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Home My WebLink About4342-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z. 3622 ..... Date ............. 0et, .....2.9. .... , 19.69. THIS CERTIFIES that the building located at ]la. esau..Poin-t--Roa~ ...... Street Map No]laas o. l~t oC1 RlVah:~o ........... Lot No. 39 ..... Cu. tchogae · .. lq o~ o ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Jun~ -' ~- · -, 19.69 pursuant to which Building Permit No..h-.~.~.2 .Z. dated ............ J. lh-~e.. A6., 19..69, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... P..r.~ya.t..e..on.e...f.a.m..~./~..d.w.e. ~.l.J:n. g ............................... The certificate is issued to .. ~Ioushang.. Eah~n ........ 0~mer. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 0or. 2~ · ~ 9(~9 · · b.y..It...V.:i.].le. ..... .... Building Inspector "] ........ aou e 57og FOII,~ ~qO. S 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? 342 Z Dote .............................. ~:',Je.....$6 ...... , ~9..£9. Permission is hereby granted to: , [[~ ~ ~.e. ey.L ~....a..~.~.:;....;.n.~,..~ .~....,~ ~ .......... Mm.tt,tt~tck ............................................... to .......... .J~.. ~g .. i:~l~r~ .. ~ ~llL~ ...~.0~, .~, lz:~ ......................................................................... at premises located at ............... ~*'"'~r~ ....... ~&~;'~*""*~&~;J~'~'"~'"['"lJ?~"OJj' .................................... .................................. J,/S....,Jle~.se.u-.~o,t~z~.,.B~ ......... g'wl;e]~e,lu~ ......................................... pursua:ntc to application dated ..................................... J,~.. ....... .~.~., 19....(,~ and approved by the Building Inspector. uu~ amg nspector j S-9 SCHD SUFFOLK COUNTY DEPAHTHENT OF HEALTH Bldg. Permit No, ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give eed location) have been inspected by this department and found to be satisfactory. Distrio~ Engineer District Engineer TOWN OF SOUTHOLD ,~/,/,._ BUILDING DEPARTMEN'K Y~'? /~ ~ /~' /~-~'*~ ¥'~'' TOWN CLERK'S OFFICE ~ /./*/_.,,.,~ ,,~ d,~/~ · /1 sou o , Y. ~mind ..../..J.~.....~...?......, 19.?.~... /~/~- Appli~tion No.....'~...~.....~E.. ........ ~d ........................................ , 19 ........ Pe~,~ ~o ............................. ,~/ /._ ~. ~ .~ . /~/~ '~ i .... ~ ......................... ~.. ' ' ~' (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application 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 property must be drawn on the dmgram which Is part of thie application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, t. he Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for ~nspection 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 IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other ppplic, able Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demohtion, as herein described. The applicant agrees to comply with oll applicable lows, ordinances, building code, housing cede, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi*neer, general contractor, electrician, plumber or builder. A .................................................. ................................................................... Name of owner of premises ........................ .H.~ ........ ~.~k~[~ ................................................................................. i~ If applic~t is a corporat~l;Ina, l~of duly olllthori],ed officer. (Name and titl~ of corporate of Il&r) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ..~1..~ .............. Street and Number .................... ~J~l~,~.....~..d~l.".~'....J~.{~ ................... C.~..~.~1~,.t~:~I: ......... · ~I_ ~7 ~)~~' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of propc~cl construction: a. Existing use and occupancy ............ .~.A.~.....~.s........~...lldl~.ln ~" '~ ............................................................ :.; .............. b. Intended use and occupancy ......... I.J~.l~ ..... ~.1.1~.~... 3. Nature of work (check which applicable): New Building ..~/~., ...... Addition .................. Alteration .................. Repair ................ ~ Removal ..................Demolition .................. Other Work (Describe) ........................................ Eshmated Cast ......... M.~ ...................................... e ~J~ (to be paid on filing this application) If dwelling, number of dwelling units ......... ii~."..[~Number of dwelling units on each floor ............................ If garage, number of cars ...... ..~.........~.~.....~ .................................................................... 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 alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ,~.~t. ................... Rear .....~d~..~ .............. Depth ~.~ ................. 10. Date of Purchase .............. ~.l~...J..~.(~l ............ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate andy zoning law, ordinance or regulation? ...L~ ............................................... 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 lot. STATE OF NEW YORK, . I c c COUNTY OF ~l~.l~l~,J~, ......... ~ .... ............... HJl~lJ~.im~...../'~.,...~.'~..~.~....J.l~.., ............. being duly sworn, deposes and says that he is the applicant (Nam~ individual signing applicat~n) above named. He is the ............................... ~l~-I'~.L~.J~....~m. IJ~l~:.l.~'J.T/d~,~.T.~.l~ ...................................................... (Contractor, agent, corporate 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 perforql~:l in the manner set forth in the applicat~en filed therewith. Sworn to before me this \ I ...... ...... der of ......, ........' ...... ................... Notary Public, .x...~~ll~..~... County (Signature oppJJcanf~// 'AR~'PU~LIC, $+ate of ~/ew Y~rk II:SIDING IN SUFFOLK COUNTY No. 52-5895900 ~omrn/$slon ~Xplres Merch~ 30, ,A ~£0 2 ,B 5£CT/OAI I¢- ~. £,~ $ T ' EL£V&T/OM "t100,%%