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Home My WebLink About4210-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ....Z...34.).......... Date ...........ApE1l.............9.................., 19..6.i. THIS CERTIFIES that the building located ot ...&3'O..COZ.v...Cr.eü..Ròa4................... Street Map No. ...................... Block No. ...................... Lat No. .....Sout:hoJ.d........Yozk..................... conforms substantially to the Application for Buil ding Permit heretofore filed in this office dated ...........·....tÑ)Ir~&'·y..·..2·7·......................, 19...68 pursuant to which Building Permit No. ...42~O...z dated ............. Mal'ch......· 2"·¡......·......·, 19·69.., was issued, and canforms to all of the requirements of the applicable provisions of the law. The occupancy far which this certificate is issued is ........ ······~·ly.u··_.··haUY'··cIwe.l·:J.,1R9·······. ................................................................................ The certificate is issued to ........obezt..JohDaOR........................................................................... (owner, lessee or tenant) of the aforesaid building. Ó /f¿ Ý. ,/C?Ir 4:/ /. . '/.fd0 L---' ................................................................................ Building Inspector FORM 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) N9 4210 z Dote ..........................Øa!'ah......å......, 19...6~ Permission is hereby granted to:....b - ert Tl1thUl A/C lobe" lo1m_. ................................................................................ ...........ÇJaH';U~~................................................ ................................................................................ to ......~~~.~..!!:~...~1.~.~.1~~.r:1.. .9.~..."p...~,J;;!,.$. t;U;œ. ..c;.w~;;,lla&................................................. ................................................................................................................................................................ at premises locoted at .......P3rt...Boad...(J".oke.). .,s..SI.....h.y...y:t....-Roa«................................... ... .... ... .... .... ..... .... ... ................. ... .... ... .~!>.~t.bQlcl.. ..... ........ ........ ..... .... .... ... .... .......... .... .... .... .... ......... .... ................................................................................................................................................................ pursuant to application dated .............................I'e.J;,.....2.í'.............., 19...69, and approved by the Building Inspector. Fee $..J~~~........... ...6tJ.~'!..:.:....\...ß.:·....~:~..,........................... Building Inspecte{ FORM NO.1 ð r /rÞ 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined '" .1J~ ~. .J. .'1. ., 19~.l. Approved........... .'.':-......,19 :.1.. Permit No. ..~ .~(. ~. .~.. Application No. ~~(ù . . . . . . . . . . . . . . . . Disapproved alc .. .~.... ..~...... \............... ········································L;;··········~..... .................(.y..... .................... (Building Inspector APPLICATION FOR BUILDING PERMIT Date .¿7.~.......... 1967 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 of buildings 0 n 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 applicaHon may not be commenced before issuance of Building Permit. d. Upon approval ,of this applicati.on, 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 of the work. e. No building shall be occupied or used in whole 011 in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of SG\.Itho ld, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction at build ings, additions or alterations, m: for removal or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, and regulations. ~ . ..7?o?r.:/.~~............. (Signature of applIcant, or name if a corpor.ation) '" .&/~:d~~~~?i:;t~ù················ State whether applicant is owner, lessee, agent, archit ect, engineer, general contractor, electrician, plumber or builder....... ...... ß.~... .... .. ...~.. )"' .. .. .... ...... .... ...... . .. .. ............ .......... . Name of owner of premises... .1?~.. .~................. .......................... If applicant is a corporate, signature of duly authorize d -officer. .......................... ..... ..................... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No. ................ Lot No. .... ......... f/-~~;~ an~~~þ " .~. f:t~{;r¡t:~·:ti~i¡tŸ···················· 2. State existing Use and occupancy of premises and intended Use and .occupancy of proposed construction. a. Existing use and occupancy .......... .!