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Home My WebLink About4229-zFORM~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~.. 3~ ..... Date .............. A~-. 8 .... , 19.69. THIS CERTIFIES that the building located at I~0&W'o':$/B' · .King 'St .... Street Map No...XX ........ Block No ..... ~ .... Lot No.~ .... 0l'i~lat. · .l~,~., ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Feb .2 ...... , 1968 - pursuant to which Building Permit No... h'229Z. dated ...... A~ri.1....?. ..... , 19 69', was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Pr&rate..one..i:am~t.~ .~e-lti~-;g .................................... The certificate is issued to ....... 1;,. · .8.t, oedle ..........0~qael~ .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~.tl~. 6.,..~ 96.9 .. by..R,..Villa ...... Building Inspector House ~ 3~0 King FOK~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4229 Z Permission is hereby granted to: ...... JJ~eJ, t..aja..A.h,~L~ar~..aJ~.....~,ac~..a.t;e,~a,l,e · ................... g.~.~.~.~.~ ................................... to .......... ~3~.. ne~.. ¢~...ffam~.~...¢~va 3~&~r~ ......................................................................... at premises located at .............. .~t~...{)~.~..~...K.~g...~J-{$ ........................................................ ..................................................... O~.~e~t~...~.,.~., .......... ~ ................................................................... pursua:n~ to application dated ................... J~lkla ....... ~. ..................... , 19.6~.., and approved by the Building Inspector. JJO~j~ ~'&~:~e j~'~t,~ by ~ A~peal~ Fee $..ll.O~Ol~ .......... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Per'mit No. d 19 9 TO WMOM IT MAY CONCERN: ~ .~,~,~h~e sewage disposal facilities for a structure located have been inspected by this department and found to be satisfactory. District Engineer District Engineer ~FORM ,NO. I Examined ........ 19 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI~:RK'S OFFICE SOUTHOLD. N. Y. Application No...~.( j~ 2- ~i INSTI~UCTION,S a. This applicati~on must be c.ompletely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of ~t and ~o~ buildings o n premises, relati,onship ~o adj~oining premises or public streets ~ 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 applicati.~n, the Building Inspecgor will ~ssue a Building pe~Cmit %o the applicant. Such permit shall be kept ,on the premises available for inspection throughout the progress of the w~ork. e. No building shall be occupied or used in whole p~ in part ~o~ any purp~ose ~vhatever until a Certificate ~f Occupancy shall have been granted by the Building Inspeci}~'. APPLICATION IS ~BY MADE to the Building Department for the issuance of a Building Permit pursuant 9o the Building Zone Ordinance of the T~wn'~of S~o'uthold, Suffolk C~o~nty, New Y.,~ck, and o~ther applicable Laws, Ordinances .or Regulati,ons, for the construction .~f buildings, additions or alterations, ,ow f. or~ removal or demo- lition, as herein described. The applicant agrees to tom ply with all applicable la~vs, ordinances, building code, housing code, an, d regulati.ons. ,i ~ ~ (Signature ~ .applicant, or, name if a corporation) ,. ..... ........... State whether applicant is owner, lessee, agent, a_r~ite~engineer, general contractor, electrician, plumber or builder ....................................... '.. · ~ ........................................................ Name of .owner of premises .................. ..... .~/~. ...................................... If applicant is a corporate, signature of duly authorized .~fficer. (Name and title of corporate officer) Location ~of land ~o.n which prop~o.sed ~ork will be don~e. Map No ................. Lot No .............. Street and Number .f~.'. ..... ~.~..~....~."2~ ~ ......... : ........... Municipa]ity~'"~-~/'"~" ............... State existing use and ,occupancy ~o{ premises and intended use and .occupancy of proposed construction. a. Existing use and occupancy .............. ~~ .......................................... b. Intended use .and ,occupancy ............... ~ ......................................... ~0. 11. Nature of work (check which applicable): New Building ..... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... C.ost ['~1-- ' '/?~' ' "(2'~ Fee ............................ Estimated (to be paid ,~n filing this application) /~ If ~d~velling, nmnber ,of dwelling units ....~. .... Number .of dwelling units on each floor ./~z~ ?.,~-... [f garage, number of cars .......................................................................... If busincss, co,mmercial ,~r mixed occupancy, specify nature and extent of each type of use .............. Dimensi,ons of existing structures, if any: Front .............. Rear ............. Depth ............. Height ................ Number cf Stories ........................................................ Dimensions of same structure with alterations .or additions: Front .............. Rear ............. Depth ................ Height ................ Number of Sbo,ries ..................... Dimensions .of eutire new construction: Fro'nt ...... ~ ........ Real' ... ~,~ ....... Depth . .~.Q ...... Height .... ;~ (J .... Number ,al S~ories ......... /..~. ................................................ Size of ~ot: Front . ..].Z.~'. ..... Rear . //.~ ~ ........ Depth .... l./.~. ....... Date of Purchase ..... .].O./TZ/.~.~. ............... Name o'f Former Owner ............................. Zone ,o,r use district in which premises are situated .................................................... Does proposed construction violate any z~ning law, .ordinance or regulati,~n? ..... , .................... Name ,of Owner ,of premises /(~.~...~f.~/~ ......... A, ddre~s . '.g...~. ~.~/.~.~...~...~.~f?.~*~h,~ne No. ~..c~. ~.././~.~. Name of Architect ............................. A'ddre~s ...................... Ph~ne No ............. Name ,of Contractor , ./r..Co..../.~/~.~.$.~'~ ............ Address~4,"~.~ ~ ~/~. Ph,~ne No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give s~reet and block number .~r de scripti~on according to deed, and show street names and indicate whether interior ,or corner ~ot. STAT]~ OF NEW YORK, )S.S. COUNTY OF .............. ) ............... ~ .... '--'~ ~ ............... being duly swor~, ~deposes and says that he is the appli- (Name ,of indivi~[lhal signing application) cant above named. He is the .............................. ~.~a~y~. 1 .................................... (Oontrac~or, agect, a~rpoeate .officer, etc.) of said owner ,or ,owners, and is duly authorized ~o lJer£~rm or have per~ormed the said w~ork and bo, make and file this application; that all statements contained in this application ~re, true to the besl of his kn,owledge and belief; and that the w,~rk will be pevf,o~med in the mann er set forth' in the application filed therewith. Sworn to before me this 7~