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Home My WebLink About3427-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P. EF~TIFII~.ATEZ OF E)P.I-:.UPANP. Y THIS CERTIFIES that the building located at ~.l~. 0~1~ .~1~ .~1~ ......... Street Map No..~1~ ..... Block No... ~ ...... Lot No. 1~11~. · ]~;t~J~lck~. I~,~', ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~:1~]~ .. 7., 1967. pursuant to which Building Permit No. ~1~. ~ dated .......... ~"2~ · · lO ·., 19 ~'7., was issued, and conforms to all of the require- men~s of the applicable provisions of the law. The occupancy for which this certificate is issued is .~.~;e. O~e. ~'~li~,]~..tl~¢~?~.~r~ ....................................... The certificate is issued to . :,~:~ ~ ~.~ ~. ,~..~?~:J,~!~L~, .I~t:e~,'r.e.~t ..... ~l~le~l~ ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval., ~..,e..1.~..~[?...~y..Ti, .~'~L~la. ·. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. J BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK AUTHORIZED) Permission is hereby granted to: .......... ~_~ ..... ~.,.~.~.../..~.~ ~'~;~'~';~'~"~;'~. ....... ~~~'"~~ ....... i ..................... TITLE NO. S-57497 IVIAURICE K~NG STANLEy LEI,~iS NOTE; "~ MONUMENT SURVEY FOR WILl_IA M HENRY I_IEBEKNECH T PHYLL. I$ ANDERSON LIEBEKIVECHT fVIA TTITUCK TOWIV OF :~OUTPIOLD SUFFOLK COUNTY, N.Y'. GUARANTEED TO: HOME TITLE DIVISION CHICAGO TITL_ INSURANCE COMPAPIY, WILL lAM H,~ PHYLLIS A. LI EBEKNECH SCALE: I'= 4*0' FEB. I0, t967 LAND SURVEYOR N Y.S. LIC. NO. ',',',3l~725 RIVERHEAD~ Pi. Y. S-9 SUFFOLK COUNTY DEPARTMENT OF ~.ALTH Date June 19, 1967. ~ag. ~e,,,~ ~o. ,~.~,? z... TO WHOMITMAY CO~E~N: The sewage disposal facilities for a structure located at W/S Qle Jule Lane., .6~.76'.S/0 property of Maurice King, Mattituck,N.~ ...... (Give deed locabi°n) - have been inspected by this Department and found to be satisfactory. bis'tric~ E~gineer ........ FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved %k 19.~.: .... Permit No. ~ L~ ~..-( 7 , APPLICATION FOR BUILDING PERMIT Date .... April ...........7. .......................... , 19 6.?_ INSTRUCTIONS a. This application must be completely filled in by typewriter or m ink and submitted in duplicate to the Buildi~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to odloining premises or public streets. areas, and g~ving a data,led description of layout of property must be drawn on the diagram which is port of this opphcatio c. The work covered by this apphcot~on may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will ~ssue o Building Permit to the apphcont Such pern- 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 or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bu,ldmg Department for the ~ssuonce of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances , Regulahons, for the construchon of buildings, additions or alterations, or for removal or demolition, as herren describe, The apphcant agrees to comply with oil apphcable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) 249 Montauk Highway, W.Sayville, N.Y. .......................... ........... ...... State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde William Henz~r Liebeknecht & Name of owner of pram,sas ..P.h~3.1i~...~r. ao~..Li~.b~.krkegt%.~. ........... If..~....~.~,.phcant is.a corporate, signature, of duly authorized officer. ..... ............................... (Name and title of corporate officer) 1 Locot,on of land on which proposed work will be done Map No ............................ Lot No.' .................... Street and Number ...W/.S..0i~. ~"~ T°~e 6~¢-V6' S/O property of Maurice King. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a Existing use and occupancy .... ~[Q~ .................................................................................................... b. Intended use and occupancy ~QQ$~$~.t..r...q.c.~'~:~.h..~..m..~.~.-.~.~..~...e..r.~.~.~.c~g..u.~.~.~.~ .............................................. 3. Nature of work (check which applicable)' New Building ....... ~ ........ Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) 5 If dwelling, number of dwelhng units ..... .Q.:p....e. ............... Number of dwelhng un,ts on each floor .......................... If garage, number of cars ...... .0..~..e. ............................................................................................................................. 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............................ 7. D~mens~ons of existmg structures, if any' Front ............................ Rear ................................ Depth .................... Height ....................... Number of Stones ....................................................................................................... D,mens~ons of some structure with olterat,ons or add,tions' Front ....................................Rear .......................... Depth ................................ Height ................. Number of Stones ........................... 8. Dimensions of ent,re new construction. Front ...~.!.../,I,~. .................. Rear .J,l,J~.t....~l..?. ........... Depth .~t.O.!.../~.!t. ......... Height ....23..t. ......... Number of Stories ..... ~1'O ..... : ....................................... ' ............................. ,' ...... ; .......... 9. Size of lot: Front ...J~.0..~. .................. Rear ..90.! ..................... Depth Ng~IJ;h..;J~),]Jj!.- South 201,95 10. Date of Purchase ................................................ Name of Former Owner .L~.r~z.~....~... ........ .~.~.~.(~....~...~.?....~.... 11. Zone or use distr,ct in wh,ch premises are situated .................................................................................................. 12. Does proposed construction v.i,o. IQt,e.any zoning law, ordnance or regulahon;) ..NO ............................................... wz±±~.am Henr~ 13 Nome of Owner of prem,ses Lithe -~zec~f, ............ Address ............................................ Phone No .................. Name of Architect ................................................ Address .......................................... Phone No ................... Nome of Contractor ~ka~'...A.~.~..g.¢*.~...I.~.¢.,... Address2~..4~.....~..O.q..t..a..'g...~....~....1~/' ......... Phone No West Sayville, N.Y. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and mdicate all set-back dimensions fron property hnes. Give street and block number or description according to deed, and show street names and red,cat, whether interior or corner lot. STATE OF NEW YORK,,; / c c COUNTY OF ~-'.~. ............... ,~ .... ,, //,~,~. ....o, ,,.. . ., ., ., ., .. ......... being duly sworn, deposes and says that he is the appJicar (Name of indiwduQ~ls~gning,apphcat,on) ..~ above named. He is the ....~...~.A?,~...~..~....~..'~ .~ ................................................................................................. ~ {/ (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and this application; that all statements contained ~n th~s application are true to the best of his knowledge and behef; an that the work will be performed in the manner set forth in the a~ation filed therewith Sworn to before me this . c~' .,..~ x ' I ~ / Nora, PuN,c, ~~-~o:/¥.~~ (Signature of