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Home My WebLink About4187-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z. 35.43 ..... Date ..... Jm].y ...... lk, ......... , lg 69. THIS CERTIFIES that the building located at .. B&~' .&~'.mnue ............. Street Map No ............. Block No ........... Lot No .... Catchog~e,. l~e~W. ~.o.~]$ ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... FSb;r.~l:Y.... ~9.,., 1969.. pursuant to which Building Permit No..4],87..:~. dated ..... F®br. uax¥.... ~9.,.., 1969.., 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~;t,v.~l:e..e~¢¢~e~s.~101~y..bV~.].~l:l,rlg ................................... The certificate is issued to . .John .&. P. aula. Hch~t ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... .......... iaii ' i"p--;'"-""ns ecto House ~ 9205 Bay Avenue FORM NO. 2 TOWN OF SOUTHOt. D 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? 4187 Z Permission is hereby granted to:L?~ ~) / ,,~ / . d~/ ,g ~ ........................... '~"~'"-~ ..................... ~_ .... ........................... ~-..~.~'.~.~ ............... .................................................... ............. Building Inspector. Fee $ ........................ Building Inspector IFORM ,NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLfERK'S OFFICE SOUTHOLD. N. Y. ........... .... Approved .......... ~ .......... 19 . ~?Permit No ........... ~ ....... /, ~,rp~owa ~/~. ~:~,; : .... -. ~.~ ...... ~ :..~. _ :_. ......... .................................... (Bui}~ing Inspects) APPLICATIQN FOR BUILDING PERMIT Date .~.. ..... ff..~. ................ 19.~..~ INSTRUCTIONS a. This application must be c.ompletely filled in by typewriter or in ink and ,submitted in duplicate to the Building Inspector. b. Plot plan showing location ef ~t and .of buildings o n premises, relati,anship bo adjoining premises or public streets ,or areas, .and giving a detailed descripti, on of layout of property must be drawn .on the diagram which is part of this application. c. The work covered by this applicat~qn may not be commenced before issuance of Building Permit. .d. Upon appt, oval ,of this application, the Building In specbor will issue a Building Permit to the applicant. Such pemit shall be kept ,*n the premises available for inspection through,o~t the progress of the mork. e. ~o building shall be occupied or used in whole o~ in pa~ ~ ~y purpose ~hatever until a Certificate .~ Occupancy shall have been granted by the Building Inspect. APPLICATION IS ~Y MA~E to the Building Department for the issuance of a Building Pe~mlt pursuant ~o the Building Zone Ordinance of the Town of S~uthold, Suffolk Gounty, New %~k, and other a~lieable Laws, O~dinances .or Regulations, for the cons~ion .~ build ings, additions or alterations, .or ~or remval or demo- lition, as herein described. The applicant agrees Vo comply with all applicable laws, ~ordi~nces, building code, h,ausing co,de, a.d regulations. ::4:: ~ ignatue ~ applicant, or. name if a corporation) ~' ~ (Addresser applica '~tl2~ ~; .. . State whether applicant is owner, lessee, agent, architect, engineer, general eontraet~, electrician, plumber or ~.i~d~, ..... ~¢;/.Z~ .................. .~ ......................................................... ............... If applicant is a cerporate, signature of duly auth,orized .~ficer. (Name and title of corporate officer) ---/~/~' ~ff> ?"~"//~ 5~ 1. Location ,of land o.n which pr~o.sed work ~11. be done. Map No ................. Lot No .............. Street andNumber ~~5; .~'~.~.~.~: '~hh~'{';li ...................... ~ ~ ~0.~ 'c'pa'ty 2. State existingseUSeandandoccu'*ceupanCYaney of ~ffpremise~n/~ 6~dig'tended~ '~use and~.oecupaney of pm.posed construction. a. Existing u P .... : ....~ .................................................. b. Intended use .and oecup~cy ... :~.~...~. ~' .. :ff from pl~aperty lines. indicate 3. Nature of work (check which applicable): New Building ...~.J... Additi,on ........ Alteration ........ Repair ......... Remov~ ........ Demolition ........ Other Work (Describe) ...................... 4. Fstimated Cost ..... ~.~./..~.~.)~? ............... Fee ................................................. (to be paid ,~m filing this application) 5. If ,dwelling, number .of dwelling units .......... Number ,of dwelling units on each flora' .............. [f garage, number .of cars .......................................................................... fi. If business, commercial ~vr 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 .............. Rear ............... Depth ................ Height ................ Number of S~o.ries 8. Dimensions ~of entire new construction: F~nt ... ~.~. ......... Rear . ~../~. ........ Depth /.2 :.Q .... Height . .~/.".~. ...... Number ,at Stories ..... ./ ....................................................... 10. Date of Purch.ase ............................... Name ~ Former Owner . ..~g~.?:.~.~..~f~..~ ..... 11. Zone.o~ use district in which premises are situated .................................................... 12. Does proposed construction violate any z,3ning law, ordinance or r~egulati,~n? .....~/..~ .................... Name of Architect ..... , ....................... .. Address ....................... Phone No ............ PLOT DIAGRAM distinctly all buildings, whether existing .or proposed, and indicate all set-back dimensions an~d block number ,or description according to deed, and show street names and STATE OF NEW ~ORK, )S.S. (Name of individu~a s'g ' g pp ' at~on) cant above named. He is the ................. /~f.~..z~..7~.~../3. ~.c~. ~ ...................................... (Contractor, agent, c,o~porate officer, etc.) of said owner or ,owners, and is duly authorized to peff,~rm or have per/~nrmed the said w~rk and to make and file this application; that all statements contained in this application ~re, true to the best of his knowledge and belief; and that the w¢~rk will be perfo~'med in the mann er set forth~ in the application filed therewith. Sworn to before me this ............ t... uay o~ ............ ~-~...~./ ~... -- ~ ~"/'l"ff~ N,o~ary Publi~'~.)i~, .~ · ([. ~(r~: ,. ·. Count9 :[erm Expires ~arch 30~ ~ (Signture of applicant) TOWN OF SOUTI'IOLD BUILDING Di[PAR~T TOWN C~-~ml['S OFFIC~ SOu-r~IOLD, N, Y. ............ 7ZYT. '.':".'". ....... APPLICATION FOR BUILDING PERMIT Date ..... .~.~../.; . . . /~ ............. ~9dp. INSTRUC'i'~ONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspectzn'. b. Plot plan showing location of lot andof buildings on premises, relationship 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 not be commenced before issuance of Building Permit. d. Upon approval of this application, 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 a~ the work. e. No building shall be occupied or used in whole o~ in part f~r any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Lnspe~...~ APPLICATION IS Billek'~y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold~ Suffolk Oounty, New York, and othsr applicable Law~, Ordinances or Regulations, for the construction of buildings, 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 regulation,.~ r~ ~.'..~, ..~ d"· j..gnature of applicant, oil name if a corporation) State wbether applicant is o~ner, lessee, agent, tarch~tect, engineer, general contractor, electrician, plumber or huilder ..... ~.~/..Z'~--~.. .............................................................................. Name of ow~, of premises....~.~../~..7..W~.~./~ .... .~.~.4~. ............................... H applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) 1. Location ~f land on which proposed work will be done. Map No..f. 7.~'/.~..~[~.. Lot No .............. S~' ~nd ~.m~ ~ ~.~ :. ~. ~Y~ ~.~ ........... : ............................ /T I -- ~ ~ ~ ~ / Municip~i~ 2. State exist~g use and ~cup~cy Of p~mi~s ~ d intend~ ~e ~ oc~ of pm~ ~cflon. a. ~is~E use ~d ~cup~cy ..... ~.~ ~ Z. ~.~ ............................. ........................ . mt~aed ~ ~ meu~e~ ~ ~ ~ ~. ~ .................. 3. Nature of work (check which applicable): New Building ...~./ .... Addition ........ Alteration ........ Repair ......... Removal~ ....... Demolition ........ Other Work (Describe) ...................... 4. ]~.stimated east ...... ./.~./...~.~..~ ............... Fee ....................................... (to be paid ,qn filing this application) 5. If ~dwelling, number .of dwelling units .......... Number ,of dwelling units on each floor .............. If garage, number .of cars .......................................................................... 6. If business, commercial ~*r mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures, if any: Feo~nt .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensio=s ,of same structure with alterations .or additions: F~ont .............. Rear ............... Depth ................ Height ................ Number of S~c~ries ..................... 8. Dimensions ~of entire new construction: Front ...~../.~ .......... Rear . .~./.f~. ....... Depth ..z/~. f~? .... , / Height . .~.. 0. ...... Number ,of S~ories ........................................ .,, .......... ,- · .;,~ ..... 9. Size of Lot: Front~.~.~.'..~..~ .... Rear ~d:~; .~ .2'~-... Depth/(f...d.j~/),.ff.~.. 10. Date of Purch.ase ............................... Name o'f Former Owner ............................. 11. Zone .or use district in which premises are situated .................................................... 12. Does proposed construction ~,. ~.vi'°laie~any .~f.~'/~ff~. ~ .~?ning 1,aw, .ordinance~. · ~/ /~,~ ~'~, or ~egul~i,~r)? ~.. ~ ...,~..~. .................. No~.~.~.~.' 13. Name ,of Owner.o.f premises Name of Architect ...... ./ ............. . ....... . A'ddress ~ .................. j.. ,Ph~one No ............ Name ,of Contrael~o'r~:~. '.~..~.~.~.~./'.~.~. ~?. . · Address ~/~t~..~..~..e)F~'..~..~. PLOT DIAGRAM from pr~,perty indicate distinctly all buildings, whether existing or ~proposed, and indicate all set-back dimensions block number ,~r de scription according to deed, and sh,ow street names and Lot. STATE: OF NEW YOg$, )S.S. ~.~.~ .~..~...~....~.~.....(a~.. i ....................... bein~ duly sworn, ,deposes and says that he is the appli- (Name ~of in.dividu.al signing application) cant above named. He is the .............. c'~.~? .e~.?~.,~-.-.~9..~.~"-~/.~, ....................................... (Gontractor, agent, corporate .officer, etc.) of said owne~ or ,owners, and is duly authorized ~o perform or have performed the said work and 60. make .and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the w,*rk will be performed in the mann er set forth~ in the application filed therewith. Sworn bo before me this un)~ (Signture of applicant)