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Home My WebLink About3638-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OEI~TIFIOATE OF OOOUPANOY THIS CERTIFIES that lhe building located at .~0~.0~..~eRd .............. Street Map No .......... ... No. Lot No..~3~...~ttituck,. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~.D$...~ ...... 19..6'~ pursuant to which Building Permit No. ~Z.. dated ......... ~e~t ..... g5 .... 19,~ was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The occupancy ~or which th2 certificate The certificate is issued to . .~{~t~ ~Lo~a~..D~y ........... ~er~ .......... (owner, lessee or !chant) of the .aforesaid building. : .Suffolk County Department of Health Approval ~aB.,..~6.~. ~68...Bet.lt, .¥illa ...... Building Inspector FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3638 Z Permission is hereby granted to: .................. .~,~.~..t.~. ....................................... at premises located ot .....~..~..~......~.......~..te..t...~..~..,~....~....~.~.t'..g. ~,~..~. ....................................................... ................................ J3,.o.#~.o~...lJ~ ............ I~.~.tAt,.~t~ ................................................................. pursuon.t to application dated ......................... J~.t* ....... ~.~ ............. , 19..67.., and approved by the Building Inspector. Fee $..'lO,.(JO .......... S-9 SCI-ID SUFFOLK COUNTY DEPARTMENT OF HEALTH Da.re 3~N 1 G 1§68 Bldg. Permit No. ~'~ 2-- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed/location) have been inspected by this department and found to be satisfactory. District Engineer District Engineer FORM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I( 19..f.(... Permit No ......................... Approved ........................................ , ~ ~ (~ ~ Application No. 3 ~ ~ ~ Disapproved a/c ~ ......................................... ~ (Building Inspec~/Sr) 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 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 ar 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 oil applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) Mat ti. tuck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generql contractor, electrician, plumber or builder. .................................................... . ..................................................................................................................... Name of owner of premises ~..o..b...e.~.'~..~..~.o.?'..~.~...~..~.?:.._...D..~..~...y. ............................................................................................ 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. Mop No.: ...!~.8:.~..~..t...~.~r.t~. ............... Lot No.: ......... .2..~. ........... Street and Number ..... ,~l.(~S,~.~D...~J~t~ ............ ~.!~..a,.~..~..J,.~.~.q~ ................................. ; ............................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy .....¥.~..?..~.~.~.....~..c?:~..~. .................................................................................................... b. Intended use and occupancy ....... .9.Tt~...~'.~t~;k~,~.....~..~.~.~.;,..~2.~ ......................................................................... 10. 12. 13. Locat property I whether in Nature of work (check which applicable): New Building ...... .~..~.. Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) / Estimated Cost .......~0.f......~./~ .................................. Fee (to be paid on filing this application) If welling, number of dwelling units ...... ..o. Tt.~ ............... Number of dwelling units on each floor ....................... If g.larage, number of cars one If ,business, commercial or mixed occupancy, specify nature and extent of each type of use Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth Hei~lht ........................ Number of Stories i Dm ensions of same structure with a. lterations or additions: Front .................................... Rear Diel~th ................................ Height ................................ ............................ Number of Stories Di~ensions of entire new construction: Front ......... 66 ....................... Rear .............. 6.~ ......... Depth ........... .~2... Heibht .................... Number of Stories ....... .o..~...e. ................ Size. of lot: Front ............................ Rear .................................... Depth ................................ Dat~ of Purchase ........................................................ Name of Former Owner Zor~e or use district in which premises are situated "An Doels proposed construction violate any zoning Iow, ordinance or regulation? ...... ~ ...................... Na e of Owner of premises ...~...9.h.'C...~.12r~L.~....l.~......Address .......... ].25.-..-~..~..~:~..~.~.~.o11~b~ No. Na~¢e of Architect ...................................................... Address ............................................ Phone No. No~ne o* Contractor ...... ~.'....5).~..z...,qg.n.~rP:.q3.9. r. Address ....... ~..~.~.~..q.e..k.. ............ Phone No. PLOT DIAGRAM ; clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-b~ck dimensions nes. Give street and block number or description according to deed, end show street names and indic :erior or corner lot. J,/ STATE O COUNTY Edw. Abitz being '.(Name of individual signing application) F NEW YORK, ~.ee OF .....S.~,ff£.O 3~ .......... f o.,~. duly sworn, deposes and says that he is the applk above nerved. He is the Contractor i (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work end to make and this application; that all statements contained in th~s application are true to the best of hie knowledge and belief; that the ~ork will be performed in the manner set forth in the application ~ ~ therewith. Sworn to ~efore me this Notary Pqbli~~...~Z..,..~.~ ....... County of appli