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Home My WebLink About3575-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. F:Et~TIFIP. ATE OF or':.I-:.UPANP. Y ~o. Z. 29,~'3 ..... Date ......... N. ove=her .... 29..., 19. TI-IlS CERTIFIES that the building located at ~. ~i~41e..R0~d~ .(G~) Street Map No. ~ .... Block No...~ ....... Lot No..~... ~a~hag~%e~..~Y.~ ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... A~g~st.. i~... , 19.6~ pursuant to which Building Permit No.. 3.~. dated ....... A~g~s~ .... 1~..., 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 ...~ivat~. ome. family..d%~eJ.~ing ..................................... The certificate is issued to .. Robem.t .Hu~ba~.. '~, ........ 0%~e~ ................... (owner, lessee~or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...~0~ .2~.~..196~..b~..R~. TO~N OF SOUTNOLD ~UILDIN~ D~P~RT~NT SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3575 Z Permission is hereby granted to: .......... alI~:Lelr+..I,Y, ...................................... to .Ja..baL~.a~..ea~..:aa~r .4ve~. Iai ............................................................................ at premises located ot ..J~.JJ.JJ.~4Jal ~..~(J~lJt...(~[~).....~a~.e&..4~.~..~alRj~..~ ............. ................................................ ...~..~.~...~..~.~.....~..,X~ .......................................................................... pursuane~ to application rlatecl ................................... ~ ....... ~J~.., 19...~., oncl approved by the Builcling Inspector. Fee $.-~Jm~) ........... Building Inspector / SUFFOLK COUNTY DEPARTMENT OF HEALTH ~dgo Permi% No.~ TO WHOM 1T MAY CONCEHN: The sewage dispssal facilities for a structure located at " ( O'i~-~le e'd location) have been inspected by this Department and found to be satisfactory. TOWN OF SOUTHDLD OFFICE DF BUILDING INSPECTOR TOWN CLERK'S OFFICE SBUTHOLB, N, Y, Mr. R. Cammerrer Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ..~...g~...o....~.e..~]g..~..J:..~ e s Zno has applied to the Town of Southold for a permit to construct a building on .¢./¢...~.i$10.1.c..~io.~&_.(.~2Z).~......g~g.~g.~g-.g.~....~..~Z., ................ as shown on the attached plot plan, submitted in triplicate, dated ................ ~g.~.....~.~.~...g:~.~Z ......... and titled ...~'~.~...~'...~.~.~?.~...~.~..~.9rt IIubbard We shall withhold further action on this application for ten days or o~erwise provided in the aforementioned Section 239K. AeOn. st ~5, Z967: %99~o~ed to ~e ~ow~ o~ Very truly yours, Southold pursuant to Sec. Z39K of the General ~unlcipal Law. Before building access to CA zv, a ~e~mi~ uncie~ sec. is6 o~ me z<i~ay_ Law must be obtained from the Suffolk County Dept. of Public Works. SUFF. OLK COUNTY DEPT. PUBIJC~A~LR~i_!ding Inspector E. ~J. Kammere~] q~m~ ~ 'r~n of Southold, ~ ~. Matsunaye, ~ief/Ig~glne~r TOWN OF SOUTHOLD I~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOt. D, N. Y. fixomined .......... , 19. ^pproved .......... ............................ ........ per.,i, Disapproved o/c ........................ ,..~ ................................................................... ................ (Building Inspector) 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 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 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. (Address of'applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~.~...~..~ ................................................................................................... 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.: ...~......4~¢r..: ....................... LotNo.: ........................ · __./..~.. . ~.... · .... .... Street and Number ..~ .~.~ ~'.~.'.....~....~.....r~..L/~. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ b. Intended use and occupancy .. ~ · 3. Natuie of work (check which applicable): New Building ..... ..)('. ......... Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estim, atedl Cost ..J..J.,~.../'L.o...O. ......................................... Fee (to be paid on filing this application) 5. If dw]elling, number of dwelling units ........ J .................. Number of dwelling units on each floor ..... ~.. If ga?age, number of cars 6. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth HeigJ~t ........................ Number of Stories Dimensions of same structure with alterations ar additions; Front .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ # Rear ../'~./~.. .................... Depth .~...~.~...~..... 8. Dimensions of entire new construction: Front ....~..~/. .......................... Heig.'ht .................... Number of Stories .......... 9. Size of lot: Front ...].J..~.:..~. ........... Rear .J.~...~....~. ...................... Depth .~....~..,.~.~...~.~...~ '~ 10. Dat~ of Purchase ........................................................ Name of Former Owner 1 1. Zon~ or use district in which premises are situated ............ 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? 13. Na~e of Owner of premise~.~.~ ....... Address ............................................ Phone No. Nam,,e of Architect ...................................................... Address ............................ -. ~. Phone No. · , ~ ~ ~-~.' ~j" Nar~e of Contractor/~/$1.~..9...~.'Jr:~,....Address .¢/'.~.'.~.~,~..~...~..~. ........ Phone / ~ PLOT DIAGRAM Locat~clearly and distinctly all buildings, whether existing or proposed, and indicate al~ set-b~ck dimensions property li(qes. Give street and block number or description according to deed, and show street names and whether int,'erior or corner lot. STATE al NEWr-Y-~RK~ / ,/~ ~ S S !(Name of individual signin abow,~ na~ed. He is the / duly'sWorn; deposes and says that he is the appli¢ (Contractor, agent, corporate officer, etc.) of said o.~,ner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and belief; that the Nork will be performed in the manner set forth in the application filed therewith. Sworn to I~efare me this ~ ..............~,/L~4.~:.~.~ day of ..~ ........ ~ .......... ,19 ..~.../.7'''~- 7// . /) Notary P~JI~~...~..,.,.~~,~........ County (~ure of applicant) //A..PO' RE.DATED: SITUATE TOWN OF-- MAP OF PROPERTY