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Home My WebLink About2243-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No Z. 18.51.. ........... Date .64. THIS CERTiFIE5 that the building located at .. /. i., 1y, �1„9"Ad..................................... Street Map No. ... ........... Block No. .....PM.....,... Lot No. ...;t=....... +rtxa!�.............. conforms substantially to the Application for Building Permit heretofore filed in this office dated •.•••••........ ..Ra.'S>*OMbBll.... 3.2 19..63, pursuant to which Building Permit No. .....224iz dated .........A3bvpzber...12., 19...6.21 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .....Pr-1va;t.3..Qr1e..fami-I • dwelling. .................................................................. ....................... The certificate is issued to ....gtaj�jgy..;.'I, . ........... .................. ............ • .....I........ (owner, lessee or tenant) of the aforesaid building. H.D. Approval May 27, 1964 by R. Villa Building Inspector FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MusT' Bi~ K~PT ON 'I'H~- J~J~J::MISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 22 3 z Permission is hereby granted to: ................... i~,t~ue~ ....................................... to ...... .~.~11~..r~'~...o~ .. ~'~/1;~.. ~we~L.~g ................................................................................. ~t premises located at ..... .~/]~,.,.J~l.~b...~O~ ...................................................................................... ............................................................. [~f,,~llmek .............................................................................. pursuant 'to application doted .............................. No~ei~l~e~,.****~7,.,, 19.**~ and approved by the Building inspector Fee $...tl O ............... SOHD SUFFOLK COUNTY ~PEP,ILT~_~L~,Tf. OF HEALTH TO ~0M IT MAY CONCERN: Date_..May. 2?, 1964 Building Permit No. 22442 The sewage disposal facilities for a structure located at e/b~uther Road n~ Ruth Road~ Mattituck .... (Give deed location) ' have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOL~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , ]9 ........ Rermit No ................................. Disapproved a/,~~_ (Buil~ Inspector) Application No. ~..~.~.,.~.~..?.~.. ........... Date ................. l~[o~ramhe~..... 12 .......... , 19.6~ .......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subrnitted in duplicate to the Building Inspector. , , b. Plot plan showing location of 16t and of buildings on p remises, relahonship to adjoining premises or public streets or areas, and giving a detailed descripti,o~, of layout of property must be drawn on the diagram which is part of this application. 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 premi.ses 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 gr.anted by th,e, Building Inspector. APPLICATION IS'HEREB'y' MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of ,t~f~ Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the constr,u'bti~n of buildings additions or alterations, or for removal or demolition, as herein described. The aDP cant agrees to cOraal¥ with all apphcable laws, ordinances and regulations. ,.Ed~,...A~;~tz ...................................................................... (Signature of applicant, or nome, if o corporation) (Address of applicant) State whether applicant is owner, le§~ee, agent, architect, engineer, generat contractor, electrician, plumber or builder. ............... oan.t~.aet o~. ...... h...,~ .......... . .................................................................................................................................. Name of owner of premises ..... ~¢a~.l. ey...S.ted-.~e.sk.~. ...................................................................................................... If applicant is a corpo.rote, sign6ture of duly authorized officer. (Name ~pd title of corp,6¥ote officer) 1. location o~k~nd ~n which preppsed work w~l~ be done. Mop ~o: ~ ................................. kot ~o: ~ .......... Street o 6"c~ 'N ;mbe~.....~:~..~.~ t ....... .~.~ ~.~.~. ....................................................................................... / t ' ~ Municipality 2. Store ~xistin~ use ond occup~c'y of premises ond intended use ond occuponcy of proposed construction: ~. [xist~no ~se ond occupon~,,~ ....~.g~...~B~ .............................................. b Intende~ use ond occupoBcv ..... 0gO..g~._~[l~ng .............................................................................. 3, Nature of work (check which applicable): New Building ..... ~ ...... Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...... ~J4'~.0~O.....~./.J~ .......................... Fee ............... I (~to be paid on filing this application) 5. If dwelling, number of dwelling units ...........~n~ ........... Number of dwelling units on each floor I , If garage, number of cars ...................... i~-H ................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature, xtent 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....~'l~...~'.t ................ Rear ......... ~6~.¢ .......... Depth ........ ~J~8 .......... Height ............................ Number of Stories ........ ~ 9. Size of lot: Front .............. 100 ........... Rear ...... 100 ............... Depth .......... ],~ ....................... t0. Date of Purchase ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated ....... 12. r)oes proposed construction violate any zoning law, ordinance or regulation? 13. Name'of Owner of premises .~.....~.~e.~;J.e¢/~ .......... Address ........ ¥~t~zL~;~O~ .............. Phone No, Name; of Architect ...................................................... Address .............................. ' .............. Phone No. Name of Contractor ...~d~/.,...~1~;~¢,~ ......................... Address ........ J~t.t~t~.&.t,~,~, .............. Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot. STATE! OF NEW yOIBK. ) COUNTY OF i~.,~.-,¢..0.$.~,., ....... ) S.S. ................... ) ........ ..~..~.~.....~l,~.,~ ...... ................ . ...................... being duly sworn, deposes and s~ys that he is the applicar (Name of individual signing application)., , above named. He is th~ ..... ......ClO~t,Z'.&~¢O~. ...... : (Contractor agent, corporate officer, etc.) of said owner or owr(ers, and is duly authorized to~i )liPerf°rm ao~. haVear perfarmedtthetrue~ h said .',workf~ and to make and f this a)plication; thqf all statements:conta ned n th's app ic on e o e best of his knowledge and bali and that the work ,~,'ill be performed' in the manner set forth in the a_,gpp, Jieation filed therewith. Sworn to before me th s (~/ /q Notary PuBlic ................ ,./i.L .......................... .~ .......... County (Signature ~, applicant)