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Home My WebLink About4462-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z. 37.96 ..... Date ............ .l~y ..... ~. ...... , 19.?0. THIS CERTIFIES that the building located at ....... Ga~l:Lnel, s · Lalm .... Street Map No.. ~ ...... Block No ..... ~1~ ....Lot No..lcll~ .... .S.o~l~;.h.o.l.d....N.:~: ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... l~e.pt ...... l(~ 19~. pursuant to which Building Pemit No. ~6~.. dated ........ -~el~t .....$6..-, 19 69., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificat8 is issued is .... Private · one · faar2iy., dYelling ................................... The certificate is issued to ...John.. Ita. x, grc~ve ...... ~mer- ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ·--'~- '-'-' "Building'" "~::Insp~tor ......... ' ........ Houso FOIi~ NO. II TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLDo N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4462 Z Permission is hereby granted to: to ........... ~.&..aev..one..~asilT~tvet21rig ........................................................................... at premises located at ............... ~f~"f~l~:rcl~z"'~Z~l~ ...................................................................... .................................................................. 8e~bo'Z~ ................................................... '~ ....................... pursua~ to application dated ........................... ~e~: .......'Jr ........... , 19.~).., and approved by the Building Inspector. Building Inspector Examined ,, ,, L- App,.,ed'~ ..................... 19 .... rermit No ~ Disapproved a/c . ~ .......................... APPLICATION FOR BUILDING Date . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspechyr. b. Plotl)lan showing location of lot andof buildings on premises, relationship 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 r~t be commenced before issuance of l~ilding Permit. d. Upon approval of this applicati, on, the Building In spector 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 shail 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 Inspector. APPLICATION IS 1-t~yv~qY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of S~athold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, and regulations. r (Sig~aj~ure of ,applicant. or name if a corporation) '"~ '' '- (Address'of aTli'~ ............... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ........ ~..t~. ~...~.~..~..~..~..O.,~ ............. . .................................................. Name of owner of premises ........................................... If ..... applicant~~is a corporate, sigu~mre of duly authorized ........ officer. ~ ~/~,4~/'ff~v~ '~-I~a/f- f~ }~ (Name and title of corporate officer) , ' ~ 1. Location of land on which propped work will be d0ne.'~p Nq~/.~.~./~..~....~.~N0.. ~. '~... ..... Street and Number ........ .... ........................................ ~:~/-- ~/Y O Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. Existing use and occupancy ...~,.~.~.~..~ ................................................. Intended u~ .and occupancy . ./~,f~.~4/~-..~' ..... 3. Nature of werk (check which applicable): NeW Building b~ Addition .... Alteration Repair ......... Removal ........ Demolition ...... ~ Other Work (Describe) ...................... 4. Estimated Oast ,~5~.~..o.,~o.. ............... Fee?-~.~.. ~. (to be paid on filing this application) 5. If dwelling, number of dwelling units .. ~. ..... Number .of dwelling units on each floor .............. If garage, number ~f cars .... ~).~.~_~ ............................................................. 6. If business commercial ~r mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensk)us of existing structures, ff any: Frcmt .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions .of same structure with alterat$ons or additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories ..................... 8. Dimensions ,of entire new construction: Front . ~?~. ...... ::... Rear . .--~. ~. ........ Depth ~ ........ Height ../~. f. .... Number of Stories ...O. d ~, .................................................... 9. Size of lot: Front . ./.g~.O ....... Rear ./.~. gY.' ...... Depth . O~g~.O ....... 10. Date of Purchase .. ~'~_~.~...'.~.. ........... Name of Former Owner ............................. 11. Zone ~r use district in which premises are situated. ,~2~,,~'~.~ .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? . ~. .................... 13. Name of Owner ,of premise~/~.~ .~/~,~.~.//..~.. A, ddress ~1 ~..~'~. ~ ~../~...~. Phone No ............ Name of Architect ............................. ~ddress ...................... Phone No ............ Name of Contractor~, [~. ,~.~t. ~.~'. ~q.~ .~.[ ~ £.lz~--Address .~.q ~.,4~.4:~...~.'~.,. Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back diraens~ons from property lines. Give s~eet and block number ~r description according to deed, and show street names and indicate whether interior er corner ~ot. 12.' STATE OF NEW YORK, )S.S. COUNTY OF ............. _) /! (Name~l~--~dividual sfgning ap~.!~eation~ cant above,, named. He.is the ..... ~ ................................... (Oontractor, agent, corporate officer, etc.) of said owner ~ov owners, and is duly authorized to' perfc~'rm o~ hav~ 'perfOrmed .th'4 ~aid work and to make and file this application; that all statements contaTrled in th"iS appli6~it~on ave~u~e to the be~t of his knowledge and belief; .and that the work will be perSarmed in the mann er set forth] in the application filed therewith. Sworn to before me this ..... ].~ ........ ~ day o, ~ ..... /'t';. [ 17_ 71 -iii ..,, .... . .... ' ....... N~tar~ Pubii~t,0l~../~nty~ (~ignture of applica, ut) ..... m,lr~,¥ PUBLIC, State of New 'fork So. 52.8125850, Suffolk Term ~xpircs March 30, S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date BidE. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (G~e deea~location) ~ ( have been inspected by this department and found to be satisfactory. P 8 Distrlot ~Uglne er ' District Engineer