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Home My WebLink About3593-zFO~ ~0.4 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. P.I~RTIFIOATI~ OF OOr-UI~ANr. Y THIS CERTIFIES that the building located at l.~/~... ~.8~b.~..D~$.V.~ .......... Street Noose Cove Map No ............. Block No .... ..XX. ...... Lot No. ~. ...... ¢~l.~.~hP. gU~... K~¥* ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ A..llgU..~.t}....~.~., 19.6.7. pursuant to which Building Permit No...~.~.,q.3..~ dated ............. AAlg.. 29 .... 19.6.~., was issued, and conforms to all of the require- ments ,of the .applicable provisi.ons of the law. The occupancy for which this certificate is issued is . .}'".1: .~¥.~'.[;.~..91.1.~.. ~'.a.$.:[.~I~y..d.w. 9~,~t~lg .......................................... The certificate is issued to . .~.O.b.??.t;.'. ~}~"~Kll~;~J.f,~l'l. ..... Q~I~I' ......................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval . ~.~.e.,. 2~ ~..~ 96.~....by. iq ~..~.:[:[~a ..... ........... 'l~il~'i~l~' i~;~[;; ......... ~'" Underwriter Cert # N$9829 tlouse # 2350 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEIU~IT CI'HIS PERMIT MUST BE KEPT~ ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3593 Z Building 'lnspecfor. Permission is hereby granted to:~) ~.~ ~,~. :,~ . . .......... ............................................. ............... ;....-,;"h"";";'":';";'"~'; ......... at premises . ..,, ~ ..... ~ .... ~ ...... .... ................................................... .................... ; ......................... ~.....~ .................................. .: ....................................................................... pursue, ,o application d~ed /T ~ ~.:Z. , 19~.[.., and approv~ by the Building Inspector S-9 SC~D SUFFOLK COUNTY DEPARTMENT Da~e Bldg. OF HEALTH Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure (Give deed l/ocation) / located have been inspected by this department and found to be satisfactory. Dimtriot Engineer District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ...... Approved ........................................ , 19....~..Permit No. Disapproved Application No....?,...~...~:...~. ......... APPLICATION FOR BUILDING PEP, MIT INSTRUCTIONS o. 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 port 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 pa rt for any purpose whatever until o Certificate of Occupancy sholt hove b~en granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 and regulations. /' (Sign.ature of opplic~t, or nome, if o corporation) ....... (Address of applicant) //? ~/~/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ..................................... : ............................................................................................................................ Name of owner of premises ,,,~,,,.~.,B,~I?../..~....../...'E..,.....-~..,~.. .~...,~.~....~.../..~...~... ....................................................... If applicant is o 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:~..~..~.~.ft:.~..J~...~'.~.. ...............Lot No:~....~.. ............. Street and Number .~./.~...~.~/~.~.~..~.~.....~/~.~...~..~...~..~.~....~./..?...~...~../~.~...~....~..~.?...~..~..~..~: ......... Municipality 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. Nat'ure of work (check which applicable): New Building ~ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Esti[mated Cost ........ /..~...~..g...~, .................................. Fee ..................................................................................... j (to be paid on filing this application) 5. If d}*/elling, number of dwelling units ................... ........... Number of dwelling units on each floor ........................ If g1~rage,· number of cars ........./. ............................................................................................................................. 6. If b.'usiness, commercial br mixed occupancy, specify nature.and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Hek ht ............................ Number of Stories ......................................................................................................... Dim,,nsions of same structure with alterations or additions: Front ................................ Rear ............................ Dep . ........................... Height ................................ Number of Stories ........................................ 8. Dim ~sions of entire new construction: Front ..........d..~.~.. .............. Rear ....v(....'~.,/-Z.. ............... Depth ....-d...~... ............ Heic ht .......... /..~.. ........... Number of Stories ......... ./. ...................... 9. Size!of lot: Front ...... /....~.....g. ............... Rear ........ ..~....¢.....~. ........ Depth ...... ~...~..."~.. ..................... 10. Dot~ of Purchase ..'~.../¢....P4'. ....... ./...¢..~...~. ........................ Name of Former Owner .~:.'....':vC...~.../.~.,~..d..¢...~./..~ ........ 11. Zon~ or use district in which premises are situated .............................................................................................. 12. Doe~ proposed construction violate any .zoning law, ordinance or regulation? ...Z~....~. ......................................... r+ " 13. Na e of Owner of premises/~.:/~r~.~...¢d'.d.d...~./~'..r')d(... ........ Address . .~../.'..°/...~..,'f..~..~..¢......./..Y.:/...... Phone m ................... Nale of Architect "'ff'"~' 'Z¢-7'"'/'"~:~',o __ _________ .......................... Address ......~../.'./..~.¢./;~¢./.~..../2....../..k.-.../.. Phone No../9..~..?..~.~ NaMe of Contractor .[.~.¢.4~..../:~..././...K....Z'~.g,...~.../2.,J. ........ Address ....~./.i .C/'.d.~../?.~../'r.~..~....~...../.!:.'.~. Phone PLOT DIAGRA,M Locat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property li~es. Give street and block numbers or description according to deed, and show street names and whether in~erior or corner lot. STATE OF INEW~,YOR~, ~,~' ) ~ ¢ COUp. TY ~F ~..~....) .... . ............................... being duly sworn, deposes and says that he is the applica~ (Name of individual signing application) above nam4d. He is the .~~ .................................................................................................... I (Contractor, agent, corporate officer, etc.) .~ of said own'er or owners, and is duly authorized to aerform or have performed the said work and to make~ th~s apphca}lon that ali statements contained ~n this apphcahon are true to the best of h~s knowledge and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to be;fore me this Notary PubJic~'K...~~. Coun,¢~ (Signature of ~'": ~'