HomeMy WebLinkAbout1168-zTOWN OF ~OUTHOLD
BUILDING D.EPARTMENT
'I'OWN CL~.RK'S OFFICE
SOUTHOLD, N. Y.
C~-RTIFICATE OF OCCUPANCY
TH~S CERTIFIES that the building located at S/S Main Road, Mattitu
............................ : .......................... Street
Map No .......... ,~*., ...... Block No ..........*.*~ ....... Lot No ....... ~.~ .....................................................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ....i .......... .A.~.~.:~..~.....]'...0. ............ 19..6...0... pursuant to which Building Permit No. ...................
dated ................ ~t~.ejg~,~....1..0. .......... 19.....6.,0, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
~ssued is ~IUAT~ O~ ~AM~I~¥
This certificate is issued to JOSeg)h ~'~i~O~ owne~'
(owner, lessee or tenant)
of the aforesaid building.
FOI~M NO. 2
TOWH OF SOUTHOLD
BUILDII'4G O[PARTMF~qT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 1168 z
Dote .................................. A~g.~,S'~....Z..o.. 19..~..O...
Permission is hereby granted to:
...Ma ~t ~.t uck ~...New...¥o~:k ...............................
to ..... ~uild.. attached..qarag~..on ..pziv. ate ..one...famillr. dwal Xir~g .........................
at premises located at ....s./~.~..M..~..i...n.....R..~."~..d..~....M...a...t..t..i...t.~....c~..*....N....e3~......Y.9.~ ........................................
pursuant to application dated ................................. ~l,~..l~O ........ 19..~0., and approved by the
Building Inspector
Fee $....~..00...]9&~ cash
Building Inspector
FORi~ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ............. ~~x~/..~. 19.~..~..
Approved..~ ......... ~4',~.....~..~.. ' 9 .....~...~e r mit No ..... .'..~...../.'./...~......~......
Disapproved a/c ........... ~ .............. ~~____.____..~_ ~
, .......
(Building Inspector)
AppJJcation No.....~...~.(~ ..~... .......
APPLICATION FOR BUILDING PERMIT
Date. August 10 ,,,
60
INSTI~UCTIONS
a. This application must. be cor0p[etely filled in bv typewriter or in ink.and su~omitted in dup{ico~e 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 of property must be drawn on the diagram which is part of this location.
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 Certifica/~e of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuanoe of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinanc, es and regulations.
(Signature of applicant, or name, if a corporation)
Mattituck. blew York
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Contractor
· Joseph Pumillo
Nome of owner of premises .....................................................................................................................................................
If applicant is o corporate, signature of duly authorized officer.
(Name and title of corporate officer)
t. Location of land on which proposed work will be done. Mop No: ~'* Lot No:
S/S Main l{oa~, Mattituck, igew Yor]~
Street and Number .......................................................................................................................................................
Municipality
': 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction:
/ use and occupancy Private one family dwelling a. Existing .....................................................................................................................................
,,.. . . . w/ garage
b. Intended use and occupancy ................................................................................................................................
3. Nature of work (check which applicable): New Building .................... Addition ...... ~ ......... Alteration ....................
Repair ....................Removal .................... Demolition ....................Other Work (Describe) ....................
4." Eslim~ted Cost ...... ~ ~ .5. ~. .0. .t . .0. .0. ..................................... Fee ~ .5. . :. .0. . .0. ..............................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............. ~ ................ Number of dwelling units on each f oar ........... ~ ..............
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 ............3...0.?.. .........
Height ............................Number of Stories ...~. .........................................................................................................
Dimensions of same structure with alterations or additions: Front ...... ,~2..~ .................... Rear
Depth ........ .2...~..~../.~,.0.~ ...... Height ....... : ...................... Number of Stories ............ .~. ..................
8, Dimensions of entire new construction: Front ......... ~.O ............... Rear ...~Q.,~ .................. Depth ...... .2].~, .................
Height ............................ Number of Stories ....... !. ...................
9. Size of lot: Front ............................ Rear ............................Depth ............................
10, Date of Purchase ........................................................Name of Former Owner ........................................................
11. Zene or use district in which premises ore situated ...... ~]~.~.R.?.~'~.&~?...~..~...~.`~..~.~..~..~..~..A.g...~.~J..~?..~.~..~..~..~.~.~ ............
~To
12. Does proposed construction violate any zoning Jaw, ordinance or regulation? ....................................................
13. Name of Owner of premises.~.¢~..e.J?~-...~.l-~tR~...~P......Address ][4~;i,~x.,~Cl,~...J4-,~,.~,~.~l&.g~hone NO .....................
Name of Architect ........................................................ Address ............................................ Phone NO .....................
l'r~-In TutbJll ..................................... Phone NO.
Name of Contractor .................................................... Address ~attr,&tuo~ ~, ¥o
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.
this application; that all statements contained in this application are trj4ie to the best of his knowledge
and that the work will be performed in the manner set forth in the apl/fill:arian ,filed therC~t'h.
Sworn to before me this ~ ml)lr~ r ,~ ~,/~ r~
STATE OF NE~,V ¥¢P~, ) S S.
COUNTY OF ~.z..z..9.z.& ........... )
................................................................................................ being, duly sworn, deposes and says that he is the applicant
(Name of individual signing application) /~
. . . Contractor ~
above named, me is the ......................................................... ~t' .................................................................................................
(Contractor, agent, corlborate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
and belief;