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Home My WebLink About4329-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z~661 ...... Date ........... No~...6 ......... , 1969. THIS CERTIFIES that the building located at .... I>e®be. Dr. E~t ........ Street Map NO.Beebe .Cove Block No ........... Lot No. 8 .... Cllteho&me .... I~¥.; ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... J~ne .... 9'" 19 69' pursuant to which Building Permit No.. 1~329. z dated ........... Jtme.. '9"', 19'69-, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . .Pti.rate. one. ~all.y..dwe.Lting ...................................... The certificate is issued to ...J .~.,~mith .-~ne~ .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 0~t .3Or.. 1969" by .Rm. Villa. ...... .... -.~4 ~ .~. l ..... ~¥~<.. ~:-~ ........... Building Inspector aouae ~ l~OK~ 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? 4329 Z Date ........................... ~IIIIB.....~. ........... , 19.l~.. Permission is hereby granted to: .... .JJJ,,..ll~lm..,Mg.....,,T,,l~.dJ~d..~. ................ to .......... ~ .~..~....~.l~.e.....~..~r~'....~1.~..~ ~.~ ~ [ ................................................................................... at premises located at ............. 3~.2~.....l~m~e...l:~[~eJztmtt~ ....... lJeJ~m..gmJ ......... pursuantc to application dated ............................... ~..l~J~....,..~ .......... , 19...~.~., and approved by the Building Inspector. Fee $.t.O..t...~. · ........... Building Inspector / App~aved ........ .?:......~.e~-~, 19 .... Permit No. Disapproved a/c .... ~ ............................ (BuildinlgXnspector) Application No.. · .~. · .~..~'¢ .... APPLICATI(~ FOR BUILDING P~RMIT ,Date .................................. '19 INSTRUCTIONS a. This application must be completely filled in by tYpewriter or in ink and ,submitted in duplicate to the Building InspecWr. b. Plot plan showing location of l~t and of buildings o n premises, relatignship 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 ~t be commenced before issuance of Building Permit. d. Upon approval of this ~applicatkm, the Building In spector will issue a Building Permit'{o the applicant. Such permit shaU be kept ~n the premises available for inspecti.im throughout the progress of the work· e. No building shall be occupied or used in whole o~ in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Lnspector. APPLICATION IS l-ij~y:lT:Ry MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soathold., Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the constructi°n of build ings, additions or alterations, or for removal or demo- lition, as herein described, The applicant agrees to corn ply with all applicable laws, ordinances, building code, housing code, and regulations. ..... ..oj.,.¢. ¢: ............... (Signature of applicant, or name if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............. . .'~...~/..~, ?. L.'..--~. .............. : ...................................... Name of ,owner of premises ........ ..~.:..~..' .... .~. · .~/.././..-'~. · ./'~. ............................................... If applicant is a corporate, signature of duly authorize d ,c,fficer. (Name and title of corporate officer) 1. Location of land on which p~ work will b e done. M.ap No ................. ~t No .............. Sir~t and Number ~[ - ~ ~ ~/~L~ ~ ~U~ ~ ~ ~ ~ Municip~ity 2. State exist~g u~ and ~cup~cy of premi~ ~d intend~ ~e ~d ~p~cy of ~ ~ction. a. ~isting use ~d occup~cy................~ ~ ~....... ~ ~ ............................................. b. Intended ~ .~d ~cup~cy .......... ~ ~/L ~ .... ~.~/.~ ................. 3. Nature of work (check which applicable): New Building . ~ Addition Alteration Repair ......... Removal : ....... ~Demolition ........ Other Work (Describe) .... 4. Estimated Cost ................................ tee ...... ~. ......................................... (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: Frmat .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .............. Rear ............... Depth ................ Height ................ Number of S'0ories ..................... 8. Dimensions ,of entire new construction: Front ........ .~.~ ..... Rear .... .~.?. ...... Depth ...ff..~. ...... Height ..... .Tr...7-'7... Number of Stories . .. / '? ~ 9. Size of }pt: Front ....... /.~..D..~... Rear ..... /..~.c..?.... Depth ...... /..7..D. .... 10. Date of Purchase ............................... Name of Former Owner " 11. Zone or use district in which premises are situated ................ .~. .... /.. f. f.,.o. ,.-.,y.~../.a./_~ ............ 12. Does proposed construction violate any zoning law, ordinance or regulation? ........................... 13. Name of Owner,of premises. ?.'../.~..-~.~ .~. ! .Zff. .... Address ...................... Phone No ............ Name of Architect ............................. &ddress ...................... Phone Nf)., ........... Name of Contractor ~1/~ ~?~£ ~Z: ..... Address .... .f. ?. ?.~..(~.~ f. ?.{:.. Phone ........... PLOT DIAGRAM : Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bahk dimensions from property lines. Give street and block number or de scription to deed, and show Street names and indicate whether interior or corner }or. ~ - 'fi STAT',: OF NEW YORK, )S.S. - '~' COUNTY OF .............. ) ~, ,~,~/,{,r ~4~ ~I ~Z~¢ ~' D~_ 4~ <)'(' g"~ being duly that he is the appli- (Name of individual signing application) cant above named. He is the ~a, ~/. !.~ · (Contractor, agent, eorporate officer, etc.) of said owner or ownars, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements eontalned in this appliCation are true to the best of his knowledge and belief; .and that the work will be performed in the manner set fortbi in the application filed therewith. Sworn to before me this Pu he Notary b ' . .................... "County No. 52-8125850, (Signture of applicant) S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: at (Give deed location) have been inspected by this department and found to be satisfactory. D~strict Engineer