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Home My WebLink About4467-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.Z~311~. ...... Date . .A..u~t~S...~...6! ................, 19.7.~.. THIS CERTIFIES that the building located at .... l~At~ .P, Oa~ ............. Street Map No .... .l. ....... Block No .... X ...... Lot No .... RaS.t; .P.a~tx~t. i~.Y, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 3. s.p.t....3..95.' 19.6.1). pursuant to which Building Permit No...~. 72~. dated ........... ~.~p.t....~95.., 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 .. Pr;tvai;e..olle. ~alally. 5¥,lllng ...................................... The certificate is issued to ... IS~b®3.L, .I~/~.~ .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No...P~ .................................. HOUSE NUMBER ...2,0~.0 .... Street ... lqain, l~oaS. ........................... East Ma~io~ N.Y. '"~ ' - -BuildingInspector'-/ ........ / FOI~M 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? 4467 Z Permission is hereby granted to: ........ ~.,...Le.....a....~.~k~.e...~K..~. ............... ...................... Mmi~..liea~. ................................... to .......... ,{{~i~.. &u..~i.%iem.. 4~11..~lG..m.~ a.Zir+~ ..Y{Y&~.~.~{ ............................................ at premises located at ........................... 8aFFI ....... ~.,Lt~.~.~ ............................................................. .......................................................... ~m.t..;~ ......... I~]C.~ ........................................................ pursuont to opp{icotion doted .......................... ~1~-~.~, ....... ~1~ ........... , ]9...~f~, ond opproved by the Building {nspector. Fee $..~,,e,..,(~,, ............. FORM NO. 4 TOWN OF SOUTHOLD BUll,DING DEPARTMENT Tow,, Clerk's Office Southold. N. Y. Certificate Of Occupancy No...~0.~6 .... Date ........... Ma.l?Qh ....'/ .... 19 73 THIS CERTIFIES that the building located at . 14/..8. ~rw~t~ .D:r$,ye .... Street Map No. ~ ....... Block'No. .~ .... Lot No.. ~,. ~.~. ~., ..... conforms substantially to the Applieation for Building Permit heretofore filed in this office dated .A~ · · · 8 ...... , lg~$ pursuant to which Building Permit No..605~ 'dated . --A~I .... 8 ..... , 19. , Was issued, and conforms to all of the reqmre- ments of the applicable provisions of the law. The occupancy for which this certificate issued is . D~=~8.a I. bU~.. {~or~)...ro~A~..Off iai. A. B~OrAI~ l~e. The certificate is issued to .. $, .PI~o~. ~0~ ..... ~o~ ..................... (owner, less~ or tenant ) of the aforesaid building. Suffolk County Department of Health Approval .~....~p ............................ UNDkRWRITI.RS Ct~RTIFICATE No ..... ~SR.~. ................................ ] ....... IIOUSk NUMBI~R..~0 .... Street . ~. ~r~l ................................ Building Inspcclor ' ' BUI~ING DEPARTM~ ~ ~ ~, ~, ~ ..... .......... .......................... ................................................. .......................................................................................................................... ~~ ~ ~/~ ............ .................... ~ - (Building In~or) -- APPLI~TION FOR BUILDING PE~IY *. ~i~ ~pplicati~ must be co~l~l~ {ill~ in by ~writ*r or in ink ~nd ~ubmi~ in ~plic~ ~ th~ Building b. PI~ plan shying I~ation of lot a~ of bu~ldi~s ~ premiss, relation~ip to adjoining pmmi~ or public st~ or a~s, ana givi~.a ~ailed ~ripti~ of I~t at p~ must ~ drawn on the diagram which is ~ of ~is a~li~tion. c. ~e wo~ c~er~ by this appli~tion may n~ be commenced before i~u~ce of Buildi~ Pe~it. d. Up~ ~al of this applicati~, t~ Building Ins~ctor will issue a Building P~it to the ~plicant. S~h ~it shall ~ k~t on the premi~ ~ilable for im~i~ th~ghout the p~r~ of the ~. e. No building s~ll ~ ~cupi~ or us~ in whole or in pa~ for any pu~e whatever umil a Ce~ific~e of ~c~a~y s~ll have ~en gmn~ by the Buildi~ Ink,tar. APPLI~TION IS ~REBY ~DE to the Building ~ment for the i~uance of a Buildi~ Pe~it ~ant to the Building Zon~ O~inance of the T~ of S~tho~, Suffolk Count, N~ York, and ~r applicable ~, O~i~ces or R~ulations, tar the con,ruction of buildings, additions or alterations, or for mm~al or demolition, as heroin d~ri~. ~e applicant ~r~s to c~ply with all applicable laws, ordinance, building c~e, housing c~e, ~d ~ulatJons. ~sabe[Ze ~gg~s East ~r~on ~.I. p ~,~~ ~ ~g~ (Addre. of applicont) Sfafe whe~er ~pplicanf is ~ner, les~, agent, ~hit~t, en ncr, general confractor, el~rici~n, plu~er or builder. ............................................................... ~.~ ............................................................. : ........................................................ ~m, o~ ~,r o~ ~m,,~ ..~.~..~..~.~....:~.~.~.~E ................................................................................... 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.: ..... ~ .............. Street and Number ............... ..~$...~l.....R..9..a..d..' . l~ast ...~..~....r...i..o..n. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy one fGm b. Intended use and occupancy same with an addition property lines. Give street and whether interior or corner lot. 3. Nature of work (check which applicable): New Building ................... Addition ...~ ....... A ion ~ ........... Repair .................. Removal ..................Demolition .................. Other Work (Describe) ...... ~1-"4' .......................... 4. Estimated Cost ...... ~.~.~.~.QO...9: .................................. Fee. ~...00. ................................................ U (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .9.~.~. ........... Number of dwelling units on each floor ............................ If garage, number of cars ................................................................ ~,.. ......................................................................... 