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Home My WebLink About4188-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No..z36~ ..... Date ........... Nov ..... & ....... ,1969. THIS CERTIFIES that the building located at M~rrehaha. -Bi~ ........... Street Map No. Laugh~g~cx, a Block No .... x~ .... Lot No..xx .... Sou~chold'' 'N~¥'~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Feb' · · '2~ ..... , 19 '6~ pursuant to which Building Permit No.. '~68Z · dated ....... Feb.~. 25 ...... , 19. ('9, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is .. p~$va~ce · one - far,:~ty, dwe ! l~rrg ..................................... The certificate is issued to .. Benry. 1~:, .~dr~,ch. & .~fa .... 2~mer& .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ............. N..~, .................. Building Inspector ouse I~ORM 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) No. 4185 Z Permission is hereby granted to: ~ / ~/// '/' ............. .Z~...~::.~.~ ....... ~¥.'.~.~ ........... ........................ .... .... ~Z~ .... ~.:..' ~ ~.:..,.~. ~,~,,~ ~..'. ................. tO .......................................... ............ :..,.*;*....;.~7....*r;.; ................... aT premises IOCQTeO az .................................... ~. .............................. ~......~.....~;.:. ............................... , ..... ..................................................................................................... ~.~.~¥ ............................. pursuan¢ tO opplication doted :'~' ;...~:., 19....~.~/~and approved by the Building Inspector. Fee $...,~. ................ (Buikling Inspector) APPLICATIO~N FOR BUILDING PERMIT Date .............. '.-: .... -- .......... 19. INSTRUCTIONS a. This application must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Building InspecWr. b. Plot plan showing location of lot and of buildings o n premises, relationship to adjoining premises or public streets or areas, ~and giving a detailed description of lay out of p~ope~ty must be drawn on the diagram which is part of this application. c. The work covered by this application may n~t be commenced before issuance of Palilding permit. d. Upon approval of this application, the Building In specter will issue a Building Permit to the applicant. Such permit shall be kept on the premises available fo r inspection throughout the progress of the work. e. No building shall be occupied or used in whole o~ in part for any purpose whatever until a Certificate Of Occupancy shall have been granted by the Buildirig Inspector~ APPLICATION IS ~l~Ry MADE to the Building Departm~.ent for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of S(~uthold, Suff61k County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build in~s, additions or alterations, or for removal or demo- ~tiouOs~l;Sc~dee~,i~SSeC~lbeadtioTnsh.e applicant agrees to ~om. ply ~:plica[~ws,~:~building code, State whether applicant is owner, lessee, agent, archit ::;,' ~in'L:f:~):s~ 't~:'~t~:i~'e~c'tt~ician, pl:~ber or builder ................................................................................................... Name of owner of premises ..... ~..~.~t~ ~ ..~ ~..~. ,9 t c-~'t If applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) W lC r ed work will bedone Ma-No LotNo, 7..~.... 1. Location of lan__d on ~bich p opes ' . t. ........ ~ ............. .... ...... , ...... ..... '" iia aii ' " ............ 2. S~te exis~g use and occup~cy ~ p~mises ~ d intend~ ~e ~d oceu~ of pm~ ~efion. a. ~isfing use and ~eup~cy ..... ~.~.g ~.~.~.~ ................................................. b. Int~ded ~ .a~ ~p~cy ..... .~k~.~ ................................................ 3. Nature of work (check which applicable): New Building ........ Addi'don .. X. · · Alteration ........ Repair ......... Removal ........ Demoliti. on ........ ~ Work (Describe) ...................... 4. Estimated O0~t ..... .~J.',~..~. .................... Fee .~.' ..................................... (to be paid on filing this application) 5. If ,dwelling, number of dwelling units ..../. ..... Number of dwelling units on each floor .............. If garage, number of cars ...... .~ ff..~. ............................................................ 6. If business, commercial ~r mixed occupancy, spec ify nature and extent of each type of use .............. 7. Dimensions;} e.xisting structures, if any: Front..)...~..o..~-T'.. Rear ....~..~.~..... Depth ..?.Z.:.~..~-~.:_ Height ....... ~....~l~umber of Stories ............................. i ................. , ........ Dimensions of same structure with alterCtlons or additions: Front ....~..o ........ Rear . ..~.~. .......... Depth .... .~.~..~..' .....Height ... !f..~.. ...... Number of St~ies ..... /. ............... 8. Dimensions of entire new construction: Fr(mt ..... ./.~. '. .......Rear ..../~ ~ ....... Depth . ./..~. ....... Height...].~..~. :... Number of Stories ....... ' ...................................................... 9. Size of lot: Front...~.~.,.~...~:... Rear ....~.c..~.3-... .... Depth ...[.~.~..:.~.. ~'i 10. Date of Purchase .. ~.* ..... [~$.~. ............... Name of Fox'ruer Owner ....~..c.~.??..s....~'..~..c.. ...... 11. Zone ~r use district in which promises are situated ............................. .~./ ..................... 12. Does proposed construction vlola'~e any ~ning law, ordinance or regulation? ... ~?.o.: .................. Name ofpwne~ premises .~. ~.~.~ ./~,.t~h~.~. 0...~ddress ~.q.~.~.~.~ .~..~Y?.r~.~.°..~.%) Phone No..7.~..K.i .~.~.~3 ' ....... 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 ~r de scription according to deed, and show street names and indicate whetherkinterior or corner lot. - ^II,L--- STATE OF NEW YORK, )S.S. COUNTY OF : .. ) ....... ....... application) ...... cant .above named. He-i~the ........................ of said owner ~r ~wners, and i~ly authorize~, to file this application; that all stat~qe~s oonttuned in th is belief; and th.at the work will be pel~l~m~iped in the Sworn to before me this ''~ ........... .o~.. f. day of MAflffiN A. NOTARY PUBLIC, State of No. 52-3233120 Suffolk County,_ Term Expires 1~8rch 30, appli- [Ckmtrac-~cor, agent, c~porate officer, etc.) have the said work and to make and to the best of his knowledge and applicant)