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Home My WebLink About2082-zFOEM NO. ~[~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES thor the building located at J~/~..~.a~..~,.~ ........................................ Street Map No....~r~: ............Block No .....~ ........ Lot No. ~ ........... ]:~.~J~t],l.Q~t...]~,.,~., ............. conforms substantially to the Application for Building Permit heretofore filed in. this office dated ........................................ {J~AI~,~.,..?/ ......... , 19.J~.. pursuant to which Building Permit No..Z2~J82.. dated ................................. ~Tl,~e......~. ....... 19..~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificot~ is issued is ........ .... i~'J, .v.a .t.e.. o~u.e...~mm, t~L¥...~.wel~ing ............................................................................................. The certificate is issued to ..~.,...C~.,...~OJ~-]~ ............................. J)~12,el~ ...................... : .......................... (owner, lessee or tenant of the aforesaid building. H.D.Approval Merch 2~ 196~ by R. Villa Building Insp~ctor .,..~ FOEB~ 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) N.° ~o82 Z Date ............................ ~..~..:e......2. ............. ~9.6.3... Permission is hereby granted to: ~olc~m~thh..Bldg..&..(~ons.'~....A/~:....~..a.~o~ ........ ....... S~t~ol~ ...................................................... to ....Bulld...n~w...on~..:~.~mil.~..:~we!lin~ .................................................................................. at premises located at ...~/~.....~.~.~.~..Ar, l.e .......................................................................................... ...................................................... ~.~ .~ue~....z~.~ ..................................................................... pursuant to application dated ................................ ~.~l~e ....... .~. ............ 19~,~..., and approved by the BuiJding Inspector Fee $..:kO.,..O.O .......... Building Inspector $-9 SCHD SUFFOLK COUNTY O~Pi ~T~ ~ENT OF HEALTH Date ~A[~ ~ 1~ Building Permit No. 23 822 TO ~OM IT MAY CONCERN: The sewage disposal facilities for a structure located at South Side Park Avenue~ Mattituck (Kopf) (Give deed loca%ion) have been inspected by this Bepart~,eut and found to be satisfactory. ----- District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ........................ ~'~ '..~ .............. , 19...:.'...Permit No...~...../.~....g..~....,~. Application No .................... Disapproved a/c .................................................... ~ ............ ~ .............. (Building InspecJor) APPLICATION FOR BUILDING PERMIT Dote .........~..~/./.~f ~:..~ ....... ~ ................19.~..~.. INSTRUCTIONS 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 of property must be drawn on the diagram which is port of this applica- tion. c. The work covered by this application nq~y not be commenced before issuance of Building Permit. d. Upon o.pproval 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 pa rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA;DE to the Building Department for the issuance 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, alterations, or for removal or demo ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (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. ...... · ~..~.~),~t./.~,~ .6'.7~;~ ................................................................................................................................................ Name of owner of premises ........ ~'..,..C.,...~':o.~9~, .......................................................................................................... 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.: ........................................ Lot No.: ...................... st~t ~,d N,mbe~ ...~:~ ....... i~W.~'~'.....~ ......... ~.~~C~...~.,~?.~' ............................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ..... ~ ............................................................................................................ b. Intended use and occupancy ~.~:~ ~ .................. 3. Natu.re of work (check which applicable): New Building ....... ~.... Addition .................. Alteration .............. Repair ..............Removal Demo t on ......... Other Work (Describe) ........... 4. Est rdated Cost ~'....~.?.j ~ Fee (to be paid on filing this application) 5, If dwelling, number of dwelling units ..............~.. ............... Number of dweNing units on each floor ...... ,~... ........... If garage, number of cars ................ ~......~.'..~...~. ............. :2.2'.'.~..2Z/.'.(.~.//.~..~.. .......................................................... 6, If bu~siness, 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 .......................................................................................................... D~m~.ns~ons of same structure with alterations or additions: Front ................................ Rear .......................... Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ..~..'~..~.i ............... Rear ....... ~....,?. ................. Depth ....?..?......~. .......... Height ........'~../.. ................. Number of Stories .......... ./, .................. 9, Size pf lot: Front ........ ?....~..O. .............. Rear ............ ..//./...O. ............. Depth ........ ..~..~ ............. t0. Datei of Purchase .?.~..lf,.:(.V'.~.~. ................................... Namo of Former Owner ......t~..:./x~/~:~.,~n~. ..................... 11. Toni, or use district in which premises are situated ................................................................................................. 