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Home My WebLink About4341-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No.. ~6~6 ..... Date ........... H.o..v.e.m.b..e.F...6. .... , 19..6.9. THIS CERTIFIES that the building located at ...I~..~r..H..o~..e...P&...&..R.., .0.,.~. ,. Street Map No...:mc ........ Block No ...... ~..Lot No. x:x I~outhold 1~.~. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ¥~y .... 28., 19..69 pursuant to which Building Permit No... k~..~.~.Z. dated ............. 1,~a¥...28..~ 19.69., was isSned, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .. Pr:Lva~..gare, g~. & .~tor~ge. {iA.cCc ~.o.I"Y)..-..$pp.r. qy.e.d..l?y..B~.A~' .. The certificate is issued to ...l~a.~.~o. Le.tt~ich ..... C~e~. ........................ ' (owner, lessee or tenant) of the aforesaid building. · Suffolk County Department of Health Approval ....... ~,R., ......................... .......... ....... · .... House TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? tail Z Permission is hereby granted to: ........ to ..... ~p~i,&4Ni~.. ~it~a.tia~. · ~ ¢~ ~o~'~.. ~ulL. lal ~ ............................................................... ........................ .(...~.~....~. ............ ~...~........~ ............................................................... at premises located at ............ ~,/~....~i,&~..~rai~,~u ..ii4~a~ .................................................................... ........................ i ............................ tlo~t.h~l~ ....... I~:~ ....................................................................... pursuon¢ to application dated ............................. lia~ ......... ~ ........ , 19.~,~.., and approved by the Building Inspector. Fee $..~.e.O~,. ............ ~uilding ~nspector/ TOWN OF SOUI'HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. y. Examined ....... /6 ~ ^pproved ........................ ._. .............. ,,9 ........ P.rmit ...... ../. .......... APPLICATION FOR BUILDING PERMIT Dat, ............................ ...Xfl.~. ....... ~.~. ............ ,19....6..~. .... INSTRUCTIONS a. This application must be completely filled in by t~pewriter or in ink and submitted in duplicate to the Building Inspector. b. Plo, t .pi.an sho, w!n~, I,oc.ation. o.f. lot .a,nd of.bu,ildit~, ~s on prem.ises, relationship to adjoining premises or public streets or areas, aha g~wng a aeta.ea aescr~p~on or ,ayouT or property muSt be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. . d,.,. U,pon. app.r, oval of .this a~. it, at, i ,o~, .the Bui. lding Inspector will Issue a Building Permit to the applicant. Such permit snail De Kept on rne prem,ses ava aa · Tar Inspection throughout the progress of the work. e. No building shall be occupied or used In whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION !S HEREBY N~DE to the Building Department for the issuance of o Building Permit pursuant to the ~Build!n.g. Zone. O.r,d,nance of t.he To, w.n ,o,f,.Southo~: .Suffolk C. oun~, New York, and other applicable Laws, Ordinances or Kegu~or~ons, tar the construction at ou.omgs, ackht~ons or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. George Bauer (Signature of applicant, or name, if a corporation) ...... ~P,,L1~ ,~.gad Southold N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................... .Qo~.t~ ~.¢..~.o.~L..~.. ~ g.exL~...O~...O.~e.~ ..................................................................................................... Name of owner of '~rem s-~ Morea Lettunich If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: .............. ~ .................... Lot No.: ,.Rc~. ................ Street and Number ....... ~.~.....~,~...~g~ .~.~.0,~ .~..~..~....~......0...~..... ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed conStruction: a. Existing use and occupancy ...~.e,~.;J,D~...~..~.~....~.~:~g.q. .................................... 3. Nature of work (check which applicable): New Building ..;.~..,Z~... ....... Addition .................. Alteration .................. Repair .................. Removal .........~ ........ Dem01i~iOn ....... ;.......i.. Other Work (Describe) ........................................ 4. Estimated Cost ..... ~.~.0OO...+. ...................... ............ Fee .....~.~0~ ........................................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ..l:~O~e ................. 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 ..~'..o.~..e..s..s...o.?.~. ..... 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 ....... ..~..~.. .............. Depth ...... ..~..~.. ............ Height .................... Number of Stories ..... J0~e .......................................................................................................... 9. Size of lot: Front .......~.~.(~.J....1..Lt~ Rear ...~.O.Q.....~....~.~0.+.. ...... Depth ...... ~.0.0 ................... 10. Date of Purchase ........................................................ No,ne of Former Owner ........................................................ ........... ~,....~l.:L~t ......................................................................... 1 1. Zone or use district in which premises are situated tt a 12. Does proposed construction violate any zoning Iow, ordinance or regulation? .............. ~'.e.$ .................... ; .................. 13. Name of Owner of premises .J~t,.~.e.O..,T~t~.~.~C,.l~:L:LC~..Address ......~.l~.l,l.~hQ'l~. ................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .Ge~.~3e,ue~. ............................. Address ........ ~.~I~t~h.~.[~. ................ 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 according to deed, and show street names and indicate whether interior or corner lat. STATE OF NEW YORK. t,. ,.. COUNTY OF- ~.S.:0,.~.~'.e l,~, :. ............ ?'~" ......................................... ..G..e..9.?.j~.e.....~.jj.l~ ......................... being duly swam, depa~es and says that he is the applicant (Name of individual signing application) , above named. He is the ............... Ccm~.a~tc~..&.JLl~e~t..~£..nw~ez'. ....................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the. saJd work and to make omi file th s application; that ail statements contained in this application are~frue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applic~6n filed therewith./,j Swam to before me this ~ ................. ~,,~.. ddy of ......................... J~ ........... , 197"9- ~-~,d.~_....-' n~ · ., v-~ ~,~ //~ ~~m~C~...~.....~C~...t .................................... Notary Public~l,~-/lZ,/.~..~ ...... County~/~,n~nE~L,Zp~u~. ~..~.~dl~of applicant) Te~m Expires March ~.