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Home My WebLink About4172-zFOKM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CEi~IFIES that the building located at .~../.8..~.o..u.t~...!~..~...l~.r....I~O.~. Street Map No ............. Block No ........... Lot No..~.o.u..t~..o.1..df..~..c~...Y.o.r.k. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... N. 0¥...~...r' .2.~. ,..., 19.68.. pursuant to which Building Permit No..4.~7..2..~.. dated ..... .~.a..n.u.ar.~f.' .2.~. .... , 19.6..9, 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~.v.a..t.? .o.n..~..~..~..~.1.~...d?.~.l.~ .ln.g ...................................... The certificate is issued to .... .M.l.l.t.o..n..C.; .~.. N.I.~..d~..~.d. ?.;....1~...o.n.d. ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~.u.n..e..~.:. ~.9.6.9.:, ~.o..~..r.t..V..t.1.]:.a .... 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) 4172 Permission is hereby granted to: TG~1~I: Colr'.S't~ A/~ It~l,t~ ~ & I~L~O to ...~..gi~.~..~..~...~L~J.l~...~ ~.l~ ................................................................................. W ~ ', at premises Iocoted ot .........~.......~..'~?~..~..-~.~P~'.~"...~J~ ................................................................ ......................................................... F~.<~l~<~3.~ ...... ~,.~. ................................................................... pursuan¢ to application dated .............................. .~.0..?. ....... .~..1. .......... , 19~.~...., and approved by the Building Inspector. Fee *J.Q.:.~. ........... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPAKTHENT OF HEALTH Date TO WHOM IT HAY CONCERN: The sewase disposal facilities for a structure located (Give deed location) JUN 6 1969 District ~Elneer District EnEineer ~FORM NO. '1 Examined ~ ...~/..., 19~. Approved ............... ::..., 19 f.;.. Permit No.../1/1..7.,~.... Disapproved a/c .................................................... ~/~ (Building~pecl~e) APPLICATIO~ FOR BUILDING PERMIT ~ ~_ ~ Date ...... :....N.o.v..~t...~..~..2. ~).. ~./~..8,. 19 .... INSTRU C-ziONS a. 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, relatkmship to adjoining pfem!~es or public stredts or areas, and giving a detailed description of lay out of property must be drawn on the dia~am which 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 i~sue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progre\ss,~._.of_ the work. e. No building shall be occupied or used in Whole O~ in part for any purpose whatever un, il a Certifcate of -Occupancy shall have been granted by the Building Insp~l~or. APPLICATION IS Id~.~'~Y MADE to the Building Department for the issuanee of a Building Permit pursuant to the Building Zone Ordinance of the Town of So,4thokl, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alteeations, or for removal or demo- lition, as hea'ein described. The applicant agrees to eom ply with all applicable laws, ordinances, building code, (Signature of applicant, or. name, if a corporation) (Address of applicm/t) State whether applicant, is owner, lessee, agent, a[chit ect, engineer, general contractor, electrician, plumber or builder ........ .o..~' .................................................................... ? ............... N~e of °W~r of premi~ o~ ~, ~on and ed' i. ~ond, his ~fe If applicant is a eerporate, siguature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which propozed work will be done. Map No ................. Lot No .............. Street and Number .¥/.,. SOu. ih. I~'fIT.bOZ,. LOzlo.~.. 9~/~. ~,~./'.il,. fl,/~-_~[ll,l~ao~d..~..So~,hold. ..... MuniclP~lty 2. State existing use aha occupancy of premises an d intended use and occupancy of proposed construction. a Existing use and occupancy · · · ...... b. Intended use and occupancy ....... .o~..e..f..a~. }..]::F..df~a.l,~.~.~g .................................... 3. Nature of ~vork (check which applicable): New Building . ..X ..... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost .$.~.0.: .0.0,0..:.0.0. ................. Fee ................................................. (to be paid (m filing this application) 5. If ,dweLling, number of dwelling units . 1 ........ Number ,of dwelling units on each floor .............. If garage, number of cars .... 2 ............ 6. If business, commercial or mixed occupancy, specify nature mud extent of each type of use .............. 7. Dimensions of existing structures, if any: Frcr.~t .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimension's ,of same structure wi~h alterations or additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories ..................... 8. Dimensions ,of entire new construction: Fr(mt ...... ~.~.t ........ Rear .. ~.~.~ ........ Depth .. 3.Qt. ...... Height . .l.~.t. ...... Number of S~ories . 3. '.: .................... ~ .'.'.:: .............................. 9. Size of lot: Front ...~.Q.0. ........ Rear . lQ0 .......... Depth . ~.Og~.l~O ...... 10. Date of Purchase ..... 0.o.~;e..~. ~..~9~.~ .......... Name of Former Owner la],q~'~.q$..]~..~.e.b~... 11. Zone or use district in which premises are situated .................................................... 12. ]~oes proposed construction violate any zoning law, ,ordinance or regulation? ........................... 13. Name ,of Owner.of premises l~,. l~ll~ol~d ........ Address .~. ~a~e .l~. Phone No.5~9.-.~.8.~2. Name of Architect ............................. -~ddress ...................... Phone No ............ Name of Contractor Tol~ax'k ~onstru~t. lon ~dress ~2~0 Sale, se H~ Phone No. 5~.9.-.2.Q30 ............................ Sa~'~rl~li~ ....... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or ,proposed, and indicate all set-back dimensions from property lines. Give s~eet and block number or de script~on according to deed, and show street names tnd indicate whether interior or corner tot. STATE OF NE~ Y. OP46,~ )S.S. COUNTY OF ~1...) · ....... illin'me ,of individual ~igning ap~51fcati.oni ....... being duly sworn, deposes and says that he is the appli- cant a ve named. He is the ........ (Contractor, agent, corporate officer, etc.) af said owner or owners, and is duly authorized to per~,arm or have performed the said w~rk and t~ make and file this application; that all statements contained in th is application ave true to the bes% of his knowledge and belief; .and that the work will be performed in the mann er set~,rtl~ in the application filed therewith. ......... !.. day of .... .... ' ......... ar7 ~-mo tc,a.¥~-~...~.-.~.¥ ~.~_ ttllty (Signture of applicant) ~4ARION A NOTARY PU3LIC, Sto~e oY R~~''' ' No. 52-3233120 Suffolk COL Term Expires March 30, 19~_q ,I I ! TOMARK CF NSTRUCTION INC. t ,I I i i LEET TYPICAL 5 [,~ T i_O.,.L{_ ,ToMARK C..N_,R,_,_,' c ~ ' '--iON JNC .~ .&Lo" 4'.xZ'' I I" O" lNG '£ TOMARK ~'-]'D~STRUCTIO[N ~NC. 5250 SUNRISE ~qIGHW/:Cy SA'fV LEE. NE1A/ YORK 1 I782 LT 9'2030 '0 '0 _1 ?LA.N _ TOMARK (_~ON~q~-RUCTiON iN(5 LT g-2030