~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy ........... ./~. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . ;)/ .,JA ¿; ~0Go /.1 3. Nature of work (check which applicable): New Building ........ Addition .. ¿teration ........ Repair... . . . . .. Re~1 ........ Demolition .. . . . . .' Other WBJ'j!: (Describe) ...................... 4. Estimated Oost .. .. ./XQ... .. .. .. .. .. .. . . .. . Fee .......... Z .5.-:-7. ç.::o. .. . . .. . . .. .. .. .. .. .. . . .. . (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 .............:........ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If busine.ss, commercial 'D'r r.lixed occupancy, spec ify nature and extent of each type of use . . . . . . . . . . . . . . :2 /" / 2 1 . -") .-, 7. Dimensions of existing structures, if any: Fl':)nt . . . . rq.. . . . . .. Rear .. IE. . . . . . . .. Depth . r..-? . . . . . . . Height. .. ././. ~.. ..... Number of Stories.... . . /. .. .. .. .. .... .. .... .. . ... .. .. .... ...... ., ...... . . , - , Dimensions of same structure with alterations or additions: Front.. .:?£,........ Rear .::?4.......... Depth ..~ 9..:........ Height . ..I.cf.~........ Number of Stories ....../............ ,. 8. Dimensions 'Of entire new construction: Front... .............. Rear.. .Ir.~....... Depth.. Ý ....... Height . .7.1. . . . . .. Number .of Stories ........ (, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7J-1 7.-"- / /,....., 1 9. Size of lot: Front ................. Rear ..' ."......... Depth . . y;v. .. .. "/:1 . 10. Date of Purchase. . ..... . . . . .I'lG. .r:. .. . . .. .. . Name 0'£ Former Owner .;1. (.,,\.. .¡([<;'PN. ...... .. . 11. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any 2OO'Iling law, ordinance or regulatian? ....... .¡t/.c?............. 13. Name of Owner 'Of premises !?qf.?:~-t .[P.f{iYA ~ N. . .4ddress (3ft/$i.cf?c:': . /AI:)/.': Pbone No. 13~~Ý..,;',f- Name of Architect ............................. .4ddress ...................... Pbone No. ........... Name 'Of Contractor J?u./",/?f.. .lZ<!-//.,j,.k. . Address . .e,~ (~(!o.~ ~ ðyPhane NO.J.3Ý-Ý'& ~ 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 Œ de scription according to deed, and show street names and indicate whether interior 'Or corner lot. 7 J- 1 i 6·(:1:: & ,- - I t/ I ;j If-cl é-Ìè /(öþr , IoU I P J-71 I luo ~o'± V 7 j- 1 STATE OF NE~:.915L-)S,S, C . R -ý ¡'?RCEV COUNTY OF ''C'r;;'' ~) (J t- c" C í\ . . . .71.0 þè;~. .r:::;. . . ~ .f:iJ/.? ~ . . . . . . . . . . . being duly sworn, deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the ...................ß~............... .......................... (Oontractor, agent, corporate officer, etc.) of said owner 'Or owners, and 'is duly authorized to perform or have perf,ormed the said WŒk and to make and file this application; that all statements oontained in th is application are true to the best of his knowledge and belief; and that the work will be performed in the mann er set forth! in the application filed therewith. Sworn to before me this ......~.':f.... day of ...~.~.... 19.~1 . . . . . .. Oounty Ckøü 1)~ ..1?d::t..' <..£.~.......... ([i~nture of applicant) Notary Public, ... [I ,. ~ -~ . NOTl.":~.'- " f':~':!~ LE " ~.o. ~.:>;.~_~ -., -:" :', 'c~:~ ;ork Term ..^µ,{(';s I\;an:t, Jù, 19~ ,FORM Na. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ClÆRK'S OFFICE SOUTHOLD, N. Y. /)7 - G ,. Examined.... ./..(·(i~" ./tJ..~/., 19. .'. ( Approved . . . . . . . . . . . . .t. \ . . . . ., 19 . . '. '. Permit No. . . .f:.-I.~ I. P. .~. Application No. ...!-r J... f. iJ. . . . . Disapproved alc ....... '.~'" ...... ........... ........... .... -- ~ ..............................................................~... ··················~:d~~····..············ APPLICATION FOR BUILDING PERMIT Date c2.. 7. . .............1~y 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.,gt; and of 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 applicatkm may not be commenced before issuance of Building Permit. d. Upon approval of this applicatkm, the Building In spector will issue a Building PeTmit to the applicant. Such permit shall be kept ,an the premises available fo l' inspection throughout the progress of the work. e. No building shall be occupied or used in whole 011 in part fur any purpose whatever until a Certificate·of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sauthold, Suffolk County, New Ym-k, and other applicable Laws, Ordinances or Regulations, for the construction at buildings, additions or alteTations, or for removal or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, and regulations.' ~ " lJ.4:-t. .1.