The URL can be used to link to this page

Home My WebLink About3607-z~ORM ~0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT '~'OWN CLERK'S OFFICE SOUTHOLD, N. Y. r!£1~TIFIP. ATE rIF cIrI.~UPANI~¥ THIS CERTIFIES that the building located at .. E/&.. S. e0ol~d. ~It .......... Street conforms substantially to the Application for Building Permit heretof.ore filed in this office dated ......... $.~p.t .... ? ..... , 19.67. pursuant to which Building Permit No....~6G~.Z dated ............ tSelat .... 7 .... 19. BT, 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 P.~t~rate..Ga.~age · (k. eeesso~y..Btdlt ....................................... The certificate is issued to .~.tallJ. ey..~io.to~.ta ........... 0wi'lei,. .................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ...... N,R. .............................. .......... ......... / House # 1060 i: ' TOWN OF $OUTHOLD · BUILDING DEPARTMENT ~rOWN CLERK~S OFFICE $OUTHOLD, N. Y. ~' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES uNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3607 Z Permission is hereby granted to: ........... L ... ~.~...~.:~,¢.~.!~ .................................... pursuant,to application dated ........... ;.;;.. ................ ~J).!~ ....... ~......., 19...~., and appr0ved ~y the , Building InsPector, Fee $ ~t~ .............. FO~M ~0, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,..,~,...,,Z ...... ,'19.~.,,Z. Approve ..................... t.!. ............... , .L .permit Ne. .... Disapproved ~ ...... ( B'~'~ect o r) Application No..?.....~....O...Z ........... 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 propertymust 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 lows, ordinances, building code and regulations. ....... .... ................ (Address of applil:dnt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of '"'~'"'~;7 ........................................................................................ 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 do, ne. Map No: ............................................ Lot No: .................... Street and Number ....... ~..~.......~ ........... ./'..~..~.....~....~~ ....................................... Municipality / [/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use ond occupancy .................................................................................................. b. Intended use ond occupancy ........ ~, ........................................................................................... 3. Natlure of work (check which applicable): New Building ......'~. ........... Addition .................. Alteration .............. Repj~ir .................... Removal .................... Demolition .................... Other Work (Describe) .................................. 4. Estil..ated~ Cost ............................................................ Fee ...................................................................................... (to be paid on filing this application) 5. If d~,elling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If g~arage, number of cars ......... /..,..f;r~r~. ............................................................................................................. 6. If 5usiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Din!ensions of existing structures, if any: Front ....,,~...~....../(. ......... Rear .......................... Depth Height ..... ./..(...z. ............... Number of Stories ....... Dimensions of same structure with alterations or additions: Front ................................ Rear ............................ Dep;th .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....(.,~.~...~..~. ........ Rear / ~ ,z~ ,,, Depth ~'fl ~.. ~" ...... ./~ ................. Number of Stories Height ' ~ ............................ S~ze of lot: Front ........................... Rear ............................ D p h ................................ 10. Dot of Purchase ....................................... Name of Former Owner ........... .~. 11. Zone or use district Jn which premises are situated ........................................................................................... 12. Doejs proposed construction voate ,coy zoning aw, ordinance or regulation? ....... ...W?.. .................................. I,... Name of Architect ...................................................... Address ............................................. Phone No. Na+e of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM L,ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lihes. Give street and block numbers or description according to deed, and show street names and indi whether in!erior or corner lot. o2(9 STATE OFi NEW YORK, COUNTY OF ................................ ....... ; .. .~ ................ being duly sworn, deposes and says that he is the appli~ (Name oFinaiviouo signing oppHcodon~ above narded. He is the / i (Contractor, agent, corporate officer, etc.) of said owjoer or owners, and is duiy authorized to perform or.hove performed the said work and to make and this applic~ation; that all statements contained in this applicahon are true to the best of his knowledge and bel and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Pu,blic, ~~~.~,~,.~ounty j