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Home My WebLink About4239-zFO~M NO.i TOWN OF SOUTttOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z..3506 .... Date .......... ,~.une ..... 18, .... , 1969.. THIS CERTIFIES that the building located at l~&eaaan~;. P;taee .......... Street Map No..~.erry. ..... Block No ........... Lot No.. 53..,. Soutl~oJ.cl,. New .¥m:k... Waters conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... Apr il .... ~k,. 19..6.9 pursuant to which Building Permit No.. 4239. Z. dated ...... April.... ~.X.,. , 19.69., was issued, and cor~forms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .private. one. family..dwelling ...................................... The certificate is issued to .. John. Kleiher ....................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... Building Inspector House # 300 ~leasan~ Place FOI~M 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? 4239 Z Permission is hereby granted to: .......... .~.~.~....~.~,~.~......,,,/.,~...~.b.~,. ................. ~:.....~-l.~ ........................................... .................. ~.~p** .~-,~. ........ ~..,.~., ........................ to ........ ~? *~d,;JL%]~ ~,~.. ~f,,~zL;~,c~,. ~ ~ ~;~,.~,~;$~f .~J~e~.~t~. .............................. at premises located at ¥ ~ ~ ' · ................. .~t..,.~ .......... ~,e.,..~.;~...~:~;~.~,~ ...................................................... pursuon¢ to application dated .......................... ,~.~:~,~, ........ ~.'~ ......... , 19...('~, and approved by the Building Inspector. Building Inspector TOWN OF SOu-i-~OLD BUILDING DEPA~NT TOWN .CI,~RK'S OFFICE SOUTHOLD, N. ¥. Application No ................. Disapproved a/c .. (~ii~j ..................... APPLICATIO~N FOR BUILDING P'ERMIT Date ................................ 19 .... INSTRUc-I'IONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspecl~v. b. Plot plan showing location of lot and of buildings o n premises, relatianship to adjoining premises or public streets or areas, .and giving a detailed description of layout of property must be drawn on the dia~-~m which is part of this application. c. The work ~0vered by this applicat/on may not be COmmenced before issuance of B~ilding Permit. d. Upon approval of this application, the Building Inspector 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 o ~ in part fro' any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspec/~e. APPLICATION IS I-I~Y~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 Ck)unty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, addithyns or alterations, or for removal or demo- lition, as herein described. The applicant agrees to cum ply with all applicable laws, ordinances, building code, housing code, and regulations. .... ..... .............. (Address of a~plicant) State whether applicant is~ o~ner,~essee, agent, architect, engineer, general contractor, electrician, plumber or ........ . ...... ........................................ Name of owner of premises ..... ~ .-..; ......... ...-v .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) hich propased work will be done. Map No./. ..~..~. ~...~. ?~.. Lot No ..... 1. Street anc~ '/~mber ..... #./-e~. ............ ~../.~....~ .................................. , Municipality 2. State existing use and occupancy of premises and inlended use and occupancy of proposed eons/ruction. 0*~- F'~'~,'l /2~.--~/.{z'~. a. E, xisti~g use and occupancy ........................... !/~.. .............. · ~ ................. .... ..... ..... .............. b. 3. Nature of work (check which applicable): New Building ........ Addition ./... Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Oost .... .3..,,-~.d.~).~,. 0~) ........ Fee ............................................ ~ .... (to be paid on filing this application) 5. If ,dwelling, number of dwelling units .......... Number of dwelling unit~ on each floor .............. If ~arage, number of cars ........ ~)./~J..~ ......~__~.~'..~. .......................................... 6. If business, commercial or mixed occupancy, spec ify nature and extent of each type of use .............. 7. Dimensions of existing structures, if any: Frorrt .../~.~. ..... Rear .. ~. ~ ..... Depth . .~i...~ ..... Height ~k~bl Number of' stories ~ e~t .~. Dimensions of same structure with .~lterations.or additions: Front . .....~..f) ..... Rear ...~. ~ ........ Depth .... ~. ~.. .... Height .... ~. (.,) ....... Number of Stories ....at...~.. ~. ........ 8. Dimensions of entire new construction: Front .... '.~. ~,~ .... Rear ..... .~. ~ .... Depth .. ~:L .~... Height . ~. ~.4~. jy Number of Stories ...... ~)..~....(- ............... ~ .....~, ....................... 9. Size of lot: Front.. ~/..~d.. ~ .... Rear.. ~ ~ .c,) ...... Depth . ./..~'"..~.. :.. 10. Date of Purchaze ..... .~.~'~. ,..... ff.~.~.~..... Name Of Former Owner .. 11. Zone or nse district ~n which premise~ are situated ............................ : ~ ................ .. .. · · 12. Does ~rbp0sed eonffcruction violate a0y zoning law, ordinance or regulation? .................... ._.._..-._ 13. Name of ,0wher,of premises .~.~..~.~. 4~./,'.e ~f..F'..~ddress~,~..0 ~.~'t. 4~..4,,.,./,~e N?~A~_~ .~..~?..~ 0 N=e Oon a ..... x.t .... .,ddress ......... h ........... PLOT Locate clearly and distinctly all Imildings, whether e: £isting or p~oposed, and indicate ~11 set-back dimensions from tm>pe~¥' lknes. Give ~eet and block number or de~ ~ertption aeoo~:llng to deed, and show. 8tr~et nmmes and indicate whether interior or cc~'ner lot. , ~ - - F P [ ~ t STATE OF_I~_~ ~1~, )S.S.)S.S. J ............ ~ ~"~ .... , ....-.-. '_' ' i~ame ~"~"' "~' ': ::~&~i of individu~ the~ "'~ being duly swT' deP°Ses and sa~'~ mat he is th~ appn' ~ cant-~e named. He is ................... (Contractor, agent~ (~l~r~e4~eer, etc.) of said owner or owners, and is duly authorized to per~orm or :have per~rmed the ~a'~"wTor~'~d to make and file this application; that all statemer~s aontained in this application axe true to the best of his knowledge and belief; ~nd that the work will be performed in the mann er set fortl-/in the application filed therewith. Sworn to before me this. .......... ./.z. ..... ...... I~LIZ~BETH AI(I~JJJlI~L~e er applicant) J Notary Public, .. ~.~.,~,~1.. , j~ ,.w ,.~ ~O°unty ~OTARY PUBLIC, Stste of New York ~l'~m Expires March 30,