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Home My WebLink About4264-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk% Office Southold, N. Y. Certificate O{ Occupancy No..~. 360~ ..... Date .......... .00ti .....1.~. ......, 19.69. THIS CERTIFIES that the building located at .... 0spicy. & .Shelf} .Iiar.bl~' Street Map No..~.!9.a.v.e.~.. P.~Block No....I.~ ..... Lot N53 ........ II~een.port ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Apl~.. 28.., 1969. pursuant to which Building Permit No..k26UZ.. dated ......... Ap.I'll...2.8...., 19 .~.9.., 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. ri.vate. ~ccessoz'¥. D. ldg ........................................... The certificate is issued to .. tterbe/'.t .Zi~g. le~ ....... (~rller. ...................... (owner, lessee or tenant) of the a£ores~id building. Suffolk County Department of Health Approval ...... 1~1.,I~, ....... ' .................. ~0~: Approved by Bd Appeal~ t ~ ...... ~. ~.t.,, &~./. ~ .~;~.~ ............. Building InspectOr , FORM 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? Z Permission is hereby granted to: ~rb~rt at premises located at ................ ~O.~....~t ....... .~,.~-Y...,~...A.~;~.~. ............................................... ........... ~..~......-.....9./. ~... m~r,...~:t,~ ~...~o ~.. ~.. ns ~ e~e~ ,t. ~ ...... .e~. pursuant to application dated ............................... ~'.;.~' ....... ~....., 19...~c~, and approved by the Building Inspector. Fee $.~..e..~ .............. (Building Inspector ) Date ................ Ap~i~L... 28 .... 19.69 INSTRU~.:riONS 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 o n premises, relatic~.ship to adjoining premises or 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 application may not b e commenced before issuance of Building Permit. d. Upon approval of this application, the Building In specter 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. Bio building shall be occupied or used in whole ou in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS ti~_~.PlR¥ MADE to the Buirding Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or derao- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, building code, housing code, and regulations. Mr. Herbert Zi.egler (Signature of applicant, or name if a corporation) ....... .(~raenpor~; ................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or~ ~. builder .................... . .(~.e. ~'..-.. b.tl~].~er. ........................................................... ~ Name of ~wner of premises Herbe~ Zleglel~ ~ if applicant is a corporate, signature of duly auth~ize d officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Ma~ No....C.~.e..a.~.e..s...l~., Lot No... ~ ........ Number ]~4~..4.~...~ ~.ntl{~. Ha Jr bo m-. Ro~_ d Street and ........ .................. .. 2. State existing use and occupancy of premises an d intended use and occupancy of propped construction. a. Existing use and occupancy ............................................................ b. Intended use und ~ccupancy ..... .s.a.m..e..Wl.t~. ~u .ao. cemsor~, b~ilding ...................... 3. Nature of work (check which applicable): New BUilding .. ;X3~I~. Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost ...17.~..+. ...................... Fee ... ~.,0~. ........................................ (to be paid ~n 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, spec ify 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 .ar additions: Front .............. Rear .............. Depth ................ Height ................ Number of Stories ..................... 8. Dimensions ,of entire new construction: F~mt .... 9.. Rear ...... 9 ....... Depth ...{5 ....... Height ............ Number of Stories ..... O1~1 .................................................... 9. Size of lot: Front ................ Rear ' ' Depth ............... 10. Date of Purchase ............................... Name of Former Owner ............................. 11. Zone ar use district in which premises are situated...~.~..~..d..~.~.~. ....................................... 12. Does proposed construction violate any z~ning law, ordinance or regulation? ........ ~10 ................ 13. Name of ,Owner,of premises .. ]/erher.~ .~le£~,~dres~ ... ~e~lpP~$ ....... Phone No ............ Name~ of Architect ............................. ~ddress ...................... Phone No ............ Name of Contractor ... 1~110 .................... Address ...................... Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether e xisting pr proposed, and indicate all set-back dimensions from property line~ Give s~eet and block number or de scriptiofl acoording to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, )S.S. COUNTY OF .. ~.~(;:1~!;.. ) ......... being duly sworn, deposes and says that he is the appli- (Name of individu, al signing application) cant .above named. He is the ....... (hr,.el'.-..B~1.1d~r. ................................................... (Oontractor, agent, (xrporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfc)rmed 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 w~rk will be performed in the manner set forfl/in the application filed therewith. Sworn to before me this ("/ No. 52-8125853, Suffolk Co,J~lt,~ Term Expires March 3~, 19~,2