HomeMy WebLinkAbout607-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No....~....~8 .......... Date .............................. A.~gu~t,....7. ......... , 19..59...
THIS CERTIFIES that the building located at~/~...,,~t%~m~,.~,v~ .....................................Stree,t
Map No. ~ ................ Block No ........ ~ ........... Lot No..:x~r~......~.t~t,[.t,~ek.s.....%f,.~.~ .......................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
........................... ~oh......17 ......... , 19..~19..., pursuant to which Building Permit No....Z..607 ...............
dated .............................. Msro~""~""', 19..~.., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy forwhich this certificate is issued is ..............
.................. P. r$~ra.~ e.. one.. ~am&.l.y. · d~vel?~,~ .......................................................................................
This certificate is issued to ....F~,e~L.],..Bi.~'..G ............. ~O~'t~e~.) ............................................................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
HAROLD R, F~£Ev£ & RONB
CONTRAr, TnRs AND BOIL. DE:RS
MATTITUI[:)K, LONG ISLAND
August 5th
1959
Building Inspector's Office
Town of Southold
Southold, N.Y.
Gentlemen:
for the above.
HRRj r: IH
Ens.
Re: R. Nine
Sunset Ave.
Mat~t~tu ck.~ ~.~.
We are returning herewith Building Permit No.6OVZ
Please forward Certificate of Occupancy.
Very truly yours,
HAROLD R. REEVE & SONS
3. Nature of work (check which applicable): Hew 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 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 ....... ~..~...i..:'. ..... Depth ......~....~.....~ .........
Height ....... ,~,./.. ............ Number of Stories ...........~_, ............
9. Size of lot: Front ....... /.~.~?...~ ...... Rear ....~..~..~.~.~.... Depth .../~.~?,~...~.....
10. Date of Purchase .../..~?...'.'~..~.y..--...~..-/~.... .................. Name of Former Owner .~..~' ..~.~,~
11. Zone or use district Jn which premises are situated ......... ~ ................................................................................
12. Does proposed construct on violate any zoning lay/, ordinance or regulation~ ~
13. Name of Owner of premises~D/,~.~.~./.../......~.'.....~.~..~.~dress .~.~.~z~.~. ........ Phone N~..~.'..~.~
Name of Architect.~.~'~'./.' .~... ................................. /...Address ............................................ Phone NO.
Name of Contractor/~',~'.../~/'.J(t?,~.~?..c'¥z'~./.,/~..~ddress .................~ ........................ 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 numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW YORK, ) S S.
~,/ ~./~. ,~:~~~COUNTY· OF ............................ )
(Name of indiviau~l sign'mg~ppl!cotion)
above named. He is the ........... C~f,~t,z'~..~, ..,'~T'..Z~'.~ ..,~.., ................................................................................................
(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 manner set forth !,n, the application, filed therewith.
Sworn to be~re me th s
..... Z.~....T. ........ day qf,, .;...X/J/.,~!-..'~.~...~,-~..~ .......... 19.,...~/. ........ :'~',::'::~¥ (Sigh6ture o~ apl~lican~',~
, /, , .
Notary PubJ c, ....~.;:...[.~./..,4F......t~z:u..~q..<.~.~..~. ........ k.ounTy