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Home My WebLink About3548-zFORM NO, 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. EIERTIFIEIATE OF EIEIP. UPANEIY No.Z 2966 ..... Date .............. Dee.,. 25 ..... , 19 THIS CERTIFIES that the building located at .g/8. Ceda~ .~ Ave ...... Street View ........... ap ~ ......... ozuc No. .Lot No..~.. 8~Ut~ldI. N,~, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... g~y...~.. , 19 6~. pursuant to which Building Permit No... dated ...... ~y .... ~ ..... , 19.6~., 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 . ~Va20..o~e. ~gm&.L~ .,z'i;8,~&~'zg ....................................... The certificate is issued to ...He&on. ~mg ............. ~e~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .P¢.~,. ~[~. ~9.6~.. ~ .B,..~l~&.. Building Inspector ~ ~OR~I NO.,~ TOWN 0F $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. ¥o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3548 Z Permission is hereby granted to: ~t~S to ..~.z..~..~...?..=.~...f~.~.:~.J-,Y.....~'.,~.].J~...~ .................................................................................. pursuan~ to applicat on d~ted ' r~'":Sr ]--~ 19...~.~..., and approved by the Building Inspectoi'. · =ee ....... S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Da~e Bldg. Permit No. TO WHOM IT MAY CONCERN: at The (Give/deed location) sewage disposal facilities for a structure located have been inspected by this department and found to be satisfactory. Distrio b t~]nglneor District Engineer /a~-,o-TZ-~'-$ TOWN OF LD PROPERTY RECORD CARD OWNER STREET ~(~:)C~ VILLAGE DIST. SUB. LOT I . s w ~ o~ ~u,~,~ ~ND IMP. TOTAL L DATE REMARKS ~G~ ~u,[~,~ co~,o~ FA~ Acre ValUeAcrePer Value ,~t~ <~/~>) ) ~ ~ Tillabl~ ~oodlond Swampland FRO~AGE ON WATER Bru~lond FRONTAGE ON ROAD /~ , ~ ~ House Plot DEPTH i ~ ~ BULKH~D total DOCK COLOR // /.¢ ,," D" '<i .- M. BJ'dg. I ~_.~' -~ ~ ~ _.~/~,' ~ -~0 ~ ~ j~dotion ~'~ Both / Dine.e ~en~i°n I~t Walls ~ension Bos~ment ~ ~4 Interior Finish ~ ~ LR. ~tension Fire Place ~ Heat ~ / L ~ ~ ~ DR. ~ Z~) ~ /~ ~ Y~ r~~ ~ TypeRoof ~¢j~ RoomslstFIoor BR. Porch Recreation Roo~ Rooms 2nd Floor FIN. B. Porch Dormer, ' Breezeway Driveway Examined ....~...~ ......... ~. .................... , 19 . . FO~M NO. I T~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19....'... Permit No. Application No ...... ,.~f. ,~. ...... ~.~ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this applicatioq. 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. Such permit 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 in part for any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. Agent of Owner Name of owner of premises .....~.?..~..~.~..D..0.~.~ ........................................................................................................................ if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ........................................ ~8.~r View ~e~Pa~e Lot No.: ........................ "~ Street and Number ...~.~..~.......~...~..~..~...~..~...~.*.....~.q.~..~.~.~.~.~....~..~...~.~ ......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy VS.~Irtt ]Let b. Intended use and occupancy .......... .O...~.?....~.~...~..:J:~.~.....~..~.,.~,.]:..~.~.~..t~ ......................................................................... 10. 11. 12. 13. Nat]ute of work (check which applicable): New Building ...~ ..... Addition .................. Alteration ............. Repp~r .................. Removal .................. Demohtion .................. Other Work (Describe) ................................... / Esti(~ated Cost .'II~0~I..P~ .................................. Fee ....~.0:~.00 ..................................................................... I - (to be paid on filing this application) If c~welling, number of dwelling units .O,110 .................... Number oF dwelling units on each floor ....................... If gbrage, number of cars .............. O1~ ................................................................................................................... If I~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ....................... Din ~ensions of existing structures, if any: Front ............................ Rear ................................Depth ................... Hei ht ........................ Number of Stories ............................................................................................................ Din ~'nsions of same structure with a.lterations or additions: Front .................................... Rear ....................... Der th ................................Height ............................Number of Stories ................................ Dir~ensions of entire new construction: Front ............. .~.~1 .................. Rear ...1t:.~. ..................... Depth ........ ~ ...... Height .................... Number of Stories ........... ..O..~...~. ............................................................................................. Siz~ of lot: Front ....~JD.0 ................. Rear ......... ~1[~ ...................Depth ....... ],~.0. ................. Dat~ of Purchase ........................................................ Name of Former Owner ................................................... ! Zor]e or use district in which premises are situated ...... IIA. II..~!~t~ ....................................................................... .... ~ ~10 Doe~ proposed construction vlolete any zoning law, ordinance or regulot on ........................................................ No'ne of Owner of premises ~.~.Ol'l..D~l~t ............... Address ..~Cll~;h~lg[ ...................... Phone No ................ Name of Architect ...................................................... Address ............................................ Phone No ................ NarJne of Contractor .~.~...~O.~.~l~,...~...0.~'.J...Address ..... ~.0.15.~.~.~],~ .................... Phone No ................ PLOT DIAGRAM Local ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property I nes. Give street and block number or description according to deed, and show street names and indic te whether in :erior or corner lot. ..... C STATE OI NEW,y.~,. lee COUNTY DF ...~.~.~ ............ ................. " ................. ~S...Z~S~.... ....................... being duly sworn, deposes and soys that he is the appli ;(Name of individual signing app[JcatJon) abow~ na~ed. He is the .............. ~e~...~..~.~ ...... ~ (Contractor, agent, corporate officer, etc.) I of sa~d o~ner or owners, and Js duly authorized to perform or have performed the said work and to make and this epp~J~afion; tha¢ a~l statements contained in this application are true to the best of his knowledge and belief; that the wprk will be performed Jn the manner set forth in the application filed therewith. Sworn fo ~efore me this . F ~ ~ ,~ ~ ~ , . . ................... ...... ....... of