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Home My WebLink About4332-zNO. 4 TO~N OF SOUTHOLD BUW.13ING DEPARTMENT Town C~erk'e Office Southold, N. Y. Certificate Of Occupancy No..~.3.6.57 ..... Date ........... l~oV. 6, ......... ,19.69. THIS CERTIFIES that the bui{ding located at . R,0 .'~,. --Pa-~adi~ .Pt- Z~dStreet Map No.. ~ ........ Block No..~c~ ......Lot No. -x~c .... Houtho.~c~ · .~.Y., ........ conforms substantially to the Application for Building Permit heretofore filed in tlds office dated ..........Nay ..... 2--., 19.69 pursuant to which Building Pez-mit No. dated .. ~ ......... i".~.... 2.., 19. ~9, was issued, and conforms to ell of the require- ments of the applicable provisions of the law. The occupancy for which this cert~cate is Lssued is .. ~ivate. ov~ .£~.ly. ~.,~:~i3~n~ ........................... . .......... The certificate is issued to .. ~)Y..~J~'~1~. ~(o~a~ ...... ~ne~c. ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~.F~.... ~r. lac.ed, e~2st~. O~,~.e312ng .......... ~uil~' ~-~t'o'r l .......... House ~ 680 pvt ~d ~ FOK~ 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? 4332 Z Permission is hereby granted to: at premises located at ........~/l~..]J,J~,JJ.e..l~.. Jll~AJ'~J,~J~..Jl~O~JLt,.~Jl~ ................................. .......................................... Jel~tlai:lA ....... li.~ ................................................................................. pursuan¢ to applicotion doted ............................ i~lJJ~ ......... I~ .......... , 19..~¥1~., and opproved by the Building Inspector. Fee $,..~J.,JlJ ......... Approved ...................... !.l ........... , 19..~!...Perrnit No. ~"/33~' 7-- TOWN OF SOUTHOLD 7//~/~,9, ~ ,.~_~,~. ,, BUILDING DEPARTM ,ENT~'/¥/k TOWN CLERK'S OFFICE ' App,ication ......... Disapproved a/c ...................... ~ ................. APPLICATION FOR BUILDING PERMIT t '~G,~ ~-. 19~c~ ........ INSTRUCTIONS a: This a~plication 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 adjoining premises or public streets or areas, and giving a detailed description of layout of pr~.rty must be drawn on the diagram which is part of this location. c. The work covered by this application may riot be commenced be'fore issuance of Building Permit. d. Upon approval of this application, the Building Inspector 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, or in part for any purpose wha{ever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance'of a Building' Permit pursuant to the Building Zone Ordinance of the, Town of bouthold, Suffolk County, New York, and other applicable Laws; Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulatiOns. (Signature of applicant, or name, if a corporation) (Address of appl[;nt) State whether applicant is !owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized~officer. ~/(Name and title of co~orote ~ficer) 1. L~ation of land on which pr~d work will be don~. M~'No: ....... ~......~.... ~t No: .................... Municipal~ 2. State existing use and occupancy of premises and intended use and ~cupancy of pr~sed construction: a, ~isti~ ~ and ~cupan~ / 3. 4. 5. 6. 7. ~ A ~n Nature of work (check which aRolicable): New Building .................... dd't'o .................... Alteratiop: ................... Repair ..................... Removal .................... Demolition ........... : ........ Other Work (Describe) ..................... Estimated Cast ..... ...~..~J..~.e.~:~l~...,...?...: .......... i ........... Fee..6..~.0..~.~. .......................................................................... (to be paid on filing this application) If dwelling, number of dwelling units ............~ ............ Number of dwelling units on each floor ................~ ................. If garage, number of ~,~ ~LJ ~.~LL~ . If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ................................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with a~terations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire'new construction: Front ....... ,~:js...~ ............ Rear ....... ~.~. .............. Depth .....~.~ ................. Height ........ J.~... ,~,,~ ..... Number of Stories; ........ J. ............. ; ....... 9, Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Pumhase ........................................................ Name of Former Owner ,,J.~,~HaW.,,.,.~z';l'l~l~,, .................. 11. Zone or use district in which premises are situated...,.,~-.~Q,/e~3,,'~,~s,~, .................................................................... 12. Does proposed constr~:tion violate any zoning IoW, ordinance or regulation.;) 13. Name of Owner of premises.~lr.~..~,..l~tlxq~...Address ..J~a.,t~Ol, i~..,hl.t.~, ........ Phone NO ..................... Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor .~.~1~L,~1.~'1~....~.~ ............... Address ..~t~3~.TlaO~,Ot~.,..~.~ ...... Phone NO. 9/e~..T..~.9.?.~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing orproposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK ) COUNTY OF .......................... ) .... ~...../~'..,~.~......'T...~.~......~.~.~..~.....~....7~'... ..................... being duly swm-n, deposes end says that he is the applicant (Name of individual signing applicati~n~ · 'n~m~~ above He ,s th, ........ ........ .................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~erformed the said work and to make and file this. a. pplication; that all statements contained in this application are t.m.e~to th,e. best of his knowledge and belief; and that the work will bo performed in the manner set forth in ~e application f, led therewith. Sworn to before me this (~_ . ~' ................ · aw of ......... ........ ..... Noto~ Public, . ...................... .~. ................................ County nature of applicant)