The URL can be used to link to this page

Home My WebLink About5477-zFOI~i~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy '" 2 ..... ' J~Y..2~. ., 19Y,~. No..,~..89. Date .................... THIS CERTIFIES that the building located at . ~.9~..B.r.o. 9'..:.~..R..o.a.d ........ Street -Map No.. I~l.l.0-. 3.~_~ .l~Block No ........... Lot No...1.1!.~ ............................ con~rms substantially to the Application for Building Permit heretofore filed in this office dated ...~.~gu. $.t..~.~ ......... , 19.?.~. pursuant to which Building Permit No...~. ?~.Z.. dated ~ugalst 21+ 19. ?$ , 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.r.~,¥a.t.e.. ~n.e..F..a~Ai..],y...D~.el~.:tag .................................... The certificate is issued to Henry PAntze (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... .N., .R: .......................... UNDERWRITERS CERTIFICATE No ............... .P.e.n.d..l.ng ...................... HOUSE NUMBER ... ~.9.~ ........ Street ..... B..X'.o.o.k.s...R.O..a~. ........................ FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5477 Z Permission is hereby granted to: .......... ]4.lm.~ ...... Il,Z, ................................. to .... ~..~..~.s.~....~..~...~.t...s.~.....m.....~....t..~..~.~ .......... pursuar~ to application dated ............................. ~ ....... .1.1J ........... , 19.~.~'.., and approved by the Building Inspector. Fee $.. ~.e.~. ............ THE NEW yORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICI"~"Y '~':~ · ~-- [~b 85 JOHN STREET, NEW YORK, NEW ~0RK10038 Ditto Application ~o. on ~le N 11 9321 ~y t~ ~t~ ~t ~ ~ ~ a~ ~t~ ~ t~ ~t ~ on t~ a~ ~pl~tion ~um~r ~ t~ pmm~s of in the follo~vlng location; [] Basement [] /st Fl. ~-e..=i~o. October 4, 1973 [] ~.d ~. Outside Section Block Lot and found to be in co~npliance with the requirements of this Board. RANGES ~)VENS DISH WASHERS EXHAUST FANS FIXTURE RXTURES OUTLETS SWITCHES FLUORESCENT DRYERS KEEPERS E R V I C OTHER AFPARATUS: H.I{lntze 595 Brooks Rd. Southold, L.I.11971 m M~NA~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. l~R~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~ ~' "~ 19.2!. Approved ,k ~ c, ,~t-I--j ~J ~ ....................................... , 1~ ........ P~mit No ..................................... Disapproved ~/c .............................................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Applicotion No...~.~.....~..~.. ............. 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 on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty 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 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 or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, artcl other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordi nances, building code, housing code, and regulations. k ............ ....................................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ~l~J~'..~J.~J;~.~. ................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done~Map No.: _...Z~?.~I~. ................ Lot No.....]:..~ ............... Street and Number .~.~.~...~.o..~..e....~..o...~.. .................. ~ .................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ................. .~.9.~li~f~lM;..~e4m~l. el~ ......................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ,..,,X. ............ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....~..2.s~ ............................................. Fee ...~*00 ............................................................................. (to be paid on 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, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...~. ....................... Rear ...... ..2~.. ..................... Depth .....~.~.~. ......... Height 24~ Number of Stories 2 .... Dimensions of same structure with alterations or additions: Front ...... .3.~.....~ ................... Rear . Depth 42~ 9" Height ...~,.2. ..................... Number of Stories ..... .1. ......................... 8. Dimensions of entire new construction: Front ...... ~.~.!....6..". ......... ~.~ ....... Rear .......~..t. .................. Depth .....4..2.?.~. .......... Height ....;,~.2..~. ....... Number of Stories 3. . 9. Size of lot: Front .... ,~C)t Rear ........ 5.0.! ...................... Depth ...~.~}aT.,~ ................. ' ' 10. Date of Purchase ...... ,~,,q=.(~0 ................................. i..Name of Former Owner ~.t~g~,e~..~,.~/~,;i,~:g~;~., ........... 11. Zone or use district in Which premises are situated .....~. fl:j~.e~f~. .................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation.;> ' . 13. Name of Owner of premises~.~:....3..~....~..'..~.~. ........... ^ddress-~.O....]~.°...~..c-.~-....~..e.....e..d~.......'~.[.e.t... Phone No.5~.-..5...~.5.~ ...... Lynbrook, N.Y. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior ar corner lot. 7y~ STATE OF NEW.~.ORK, ~ c¢ (Nome of i~i-vic~l signing oppl~'oo~ion) . above named. He is the ..................................................... ..<'~r2...?. ......................... {Contractor, a~l~t, corporate officer, etc.) of sold owner or owners, and is duly authorized to perform or h~ve performed the sold work and to moke end file this application; that all statements contained in this apPlication are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application, filed therewith. ~ IVdBLIC, State of New York No. 30-1173900 I~llfled In I~meu O0u _n~/