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Home My WebLink About3351-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OI:'P. TIFiI~ATE: DF' or':I~UPANP. Y THIS CERTIFIES that the building located at . .W~. ~%'00~. AVII~ .......... Street Map No. -1111:~ ....... Block No. ~ ....... Lot No. 'Jl:Xlll; .... P~I~'I~I~' ' ~i~i ......... conforms substantially t,o the Applicati,on for Building Permit heretofore fi/ed in this office dated .......... ~IRll .... ~' ...... 1967. pursuant to which Building Permit No. 3~J,' Z. dated ............ ~[SJ~"~ ...... 19.6~, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The occupancy f. or which this certificate is issued is '~A~dl;e' ~' 'falL%~L~ 't~il~].~:~'~ .......................................... The certificate is issued t,o . '~1' tl;~'t~ ....... (';~1~'~;;';; 't;~i~t') ........... of the aforesaid building. Suffolk County Department of Health Appr, oval. ~1~1~1'1.. J.~..~J~6~---~ .~t:[~[. -3~ .... T~o house ke~. ~etuwned hex~wlth m ] g spe r ~ FORM 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? 3351 Z Permission is hereby gronted to: .......... tO,y.~.a~e...it~e.a ..~..C...~e~,...C.~-unp .............. Ik~...~.~, ....... ~,,~.verlma~! .................... to i~l~,l,~.. ~1t~.. oJ~e...£ a~,l~.~'...~l~.e LI.:I~ g .................................................................................... ot premises Iocoted ot ....W/~...Ca~.~,~I~,..&ve .................................................................................... ............................................... l~.e ~.OP, t C.~.. I~. ,.~. ~. ................................................................................. pursuan.t to application dated ....................... ~..11~"~.....~, ............ , 19~.~...., and approved by the Building Inspector. Fee $10~,0(~ ........... Buildin~ Inspector S-9 SCHD SUFFOLK COUNTY TO WHOM IT MAY CONCERN: DEPARTMENT OF HEALTH Date AP~ I 0 at The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. District Engineer TITLE NO. S-~433 NOTE: · · MONUMENT SCALE: 1"=40' NOV. 21~ 1966 DEC. I~ 1966 FEB. 20,196 7 SURVEY FOR COR/VELL ~ LOUISE CRUMP PECONIC TOWN OF SOUTHOLD SUFFOLK COU~TY~ ~. ~ GUARANTEE~ TO: FARMERS HOME ADMINIgTRA- TION, 5ECURIT~ TITLE B ~ARANTY CO ISLAND ABSTRACT COR~. LAND SURVEYOR N.~ L~C. NO. 28725 RIVERHEAD~ N.Y., , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ....................................... , ]9 ........ Permit No Disopproved ~/c Application No..,.~.......~....~...( ......... APPLICATION FOR BUILDING PERMIT Date ...... ..................... INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildinc Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and gwing a detailed description of layout of propertymust be drawn on the d~agram which is part of this application c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Bu,lding Inspector will ~ssue (~ Buzlding Permit to the applicant. Sucl permzt 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 ~n pa rt for any purpose whatever until a Certificate of Occupanc 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 th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the constructton of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. ...... ..... ..................................... (Signature of apphcant,-e_: ~-:._-:::~, ~f ..... ~:,,-.,ul;,,.~) ...... ...... ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, ......................... ............................................................................................................................................... Name of owner of premises ........ ~./~x~..~....~.~.../. ....... .~.~.~.(~./~'.~ ........................................................................................ If apphcant 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: .~..~.~.-~..!~..~/'a ...... Lot No: .................. Street and Number ..... .~ .~..~.~.~/~.. ..... ~..~..~../~....~...~ ............................................................................................ Municipality 2. State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Ex~sting use ond occupancy ........................ ~ ............................................................................................... b. Intended use and occupancy ......... ~ ~ .~./f~.(. ~.~..~.<~. ............................................................................................ 3 Nature of work (check wh,ch applicable): New Bu,lding .../~..~. .... Addtt,cin ................. Alteration .................. Repair .................... Removal .................... Demoht~on ............... ' ..... Other Wo[rk (Describe) ...................................... 4 Estimated Cost /. ~' o ~ o '~- Fee .......................................................................................... (to be paid on filing th~s application) 5. If dwelling, number of dwelhng units ........ ..~....~....~, ....... Number of dwelling units on each floor ............................ If garage, number of cars ........... ..~....~.....~.. ................................................................................................................... 6. If business, commercial or m~xed occupancy, speofy nature and extent of each type of use ................................ 7 D,mens,ons of ex,sting structures, if any: Front ..... ~ .......... Rear .... ~f ........... Depth ..~:.... Height ........ ~ ........ Number of Stories .........:~ ...................................................................................... D~mensions of same structure with alterations or add,bans Front ........... : .................... Rear ................................ Depth ............................. Height .............................. Number of Stories ........................................ 8 D,mensions of ent,re new construction' Front ....... ~....~.. ............. Rear ........ . .h~....~... ........... Depth ..~,~.....~..~....~...~..~. Height ......./,,,~.....r. ......... Number of Stories ...... ..~....~.....'~.. ......... 9 S~ze of lot: Front ......... ~...~..i ........... Rear ...... t]~l~...~...'~'...~ ....... Depth ....... ../....7~..~.~...~ ........... 10 Date of Purchase ........................................................ Name of Former Owner ........................................................ ]1 Zone or use district m which premises are situated ................................................................................................ 12. Does proposed construction wolate any zoning law, ordinance or regulation? . ...../~...~ ....................................... 13. Name of Owner of prem,ses .l~...~..i~..~../:!..p ............... Address ...~.~.~.,.¢.....~..~..~.¢..~..~iic. Phone No .................... Name of Architect ...................................................... Address ....................................... Phone No .................... Name of Contractor .~i.~-~.E,~-.,~.I.I~..¢......~...~..../:f.~...~ ....... Address .~...£..~....~...7..~..~../..~..~...~..~.~..~./?. Phone No. ~.~Z.~..~.~t.' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~st~ng or proposed, and indicate all set-back dimensions fron property hnes G~ve street and block numbers or description according to deed, and show street names and ind~cat~ whether ~nterior or corner lot STATE OF NEW...YOR.K,/ COUNTY ...~~ ................... being duly sworn, deposes and soys that he is the ~ppl car above n~med. He is the .................~..-~:~r~..r. ..................................................................................................................... ~' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa,d work and to make and fi th~s apphcation, that all statements contained in th~s apphcation are true to the best of his knowledge and behe and that the work wdl be performed in the manner set forth in the apRlication filed therewith. Sworn to before me this_ ........................ ~. day of~.~....:.......~;r~ ............ , 19....Z x/~/_. ~ ~ / ~'/ , '"~' . .C,'~ ~ ,~ ~ % ~l~ c,^~r~ .... ,,,..~...~ .............. Notary Pubhc, ..~...f~'..-f'~.,~t.~C..~.?~'~ (Signature of applicant)