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HomeMy WebLinkAbout4134-z?OWN OF SOUTHOLD BUILDING DEPARTMEI~T TOWN CLERK*S OFFICE SOUTHOLD, 1~. Y. P. IEI~TIFI~ATIE OF CII~P. UPANP.¥ No....~. 3.7.49.. Date ....... ~e]~uary .... 2., ....... , :19.7~1 THIS CERTIFIES that the building located at . .~,~/~ .Tal:h~%l. Roa~l ........ Street Map No..gennec~tt Block No ............. Lot No...4~ .... Southol.d,. ~{o~ ......... Pa~k conforms substantially to the Applicati,on for Building Permit heretofore filed in this office dated .... ~ov~mbt~r .... ~ ~.., 19.6~ puts uant to which Building Permit No. 4134. Z. · dated .... ~.Q¥~(~. .... ~t)~ .... 19..68, was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. The occupal~cy for which this certificate is issued is ... R~.iY. ai:e..~, f~ratly. ~elltng ........................................ The certificate is issued ~o ...Le~ .K~as~ski ........................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .January. Building Inspector FOP.,~ HO, :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT; TOWN CLERK'S OFFICE SOUTNOLD, N. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ]134 Z Permission is hereby granted to: .............. ~..e..o....~, ,a.s. ~?..s..~ ~ ................................... Southold to ...... ~..l~l~..r~e.W...o~e..£amil~...~we&lin§ ................... ~ .......................................................... at premises located at .......... 1Q.~....tf.....~.~D.t~i.o.o.t.t;..P. ark....~. ................. ; ........................................ .. . Z.S.......T.U~h~ll..!~o~d ..........Southal~.. N...~.. ................ pursuan,t to application dated ......................... NO.~. ......... 20. ...... , ...... , 19....6~ and approved by the Building Inspector. Fee $..!..O..,..O...©. .......... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date J~nuary 29~ 1970 Bldg. Permit No. 4134 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Map of Yennecott Park~ Lot No. ~. Southold (Give deed location) have been inspected by this department and found to be satisfactory. District Engineer ~FORM ~NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTHOLD. N, Y. Examined ../ ......... , ..... '..., 19 .... Application No ................. App~ove~d ..................... 19 .... Permit No ........ :. .......... Disapproved a/c .................................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspec5ov. b. Plot ,plan showing ~oeation ,of bet and :of buildings o n premises, relati~shlp to adjoining premises or public streets ~ areas, and giving a detaile, d description of layout of property must be drawn .on the diagram which is part of this application. c. The work covered by this applicathan may nol be commenced before issuance of Building Permit. d. Upon approval ,of this applicati.zn, the Building Inspector will issue a Building Permit "[o 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 f, or any purpose whatever until a Certificate ~of Occupancy shall have been granted by the Building Inspec~r. APPLICATION IS HERF23Y MADE to the Building Department for the issuance of a Buil,ding Permit pursuant ~o the Building Zone Ordinance of the Town of S,~uthold, Suffolk C~unty, New Y.,r~rk, and other applicable Laws, Ordinances .or Regulati,ons, for the c.onstruction ,of build ings, additio.ns or alterations, or f~r removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable la~vs, ordinances, building code, h.~using code, an~d regulations. (Signature of applicant, or, name if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architecr, engineer, general contract~c, electrician, plumber or builder ................ ~.o. lg.~i:¢~.c.~ 0,~. ...................................................................... Name .of ,owner of premises . .L.~..O..~.l.*.a.~..rl~ .k.~. ........................................................... If applicant is a corporate, signature of duly auth,orized ,~fficer, (Name and title of corporate officer) 1. Location .of land ,on which prap,osed work will be done. Map No. ~r?.l.~'~qg.~.g. ~]~; Lot No..~ ........... Street and Number ... ?.'~'~.:[.~..R..a.a..~ ....... ~0.11.t. kLo~cl ............................................ Municipality 2. .State existing use and ,accupancy ,o{ premises and intended use and ,occupancy of proposed construction. a. Existing use and occupancy .... Y. gg.aJ.li..~rl~ ............................. ~ ................... b. Intended use and occupancy ....... C~qq..J:e~.~itjL2y..(l~e..;iir, g ................................... 10. 11. 12. 13. Nature of work (check which applicable): New Bul]ding XXX Addition Alteration Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... :~stimated C,ast , 22 y004)..~. ................... Fee ...~ 0~.00 ....................................... (to be paid .~n £iling this applicati,on) tf ,dwelling, number ,of dwelling units .... Olla.. Number .of dwelling units on each floor .............. If ~arage, number ,of cars ...tw.o ................................................................... If business, co.mmercial .~r mixed occupancy, specify natm'e and extent of each type of use .............. Dimensi,ons of existing structures, if any: Fr~nt .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions .of s.ame structure with alterations .or additions: Front .............. Rear ............... Depth ................ Height ................ Number of Sto~ies ..................... Dimensions ,of entire new construction: Front ... ~X.~.~... Rear ..... Height ............ Number ,~f S~ories ........................................................... Size of ~t: Front . .].~) .......... Rear ...].3.0. ........ Depth ...! 7~. ........ Date of Purch,ase ..... J .~.68 ..................... Name ~f Former Owner ... ~}~14..~l~lhJ,],:~ ........ Zone ,or use district in which premises are situated .... !~A.?..~i~.l ................................... 'Does proposed construction vi,olaie any z~ning law, ,ordinance or regulati,en? ...... ~10 .................. iName ,of Owner,of premises . .L.. K~a,qlae.sk;L... A, ddress .. ~qol~thoJ. d. ......... Ph,~ne No ............ .Name of Architect .. ~...]~.$.~;~/.O. Qql ............. Address ...R.~..v.e.2~l.~.a. ql ........Ph!~ne No ............ Name ,of Contrac~er .. L.. ~&~IxeCkJ. ......... Address ..... Soxl~;ho].d, ...... Ph,~ne No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing ,or ,proposed, and indicate all set-back dimensions from pr~perty ,lines. Give street and bI,ock number ,qr descripfi, on according to deed and show street names ,and indicate wheiher interior ,or comer 1,ct. I 50, STATE OF NEW YORK, )S.S. - ........ ........................... ~,~ ~v~ ~ ........ COUNTY OF olk .... ) . \ ....................... Leo. Kwasneski,. being duly sworn, depose~nd says that he is the appli- (Name ,~f i~dividu.al signing application) cant above named. He is the ............ ~N~e~ .v..b~i~d$~ ............................................ (Oentracsor, age,t, o~poeate .o~ficer, etc.) of said owner ~or ,owners, and is duly auth,orized to pe~3rm or have pe~ormed the said w,~k and to. make ~and file this application; that all statements contained in th is application ~re true to the bes~ of his kn,o~ledge and belief; and that the ~rk will be pe~o~ed in the mann er set ~o~h~ in the applicatio~ filed therewith. Sworn to before me this