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Home My WebLink About3495-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OERTIFIEIATE OF OI-t. 12UPANEIY No. Z Z~6~ ..... Date .........0.ctot~.r.. 19 ..... ,19.67. THIS CERTIFIES that the buildin~ located at lilaltilre .},'al}: ............. Street lX~I~ ~a~.at.r.o.. E.~.%atl~gek No... x~ ....... Lot No. 22 ..... }',attituck s. Ii, :', ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... I,~y .....99 .... , 1967. - l~ursuant to which Building Permit No. 3149~.Z. dated ........ llalt .... a9 ..... ,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 Pl. iva$,o .on, .famt. ly. due'~ 1.~g ....................................... The certificate is issued to Sta.nle;/...i~og~/~2~ ....... t~,~r~oi,' .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department 'of Health Approval . .U~ [...~$...t.~¢7...~;~. 2~,. ~,:i2.1a.. FOF~M 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 t95 Z Date ....................................... Permission is hereby granted to: ............... ~.~,~,.. ~.~.~.~. ................................. at premises located at ..~.O:~...~[....~[.[..J~E~....l~.~.~.~t~.~..~..~ ........ ............... ........................................... ~t..&~'.~...~. ......... -Y.~t,~,~, ............. . ......................................... pursU.~n¢ to application dated .................................. }. -~ ......... ~....., 1~...~, and apprOVed b~/the Building nspector .Fee $... ,~.~ ~.~......,., S-9 SCHD SUFFOLK COUNTY DEPARTHENT Da~e Bldg. OF HEALTH Permit ~o. TO WHOM IT HAY CONCEKN: The sewage disposal facilities for a structure located (Give deed locatiou) ~ ~ have been inspected by this department and found to be satisfactory. District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING D£PARTMENT $OUTHOLD, N. Y. Approved ........................................ , 19.~! .... Permit No ........................... Disapproved a/c ................................... ................. "'"' '"" '"' '"' ' '~'""V'" ' - '(q" "~" '"/~' '"/~" '"'~(Building~b'~"/~'b~t '"'"'""'" or) ........... "'"'"'"'"'" APFLICATION FOI~ BUILDING i~I~P~MIT 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 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 issuence 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations· ................................... (Sig ature of/applicant, or name, if a corporation) ....... /(Address of applica6t) / ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises '-~"~.?..,~.. ,~ 4 .~./~.. (,ti O OJ/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.: .....~...~....~..~ .................. Lot No.: .....~......~m... .......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended 3. Nature of work (check which applicable): New Building ....... ~... Addition .................. Altera,tion .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .... ~...~..,....~...~...~....,...~ ................... 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 ............ (~).....~.....~: ................................................................................................................... 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 alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .~.~' ................... Rear ....~.....~. ................. Depth ....~....~. ............ Height .~....':~.....~,~.~...e~ Number of Stories .................. ~ ................................................................................................ 9. Size of lot: Front ...... /...O...?. ............. Rear ........ l...O....O. .................. Depth ....... ..,"~,.~ ............. 10. Date of Purchase ~..~...~.?.~.....~. ...... /.~..~.....~. ................ Name of Former Owner ....~./~.~..~.~.~¢~.,..~.,..,~..'.~. .............. 11. Zone or use district in which premises are situated ......... ./~,...~...{...~....T.. .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ..~..~ ............................................... 13. Name of Owner of premises .-.~,.~...~..~..~.~.....J~.~..~...~.~ddress ....,(~...~....~....~/...,T,,z,f.~;..~.,/.....4~..y.. Phone No.m0.~.~..... ,~..~...~.? Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~-..~/'.~../~'..~ ./~/...~,~......../~'...fF...'v.D..~',..~...Address ..~L.U..~...~./Z~..~.-~.~...~'..~.., ...... Phone No,)~..~..7....7..~..?..~',./ 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. ~ (b"7-' ~k: STATE OF NEW Y~R~.~ 1, ~ ~ COUNTY OF ...... ~]'.9,~, .1.. ¢~,~1,; ......... .~ .... . ~5'[;~k~O~, ~O~7~,]~ . bein duly sworn, deposes and says tha¢ he is the applicant (Name of individual signing application) above named. He is the ............................................. 4.~{Jk~: ................................................................................................. (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 ~11 statements contained in this epplicetion are true to the best of his knowledge and belief; and that the work wi[I be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ........ ...................... ..... FOI~M ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Examined ............. : ...... ~. ........ t ......... , Approved ........................ ,..r. ............. , 19.:.~ ..... Permit No..~..~/..~.~..~...~?? Disapproved a/c ........ APPLICATION FOR BUILDING PERMIT Application No.......~.~,I.~..~.7....:'... 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, end 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 nat 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 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. .... .............................. (Signature of/applicant, or name, if a corporation) (Address of apl~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ...................................................................................................................................................................... Name of owner of premises ..... .~Z..~..,~....~/.~,..~..~.. ....... .~..~....L~...~./.%. ......................................................................................... 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.: ....~...~...~.'....~.. ................... Lot No.: Street and Number .~...D..~...:..~....~.....~.. ............... ..,~..i~..?.;...7~...~r.../.~....~. ......... ..~...q.~... .................................................. 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 Building ..... ~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. ' Demolition .................. Other Work (Describe) ................ ; ....................... 4. Estimated Cost /'~.~ 6~0 0 ~ 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 0 ~ ~. 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 ...... .~...~. ...................... Rear ...... ~..~ ............... Depth ......~....~.. ............ Height .,g...~....../f/.,~'.~..~.,tNumber of Stories ............... ...~. ................................................................................................. 9. Size of lot: Front ..../.~../2 ................ Rear ........... /..C~.O ................ Depth ..... .~..~....~.. .............. 10. Date of Purchase ..~:..~.O..~..C.~-......~. ...... Z~../~..7.. ......... Name of Former Owner .~..(~..-,~..~..e...'~.......~..'~...C'. .................. 11. Zone or use district in which premises are situated ......... L./~....~../....&...~. ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ..~...7~.~.~..~..~,~f.....~..9..~.~...~'.Address ....,<~.....~.i.~,..?/...~..~'.¢x~.)...~..~..,. Phone No~.~..~...':r...o~'.ff.?..7 Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~.-~..~..~fl,~......./~...~...~..~.~'.....Address . .~.J..~..~./~(.~.q. ....... .~...~:.... Phone No..P.~....~..':,,'~.7..~. / 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. ~.o 7~ ~ /~ STATE OF NEW YORK. t S $ COUNTY OF ..... .$.~f.f.q~,k ......... .f · · S~;~.t~le~. Wowe, k h~ ,~, duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........................................... D.W~,~. ................................................................................................. (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 opplication; that all 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 filed therewith. Sworn to before me this ....... ....... ............... ....... .................... 'No. 52-7452500 - Suffolk County Cornrn~ss~on ,~x~res M~rch 30, 19..~,~'