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Home My WebLink About3655-zFORi~ 1~O. 4 TOWN OI~' SOUTI-IOLD BUII.,DIN~ DI~PART~4I*-NT $OUT}IOLD, N. Y. E:ERTIFIP. ATE OF EIE:I~LIPANE:Y THIS CERTIFIES that the building located at ~OadOl~..LalIO ................ Street Map N~.a.~;..~¢.~lock No.. ~ ........ Lot No. ~ ....... ~li~Ok.F .E.,.~. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~9~, .~.., 19.~ p~rsuant to which Building Permit No. dated ............ ~.2~ .... ~. .... 19.6~., was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. The .o.ccupancy ~or which this certificate is issued is .Priva.to. ~o..family..dwelling .......................................... The certificate is issued ~o ~.~0~ ..... 0~.~ ........................... (owner, lessee or tenant) of the ~oresaid building. .Suffolk County Department of Health Approval .~.2] ~' ']~68' · 'by' 'Ri' 'Vt[~ ....... ............. ...... '" .... House ~ 280 ~' FORM NO. ~ 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? 3655 Z Permission is hereby granted to: ~att ituek to ~t~ld ..n~..one.. £am~.~.. &~ ll~u~ ..................................................................................... at premises located at ~.O..~...~......~.~l,.~.~..t..l~.~f....E.~.~.9,~.~ ................................................................ ....................................... .a..e...a..d....o~....~.e. ............ .~.t,..t..~.t...u.~..k., ......~.;....~.:. ............................................ pursuan,t to application dated OC'~, ~ 19..~.~.., and approved by the Building Inspector. Fee $...1..O..?...O~.........t..~..t~l~t'el'red i'oF~ canceled ~rait f 3~66 Z S-9 SUFFOLK COUNTY DEPARTMENT OF HEALTN Date Bldg. Permit No. TO WHOM IT MAY CONCF~N: The sewage disposal facilities for a structure located deed location) have been inspected by this department and found to be satisfactory. District Eugineer District Engineer FOI~M NO. I TOWN OF SOUTMOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLDi?N. Y. Examined ...........?:. .......... /. ............ , 19 ./.. Approved ........................................ , 19..~.'..i. Permit No ............................. , ........ ...... ................................. Application Nc). ~ ~' ~z-~'- APPLICATION FOR BUILDING PERMIT Date ........................ .0.~..~..0..b,.?..~......~ ........... , 19..~? ...... ./ I NSTRUCTI ONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. j b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premi.ses 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 Fommenced before issuance of Building Permit. d. Upon approval of this application, the Building IF, spector 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 ~hall be occupied or used in whole o,,~ in part for any purpose whatever untiJ!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 demblition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. Edw. Abitz (Signature of applicant, or name~ if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eiectFician, plumber or builder. Oontraoto~ ~ Virginia Herndon ~ Name of owner of ~ ........................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Matt 1. Location of land on which proposed work will b~ done. ~wap ~o.: ........................................Lot No.: ........................ Meadow Lane Matt:.~tuck~ ~ .~. Street and Number .................................................................................................... ..: ............................................. Munic/ipality 2. State exlsti~ng use and occupancy of premises and intended use and occupancy Of pro'posed construction: vaoaot land a. Existing use and occupancy b. Intended use and occupancy o~e family dwelling 3. Nat'~ure of work (check which applicable): New Building .~'.~*1:, .... Addition .................. Alteration Rep~air .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost .......~.t.(~0 ....................................... Fee [ (to be paid on filing this application) 5. If clwelling, number of dwelling units ....~ne ................. Number of dwelling units on each floor ....................... If g?age, number of cars ..... 6. If business, commercial or mixed .occupancy, specify nature and extent of each type of use' 7. D~mens~ons of ex~st ng structures, Jf apy: Front ............................ Rear ............. : .................. Depth Height ........................ Number of Stories Dimensions of same structure with alterations or additions: Front .................................... Rear De~th ........................ i ........ Height .....i ...................... Number of Stories .............................. .. 8. Dir~ensionsM of entire new construction: [Front ........... ~[J .................... Rear ......... 68 ............ .. Depth .)+~ ............. HeiDht"L ......... , ........... Number of Stories ..... O~G'"'"' ............................................................. 9. Siz?/of lot:' Frqnt ............................ Reai .................................... Depth ................................ 10. Dat!e of Purch~ase ................................. ~ ................... ...Nome of Former Owner 11. Zor~e or use district in which premises are situate,d 12. Do~s proposed bonstruction violate any zoning ~a~v, ordinance or regulation? .............................. No, ne of Architect .......... .~ .................... ; .............. ........ Address ............................... ; ............ Phone No. i PLOT DIAGRAM Locate clearly and distinctly all buildings', whether .'bxisting or proposed, and indicate all set-back dimensions property lines. Give street and block number or deso~'iption according to deed, and 'show ~treet names and whether in~erior or Corner lot .................. ;~ ........................ STATE COUNTYiOF . ..J].l~t~ ~.O ~. ............ ~, o.o. J ................ j ............... ~¢~,.~..,~-l,~JT~ ..................... ~ ...................... being duly sworn, deposes and says that he is the appli( J(Name of individual signing application) . ' . obow] no~ed. He is the ............ gO~ ........ ?~. .................................................. ,~ ........ ~ ..................................... ' ' (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized t~ perform or hove performed the said wbrk and to make and this application; that all stotements contained ig this application are true to the best of his'. knowledge and belief; that the ~ork will be performed in the monnerls~ forth in the application ~iled therewith. Sworn to ~efore me th s , Notary PqbficJ'.~..~.~.c....~.,...../~¢,~... Coun~ , (Signature of apphcan ~ ~OTARY pUBLC State ol How Yo~ , '