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Home My WebLink About5452-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . !~h. ~. ~ .[~..aeC. DR. Street Map No. 8~1~et. ~t9~]18ck No...~[ ...... Lot No..~.6 .... .Nat..ti~'ll.e.k...N~Y~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............&~.t. 1.,0 19.~.. pursuant to which Building Permit No...~,~.~... dated ........ A...1~...t....17.., 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.!Va.t.e...~, e..f.a..~...~...d.v.e.1..1.~, g ....................................... The certificate is issued to Alex..H1. ~S..S. ka ...... . .~..e.z'. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...~.a~...1.1...1.~.72. b.~ ..1t:. ?.!!!.a. ...... UNDERWRITERS CERTIFICATE No. 1[ 111~2 HOUSE NUMBER...2(~ ...... Street... B.~th. lt~aad ................................... 100 8~nset DF ...... ...... 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) 5452 z Permission is hereby gronted to: ......... .Is3~....lU,d~l~..Cmmt,~..l~a~ ............ to ..,ii~iL4..a~ms ..e~e...£~d,3,1r..4~ ~ta~ ................................................................................. at premises located at ........... ,~II.~...~.....~,I~B~I.~.~..]/~IM~j~IL....I~.tR,~..,~' ........................................... .................................................. ii~l~..tte~ .............. Itat, t £t~l~ .................................................... pursuon( to opplicotion dated ............................ ~ ....... -~0 ........... , 19...~.~, and approved by the Building Inspector. Fee $.."J .Q '~J~ ........... .............. , ........... ~..:.::~ ............................................ :~- .~,~, Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date JAN 1 1 1972 Bldg. Permit No. ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure (Give deed loc~'~ion) located have been inspected by this department and found to be satisfactory. Chief of General Ym. gineerlm~ Servlcee THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY {-- ad 85 JOHN STREET, NEW YORk, NEW YORk 10038 Alex H!uszka ~ Sunset Dr. Ruth Rd. Stanley Rd Mattituck, L.I. outs~ e 2 ~,.. ~.,,,i.oa,,~ March 2 7, 19 7 2 andfoun,I to I ...... c,.~,.nce with the req,,irements of this Board. OUtLE~S e~C~*C~S 5W~XCnES I ~IX~RB RAN6~S COOK~N~0~CKS OWN5 1~15~ WASHERSI EX~A~SV FANS SERVICE DISCONNECT E R NO, OF CC, COND ! A, W. G, NO. OF HI tEG *Furnaces: 1-1/Shp., 2-1/12bp., George Zimllnghaus 14 Park Place GmtDA/~NAODD ''~ a. This application must be completely filled in by typewriterr or in ink und submitted in duplicate to the Building Impactor. b. Plot plan sh~wing location, of lot and of buildings on premises, relationship to adjoining premlee~ or public etmets c~ araa~, and giving a detailed descr,ptlon of layout of property must be drawn on the diagram which le part of ~hle al~plleation. 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 purpaee Whatever until a Certlflcato of Occupor~/ shall have been granted by the Bulldog Inspector. A,P, PLICATION IS HEREBy MADE to the Building Department for the Issuance of a Building Permit pumuont to the B?ild!ng Zone Ordinance of the Town of Southold, Suffolk' County, New York, cnd other applicable I. awl, Ordinances .~l~eEIot~, ~ the construction of buildings, a~. itlo.ns or alterations, or for removal or demolition, as herein described. al~ltc~'~t agreel )o,com~l~ with all ml~llcable' law~,' ordinances, building code, housing cede, and regulations. ..... {Signature ct oppllcont, ar name, If o corpora)Ion) ........ ...... ................. ............ ......................... (Address~of Ol~llCo~lt) State whether al~llcant is owner, lace, agent, omhitect, engineer, genaml contra~t~, ' electrlcibn, plurals' or builder. ,.c..a~..~.~,~.,...n...: ............ ...... ....................... ,,,,,,,,.,,,,",,.,.',,, ........ ,,,,,..,,.,.,..,..., ..... ..... rem,, .~.~.~.....,/~..~.U..~...~:~.~........, ................. . ........... ,.,..,.,,.~. Nome of owner of p . . .~ ,., ,,, ........ ,, ........... ,..,~ ~, ~?~.t~o~ra~, ,ig.at.ra of du~, o.tho,,.ed o.~:.,. ..L.,~...:..~ .......... .~.....~.....'. .................. (Name and title 'of corporate officer) ~ U I. Location of land on which proposed work will be done. AAap No.: ,,,,~,,~,.~ ....... street ond Numb., ........ .~,U..Z'.~......~.~.....~ .............. ~..~..~.Z/Z..~...~.¢. ......................... ~ ...... ~ .................... 2. State existing use and occupancy of premises and Intended use and ~ccupancy of prapaeed e~mtru~tlan: · ., ~.~.....~. ~,~u ~. a, Existing use and eccupancy ,,., ,~. ............................ ~.,,... .......... ,..,,,,,.,~,,.~.., ......... ~... .......................... b, Intended use and ocCupan~ 3. Nature of wo~k {check which applicable): New Building ~ ...... Addition ................... A. Iterotion ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................. 4. Esti.m. ated Cost .....~.~. ........... ~ ............................... r....ree ................ ./....~......~.~ ...................................................... (to be paid on fi~ing 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 occu~x~ncy, 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 ....... ~.~.....; ....... , ........ Rea~ ...~... ................. Depth ...'~....~'......~ ....... Height .....].~. ......... Number of Stories .............:./. ................................................... ,......* ....................... ~ ............... $ ze ot: ront ...... ........... eor ......Depth Date of Purchase .............--'~,/.~.~.~.. ............................ Name of Former Owner ....................................................... Zone or use district in which premises are situated ..................................................................................................... Does proposed construct;on violate any zoning law, ordinance or regula'tion? ...... .~ .................... ~...~,~ ....... ' ................. Name of Owner of premisesA'.:~.L/~/.--e~.~.~.,.~.?a~......Address .~..~..%~...~l'.....~..~.~..~.'..~.~.T.~...~...~'hone~ ~'o.~..~.....~.I./...~... Name Of Architect ................................. ................... Address ......... .....; .............................. Phone No ......._ ............ Name of Controctor~"'../.l~)..~t.0e.J.q~..~......./~/.~...'.?/..."?,,~.....Address7 ....;.'.'.:.~.~?~.~'...t:~' ....... Phone No~,~..~./..7.."L. PLOT DIAGRAM ' 10. il. 12. Locot.e' clearly and di~tinatly oll buildings, whether existing or proposed, and indicate all Mt-back dimensions from p.ra~..rty, hoes. Give street and block number or description according to deed, and-~aw street nam"e and indicbte whetrmr d~teri~r Dr comer Jot, ...... ' : ' . - % STATE OF NEW )~ORK,~. e./)' I SS. ' above nomed. He is the ......................... i!! .............................................................. 2.....~..:...../~..,~i~.~......./..! ........................ (Controctor, ngent, corporate officer, etc.) of said owner or owners, and Is duly authorized to per~orm or have performed 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 performed in the manner .et forth in the application filed therewith.