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Home My WebLink About546-zF, OR~I 1~0. 4 TOW~ OF SOUTHOLD BUILDING D]~PARTMENT '~'OWI~ CL~-RK'S OFFICE SOUTHOLD. N. Y. CERTIFICAT£ OF OCCUPANCY Z 974 January 18 61 No ....................... Date ............................................................ 19 ....... THIS CERTIFIES that the building located at ~.~...8....0~.d..,,~.~.]'.e...La..*....M,a,.~.~..~.~Sl~reet Map No ........................ Block No ......................... Lot No .................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated Deceml0ete 22 19 58 pursuant to which Building Permit No. I~ ~146 dated December 22 58 .... · ............................................. , 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 ....................... '/'his certificate is issued to ............................................................................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector ;: FO~M NO. 2 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) 546 Z Date December Permission is hereby granted to: Lo B. Reeve A/C Stanley Lewis Mattituck, to move an existing dwelling to this location W/S Old Jui~ Lane at premises located at ............................................................................................................................. Mat tituck ~ N. ~. pursuant to application dated December 22 19 ~'8 , ........................................................................ and approved by the Building Inspector 10.00 Fee $ ........................ Building Inspector FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ 19 ........ ~.~.. _ _/,.~ Approved ........................................ 19 ........ Permit No .......... Disopproved o/c .............................................................................................. Application No. ~ ........... (Building Inspector) APPLICATION FOR BUILDING PERMIT ote ......... ..................... INSTRUCTIONS a. This applicotion must be completely filled in by typewriter or in ink ond submitted in duplicote to the Building Inspector. b. Plot plon showing location of lot ond of buildings on premises, relationship to odjoining premises or public streets or areos, ond giving a detailed description of Ioyout of property must be drown on the diogram which is port of this location. c. The work covered by this opplicotion moy not be commenced before iss~nce of Building Permit. d. Upon opproval of this application, the Buildin~ Inspector will issue ~ Building Permit to the ~ppllcont. Such permit sh~ll be kept on the premises ~v~ilable for inspection throughout the progress of the work. e, No building shall be occupied or used in whole or in p~ for ~ny purpose whatever until a Ce~ific~t~ of Occuponcy sh~ll have been gmnted by the Buildin~ Inspector. APPLICATION IS HEREBY ~DE to the Building Department for the issuance of ~ Buildin~ Permit ~rsuant to the Building Zone Ordinance of the Town of So,hold, Suffolk Count, New York, ond other ~pplic~ble Lows, Ordinances or Regulations, for the construction of buildings, ~dditions or ~lterotions, or for remowl or demoliti~, as herein described. The ~pplicant agrees to comply with ~11 applicable laws, ordinances and regulations. (Signature of applicant, or n~me, i~ a corporation) .......... .......... ............ (Address of a~licont) State whether applicant~~gent, architect, engineer, general contractor, electrician, plumber or builder. .......................... ....... .;._.: ..................... ...... .; ........................................................................... Nome of owner of premises ......... ~~ ....... ~ ........................................................................ If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) 1. Location of land on which propas~,w(zrk^willrbe done. Map Nc~ ........... ~ ....... i .................. Lot No: .......~.. ........... ....... ........ ~zree~ aha ,,4umoer ..... ,~..... ~ ........ ~icipality 2. State existing use and occuPancy of prernise.,s.-and intended use and occupancy of proposed construction: a. Exasting Use and occupancy ............. "'~'C~"'-'~Z;""~:'""~":.(-'~ r~/') , ................................................................. b. Intended use and occupancy ................... ~,~ ...................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Repair .................... Removal ............. : ...... Demolition ................... .~t_~her Work (Describe)/~/~.,~.~./.~, 4. Estimated Cost .............................................................. Fee ..J.~) ................................................................................. ~ (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 ............................ 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 ............ ..~.....? ........ Rear ........... ~....~.. ........ Depth ......~....O. ................ Height ............................ Number of Stories 9. Size of lot: Front ...... f..~ .......... Rear ......... .~.....~.. .......... Depth .....~....O....0. ............. 10. Date of Purchase ..... ~..~......~......(-~. ................................. Nam~ of,, Fo~.~/Owner ...~ .................................................... 11. Zone or use district in which premises are situated ....... ~ ................ : ...... ~ ............................................. 12. Does proposed construction violoAer~.~ /~any ~w, ordinance or regulation? ........... .~...~.. ..................... ' ....... 13. N®e of Owcne fro premises..~.....~ ..................... ~ Address ............................................Phone NO ..................... Name of Architect ................ .~. ........... .~... ....................... Address ............................................ Phone NO ..................... Name af Contractor .................................................... Address .................... ~ ....................... 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 nkL~mbers or description according to deed, and show street names and indicate whether interior or corner lot. ""7"~-~~(..~ ~0o STATE OF NE~AYQP, K_~~_ ) S S COUNTY OF ~._) ' ............................ .~.../....~......~....:......~....~...being duly sworn, deposes and says that he is the applicant (Name of individual'signing application) above named. He is the ......................... ~~ ............................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 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 manr~r set~/[orth in the applicationjiled therewith. ,','o Sworn to before me this ;e,~/:.-,~', ........................ ~;]y aT ....... u...~..T. ..................... ,. ly..~.,~.~;,~;:.z<,~ ~ w ¥o,-~ ~31gnaTure ot/appncanb