12. Doesi proposed construction violate any zoning low, ordinance or regulation? .. ~...~'..O.....~.. ......................................... ?3. Nam'e of Owner of premises ....~..0.,..~..O..~...~...... ......... Address .~.'/.,.~/.;f~...~.....~.,C.,.....~..~vt£..~...~'~one No .............. Name of Architect .................................................... Address ................................................ Phone No .............. Narr(e of Contractor ~.r-46.~.,.~4.'~.Z~'.-~.....4~.Cr,.~.:.-:r....~'.~.~r/'Address ...,~.~.~.~..~...~ ....................... Phone PLOT DIAGRAM Locat~e clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions f property lines. Give street and block numbers or description according to deed, and show street names and indi whether irfferior or corner lot. STATE OF: NE,W~/YOP,~,~,~. ) COUNTY .OF ,,~,,..,/~.,..mT..f ......... ) S.S. ................ , ........................................................ duty sworn, deposes and says that he is the applic( (~ame of individual signing application) above non'ed He is the ~'¥~,'ttcZ'~,,, J (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 apphcat on; that oil statements contained in this application are true to the best of his knowledge and belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to ~.z~f~ me this ~ · oral Pu" Ii~/~6~'/:~'';~'~ - ........................... ,x~ .y ,a ~'~"~f"~'"'""~"~,'r;/"~:e~ ..... C~efu'rff~~ / (Signature of oppllca,n,) NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ........................ .~¥. ............ , ]9....~./..Permit No. ~ ~ C)~- )----- Disapproved a/c ................................................. ~ ...................... ............ . ........................ (Building Inspecf,~ri ' ' APPLICATION FOR BUILDING PERMIT Date ........ .~::<v~.~.:.........~.. ............... , i 9.¢~. INSTRUCTIONS 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 of property must be drawn on the diagram which is port of this applica- tion. 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 o Building Permit to the applioant. 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 pa rt for any purpose whatever until o Certificate of Occupancy shall have been granted by 'the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (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. ..... ~. i ~. ~...~.,~'-~.c~z...~ ................................................................................................................................................. Name of owner of premises ...... ~..:...~L.,...~'~..~....,~.~. ........................................................................................................... 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.: ........................................ Lot No.: ...................... Street and Number ~.,.,,,~..,.......~.~.~/~.....Z~..~:~ ........... ,/7. ,~4~.Z~.C~_<...,,4,,,~.., ................................................. Municipality 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ....~.'~.../L/.~.... .......................................................................................................... b. Intended use and occupancy ....... ~.~.~..~.....~.....~: .......................................................................... ; ................ property li~ whether in' 3. Natuj'e of work (check which applicable): New Building ....... ..J~........ Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estim.ated Cost .......... .~..~..~....~.~.~. ............................. Fee ..... ..~.~./..d?.:...~.~. ........... (to be paid on filing this application) 5. If dwelling, number of dwelling units .............../. ............... Number of dwelling units on each floor ....... ,,~.. ............. 6. If bu§iness, commercial or mixed occupa,ncy, specify nature and extent of each type of use 7. Dimehs/ons of existing structures, if any: Front ............................ Rear ............................ Depth Height ............................ Number of Stories Dimehsions of same structure with alterations or additions: Front ................................ Rear Deptl~ ................................ Height ................................ Number of Stories ................................ 8. Dimehsions of entire new construction: Front ....... ~..~...~. ............... Rear ....... .~.'.~..'~.. ............. Depth ..../~....~.. ' Height ....... .,~.../. ................. Number of Stories ...........(. ................. 9. Size df lot: Front ........ Z.~'.~. ............. Rear ............. ~..'~'..~. ............. Depth ......... A:....~Z~:}.~ ............ 10. Date ;of Purchase .(2,M,~'/I~I~I,//~. .................................. Na,m~ of Former Owner 11. Zone or use district in which premises are situated ........................................................................................... 12. Does "proposed construction violate any zoning law, ordinance or regu ationP ...~.~...~ 13. Nam~ of Owner of premises ....~..,.~.~f~.~...~T .............. Address ,~,/Ji'~./Z?~....~,...(,'~f~9~. J:'..~/~r~one No. Nam~ of Architect .................................................... Address Phone No. Nam~ of Contractor ~.O~,~f;~4~/~t....~r~....~z....~,~'Address ...,~'~e.~?,tA~2. ...................... Phone PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions ~es. Give street and block numbers or description a,ccording to deed, and show street names and erior or corner lot. COUNTY qFC) S.S. (Name of individual signing application) ' (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 application;; that oil statements contained in this application are true to the best of his know edge and belief; an that the walk will be performed in the manner set forth in the applicat on f ed therewith Sworn to be}or~ me this ,~ '