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Home My WebLink About3390-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. F:.IERTIFIP. ATE: E]F OE:E:UPANE:Y No. 2; 2883... Date O.o. tO..~: ,20 .. , 19 67. THIS CERTIFIES that the building located at Ma~afcooka j;~lafc. Street Map No. ~XX Block No. ,XXX Lot No. ~ Mati;ituuic~ .N.:E, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated Fel~.~lary 6. , 1967. pursuant to which Building Permit No. 3390 Z dated MaX~ ~ ., 19 67, 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 or~e family .dwe3~lil~ .................................... The certificate is issued to .C.e..d~..ic..H....W..i..c~.h..~...-...Ow~4~]; .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....N~.. ............... Building Ins/lector---' FOF,2~ NO. 2 TOWN OF $OIJTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (TI[IS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 3390~ Z Vo~e .......................... ~,~m~ ...... ~. ...... , ' P,en~i~ion is hereby granted to: .............. ~tt;~,.....l.~., ........................... at premises located at~,....[il~.El,..1;~:~V~i~..tt-~tl~t~..l~!~ir.l~..pOl]~ ...................................... ' .L...;..,..: ....... : .................................. ~s.t,t.t,~elt~....~,tte ................................................................... 19..~., and approved by the FO~M NO. I TOWN OF SOUTHOLD ~ ~ C0 BUIII~DING DEPARTMENT TOWN GLERK'$ OFFICE SOUTHOLD, N, Y. ~r~ve~ ,~, ~ ~ . -~9 .... PermtN~ ........... Application No ............................. APPLIGATION FOR BUILDING PERMIT -' ~ ~ ~ I NSTRUCTIOI~ a. This application must be completely fdled 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 15 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buitdin~ Zone Ordinance of the Town of 5outhold, 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, building code and reaulotions. ~ ' (Signature of applicant, ~or name, if a corppration) / ~, ~,~ ~ (Address of applicant) State whether applicant is owner, lessee, ag , architect, engineer, general contractor, electrician, plumber or builder· Nam® of owner of premises ......... C, edri~.~...Wickha~ ....................................................................................................... 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: ......... Neae .......................... Lot No: ..~e~e ........ Street and Number ....~la~'.~.e,t,,o.~k~.~.s)J. at,~..M~tJ~t~tc~.~../,elt~..[s~ade..~ew..~o=~ ............................................. /V~unicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~a]~X...~13~E,~,g.w..fDz'..se~,~.o~.~.~:e~'-~--~ ....................................................... b. Intended use and occupancy ....................... -~ee~oael.~:ent~. ........................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ....;..~.. ......... Alteration .................. Repair .................... Removal .......~; .......... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ....... J.2,0QD,~......~ ............................. Fee ..... .~,l~i~OQ ........................................................... '..:..,, ..... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... ~ 7. Dimensions of,existing structures, if any: Front ...... J~5..~.~.~.t,...,.. Rear ..,..l~..li~.e.t ........ Depth ...~f}.Zeet~ ............. Height ....12,.{~e~t ............ Number of Stories ...... OM ................................................................................................. Dimensions of same structure with alterations or additions: Front ..... ~§.~'®e~ .............. Rear ...,Z'[.:~;e~.t ............... Depth ....... .4O. Jeet.., ...... Height ....... 1.2.teet. ......... JNumber of Stories .........~ ....................... 8. Dimensions of entire new construction: Front ....... .15.~.~'ee/, ...... Rear ...... ~....ge®t, ..... Depth ....... 4'O...f~t ....... Height ....... .1..2....t'.e...e.t. ........ Number of Stories ........ ~f~ ............. 9. Size of lot: FrontO]p~a:~ce]....,.. Rear, ....... ::~'~.~.tdt. ...... Depth ....~.l~i~r,.....~l~.t'eet 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ]1. Zone or use district in which premises are situated ............. ..~.~J,~,ftl~l~}, .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ -[¢e~ ..................................... 13. Name of Owner of premises ..C,,~,..W.i. ei{h~m.....'......Address ..Ma.t~t. uok.,..~,~. ............ Phone No.M~,g,8~O.. Name of Architect ................. .C.J-L..W:icJcl~u:=. ......... Address .....~e.ttSt~J~.,N...~' .......... Phone No. M~9~833G. Name of Contractor ............. .C.,~zL.;W5~,l~.h~m ........... Address .....J~tt.[t.t~J~.~.,.~ .........Phone No..M~.gw~O .~? PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ ~ ~ COUNTY OF ........................... ~.....~ ~i:~' . ........ ~....~~~:::~ ...... being duly sworn, deposes and says that he is the applicant m( Ne~ :tis, ;hcl~viduo, signin~ , ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform .or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ...... .................... , /_" - ~' , , ~L ~ ~ ~AR)ORIE 0,.~...~...~~.~ ................ Nota~ Public, .~~..~.~.~ta~.P~e of New lo~ (Signature of applicant) ~ ~ NO. 52-s7~0350 Qualif~d in Suffolk Ooun~ t ~. ~mmissbn ~ires ~arch 80, ~