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Home My WebLink About3355-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. EIIERTIFI~ATE I-IF ClI~.EIUPANEIY No. . ~. 2824 Date . . ae~t .e.m.b. er .1..., 19.6.7. THIS CERTIFIES that the building located at Cardin&l Drive .. Street Map ~. ttituc~, S~k ~o ~ Lot ~o. ~ ~ 29 ....... ~%~.~. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~an~F .~ ....... , 19~? . Dursuant to which Building Permit No. dated ~Y %~ ,19~7 , was ~ssued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued ~ p~v~ ~ ~.~i%~ .~%~.%~g ................................ The certihcate is issued to ~h~. ~J ..... % .~ .......................... (owner, lessee or tenant) of the aforesaidbuHding. ~ ~ ~. ~ Suffolk County Departmen~ of Health Approval ...... ..... Building Inspector FORM NO. 2 TOWN OF $OOTHOLD 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? 3355 Z Permission is hereby granted to: ......... ~v..Abit~.. ............ l~.t ~.tuek .............................................. to ~..~,~.. ~.e~...o~.e...~.e~l,;I,~...~,3,~ ................................................................................... at premises located at ...... ..~..~...t~.~....~.~.....~......~..........~...t...~..i...t~...`~....k.~...~.~.t~...~.~.~.~. ........................................... ........................................ ~,Z~I~3,..D~ ............ i~tt~tu~k ........................................................... pursuoni to application dated ....................... -TO~t~ ....... ,%2 ....... , 19..~., and approved by the Building Inspector. Fee $...~.0........0~.. ......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da~e ~U~ 3 1 fqH7 Bldg. Permit No. /~O TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ,~ ~_~, ~ ~/~ ~ ~. (Gi%~ deed location> have been inspected by this department and found to be satisfactory. 1~O~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE /'~ SOUTHOLD, N. Y. Approved ....................... ~ .......... , 19 ........ Permit No..........'~ff........"-' ..~'...........~"~'. Disapproved o/c ..~ .................... ................................ .............................. AP 'ICATION FOR BUILDING PERMIT Application No ............................ INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin~ Inspector. b Plot plan showing location of lot and of build,ngs on premises, relationship to adjoining premises or public streets o, areas, and g~wng 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 opphcotion, the Building Inspector will issue o Building Permit to the applicant. Sud permit shall be kept on the premises avadable for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or tn part 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: Bu,ldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The apphcont agrees to comply with all applicable laws, ordinances, budding code and regulations. ............. E d.~:a~.d.. J~b.~,t ~..I.z~c ............................................. (Signature of applicant, or name, if a corporation) ~ttituc~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Charles Name of owner of premises ......... ~~_ ............ ~.~'aC~!. ........ ~...~-.~..~...~.[. ................................................... 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' ..~!.~..~..~.~.~...C..~......~..S.~. ....... Lot No' ..$.~....&:...~.0.. Street and Number....C..~,~'~$~¢~. ~.~,.Y.e, ....... ~.~.t.1~.~.1~,¢]¢ ....................................................... Municipality 2. State ex,sting use and occupancy of premmes and intended use and occupancy of proposed construction: a Existing use and occupancy ....Y.~,.C.a~..~a~cl. .................................................................................................... b Intended use and occupancy .... .o...~..e....~_~..J....~.~....~.~.e.~..~..~...~.~ ............................................................................ 3 Nature of work (check which applicable): New Building .... ~ ..... Addition .................. Alteration ................ Repair .................... Removal .................... Demohtion .................... Other Work (Describe) .................................... 4. Estimated Cost .... .~.'....2..~..j..O..0.0.....P.~.~ .......................... Fee ...,~.0. ................................................................................ (to be paid on filing this application) 5. If dwelhng, number of dwelling units P~t~ .....................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. D~mensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Height ........................... Number of Statues ............................................................................................................. D~mens~ons of same structure w~th alterations or aad~t OhS: Front ................................ Rear .............................. Depth ............................. Height .............................. Number of Stones ........................................ 8 D~mens~ons of enhre new construction: Front ........ 6.~ ................ Rear ....... ~.8 ................ Depth ....... .br.~ .............. Height ............................ Number of Stones ....o.~¢. .................. 9. Size of lot: Front ...LJ:.~.0. .................. Rear ........ 2.~.0, ............ Depth .2,80...17,/~ ............. 10 Date of Purchase ................. 1~.66 ............................. Name of Former Owner ........ b-f~.~t..~$.~ .......................... . Il^ti ] 1. Zone or use district in which premises are situatea ........ ~ ..................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation? ............... ..~..o.. ............................... 13 Name of Owner of premises .... .~f~.3.Ji,~....~..Z'...~..O.~.....Address ............................................ Phone No ................... Name of Architect ...................................................... Address ............................................ I:~hone No ................... Name of Contractor ...... .~..~..~..b.~..~.~....Z.~,.o. .............. Address ...... ~.?,~.J~.~.~.~.q~ ................ Phone No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions froi property hnes. G~ve street and block numbers or descnptson according to deed, and show street names and radical whether ~nterior or corner lot. STATE OF NEW ~YO, E~<, .1 COUNTY OF .... ~.l!..ihzL.q.l.~ ......... S.S. ....................................... :~,>;~,~'d,.,~,13,~..t~- ............................. being duly sworn, deposes and says that he is the applio (Name of ~ndwidual signing application) above named. He is the ........................... CoZ~tm~c.~¢).~'. ................................................................................................ (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 th~s apphcat~on; that all statements contained in this apphcat~on are true to the best of his knowledge and bel and that the work w~ll be performed in the manner set forth in the apphcat~on filed therewith, Sworn to before me this ,~"~--~'-- ,~ r ~,~ .................. 'J2.. dayof ............... ,,T~a~,.~¢ ............ , 19.6.7.- ~ ,~ ~, _ . ~ /...7- . .............. ~;?...~.~.x.~:.r~ ..... ...~....~ ...... ~...~....m~....~ ........... Notary PubJic,~~-.....~..,...~'..(,,4¢..~....'~..c* .~. County (Signature of applicant) ~" fl IW~RIO~I A PF~ r 'T ~Y NDTARY PUBLL, S,: :-'d~',,~ York I~o 52 $25~iZ0 24,,c1,~ CauntyG -~