The URL can be used to link to this page

Home My WebLink About3363-zFOIL~I ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~'OWN CLERK'S OFFICE SOUTHOLD, N. Y. OE:RTIFIOATE: OF OOOUPANOY No..Z./~0~... Date ...... April"4', ............... , 19.~. T!~Is CERTIFIES that the building located at ~IhII~IIq~I'AvI~ ......... Street Ma~No. ~. Block No .... f ........ Lot No. 1~"' ~0~ · L~ ~'.'~ · ~.' ' :~ conforms substantially to the Appli'cati~on for Building Permit heretolore filed in this office ~hte~ .. ,,~. J~.--~ .......... ~19~7. pursuant to which Building Permit No.~. '33~3' ' / ~at~d/?" .J~.. 23 ........ /.., 19~., was issued, and conforms to all of the require- me~ts~: ,of the applicable provisions of the law. The occupancy ior which this ce~ificate is issued ~is ..... ~a~. ~. ~&l~. ~Oll.~ ...................................... The ce~ificate is issued t.e ............... g~d-~ .... ~r ................. (owner, lessee or tenant) of the ~ore.said building. ~1 ~ ~ Suffolk County Department of Health Approval ......................................... FOEM 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? 3363 Z Permission is hereby granted to: Ceo Aha. ers ..A~..C E~ward gilier ............... .~.~.t.qb..~.~ ........................................... to ,,r~..~....a..a..~..~...!:',a. ~..e....~.t..e...r..a...t.~,.°,n..~....°.~....e.*~..e.~.g.....a.~ !~;~ ................................... at premises located at .~...O..~.....1..~..t.......J~....~..~...~..O..~.....~...~..t'. ............................................................................ ............................... ~.S...i.~,~m~que..A~ra ................................................................................ $outhold pursuant to application dated ............................. ~.~T~, ........ ~-.9. ......... , 1~.~......, and approved by the Building Inspector. Fee $~......0~... ............... FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. Dzsapp roved a/c ..~~ ............... - APPLICATION FOR BUILDING PERMIT Date ........ ..~.¢.,. ........................................ , 19..~ :7 INSTRUCTIONS a This opphcot:on must be completely filled ~n by typewriter or ~n ink and submitted in duplicate to the Buildi, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjmmng premises or public streets areas, and gwlng a detailed descr,pt~on of layout of propertymust be drawn on the diagram which is port of th~s applicotic 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. Su. permit shall be kept on the premises available for inspection throughout the progress of the work. e. No bu,ld,ng shall be occupied or used in whole or m part For any purpose whatever until o Certificate of Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regular,ohs, for the construction of buildings, additions or alterations, or for removal or demolition, os herein describe Theapphcantagreestocomplywithallapphcable~_laws, ordinances, bu~ond~ ............................................................... , (Signature of af~licant, or name, if a corporation) .................. ...... ...... iiiiii pr/~ / F ~ ~ ]) ~ /~ ~ U (Address of applicant) ~ State whether applicant is owner, lessee, agent, archit~ect, en~r~er, general contractor, electrician, plumber or build, Name o~ owner of premises ...................................................................................................... If applicant is a corporate, signature of duly authorized officer (Name and title of corporate officer) 1. h h e ark ~1 e ~'~]~ J Location of land on w c propos d w w'lb done. Map No ....... :~,....,~.~ ....... Lot No: ........~ ....... Street and Number ...... ~ ......... ~i~ii~ ..... ~ ...................................... 2. State existing use and occupancy of premlse.~s and intended.~e and occupancy of proposed construction: ............................. ..................................................................... a. Existing use and occupancy b Intended use and occupancy ........................................................................................................................... 3. Nature of work (check which applicable)- New Budding .................. Addition ...... ~ .... Alteration ................. Repair ................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ................. /..,~.).~ .......................... Fee ........................................................................................ (to be paid on fihng th~s 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. D,mensions of ex,sting structures, ~f any: Front ........... .~..,~ ......... Rear ....... ~.,~ ............ Depth ....'~...~.. ................. Height ............. /..q...~ ........ Number of Stories ................. ./. .......................................................................................... D,mens~ons of same structure w~th alterations or"add~t~ons. Front ......... .~...Z... ................ Rear ....... .~...~- ................. Depth .............. ..~./., ........... Height ............ ./.~'.. ............. Number of Stories ............. ./. ......................... 8. Dimensions of entire new construction: Front .... .?....~..~.~ ......... Rear ..?~.~.Z...Z..../../..~....Z~... Depth .......................... Height .............. ..~.?/.. ........ Number of Stones .......... ./. ................ 9 S~ze of lot. Front ......... .~..~. .............. Rear .......... ?..~. ............. Depth ...... .~..?...O. .................. 10 Date of Purchase .......... .~ ............~.g....7. ............. Name of Former ~Owner ...................................................... 11 Zone or use d~strict ~n whichk/'' premises are situated ............................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulat~on~ . 13 Name of Owner of premises ......~.......~ ............ Address /..9..~..~...~........~...~e No ................. Name of Arch,tect ...................... ~ ............... Address i~iiiii~ii~ Phone No .................. Name of Contractor .~. ......................................... Address Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes G~ve street and block numbers or description according to deed, and show street names and md~co whether interior or corner lot. 7O I STATE OF NEW YORK, ) ¢ c .................. ~ ......... ~..~... .............................. being duly sworn, deposes ~2nd says that he is the appli, ....................................... .......................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the so~d work and to make and th~s opphcotion, that oil statements contained in this application ore true to the best of his knowledge and b~ and that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me this .......... ....... .... ...................... ............................. ~erm ~xp~res ~tarch 30,