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Home My WebLink About4179-zFORM NO. 4 TOWN OF $OUTHOLD BU~.rHNG DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. ~-.352.7. .... Date ......... ,Tul¥... 11, ..... , 1969.. THIS CERTIFIES that the building located at llaln. Jtre~t: ............. Street Map No ............. Block No ........... Lot No.. BoutJ~ld,. Ile~. ]~o~k ......... conforms substantially to the Application for Building Permit heretofore filed in thi, office dated ... Januar.y.... 2.7.~..., 1969. pursuant to which Building Permit ,No. 4179. Z.. dated ... g~uar~.... 21~ .... , 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 ...Bua:Lneee-X)u&.LdIn9. (rutaurant) ........ i ........................ The certificate is issued to ...8~:e~,~ .i~t~.ko~r~. ................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... House 4l, 55500 IiaJ, n Street FOH, M NO. 2 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? 4179 Z Permission is hereby granted to: eo#.l~Lt~.~.-~on~..Z~c..~...,~te.~e..~l~tlm~l~ (~zel~eto~) & ~ Oe~lm (~) at premises located at ......................... ~/'~....Y,~l~..Jt4)lt~ ................................................................. ................................................................ J~tJ~l~t..~2~ .............................................................. pursuar~t to application dated ................................... ~'411~ ......... ~IL.., 19..~., and opproved by the Building Inspector. Fee $,.,~..~ .~.~. ............ MAp OF LAMp t? ¢DOUTLtOLD ,~ .. · mou plpb Disapl~oved a/c .... ~. ~~... ~ector) INSTRUCI'iONS~(~ a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan shewing location of lot and of buildings o n premises, relatianship to adjoining promises or public streets or area~, .and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may n~t be comme~ced befOre issuance of B~ilding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pemit shah be kept .on the premises available for inspection throughout the progress of the work· e. No building shall be occupied or used in whole o~ in p~rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS ~Y 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 Ck~unty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or far removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, building code, h~using cede, and regulations. (Sigl~tur. e of .applicant, or name if a corporation) ~; ' ~a~)~ii~/~)' ............... State whether applicant is owner, le~see, agent, arehite~eer, general contractor, electrician, plumber or builder ....... ~ .......... ~ ...... ...y/ ....... .~ ~..~ ............................ ~ ~.~,, ~. .......... Name .of owner of prem~ses~~.~.~ ............ .-~. · ~) ~of corporate officer) 1. Location of land on which proposed work will be dp~ne. M ap~o~ ............... Lot No .............. Street and Number..~'~7~..~..,.....~.~. ~.~...~.~...'.. ...................... ~ / _ .~ ~ ~ 0 5 v Mu~/~'pality 2. State existing use and occupancy of premises an d inlended use and oeeu!~'ancy of proposed construction. a. Existing use and occupancy . .~....~/f~ b Intended and .~. ~ .~y~....~..~.~.~.~. e ........ · u~e occupancy ~ ..................................... 3. Nature of work (check which applicable): New Building ........ Addition .../..... Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost .... ~.~2..~.----~.. .............. Fee ................................................. (to be paid ~n filing this application) 5. If d~velling, number of dwelling units .......... Nnmber .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 7. Dimensions of existing structures, if any: Front . . ~ ...... Rear . ~ ........ Depth ,~.'~. ......... Height . ./.--~. / Number of Stories .. Dimensions .of same structure with alterations or additions: Front ....'.z~..~. ...... Rear . .~...~. .......... Depth . ~.~..C,.) .......... Height .../.-~.. ........ Number of S~ories . ~ ........... 8. Dimensions ,of entire new construction: Front ... ~ ~. ......... Rear . ,,~.~..[ ...... Depth~7~P ......... Height . ../.5 .-~. .... Number of Stories . .~'r~e~. ..................................................... 9. Size of iot: Front ....~.d ........ Rear ....~g2 ......... Depth . ./.~2z~. ....... 10. Date of Purch.ase ............................... Name of Former Owner ............................. 11. Zone or use district in which premises are situated .... ~ .- ........................................ 12. Does proposed construction violate any z~ning law, .ordinance or regulation? . .):v~. .................... 13. Name .of Owner.of premises ..................... A, ddress ...................... Ph~yne No ............ Name of Architect ............... ~ ............ A'ddress Phone No ............ Name,of Contrac~or~.~:~.~.. ·: ..... Address ~i~.'/i~ii 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 .er description according to deed, and show street names and indicate whether interior ~r c~rner iot. STAT~ OF NEW YORK, )S.S. · COUNTY OF ............ ~.. ),,~'.., ,~"~~ ,~ ............ ~~-~. · -. ~.. ~...... being duly sworn, ,deposes and says that he is the appli- (Nam~ ~of ~lndividu.al signing appli%ation)~/,] ~,/~---- ~'~ cant above named. He is the ........ ,,:.;~-~-~- .~-...~ ..................................................... ":" (Contractor, agent, cca-porate officer, etc.) of said owner ~er ,owners, and is duly authorized to perform or have per~orrned the said wqrk and to make and file this application; that all statemenls contained in this application ave true to the best of his knowledge and belief; and that the work will be perfo~ned in the mann er set fort~ in the application flied therewith. Sworn to before me this Ncecary Public,: .-..~...~.v...~-~.. .... ~.~/]~ourgy -~ ..................................... ~:~Y~ ~~'~'~ (Signture of applicant)