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Home My WebLink About2020-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... ~O~1~t..~/~,..,~.eoot%~c..~l~z...~l.'~.~t Street ~a/S~ Mattituck Pa~,rk, P, rop p ,xlo ....................... I~,OCK I~O..Sf~C~"gC .......... Lot No...:~C ......... }~.tt£t~k ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. A,~0~.:J,[.....b~. ............. , 19.6.~.. pursuant to which Building Permit No..Z2.0~g... dated ................................. ~k~......Lk..., 19...~.3., 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 ........ .............. ~. r.i.~.a.~.e ..~e...f~ail¥...~eJ.!~g ........................................................... ' ........................ The certificate is issued to A:Ll~.n..~eml.tT...Ca~'.~ ...................... 0~e~. ......................................... (owner, lessee or tenant) of the aforesaid building. 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.° 2020 Z Date .............. A]~(L~.i]b ...... .~ ...................... i 9..63.. Permission is hereby granted to: · Ha.t ~.l.~ek. ......................................................... to ............... build.. ~n.,a~di~ i~n...on., an.. ~ s.ting., dw~ lll~g .......................................... ............................. S~.$...~e~oni~..Ba¥...Bl~ ........... Ma.tti.tunk ............................................... at premises located at ............................................................................................................................. pursuant to application dated ................... ,~l~.l], ...... ~1~. ...................... 19..6.3., and approved by the Building Inspector Fee $. ~.,,l~ ............. I~O~IYI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ×am,ned ........ .................. Approved ........................................ , 19 ........ Permit No .............................. Disapproved a/c ....... ....~..~....~ <Bu i ii ; ............. ' ....... Application No. ~ 0 ~ '0 APPLICATION FOR BUILDING PERMIT Date ........................................ , ........ 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 p remises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part 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 a Building Permit to the applica:nt. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shol~ be occupied or used in whole or in port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MA.DE to the Building Deportment for the issuance of a Building Permit pursuan~:~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. ....... (S'g a 'ure of app/fica, nt, or name, if o corporation) / (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of rem ses .~...~----~, , If applicant is a. corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No,: ...................... Street and Number "~"~'"'"~¢"'~~"'~'""' "~"~"~'~'~'~i~'~"~"~ 2. State existing use and occupancy of premises and intencled use and occupancy of proposed construction. a. Existing use and occupancy b. Intended use and occupancy .............................................................................. 3. Nature of work (check which applicable): New Building .................... Addition ....~............. Alteration .................. Repair .................. Re~.nova! ........ Demo t on .............. Other Work (Describe) ~ ao.~6 ~-- ' ................. 4. E-'stimated Cost .............. ~...~. .......................................... Fee ...~ .......................................................................... (to be paid on fi[infl this application) 5. If dwelling, number of dwetlin~ 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 ...~.~.~o ..................... 7. Dimensions of existin~ structures, if any: Front ..... ~.~ ................. Rear ~ ~ Depth Height ...... ~, ................... Number of Stories ....... ~ ................................. ~ ........................... z ....... Dimensions of same structure with alterations or additions: Front ........ ~g ................... Rear ..m~.~. ...................... Depth ................................ Height ...... ~ ...................... Number of Stories ......... ~ .................... ' ......... ~.~..~ ............ Depth 8. Dimensions of entire new construction: Front .......... ~.~ .............. Rear .............................. Height .............................. Number of Stories ....... ~ .................... 9, Size of lot: Front ................ ~ ........... Rear .................................. Depth .............................. t0. Date of Purchase ............................................... Na'm~ of Former Owner .................................................... 11. Zone or use district in which premises are situated ..... ~.~...~....f'. ................................................................................. 12, Does proposed construction violate any zonina law, ordinance or regulation? ..... ~ ~. .................. rt Co~P, ......................... Name of Owner of premises ..... .~..~.~/.z.~....4l.~...~ddress ........................... Phone No .. 13. Name of Architect .................................................... Address ................................................ Phone No ................... ~ ~~.:..~.~.~......~.~.:.(g~ddress ....~.~.(.~.~.~. ....... Phone No .................. Name of Contractor PLOT DIAGRAM Locate clearly and distinctly ali 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 i6terior or corner lot. STATE OF NEW' O~, ~ ) S COUNTY OF .~ ~..) '~' , g.:.. Z~.~.~E F/~..&.~.WZ......Z ~.:....~/.~Z~ b~in~ (Ndme of individuq] signing applicetion) obo ,am.d.H, i, ................... ....................... / / ......................................................................................... (Co tractor, Qgent, corporqte officer, etc.) of seid owner or owners, qnd is duly authorized to perform or hove performed the s~id work end to moke ond file this epplicqtion; thor ell stotement.s conteined in this opplic~tion ~re true to the best of his knowledge ~nd belief; and thor the work will be performed in the mqnner set forth in the opplic~tion filed therewith. Sworn to bef~ me this ............ ............. '" ~/~ ',~ ~/~ ~ }~u)m, ~. ,~.,, ........ (ZZ~ .............................. ~ ................ Notery Public .~.~.ff.~~*~h~e~t~w Y~k (Signmure of epplicent)[