner I~/ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. or .......................................................................................................... Name of owner of premi,~,es ..~.I,p(J¢)..,~..~§W&3t...T.~, ..................................................................................... .................... If applicant isa si~'nature of duly authorized officer. .................................... i.'. ........ ,,.~ .............................................. (Name and }itle of corporate officer) 1. Location of lend;on w~ich proposed work will be done. Map No.: ............ ~ ..................... Lot No.: ~ ................ Street ond Mumber . '~ .......... goag[ l .......................... ; ......................................................... / 2. Stoto oxis}ing~ uso ond~occup*ncy of promises ond intended uso ond occuponcy of propos~ construction: o. [xi~tin0 use ond o~cupancy ..... ~O~.~..~J.~ .................................................................................... b. /Intended uso ond bccuponcv ........... ~g~ .......... ~.~...~.~.~..~..~.~g.~n .................................... APPLICATION FOR BUILDING PERMIT Date ................................... LvJ~.~ ....... 26..-.., 19..,67 ..... INSTRUCTIONS Approved ........................... :; ...... ii,i-,, 19....IL. Permit No ..... ~..~/....~.~,....~ Disapproved a/c .......~ ................... ~i ................................................................. ....... ....... ................................... : ....... ~ ' (Building I~pector) 3. Nature of work (check which applicable): New Building .................. Addition..............~ .... Alteration ............ : ..... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... 1L~.0.Q0.,.J~j~I'J ............................. Fee ...~.~0.O .................................................................. ........... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ,~QI~.~ ........... 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 ..~.I~.~.,~,11[I.~. ....... 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 ............................ ~l~mber of Stories ....................... ~l~' .... s. D~mens~ons of entire new construction: Front .,SO. ............................ Rear ........ ~.0 ......... -..-.... D~pth..:l,0~. ....... 7..T... Height .................... Number of Stories ..~.~..~. .............................................................................................................. 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ................. ' ................................ i ...... Nome of Former Owner ...~,.~.e.~.*.~..~....g.~ ........................ 12. Does proposed construction viblate any zoning law, ordinance or regulation? ......... ..~..~. .............................................. 13. Name of Owner of premises .~l,J~gg...?...~l~. ....... Address ...... J~.g.l~,.~ ................... Phone No ..................... Name of Architect ..... ' ............. .................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distir~ctly 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 inter or or corner lot. I STATE OF NEW Y~R[. ~. tSS COUNTY OF ....... ~..i~..~.~].O....&~.. ......... ~ · · ................ ~ .......... ?.-...~ .......... ~ ..................................................... u duty sworn, deposos ~nd so~s t~t ho is tho (~*mo of individu~'l si~nin~ applicotion) obove homed. He is the ...... ~. .............................................................................................................................................. '. , (Contractor, agent, corporate officer, etc.) of said owner dr owners, and is duly authorized to perform or have performed the said work and to make and 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 fo~h in the application filed therewith. Sworn tg;befor~ me this ............/~....."~,.' day of' ..................... ~.~. ............... 19..~.. ~ q ,~ ~'' , ,,~' i ,,~. . ' W .... /~ ..L..U...~,~../,.....~..~~.......~t....~...4.:.At .................. Not?y pu~lic,~./~bD....~~ ....... County , (~g~ature~f applicant) ~rm [xptres ~arch