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Home My WebLink About3411-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEEK'S OFFICE SOUTHOLD, N. Y. P. ERTIF'IP. ATE OF' DP.P, UPANP. Y No. ~.. ~ .... Date .............. THIS CERTIFIES that the building located at ~[ .tl~l~l~. ]~.~;~ Street Map No. ~. Block N~. . .Lot No. ~l~l~ · conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... M.~.~h.. ~), 19.6~ pursuant to which Building Permit No. ~tl--~% 'S' dated ........... F, ar~t · - .~, 1967 ', 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 ~,~,~ .~ .fa~l.-~ky. d~el~.~t~ ....................................... The certificate is issued to . An%hork.v. .&AnJ.]'~ .}/eimir~ ........ ~ ............. (owner, lessee or teuant) of the aforesaid building. Suffolk County Department of Health Approval ,~11~ ..... ~.~7...~. 1~o.~'~. Building Inspectori FOi~,,~ 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) 3411 Z Permission is hereby granted to: IIl~t~y~...ll~...J',-,zlt .......................................... ............................................................................................... at premises located at ..... ~.~.~.~...~...~...~.~..~.~.~.~.~...j~..~.~..~.~.~.~.~.~..~.~.~t~`~j~j~..~ ........ pursuan¢ to application doted ............................. ..~.....b,.....2~. ........... , 19.1~i.~..., and approved by the Building Inspector. Building ~ect~br ..... SCHD SUFFOLK CO~Y D~,P.% ~%~[P OF HEALTH Buildzug Permit No. ~,y~// ~ The sewage disposal facilities for a structure located at / 1(Give deed location) have been inspected by this Department and found to be satisfactory, 1967 DistricDi~Engineer FOI~M NO. 1 'UOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ¢' 19....:.~., Permit No. ~ g.[ Il ~_- Disapproved ~ ..... Appl,cat,on No...~...~..!.( .............. APPLICATION FOR BUILDING PERMIT Date ..... ~ar. ch..20~..l~6Y. .......................... , 19 .......... INSTRUCTIONS o. This apphcotion must be completely filled in by typewriter or m ink and submitted in duphcote to the Buildm Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to ad oinmg premises or public streets c areas, and giving a detoded description of layout of property must be drawn on the diagram which is part of this applicatio~ c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of th~s application, the Budding Inspector will ~ssue o Building Perm,t to the applicant. Such perm 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 Occupanc shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ord~r~ances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbed The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. ,~a~.e,v..ay. Custom Builders Corp,. (Signature of applicant, or name, if a corporot,on) Box B~ Shirle~ New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Bull .d.9.r ........................................ Name of owner of premises ...ku.th.._ozz,v..~.,~.i__t~.~e.i. mi~k; ............................................................................................. If applicant is a corporate, s,gnoture of duly author,zed officer. (Name and title of corporate officer) 1 Location of land on which proposed work wdl be done Map No · . ..................................... Lot No.' ....................... Street and Number Westview Drive Mattltuc~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction' a. Existing use and occupancy Vacant land. b Intended use and occupancy ~esidential home. 3. Nature of work (check which applicable): New Budding ........ ~ ........ Addmon .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost .... !.~..~../..~...~ ................................... Fee .~....0.. ............................................................................... (to be paid on filing th~s application) 5. tf dwelling, number of dwelling units ...... ..(~...e ................. Number of dwelling units on each floor ........................... If garage, number of cars ........'D~r~ ............................................................................................................................. 