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Home My WebLink About4225-zNO. 4 TOWN OF $OUTHOLD BUn.r~ING DEPARTMR. NT Town Clerk's Oglee $outhold, BT. Y. Certificate Of Occupancy No. Z66:lfl ..... Date ...............A~ ......I~.., 19. THIS CERTIFIES that the building located at . R e0~Pte. S/.~ .l~al~r~ew. RoadStreet Map No. Koka .0.]l.A,Block No ....~1~...Lot No. ~... ~out~ol~l. - ,N.Y, ......... conforms substantially to the Application for Building Permit heretofore fi]ed in this office dated ............ Feb ..... .~., 19.69. pursuant to which Bugdh~g Permit No. 422.~ · dated .........April..L~ .... , 19.6~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thJ, certificate is issued is .Pr~.v. ate. ~ax'aga. (. nnfinishe. 2r~ .flo. o~-) ........................... The certificate is issued to . .Robart. ~2.e~e~s ....... 9wrier. ........................ (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .N., R... ............................. UNDERWRITERS CERTIFICATE No..I~ ~ H.. ....................................... HOUSE NUMBER...7.~0 ....... Street.. ~ ..'....~a~ .~a~ew. Sae~tl .......... .... .......... 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? ~225 Z Permission is hereby granted to: at premises located at ................... lt~...~12~..~4.~,,:~..e...~L'~..~.....~l[~ll~:lJIIM..~l~ ................. ....................... ..s..e.~.t..~.o.~ ............................................................................... pursuant to application dated .................................... ~1~ ....... ~ ....... , 19...~, and approved by the Building Inspector. a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspects. b. Pl, ot plan showing R)cation of ~ct and ~ buildings o n premises, relati~a~hip to adjoining promises or public streets ~r aroas, and giving a d~ailed 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 b e commenced before issuance of Building Permit. d. Ul~n approval of this application, the Building In spector will issue a Building Permit to the applicant. Such permit shall be kept ~ the premises available fo r inspecti~ya througl~ut the progress of the work. e. No building shall be occupied or used in whole c,~ in part for any purpose whatever until a Certificate g~f Occupancy shall have been grar~ted by the Building Inspector. APPLICATION IS I-m~l~Y MADE to the.Building Department for the issuance of a Building Permit pursuant to the Building ~one Ordinance of the Town of S~athold., Suffolk Ck)unty, New Y~rk, and other applicable Laws, Ordinances or Regulati~us, for the cons~ucti0n of build ings, additions or altorations, or for removal or demo- lition, as hexein described. The applicant agrees to comply with all .applicable laws, ordinances, building code, h.~using code, a~d regulations. (Signature ~f applicant, or aame if a corporation) (Address of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, blumber or If applicant is a corporate, signature of dJ~rv authorize d officer. /~/Name and title of corpor ' ) 1. Location ~f land ~n which p~ropos.ed work__will b_~e don~e~ M,2~p No ................ Lot No .............. State existing use and ~ccupancy ~f premises an d inlended use and occupancy of propo~d construction. a. E~xisting use and occupancy .... ~..~.O~--.~ .................................................... b. Intended use .and occupancy . .~t:~....~ :~ ............ ?i':~.~ ....... ..--.......-*~ .\~: .... · '.,', 3. Nature of work (check which applicable): New Building ........ Addition ........ Alteration ...... Repair ......... Removal ........ Demolition ........ Other Work (Describe) .~,~,~' ........... 4. Estimated O~st ......... ~.te.~X~;FP.. ............ Fee . ..~.~5~',o..E ...................................... (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 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 alterat~ns.or additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories .. ;; ................. 8. Dimensions of entire new construction: Front . ...~.~'. ......... Rear ....7-..~ ....... Depth . ;~ ....... Height .... ~'. ..... Number of Stories .~ ............................. ~ .............................. 9. Size of lot: Front ................ Rear .... Depth ............... 10. Date of Purchase ............................... Name of Former Owner ............................. 11.Zone or use district in which premises are situated...--. ........................................ ce ction vio e any ing law, inan or iiiii ................. premises .-~go'i~e ~.c. Name of Architect ............................. Address ...................... Phone No ............ Name of Contractor ~O~C~.~ ~..'~.~.(~. ...... Address . ~z~.~gC~O. ~ .~.~:.. Phone No. '1~.:2.~t7~3 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from propert~ lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot, STATE OF NEW YORK, ) S.S. COUNTY OF .............. ) .... ~LIP..~--3~.~...~..tOIT~ ................... being duly swolTl, depOses and says~that'he is the .appli- (Name of individual signing application) _ cant above named. He is the .... ~t~. ..... .O.J~.k~.~ ............................................... (Oontraetor, agent, corporate officer, etc.) of said owner or ~vners, and is duly authorized to perform or .have performed the said work and to make and file this application; that all statemer~ts contained in th is application are true to the best of his knowledge and belief; and that the work will be perf~wmed in the mann er set fortl~ in the application flied therewith. Sworn to before me this ltOTARY PUBLIC, State of NeW yorl~' No. 52-8125850. Suffolk Cou,~f ~rm [xpires AAarch ~0, ~' (Signture of applicant)