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Home My WebLink About4129-zFOI~M 1~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y, P. ERTIFIP-ATE OF r'II]I~UPANI~Y :No. ,Z... 33~.b. · ·. Date ......, ......... leee~e~...6., 19..68 THIS CERTIFIES that the building located at .~.~...k/e~t;ph&ll& .R~ ...... Street Map No..~ ........ Block No..~ ......... Lot No. ~ ..... ~t't~;i'~¢l~' · ~.,. ...... conforms substantially to the Applicati,on for Building Pgrmit heret0~re filed in this office dated ......... 1~10~ .... ~[-~ ..... 196~. pursuant to which Building Permit No.. ~4]29~. dated ......... l~lO.~,...].~. ...... 19.68, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .o,ccupancy for which this certificate is issued is . Prtvat~ 'garag~ '& 'Sturage' Bl~t'g ....................................... " of the aforesaid building. ,Suffolk County Department of Health Approval .... N.,]~.~. ............................... Building Inspector 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? 189 Z Permission is hereby granted to: .... ~a~. ~...~...~ L~.~... ,.~;~.~. ........................ ................... ~'.'~..t,.'L ~.~.~ ......................... Fee $.....~t, L~.Q ......... ~O,RM ,NO. 1 TOWN OF SOUTI-IOLD BUILDING DF, PARTM;ENT TOWN ,~K'S OFFIC]; SOUTHOLD, N. Y. Examined' ::.~.(..~...., 19..~.'r App~av~l .................... ,19 .... Permit No .................... Application N0....g'(...[...'~..~...Z~.. Disapproved a ' '"' ' i2 ......... ~ APPLICATI(~N FOR BUILDING PERMIT Date . .~...0~....: .( .~...-~. ......... 19.~ INSTRU~-rIONS a. This applicati, on must be c0mpletely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Pl~t plan showing location of lot and of buildings o n premises, relatkmship to adjoining premises or public streets .or areas, and giving a detailed description of lay out of property must be drawn on the diagram which is part of this application. c. The work covered by this application may r~t be commenced before issuance of B~ilding Permit. d. Up(m approval of this applicuti,~n, the Building In 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 shall be occupied or used in whole ox~ in pa~ f~r any purpose whatever until a Certificate ~f Occupancy shall have been granted by the Building Inspects. APPLICATION IS I-l~_~l~RY MADE to the Building Department for the issuance of a Building Permit pursuant t~) the Building Zone Ordinance of the Town of S~uthold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with ail applicable laws, ordinances, building code, housing code, a~d regulations. ~Signature of applicant, or name ff ~ ~rporation~) .... ---- kl (Address of applicant) State whether applicant is~-~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................................................................................................... Name ,of owner of premises .~>-,~..~..~.~l~-, .~49. · .~- · .?.. ~ .~..~. ......................................... If applicant is a corporate, signature of duly authorize d officer. (Name o_nd title of corporate officer) 1. I_~cation of land on which proposed work will b e done. Map No ................. Lot No .............. · Municipality 2. State existing use and occupancy ,of premises an d intended use and occupancy of propped ~ction.. a. Existing use and occupancy C~.~..~.~ ......................... b. Intended nsc and occupancy .~,~..~..'~.~..~.? ................................................. 3. Nature of work (check which applicable): New Building ........ Addition ~/ Alteration Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost .... ~.0.~ ...................... Fee ~ (to ~oe paid on filing this application) 5. If ,dwelling, number of dwelling units .......... Number of dwelling units on each floor .............. If garage, number of cars .. |..C....~... ............................................................... 6. If business, commercial ~r mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures, ff any: Front ...t..~..' ....... Rear ..1..~. ~ ....... Depth . ~! ........ ight ~.' ..~..~Q..~. He ..~. .... Number of Stories ........................................................ Dimensions of same structure with alterations .or additions: Front ... ).~. ........ Rear ............. Depth ~-' Height 8' ~r ~A~O~ Number of Stories - 8. Dimensions ,of entire new construction: Front ................. Rear .............. Depth ............ Height ............ Numbar of Stories ............................................................. 9. Size of lot: Front ....i.~..0.' ....... R'e~/r* -..-..-.~..~.~... f ...... Depth .. ~ .%..O.o.'. ...... 10. Date of Purchase ........ ~.~.~.~ .................. Name of Former Owner .~.t~..~.....~..~.--~...~. .......... 1L Zone or use district in which premises are situated.. ~'~..~3~.~.0...~L~.'~... ~..~..~ ................................. ~27 Does proposed construction violate any zoning law, ordinance or regulation? . ~...O. ..................... ~3... Nar~e p~.0Yvner-of promises ~ .~..~,-~...~..T.. -~ddress ...................... Phone No.'~ .~..7.g.~.~..~ Name of Architect ............................. ~ddress ...................... Phone No ............ N~me of Contractor ............................ Address ...................... Phone No ............ 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 number or description acoerding to deed, and showstreet names and indicate whether interior ~r co~fler lot. F STATE OF NE~ Y(~I,n~.)S.S. COUNTY OF . ) · · .~ ............. being duly sworn, ,deposes and says that he is the appli- (Name of individual signing application) cant above named.~PIe is the .... ~(JT(~T... .......................................................... (Contractor, agent, oorporate 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 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 fort-~ in the application filed therewith. Sworn to before me this ARY PUBLIC, State of New yor~ No. 52-0618100 Suffolk Couo Commission Exmres Uerch 3e, l~°~-~