6. If business, commercial or mixi~d occupancy, specify nature and extent of each type of use ............................ 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 ............ ~.2. ................ ,. Rear .......... .1,~, ............. Depth ...... 2.8 ............. Height .................... Number of Stories ..... O.-'3e ................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ~J[" d::[$1; 12. Does proposed construction violate any zoning law, Ordinance or regulation.;> ........... D.Q ............................................ 13. Name of Owner of premises .~....~.....];...~.~.[§~..~..s. ........ Address ....... ..~..,...~.[',,I,Q~ .............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... n sa~e Name of Co tractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from or description according to deed, and show street names and indicate STATE OF NEW YORK, 1. ,. ,, ................................. ..~..s..a....~..e...~..]....e.....~.~[j~..:[L..~..s. ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signi.ng .application) (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 cantoined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ,4 (Signature T~m Expir~ ~ ~/~/~//~-~ TOWN OF ~OUTHOLD BUILDING DEFAITM~T TOWN CLERK'S ~TH~, N. ............................. {Bulldin~ Inspector) [ ........................... APPLICATION FOR BUILDING PERMIT ~ Date ~ay 28 19. 7o INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plat plan showing location of lot and of buildings on prem sas, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whlch is part of this application. c. The work covered bY this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will Issue a Bud ng 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. RB APPLICATION IS HEREB. Y MADE to the Bud ng Department for the ssuance of a Building Permit pureuant to the uild!ng Zone. O~inance of the Town of Southold, Suffolk County, New York, and other applicable I.awl, Ordinances or egu~ations, tar the construction of bu Id rigs, additions or al.tarot OhS, or for removal or demoliltan, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. ~attituck Airbase. Inc. (Signature cf applicant, or name, If a corparatlon) (Address of applicant) State whether applicant ls owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. Name of owner of premlsel .................... O..:..H..:....W..~..a..~...~.~...m. ..................................................................................................... If appli~'~t~ a corporate,/~lgnature of duly authorized officer.'~'~ · ............ ..... (Name and title 'of corporate officer) 1. Location of North si e land on Which proposed work will be done. Map No.: ........................ ~.~.....~:.. Lat No.:., ...................... "--- ~ ~ ~ .... I(/'~ present s~e~p'b~ZcfJ.~g~ West Strata and Number . ~.~ ...........~. ~ D~ ~ .............. ......................................... ~.w~ ~ ~T~, ~.~.~.~................ Munlcl~ll~ 2. State exl~lng u~ and ~cu~ncy of premiss and Intended use and occupancy of pmp~ con~tmctl~: a. ~istlng u~ a~ ~cupan~ ........ ~ ~ b. Intend~ use and ~cupancy ....... ~n~.~.~o~.~L.e~e~.~.~.A~.~ne.~.. ......... ~. Nature of work (check which applicable): New Building .................. Addition .....~ .......... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .......... . .............................. 4. Estimated Cost ...................... ~.~D.0.Q~DD ................... Fee ..................................... (to be paid on fi{ing this,~plication) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ * If garage, number of cars ................................................................................................................. 'B'6'~fi~g'~ ........... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .~[~l~[. .... 7. Dimensions of existing structures, if any: Front ..........]..2..0. ........... Rear ..... ~...2..0. ..................... Depth 50 Height .......... 1.0 .......... Number of Stories ........... ~. ............................. Dimensions of same structure with alterations or additions: Front ..... 31~]~L...lg.~ ........... Rear ...... ~...1.20 .... Depth 64 . Height 10 ................................ ........................................................... Number of Stories 8. Dimensions of entire new construction: Front ............ .~.0. ................... Rear ...... .~.~. ................. Depth ....... .1..4. ............. Height ....... 1.0 ......... Number of Stories ............1 ....................... . 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violGte any zoning law, ordinance or regulation> No 13. Name of Owner of premises C.H. Wlckl~m Address lv~tt~tuck N.Y. Phone No. 298-8337 None Nome of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..............~-Ione ............................. Address ............................................ Phone No ..................... PLOT DIAGP, AM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give Street and block number or description according to deed, and show street names and indica/'e whether interior or comer lot. ~ 7o' ~ · # .. N'i~ OF ..-~.~...'~-~...~./....~. ....... $'~'~' ....... '...(.~4'~.~....~.4.c~4'~ ................................ being du~y sworn, deposes ond says that he ~s the app~cont (Name of individual ~gning application) -- ~ above named He s the ~ .~.~....0.. ~..~..- .~... / ~' (Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said work an'd to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha'r the work will be performed in the manner set forth in the application filed therewith. Swom to before me___this~/' ¢ - - ' ./'~l .......... ............... · ,/_;J , ..................... cou. ....... ............................. JANET L. JAZOMI ~ . · ( -'