~. ~~~~............ (Signature of applicant, or name if a corporation) '" '~~~~~:;':~t)"""""""" State whether applicant is owner, lessee, agent, archit ect, engineer, general contractor, electrician, plumber or builder....... ...... ß. W~......... .. ~... if..................................................... Name of owner of premises. . . . f?4.f-.. . . r::f7..&-:<>:~ . . . . . . . . . . . . . . . .. .......................... If applicant is a c:>rporate, signature of duly authorize d ,officer. .......................... .......................... (Name and title of corporate officer) 1. Location of land on whi~proposed WOr~Will be done. Map No. ................ Lot No. ............. Street and Number....I:.. .8. .f~.~. .51.~ .(þ/;:.~'~..t?i.~~~~........................ Municipality 2. State existing use and occupancy ,of premises an d intended use and occupancy of proposed construction. a. Existing use and occupancy......... ../~................... .......................... b. Intended use and occupancy ........... ./~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 10. 11. 12. 13. _ 3. Nature of work (check which applicable): New Building. . . ..... Addition. .¿-Alteration ........ Repair _ . . . . . .. Re~1 ........ Demolition .. . . . . .. Other ~k..iDescribe) ...................... 4. Estimated C:Jst ..... 'I fQ,.. . . .. .. .. . . .. .. .. . Fee .............. ~ . 1..C!7:...:). . . . . .. . . .. .. .. . . . .. . .. .. . / (to be paid ·an filing this application)l 5. If dwelling, number of dwelling units ... ...... Number of dwelling units on each floor .............. If garage, number ·of cars ...................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G. If business, commercial·'X mixed occupancy, specify nature and extent of epoch type of use..... .-'#..... 7. Dimensi,ons of existing structures, if any: Fmnt . .:2.j.. . . .... Rear.::?G......... Depth . ~~. .. .... . Height... ./(.~....... Number of Stories.... ........................~. ..................,....... Dimensions of same structure with al!erations 0, additions: Front ..? ~ . . ./.... Rear .~~.......... nn' . 1'1' . D~Pth : ..,... T. .. . .... . ... Height ................. Number of Stones ..../.,............. ¥' 8. DimensIOns -of entire new constructIon: Front ... . . . . . . . . . . . . .. Rear ... II! . . . . . . . .. Depth ...........- H.eight ..7~....... Num»er of Stories........f. -.............. ÜÖ·I···· .......................... Size of lot: Front.. 7.r..... .J" R7 . ..1.r......... Depth ./......... rI J V Date of Purchase ........... ..?6..............Name <:11 Former Owner I'f.~..~.f.t~~~.......... Zone -or use district in which premises are situated. . . . . . . . . . . . . . . . . ~.-. . . . . . . . . . . . . . 'A/(j . . . . . . . . . . . . . Does proposed construction ):,i-olate any zoning law, -ordinance or re~tiO'l1?:/.i/'" /.v.... ., '1:11 ~.. . Name-of Owner of premises If~þ.,·-!·/:..,J#tY.~.t!~(. Address ß/.I/~(...~ .J.~. '/..: PhQl1e No. t;S;:o.a(-:-((,6- Name of Architect ..·..ï;·.~;F·7ž..._ï,·;;¿·..A:ddreSS ·"t:;¡;"I/;~:;;'''''~·'#,i Phone No. 'j¡;c.¿)5~ Name -of Contractor .PI"..I, I.... .. . .,,,t: .1.~.... . Address ··.·.····.....····.·7 Ph<m.e No.7....... .. . 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·or description acoording to deed, and show street names and indicate whether interior or corner lot. 7ft .lL:~'~.~-- _ t I , ,~ ~~7' Lr~ ~O I ::t.. 1- 1)- , ~~t~i::~~'~'~!lt~ ~.. .. . . . .~ ~~~~y q~:::s and says that he is the appli- (Name of individual signing application) , cant above named. He is the .................. .13.U.f U~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Oontractor, agent, QOl1JOTate officer, etc.) of said owner or owners, and is duly authorized to perform or have periiormed the said wOTk and to make and file this application; that all statements oontained in th is application are true to the best of his knowledge and belief; and that the work will be perfœ"med in the mann er set forth! in the application filed therewith. Sworn to before me this ----ì-----T l 5~'t I I ..5 A-Ói:-fë.. /<ókF , /0(' , luo .. _.~.-.- ...... ~. '1.... day of ... ~ .~..... 19.~.í Notary Public, ... ~- . . . .. County _ a¥1'ðJ0 Új! JU 1 v;ä . .1?C(~~~.t. .c;¡::L¿-/............. (Signture of applicant) [L1,>P.~'-1 NOTARY ,,,~,-I.I .1.'"'' , . N Ir·;;Ur ,~. '~,C\ILlE D. 51.,~ 1 ~ -" . ",,",:, r:' r - fern-; ÈY.~I;::·;:;U' Stdfc.i: 2'L" YQrk s March 30' ~~!l . 19.q¡