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Home My WebLink About3633-zIvOB~V/ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTHOLD, N, Y. EIERTIFII~AT~' ct-r I~I~I~UI~ANI~¥ Map No .... .g.... Block No.~. *.or No. ~ ..... P'14./~.7..r.~.~..~.~:-~. conforms substantially ~o the Applicati,on for Building Permit heretofore filed in this office dated ........... ~'~..~l..~.[, 1~.~.~ pu~rsu'ant to which Building Permit No. dated .......... ~,~...4J..., 1~.~ J~, was issued, and conforms to all of the require- men,~s ,al the .applieable provisi.ons of the law. The .occupancy ~or which this certificate is ~u~a ~../~ ~.e.t .,V ~:, A,~...,~.~. A~. ~ ~. ~< ~..~... (& ~.c ~..,~ :. ~-~, ¢ .... The certificate is issued t,o ~.~....g%:...o~T:A.lk.f~..~..(6[.fk* ............... (owner, ~~t) of the aforesaid building. rSuffolk County Department of Health Approval ~. ~'~ ~ . :.. .... · ' g specter 1 .... irOILM NO. ,i BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi-HIS PF.R~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 3633 Z Permission is hereby granted to: .~..~~....~....UI~AA~.~Iuim & mrs .......... 3~: ...... ~.~t~.~ ................................. ................ {{.'m.,qU~ ~,.,, .ii, ~., .............................. to .,tduJ3A.~¥..3~&l,Ge&G..~u-~l....~ ..I~OALGe..~I~p. ................................................ at premises located at ...~.&....J~lt~,j~:lA,~l~.~O&C~ ......................................................................... pursuant to application dated .~ ............................ ~..~.~ ....... .~.3~ ........ , 19....~, and approved by the Building Inspector. oudaing Inspector SUFFOLK COUNTY DEP~TME~ OF HEALTH Riverhead~ New York ~T~PE OR PR!~T LEGIBLY IN INK Building Permit No.~. ~. ~. ~ ~ Health Department Plan No, ~?/~ ,Appl,fpatipn for App,ro~l, .of 09, ,~erctal,, Sewage, ,D, isposal SMs,t,em TO: The Suffolk County Department of Health Date ~p ~-! .. f. ? ~ /~ Application for approval of commercial sewage disposal system is hereby .requestede Village I hereby certify that this commercial sewage disposal system has been con- structed in accordance with plans approved by the Suffolk County Department of Health on (date) ~ J ! 6~ 7~/~. ~ a~d with all the requ~rements of the latest bulletins on sewage disposal of the ~Suffolk County Department of Health. ' Applicant,s Smgnature . ' ' (Builder'"~. (~mer') Keady for inspection ....... .......... Installation satisfactory - Yes_.. Based on the information stated hereon by the applicant and other information made available, it is the opinion of this Department that this system with proper maintenance can be expected to function satisfactorily and is not likely to 'cause a nuisance, provided designed sewage flow is not exceeded. Structural features are not included. · Date District Eng!naor 'SCHD - S-13 6/ 8 CO, N MAP oF- WILL. Ai'V) A. NdAT-F ,SU:FO~,t.4. Cc.~ N,Y. FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19..~..!... Permit NO ............................. Disapproved a/c ........................ APPLICATION FOR BUILDING PERMIT 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 js 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. APPLIC,~TION 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, ordinance~t.~)ui~J~'/)~g code~~r .... ........ ...z. .e. ....... ................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................... .o...r.. ..................................................................................................................... Name of owner of premises ..... ...................................................................................... 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.: ............ ~...~.~. .................... Lot No.: ....~ ............. Street and Number ..?.f/...~......l(.f,e..~.~.~$..~...~.o.~,~ ......... .~&.%..~...%..~..9.~,f ................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~.~,,g,,~..,~,~,,,~,,~.~ ..................................................................................................... b. Intended use and occupancy ~.~..~...~.~..~..e.~..~.~J.~.~.-.~.~..~.~.~;~'.~'.~.'~.~ ................................................ 4. 5. 6. 10. 11. 12. 13. L.ocet, property Ii whether inl Notalre of work (check which applicable): New Building .,X~....X~... ....... Addition .................. Alteration Repa!ir .................. Removal .................. Demolition .................. Other Work (Describe) (to be paid on filing this application) norle If d~/elling, number of dwelling units ............................ Number of dwelling units on each floor if gq, rage, number of cars If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth Heig(ht ........................ Number of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear L Dept~h ................................ Height ............................ Number of Stories ................................ DImpns~ons of entire new construction: Front ........... ,~Q .................... Rear ....... 3.0. ................ Depth ...... .0..0, ....... Height .................... Number of Stories ..... · ' LF~. ..................... Depth ................................ SIzmof lot: Front ..~..~. ..................... Rear .............. 'i~8 Dat(~/of Purchase .............. ..]?)....6.~. ................................ ~a~e of Former Owner .$.:~.?.¥..e. B dist Zone or use district in which premises are situated ......................................................... _J r , · :) No Doe~} proposed construction violate any zoning law, ordinance or egu~at~on. NonCe~ of Owner of premises .WT&....S...t.¢,z.k..s. .................. Address ............ ..M..a..t..l.;..l...t.?_..c...k. .......... Phone No. S ' PLOT DIAGRAM ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr ~es. Give street and Black number or description according to deed, and show street names and erior or corner lot. SEE FILED PLANS STATE O' oNFEW g. ctO¢~6~. } COUNTY ................. ~ ........... S.S. John Car~entieri ~. .................................... ~' .......................................................... Demg duly sworn, deposes and says th,mt he is the applk (Name of individual signing application) above nat of said o~ this appli that the ~ Sworn to ,efore me this 6 ............... ,..2~. day of ......... Notary P~'blic~~ ~ ..... County, ~ed. He is the Contraotor (Contractor, agent, corporate officer, etc.) ,net or owners, and is duly authorized to perform or have performed the said work and to make a,nd :arian; that all statements contained in this application are true to the best of his knowledge and belief; ark will be performed in the manner set forth in the application (Sig 4icant) ,I :F ! HOWARJ) C, TM ...... ~ OHARLL3 L,, ~t~Wtt~ t ,! ~s endorsement appears in the office of ~~ ~m approval does net include st~actural fealures and ts