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HomeMy WebLinkAbout3412-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFIBATE OF BP. BUPANnY No. ~ ~:~'/~7' .. Date . ~-~g...9 . . , 1967 THIS CERTIFIES that the building located atl[o~[,h ~]~& I~ Street Map~..e~t by $~1~o. .Lot No. ~ Oz&en'b ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ]~[~F~h. ~, , 19 6~' pursuant to which Building Permit No. .j~b~12 dated F~ll'ch ~ . , 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 . PFiYa~ .o118 fatnil~, d~ll~ir~ .............................. The certificate is issued to ~o~el~h.Mlts .... ~ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Building Inspector 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) 3412 Z Permission is hereby granted to: ot premises Iocoted ot ......~"~.~e~[~[~Z~e~t;~?~ .................................... ......................... }i~.t~3.. ~e~ .. [)_~£~.e.~.._ .Oz'%e~t, ............................................................................. pursuan¢ to application dated ................................ ..~....Z~...~.. ....... ~..., 19...~..~..., ond opproved by the Building Inspector. Fee $...~..0..,....0~_ .......... ~ Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located a t~/g/~ i~/O~h~ .~c-~ ~)~/~. //~0 ~ ~/~ T~ ~R~ ~ ~~ ~ (Give ~eed location) [ have been inspected by this department and found to be satisfactory. ores ~i~'~'str~'ct Eng~.neer NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Exam,ned ....... Approved ........................................ , ]9 ........ Permit No ................... Disapproved o/c ~....~ ....................... ................................. Application No...~....q....~..~ ........ APPLICATION FOR BUILDING PERMIT Dote ............................................................ , ] 9 ............ INSTRUCTIONS o. This upplicotion 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 odioining premises or public streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is port 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 o Building Permit to the applicant. Such permit shall be kept on t~e premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulj~tions. (Signot~/re of op. plicont, or nome, if o corporation) (Address of applicor~ State whether applic~nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~'~, :[ a°~:ra°fcoP[:omr 'aSteel '~:'~ dully '~ut~ho'; 'Jr'ed ~':;i ;'e'r'/.''~ ......................................................... (Nome and title of corporate officer) 1. Location of land on which propos.t~w~.~be do~, ~M, op No.: ..-..~....~~ ...... .cL_Lot No.~,..?....,~...~; ........ Street and Number ....~.~ ..... ~ ......................... Muni~.i~.... ....... .~.-~. ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy .....~-~-~.~. ......................................................................................................... 3. Nature of work (check which applicable): New Building .L...../~...i ...... Addition .................. Alteration .................. Repair ............... [~/Removal ..................Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ..~7......¢2....., ........................................... Fee ...................................... (to be paid on filinb"~i~ik"~ii~'fi~;~'i .................. 5. If dwelling, number of dwelling units ...... ~. ................... Number of dwelling units on each floor ......... .( ................ If garage, number of ~rs ....................................................................................................................................... ~ ..... 6. If business, commercial or mixed occupancy, speci~ nature and extent of each type of use ............................ 7. Dimensions of existing structures, if 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 ....... ~.~.