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Home My WebLink About3383-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P. EI~.TIFIE:ATE: I-IF E)P,E:UPANCY No.Z 2861 .. Date . O¢tobe~ 9 , 19 6? THIS CERTIFIES that the building located at l~/~ Cam]~ft~'e La~.e .. Street Map~o.~"~----- I~e&d CO~ock No. Lot No. 1~ Pe.e.Ol'~.e.~....~.~.~.~. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ~.eb 27 , 19 67 pursuant to which Building Permit No. 3383 Z dated .Feb 9~. , 19 67, was ~ssued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for whmh this certificate is msued is PrIYa~e one. f-m~ ~ y. dw. allIng. ............................. The certihcate is issued to .Baymorml Ke~r~.$.%ex' .......... 0~ex, .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 0~t ~. 19~.?...b.y..R.:..V~.~.~.~. Budding Inspector ~ 1~0~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3383 Z Permission is hereby granted to: .......... .......... ~.2D.....3e~.. 2~t'J~ ............................ ............ ~;LV..~,.x .h aacl.~.., i~. ,,.~.,, ............................... to ...~I,;L~...~0~...~c...~ a~ "~,~ ...4~.~1.~ ~'~§ ................................................................................. at premises located at ..........J~t-..~l,~...Jt~',l~:~f~fit~J...~.o~ .............................................................. ...................................... g,~q~..~t ....... ~.e~c~L~ ..................................................................... pursuan* to application dated ............................... ~$J~ .......... ~. ....... , 19..~., and approved by the Building Inspector. Building InspectorL S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Da~e Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at No~h side of Campfire Lane, 100' ~ast of Arrowhead Lane (Give deed location) Peconic, New York have been inspected by this department and found to be satisfactory. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ............. Approved ....................... ~.). ............. , 19..~..~.Permit No ................................. D~sapproved a/c ................................. ................ ................................. Application No. ~ ~ °c- ~ 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 buddings on premises, relationship to adjoining premises or public streets areas, and gwmg a detailed descripbon of layout of propertymust be drawn on the d~agram which is part of this applicotio~ c The work covered by th~s apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of th~s application, the Budding Inspector will issue o Building Permit to the apphcant. permit shall be kept on the premises available for inspection throughout the progress of the work. e No budding shall be occupied or used in whole or in part For any purpose whatever until a Certificate of Occupan. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of o Budding Permit pursuant to tl Building Zone Ordinance of the Town of Soufhold, Suffolk County, New York, and other applicable Laws, Ordinances Regulabons, for the construction of buildings, addmons or alterations, or for removal or demolition, os herein describe The opphcant agrees to comply with all apphcable laws, ordmances,,building code and regulotigns. /~/ (S~gnature of applicon, or name;if a/corporation) (Address of applicant) State whether applicant is owner, lessee, ~gent, ~rchitect, engineer, g~er~l contrg~tor, electrician, plumber or bud¢ ................... ................................................................................................. Name of owner of premises ....... ~..~.~.~.~. ................ /~.~C~ ............................................................. If applicant,is a corporate, signature_ o,f duly authorized officer. .......... ' b-f'i ................... ]. Location of land on ,hic~h proposed work will be d. oz~. Mop No/"'~ ' '/"~~.....~.....~.....~....'...'~..( Lot No: ...... Street and Number ....~.~ ......... ~.~... ..... ~..~ .................................... ~ U Municipality 2. State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~...,..~.....~....~ ..................................................................................... b. Intended use and occupancy ..........~....~.~...,.H......~.,...~'...~.. .......... ..~.....~....~..../....~...~...~'....o.'..,~.. ......................................... 10. 11. 12. 3. Nature of work (check which applicable): New Building ..... ~ ...... Addihon .................. Alteration .................. Repair .................... Removal .................... Demohtion .................... Other Work (Describe) ..................................... ... r, ../....9. ............................................................................... 4 £shmated Cost ..... *~ .................................................... Fee (to be pa~d an fihng this application) 5 If dwelling, number of dwelling units ..... ~ ................ Number of dwelhng 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 ex~stmg structures, ff any: Front ..........................Rear .......................... Depth ........................... Height ............................ Number of Stories .............................................................................................................. D~mens~ons of some structure w~th olterabons or additions' Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ~' , 8. Dimensions of entire new construction Front Height ..~....~.. ................ Number of Stones ............................ / ' ...... ....... S~ze of lot: Front .... ./....¢~. ................ Rear Depth ................................ Date of Purchase ........................................................ Name~?f l~ormer Owner ./~.~,.Z:../~.~./~'../..~.~....../~.....¢.,..~..~...~?.~..! Zone or use d~strict in which premises are s~tuated ........... ~.'.....~.! ................... ~.~;~,~ .................................. Does proposed construct~on¢,w ri,vi°late any/4 £/~z°nlng law,off,ordinance or regulat.~o~?., ........ L..v_...¥. .................................. ~'a e f~ne of re ,s~r~?'/u/a~¥¢¢ I.'.;A"d~"Cess ~ m o uw r p m e ........................................ Ac ............................................ Phone No .................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Controctor~..~,..~...¢.~......~......~...!....(...e..~...~...~......Address .~..]...F...L...~_..~..~...~...~.,~....~.,..¢..; Phone~N~o..~..~..~(.?....~'., PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex,sting or proposed, and indicate all set-back dimensions fror property hnes Give street and block numbers or descnptson according to deed, and show street names and indscat whether interior or corner lot. /Cj / TE OF NEW~--~R~./~//~_~ S S ~NTY OF ...~.':...../ ' · .. ............. .~...~'.~ .~...~r...~........~...~...'~..~.... ......... be,ng duly sworn, deposes and says that he is the appl (Name of individual signing ~~~:~~~ named. He is the ........................ ~~~.'""" ................................................................ (Contractor, agent, corporate officer, etc.) owner or owners, and is duly authorized to perform or have performed the said work and to make ~hcation, that aH statements contained in th~s apphcation are true to the best of his knowledge and t the work wdl be performed in the manner set forth m the applicahon filed therewith. ~ before me this ~ ~ / - ......... . · ''' .... Bomb,ss,on ~xp,re~ .... ~ f :/ 0 c~WA~ ¢-C b-~0 Ul~D_~ TI O_/Y ?~.41¢ I ~ W/¢33-4~ ~A $ T£R_L Y d f .Z.