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Home My WebLink About3373-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFIrI. ATIS OF Or.P. UF~ANr.¥ No. ~ .28~0 .... Date ........... ~I]tt ....~v~ ......, 19..67 THIS CERTIFIES that the building located at . .I/~...~...l~. ~ ......... Street Map No.~'. ..... Block No ..... ~ .... Lot No. l... ]~l;*,i~ .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~'tb .... '~ .... , 19.67. pursuant to which Building Permit No.3373. I. dated ........... Pcb .... :~..., 19.,;. ?., 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 .1~1~. ~l.~.i~g. ~,igh.-'~e~to~ .e££.iee ............................ The certificate is issued to . .l~,..).~.. 3a~d~.~'.s ........ 0~me, r ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... ]..'~..-., ........................ ' ' Building Inspector FORM NO. ~ 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? 3373 Z Permission is hereby granted to: ......~...,......~.e.l~.....A/~.....i~t~,....~.e~,e~ ........... ............. .~u.t. cb_alD~e ............................................. to b~l~d..azk.&ddi.t~on..&..make..~.ter~t~on~..~..ex~s~n~..el~l.t&n~.&.~l~e~or~ off,c: ot premises Iocoted at ~I/.5......~.'.aLz~..~Roads.....14at~t:L:l;ueks...~..~. ............................................... pursuant to application doted ........................ ~e~ ......... '~ ................ , 19.6~11.., and approved by the Building Inspector. .ee .......... Building Inspector FORM NO. 1 TOWN OF $OUTHOLD BIUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ............ Approved ........................................ , 19 ....... Permit No ................................. D~sapproved a/c ....~...~ ................ ~ ........................................................ ............. z~ ........................................... ~ ............... 5 ...... ~ ........ ~... ~(Buildino Ink,tar) Application No ........................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and g~wng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicat~o, c. The work covered by this apphcation may not be commenced before ~ssuance of Buddmg Permit. d. Upon approval of this apphcation, the Building Inspector will issue a Building Permit to the applicant. Suc permit shall be kept on the premises available for ~nspechon throughout the progress of the work. e No bu~ldmg shall be occupied or used in whole or ~n part For any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bu~ldmg Deportment for the issuance of a Building Permit pursuant to tl Buildmg Zone Ordmance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, oddmons or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordmances, building code and regulations. Wm. Beebe (S~gnoture of apphcont, or name, if a corporation) Cutcho§ue (Address of applicant) Contractor Name of owner of premises ....D.?....:..1'~.~.]r!.J:.~...~.....G..e...~.~..~..e.~ ................................................................................................... If applicant is a corporate, signature of duly authorized officer. (N~me and title of corporate officer) 1. Location of land on which proposed work will be done. Map No .... ~ ................................. Lot No' . ......... ..7-~.... Street and Number .~.~..~ in Roa.~ ttituck~ N.Y. Municipality 2. State ex~stmg use and occupancy of premises and mtended use and occupancy of proposed construction: D · a Existing use and occupancy . .~.~.$~. ~.....gg.~.~...q~.~.~ ............................................................... b. Intended use and occupancy ......... ~fl..~...~..~.~.~Q~ ................................................................. 3. Nature of work (check which applicable). New Building .................. Addition XXXX Alteration Repair .................... Removal .................... Demolihon .................... Other Work (Descr,be) .................................... 4. Eshmated Cost ..2.~.0~0..~.,~:1 .................................... Fee ........ .~,,OID ...................................................................... (to be pa~d on fihng this apphcation) 5. If dwelhng, number of dwelling umts ....... .0,~. ............. 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 Dm~ens~ons of ex~sting structures, if any: Front .......................... Rear .......................... Depth .......................... Height ............................ Number of Storms ............................................................................................................. D~mens~ons of same structure w~th alt~rahons or addihons: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stones ........................................ 8. D~mensions of enhre new construction: Front ..... ~.. .................... Rear ..... ~ ..................... Depth ......... 3.0 ............ Height ............................ Number of Stories ..o..n.e. ..................... 9 Size of lot: Front ............................ Rear .......................... Depth ................................ 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... 11. Zone or use d~stnct in which premises are s~tuated...!!~U...cl.i~,t ......................................................................... 12. Does proposed construction violate any zomng law, ordinance or regulahon;~ ...... rz~ ......................................... 13 Name of Owner of premises ..~...rq.......~.e..~.~.~..s. ........... Address .....N. fk~..~.~¢.~ ................... Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ..~...m....:..~..e..~.b...e. ............................. Address ...... ~.~...~.q~1~.¢ ................. Phone No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fro~ property lines. G~ve street and block numbers or description according to deed, and show street names and indical whether interior or corner lot. STATE OF NEW y ( RK COUNTY OF .............. / S S. ......................................... ~lll~..~fl~.be ................................... being duly sworn, deposes and says that he is the applic (Name of indwidual s~gning application) Contractor above named He is the .................................................................................................................................................... (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 apphcation; that all statements contained m this applicat,on are true to the best of his knowledge and bel and that the work w~ll be performed in the manner set forth m the apphcation filed therewith. Sworntobefore methis ,, /, r~. ~. ~ ~ ............... ~. ....... dayof ......... ~.~. 1~.~l ~ &.qCxV. ............... , 19...62. ~/ ~ Notary Pubhc,~~.....~. ...... ~C~ty (S,gnature of applicant) " ~ARY FU3LIG, St~'2 c~ h ,/ ~ork ~o 52-3%3120 Su~,ol,~ Count~ Term [xp~res ~rch 30, 19~/