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Home My WebLink About4185-zFORM NO. 4 TOWN OF SOUTHOLD BUII.IHNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z. 3667 .... Date .liovtmb~r..26, ............. , 19.69. THIS CERTIFIES that the building located at W/~. Stars. P, oad .......... Street Map No ............. Block No ........... Lot No..~t .Maz~to~,..l~m..York. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Fe~:a~uar~... 18,..., 19.59 pursuant to which Building Permit No.. 4].85. Z. dated .... Sel~t~. ].8 ..... , 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~v&te, om. ~ma~14~. d~l,~g .................................... The certificate is issued to .... Thoma~ .&. ~orotl~¥ .O;l~onneXl ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Hmm~ar. 25.,.. 1~.9,. ~O~'~:..V.:L~,].& Building Inspector Houle ~ 4325 J~l lP. oid FOR~ 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) 4185 Z Permission is hereby granted to: ...... ..Jt....~ ......... .~,'L,~e.~.~a,a ............................. .............. II,Z, ........................................................ to ......... ~.,~ ~,. mw.. ~n~.. ~a~,l.~ .. ~i~>~ ~ 8' .......................................................................... at premises located at ........l~.~....~t,&~,..~ff~ll~ ............ (.~.~.Za...~s.~.~ .................................. ................................................... l~ ~..~a~&o~t...N.,~ ................................................................... pursuan¢ to application dated ......................... ~.~J). ......... .'J~ ............. , 19..~9., and approved by the Building Inspector. Fee $..I.Oe.QO. ......... FORM ,NO. 1 TOWN OF SOUTHOLD BUILDING DI~-PAR~T TOWN CL~RK'S OFFICE SOUTHOLD, N. Y. Application No ................. Approved ..................... 19 .... Permit No .................... Disapproved a/c ~.~..,---~-~. ~._:~:_~.~,~-r.... :-~.. (Building Inspector) APPLICATIO,N FOR BUILDING P~-RMIT Date .............. .F.e.~'~l~/~:t'~.. J ~ ....19.69. INSTRUCTIONS 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 ~f buildings o n premises, relati~mhip to adjoining premises or public streets or areas, 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 ~ot be commenced before issuance of Building Permit. .d. Up(m approval ,of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available fo r inspectio~ 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 HEBI~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 C~unty, New York, and other applicable Laws, Ordinances or Regulations, for the construction ~f build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, building code, housing code, and regulations. Carls Hobil Homes (Signature of .applicant, or name if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ........... .~g~l~;..Of..O'~llel'. ~. DlL~J.der. ....................................................... Name of ,oWner of premises ~hO~qa$. ~. ~/c, roq~... (~ tDeI~l~e..~.% ........................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location ~)f land on which proposed work will be done. Map No....~.~.a.~'.~...0.D.~... Lot No.. ~ ......... Street and Number . '~/.~..~..t.a.r..s. ~o..a.d.....k.'.a.s.t. ?.~.r..i.o.q .......................................... Municipality 2. State existing use and ~ecupancy ,of premises and intended use and ~occupancy of proposed construction. a. Existing use and occupancy . ...~a2,al~.~. Z'a~i .................................................. b. Intended use and occupancy ..... .o. riq'...i.'~jlq~?~5~. :c:.¥~:.~.~:g ..................................... 10. Nature of work (check which applicable): New Building .. ~ Addition ........ Alteration ..... Repair ......... Removal ........ Demolition ........ Other Work (Describe) ................... Estimated Cost .. '~2)~0"_$ .................. Fee .. i$0,0~1 ....................... . ............ (to' be paid ~n filing this apphcation) If ,dwelling, number of dwelling units . ~I~O..... Number of dwelling units .on each floor ............ If ga.r~ge, number ~f cars .......................................................................... If business, commercial ~r mixed occupancy, specify nature and extant of each t~pe of use .............. Dimensions of existing s~ructures, if any: Frc~t .............. Rear ............. Depth ............. Height ................ Number of Stories ............ : ........................................... Dimension's of same structure with alterations or additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories ..................... Dimensions of entire new construction: Front ~..'-21~... Rear .... ~1~ ....2~ DePth ...1~$ ...... Height ............ Number of Stories ... Ol~ ...................................................... Size of {ot: Front. '~0 ........... ReAr .:, ...g0./ ...... DePth --. m37~ ..... Date of Purchase ........ ~ .................. Name of Former Owner ...p,. ~l~;J, ........... ~ Zone ~r use district In which premises are situated....~A~.. ~g~.~ ...................................... Does proposed conStrUction violate any z~ning law, ordinance or regulation? ..... ~ .................. Name of Owner.of premises . .~. ~. 1) .~.~4)~O],'~ddress ...................... Phone No ............ Name of ArchiteCt ............................. ~ddress ...................... PI~me No ............ Name ~f Contractor . ~aX'~.s..~4~b&~. ~.. · Address ...]~$e~h$&~ .. ..... Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from pro~rty lines. Give s .treet and block number or de scription according to deed, and show' street names and indicate whether interio~ or corner l~t. 0 STATE OF IVEW YORK, ) S.S. COUNTY OF . .l~%lff~3JL.. ) ................. ~$1~ -~a.l~i~. ~ ............... being duly sworiq, deposes and says that he is the appli- (Name of individual mgning ~tpplication cant .above named. He is the ...... ~t. 'Of' .¢0~tl'&OtO~ ............. ................. . ............... (Gontractor, agent, corporate officer, etc.) of said owner ~r owners, and is duly authorized to perform or have performed the said work and to make and file this application; (hat all statements contained in this application are true to the best of his knowledge and belief; and that the ~k will be performed in the mann er set forth in the application filed therewith. Sworn to before me this ,> (Signture of applicant)~/ '