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7 Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions. Front ................................... Rear ..................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~)~.....6...2..~.~.. ......... Rear . ..~=J~ .. .6. .2. !. .t. ....... Depth ..... ~.~.~. .......... Height .................... Number of Stories ..... . .~...o. ............................................................................................... 9. Size of lot: Front ......... ],~.! ............. Rear ........ 7.~..~. ..................... Depth ................................ 10. Date of Purchase ..~....~..9..b.,...]-..8.~...~9~.7. ......................... Name of Former Owner .~..:L~...J-...~.....~...~.~..~..:F.~..~.~...~.°..n. ............ 11. Zone or use district in which premises are situated ................................................................................................. 12 Does proposed construction vialate any zoning law, ordinance or regulation? ...J~a ................................................ 13. Name of Owner of premises A.~.+4~OZ~..~k .......... Address ~l~..~9~¢.?..~.~..,~9..r~..s.~i~ne No..~..0....6..-.~..0..0.~. Name of Architect ~..e.~....~...c~...~. ................................ Address~?.O....~..~.....]'..6~.s.~-..~...f'..'..~...~..~9~hone No ................ Name of Cantractor ..~..~.-f'.9..~.~Z...0..qg.~.o..n...~..~...s. .......... Address .~.o..z....B.~...~.b.~.e.~....~.:..~.:.... Phone No .2. .8. ~ .-. .? ~.8. .0. . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions rrm property lines. Give street and block number or description according to deed, and show street names and indicat whether interior or corner lot. STATE OF NEW YORK, ~ ¢ e COUNTY OF ................................ .~ .... ................................................................................................ being duly sworn, deposes and says that he is the apphco (Name of individual signing apphcation) above named He is the ...................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or.hove performed the said work and to make and f this application; that oil statements contained that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me this ...... ......... day of ........... -- - . .............. ...... ........... Notary Public, .~.[.t~ ..... ~.,..[~Coun~ (Signature of applicant}~ ., = ~o~' _~,, _..~,_~,, ~. . ~1 I~L~ ~ ,.~ ..-~ .., ,.. ..,.._ ~,,, -... ,, . :. 2". ,~ ~ , . ~--~ _, ~ ~,,,~. t,, , _~ ~_ T~ )"~ . '- -.. ~:F / ~ ~ ---- , ~ .~ ~ . ,,-e ~ -,~[~ ~ . ' ~ ~-~='~' ,~ , , ~ ~ LIVING RM. ,l ~ .. ~ ~.o ~7-a o~.lY~.~. ~ -' · pOR~ICQ ---4 ~ ~: __- ,. , ,. ~ - ~TE: J't~-~ ONE FAMILY Rt~lOtN~t ~LAN -~ .................. t ~ .EVISIONS: HE ~MAN H. Y:~RK ARCHITECT S~M ICA NtW YO~K D~ING .T ,~'-o'' 1' Iht ffi/~11 .... ' ' ~ ONE FAMILY RESIDENCE I / I C~ ~x~, 3-~g.~. I II'~'° J~l ~-'J]~ ~[-~'-~ -'l . / J ~1 L~)~I(~ J~Uo~(~?~ I t~-- I ~ II I ~ (~) ~ ., I ~ I I ~ ~1 ~'-~-~,~. .~-~/~-~.,. o~-~l,~'~ .". ,, ~1 I . ~ S~COND FLOOR ~ ~l ' ..~:,~,o..: I IH~RMANN. YORKARCHITECTI I ~.~l I' h( j ~~~ j j , j ~o-~4 ~ sT ~a~alca ~t, ~w ~Or~ j I~m~n° ............. I I I ~"'"~ I I I ~,~,~ ~:.~¢' ~-~ .j , I I I 1 iq- 4--- I DAT r.: I~EVI ,~ION .~: HERMAN ONE FAMILY RE. St DE NC;E H. YORK. ARCHITECT tGI ST, JAMAICA ~, NEW yOI~ PLA* NO57-45 -./ , -- , ' "~', ,,, , Z .......... / ~-.+-. ,'--'r.. = .................... :::::_=- --~.~ ...... ~l I ~ ____ , .I .~ f ~ · ,, ~-% .~ _ ....... ~ ......... ~ ~ .~, l- ~l ~ ~.~ I~ll Ill I / , ,, (., ,, ' ,, - T - ! / ~ ~~ -' ' ' " ' '""' "" ' ' .... ~ ~ ~ ~ ~ , "' / I I ', , i, m ~~///I a~-3,%',o.s: I HERMANh. YORKARCH TECT I I ,. I I' -'~ [ I ~~ I I ,o.ok ,~ s~ ¢.~.,~. s~. .~. ~o.. I I~'"~ ...... ~.~"1 I .' "J .. ,...--Fu~_ ~o~----"F !-,..-~Fo~.~. a~,~-~ ~u~ ~o~ ~~ } , w~": r-~,' ' . ~¢~ _~.~. _ .............. "'~' , ~ ~L~ j~ -. , ; ~ . t~ ,, il ~,. · ~,_~ ~ , .. . .~ - -. ~' OPehl . , -' ~CkO~% SECTIOH~ n~v,s~oNs: NE, RMAN H. YORK ARCHITECT