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Home My WebLink About2388-zFO~ NO. 4 TOWN OF SOUTHOLD RUJLDI~IG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATe OF OCCUPANCY No. Z...l.C)20 ............. Date .............................. 5.ep.tembe=..~, i 9...6~ THIS CERTIFIES that the building located at .F~/~...i)ee~..H~e..]~t~e...(.~.~a~. h~;treet Map No..~ ........... Block No...:~Y,~ .......... Lot No. ~ ......... ~.I;1;.~.t,U~I.....~,~.~ ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~iq/'.....l[ ............. , 19..6,1+_ pursuant to which Building Permit No..2.~1~.. dated .......................... ~a~....~,'~ ............. , 19...6.1~., 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 ........ ....... P.~.t.v.a.~e.. one...~,~m.i.l~ .. d.~et.t i.ng .......................................................................................... The certificate is ~ssued to ...l~i~l'~l~;..~ge.~'l~. ............ ~tll~.. ................................................... (owner, lessee or tenaint) of the aforesaid building. H.D. Approval Sept 3t 196~ FORM NO. :~ 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.° 2388 Z Date ........... ,........;.....~ ....... .~X~ ........... , 19...~. Permission is he?eby granted to: · ,.dw.. Ah:l..~Z..,..A/~..., ,MilZ.. Mat,.~. ................ ~,~: ......... : ........ ,...:.,. ................ to `~m~.v.e~aa.~xia~i~a~e~we~ia~t~ae~.~a~.~.~s~e~.....~ at premises located at ...... :Z/$.:...lq.g..De~,p..l~iol..e...~:~.:l, Ve ............. ...~ ............................... ~ ........... ..... ~ ................ ' .............. : ......................... ~.t.~i.~.~ .................................... ,.i ....... .................. , .............. .. 19.~[F.., hnd approved by the pursuant to application dated , ................................. J~t~"~ ....... ' ..... Building Inspector SUFFOLE COUNTY ~EP4RT~'~[~T OF HEALTH Date ...... ,, Building Permit No. ..~388Z . TO ~lG~ IT MAY C~CERN: The sewage disposal facilities for a str~cture lpcated a~ _~_~/s Deephol~ Dry, Mattituck .... (Oive~-dee-~ocati.on) have been inspected by this Depart~en% and found to be satisfactory. District Eno~neer SUFFOLK COUNTY DEPARTMEb? OF HEALTH TO WHOM IT MAY CONCERN: Date f~. ~ ~ Building Permit No. The sewage disposal facilities for a structure located at (Oive 'dee~ location) ¥ have been inspected by this Department and found to be satisfactory~ District Engineer FO~M NO. I Approved ........................................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. ¥. 19 ........ Permit No .......... ~ .................... Disapproved o/c ......... ~ ............ ~,-~ ............ ~ .......................... ~ .. r) APPLICATION FOR BUILDING PERMIT 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 Ioca(ion of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 shatl 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 Certificate of Occupancy shal{ have been granted by the Building Inspector. APPLICATION IS HEREBY MADE 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 Lows, 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, ordinances, building code 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. Contractor Name of owner of premises .......N~...:~,l.-.~-~,t.t..~,g.e, ucy. ....................................................................................... . .................. 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: ..... /~fl~f~,%k;L ..................... Lot No: ..y,.,X ............. Street and Number ]..lf.~O.!...J~...~o~JJ,Y.e.....]~/~....?, ~...D.~,~]~.o..-Dr.t......~.~e~ ................................ t~umclpallry 9, State existing use' and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy .~.O,(~.O~..~Lo!~ .......................................................................................................... b. intended use and occupancy ......... O~e..~.~,~],~r..~A~,~.,],~§ .......................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Remoyal ~ ........... Demolition .................... Other Work (Describe) ...l'~l~la&l;~. ............... 4. Estimated Cost ..........'13.~.0t~0 ................................... Fee ....'10 ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... J ..........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 ...~.....i ............. 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 ............................ Depth ............................ Height ............................ Number of Stories ..... - ....................... 9. Size of lot: Front ...... ~,00... ............. Rear ......... ~.0~ ........... Depth .... '1~.0 .................... 10. Date of Purchase ......... ~. ..................................... Name of Former Owner ......... ~,~.~e~]r~l. .............................. 11. Zone or use district in which premises are s~tuated .................. ~ ............................................................................ 12...Does proposed .gonstruction Violate any zoning law, ordinance or regulation? .............. ~ ................................... 13. Name of (~ner ~)f premises ..... ...~. ~.-..~.1~.~ ............. Address .......... .~jI,~.'1;,~.t~.1~I~ ............ Phone No ..................... Name of Architect ...................................................... Address ....... ~ ..................................... Phone No ..................... Name of Contractor ..~:Ll.t~..~,J,.~. ........................... Address ............ ~11,~.1~I,.$.~ .......... 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, end show street names and indicate whether interior or corner lot. 5o STATE OF NEM4 YORK, ) COUNTY OF ..J~ ............ j S.S. ......................... ~l.~l..Ab,t,~ ............................................ _....being duly sworn, deposes and says that he is the applicant (Name of individual signing application} above named. He is the ................ ~l'~a~F,O~ ................................................................................................................ (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 'in the ap~olicetion filed therewith. Sworn to before me this ~. ~' /).~ ~c.,^~ ....~..._~~...~........~..~..'~,~... .................. Notary Public, /~.£ ~ ounty,~- (Signature of applicant) ~' . No. 52-0618100 ,~flolk Courl~ ,..- ~ ~-' Cornn~issi~n E~pire~