~. .................... Rear ...... ~.~..t. ............ D~th ....~.~.~. .......... Height ....~.~..f ....... Number of Stories ...Z ................................................................................................................ 9. Size of lot: Front ...... /.~.¢.~. .......Rear ....... ~.,..P ..............Depth ...4..~.~.e..~..~ ........ 10. Date of Purchase ...................................... ~ ................. N~, o~ Former Owner ~~~..~., 11. Zone or use district in which premises are situated ....~.~. 12. Does proposed construction violate any zon ng aw ordnance or reau at on> 13. Nome o{ Owner of pre~es~,,..~~ ....... Addross .~ ....... ................. PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~ lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. · ,, t STATE OF NEW YORK, Icc COUNTY OF ...~...U..r"'.~..~'.~.~. ........... .f"'""' .......... .T.~.~.~......./~.~.~.~.~,.~..Z~. ........................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ..................... .~..~.~/.~..~..~...~..~...~....~... .................................................................................................... (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 a.nd file this application; that all 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 ,,~ ..... ~.~.~ ........ day of ........... ~..¢~.. .................. , ~.~.7...-'~'~.~.~ ~ 9-~._.~~ No,a , Pub, c.--' '--" . - ' ........ ............ .......................... .... :A~,~. ~.~.~/¢/ ......' .,.-~;;..;}..;;~;~;~q~t~ty t~ (Signature of applicant) ' Tc~'::: ~.2-~4: ~: }' '' : '~ ,, © ~ L,=--.. k/b,,'"'F --I -TIIr C L/%O~ lC. o i NOTICE: Electrical, h~otlng, omi plumbing shown m~ ,plons ~ suGgest~ Ioyou~ only ond, moy hove ~ ~ olter~,to Pons a~ s~cificotions as drawn meet ~ml ~ H', A, ments* in ~e~ ar~, ~y m~iflcaH~s or c~es which ~y ~ necessa~ t~ meet such r~ui~n~ are at the builders respo~ibili~ a~ e~e~, ' , REVflSION$ COPYRIGHT B~ SCHOLZ HOMES, INC, NOIITH AMERICAN HOMES A DIVISION O~C DATE P. II77-P. E)ELC.) X.~ D)X~TM ELEV'5 r Ir II "ff ff I , NORTH AMERICAN HOMES REVISIONS m~ ~ ~-~ ::) Plans and ~eclflcatlons as drown meet general F. H. A. guarantee individual interpretatio~ on such r~luire- wh,ch may b~ necessary to m~et such requlrement~ ore 4-1L O" p~ovlk~c~ ~L [OUOD¢.7 ICCL 0" 0,01 I =~*I C L A,%~I~. ~COLJ k3 OAT I Ok.D ~,LbCM COLOVO l A.L ~OL)L)E>~TIOO ~'_YPIC,b U QreAV,/L + ~ iL- lO NOTICE: Electrical, heating, and plumbing shown on plans are suggested layouts only end may have to be altered to Plans and speciftcations as drown meet general F. H. A. and code requirements, hut Scholz Hames, Inc., con not guarantee individual interpretation on such require- at the builders responsibility and expense. Ifil I REVISIONS se..ctlo~J '['~mO ~lzLt..~.~t ~.Z~- lin NORTH AMERICAN HOMES A DIVISION OF L¶l;llilI:lllfiltll~ll ,oo, ~ (~,,M~ '6,,/,¢, & 0~ C 0 N S U L T I N G A R C H f T E C T S .1177 DATi T, PU$.5 $8' '°L- yk'VOOD 511F_~I?#/.Vg I / -~ £~r ?~ooo // _1. EMV£ DETAI[_ NOTICE. Electrical, heating, and plumbing shown on plans are suggested layouts only and may haw to b~ altered to meet local codes or conditions, Plans and specificahons as drawn meet general F. H A and code requirements, but Scholz Homes, Inc., con not guarantee individual interpretahon on such require- at the builders responsibility and expense, SILL F~EVI810 .NS DETAIL · ~ · C4P -1177 C T S lC) ,k. ~-T I) NOTICE: CONSULTING ARCHITECT,: Id,.'. eo" -M-It -1'-4" ¢& FP. 147- _? (ID) ~,~ !'-0" ~OAL~t LL L- A'Y'O©T ,ALT. FLS~O~.CE_ L0dT'o L_ C L a%% ~ c E LCv.'I ~OtO (1(~)C3-'205-8_ /~8~ 17L{~' Tgcyas LiYOOT .Fc::~ I~l~cu COLOkl. ~ b,L .0.-,,:~: NORTH AMERICAN HOMES guaranteea~ ¢~e requirements,i~lvid~l interpretation~t ~holz H~eS,on suchl~" r~uire-Can not COPYRImHT BY 5CHOLZ HO. ES, INC. C O N S U L T I N G a R C H I T E C V