The URL can be used to link to this page

Home My WebLink About4251-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~ Town Clerk's Ot[ice $outhold, N. Y. Certificate Of Occupancy No .... Z. 3.530.. Date ...... July ...... Il., ........ ,1969. THIS CERTIFIES that the building located at II/~. llortl~ l~oad · ((~27) · ~ Street Map No ............. Block No ........... Lot No. Gzeeaport,.. 31me..York ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated .... April.... 1.7., .... , 19.69. pursuant to which Building Permit No, 4251. Z. dated .... AprLl.... 1.7., ..... , 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 ... p~tvat, e .one..£~d~.y. ~111n9 .................................... The certificate is issued to . Frank .Rink .& .Ano ...................... ' ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... House # 56525 l~or~h Road FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? Z Permission is hereby granted to: to ........... k:t,l,(t..~z~..m~,d~,tez~.~'.~..a~.~e~t~s..~..~..~t~ ..... at premises I~ated at ...................... ~..~..~ .................................................................... ....................................... ~~ ......... 'N'~'~ ................................................................................ pursu~ to application dated ................................ At~~ ...... ..~...., 19.~., and approv~ by the Building Ins~ctor. Fee $....~..e ~)~ .......... TOWN OF $OUTHOLD BUILDING DE~PARTMF..NT TOV~N Cv-~-~:tK'S OFFICE SOu-A-rlOLD, N. Y. Appeared .................... ,19 .... Permit No ................ :... Disapproved a/c ..~... ................. , ..... INSTRuCTIoNs a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. P~ot plan showing location of lot and of buildings o n premises, relatim~ship to adjoining promises er public streets ,or areas, and giving a detailed description of lay out of property must be drawn on the diagram which is part of this application. c. The work covered by this applicat[qn may n~t be commenced before issuance of Building Permit. d. Upon apProval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shah be kept .on the premises available for inspectign throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS I-1~2~.~7~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sc~atho ld, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for romoval or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, ~ regulations. ~. '~ Richter Rome Improvement Co (Signatare of applicant, o~ name if a corporation) ....... Greemper.t ................................. v--/~r'~ ~c~,_~ ~ (Address of applicant) State whether applicant is owner, lessee, agent, archite~ct, engineer, general contractor, electrician, plumber or builder ................... Cont ~e ~or ................................................................... Name of ~)wner of premises .... F~e~k .R~ ~k..&. A~Io ..................................................... 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..:~J[ .......... Street and Number ~..~. y )' .~. ~/.~ .1~.~$11 .I~.~..(.C.~7.)..~r.~e~uor.t. .......................... ........... Municipality 2. State existing use and occupancy of premises an d in'~ended use and occupancy of proposed construction. a. Existing use and occupancy ... ~e~L[:~ ...................................................... b. Intended use .and occupancy ........ ~$1~e. ~rll,'~h. ~t4~lJ.t:Lclll .................................... 3. Nature of work (check which applicable): New Building ........ Addition .11:~ .... Alteration ~ .... Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... Estimated Cost . .~D00,.~._ .................... Fee ... ~,0.0. ....................................... 4. (to be paid on filing this application) 5. If dwelling, number of dwelling units . .0l~ .... Number of dwelling units on each floor .............. If I~arage, nUmber of cars .... 011,e. .................................................................. 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 alterations or .additions: Front .............. Rear ............... Depth ................ Height ................ Number of Stories ..................... 8. Dimensions of entire new construction: Front ...20 ............ Rear ... 20 ........ Depth ... 2~ ...... Height ............ Number of Stories .. o11~ ....................................................... 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 .... ~.A.~. .dt.~t ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .... I10 .................... 13. Name of owner,of l~remises . l~.~.]iX ~i~, .&. AIIo....~ddress . .(~].end~le..Quaena Phone No ............ Name of Architect ............................. Address ...................... Phone No ............ Name of Contractor . .R..i.c.h..t..e.r...H.o..~l.e...I.~..v.t.. Address .... .G.I'..e.e.l~. p.o. lNt ...... Phone No ............ 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 de scription according to deed, and show street names and indicate whether interior or corner lot. STATE OF ~ YORK, )S.S. COUNTY OF . lk..) .................. ~l'~lll'. ]~$chtel~ ............... being duly sworn, deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the ........ .Colltr&eto~ ...................................................... (Oontractor, agent, oo~-~orate officer, etc.) of said owner or owners, and'is duly authorized to perform or have per~rrned the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perforated in the manner set fort~ in the application filed therewith. Sworn to before me this ........... 1.7... day of .......... ~[0~ll.. 19.69 Notary Public, ..... ' ... Count~ %q~TARY pUBLIC, State of NeW Ho. 52.8125850, Suffolk 'Term Expires ~Tarch