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Home My WebLink About2813-zFOlt~IVi NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z 2209 August 20 65 No ............................. D~8..... M~i~.I~.~ ..~ .......................... , 19 ........ THIS CERTIFIES that the building located at ~ ............... ~ .......... J~t; ~'~t~J[; ~' ' ' ~ ~ ~ i' ' Street Map No ....................... Block No ....................... Lot No ..................................................................... conforms substantially tod~.h~,pp¥otion for ~lding Permit heretofore filed in this office ~lj~l~J ............................................ ,T~,~'"9 ........ , 19..6.~. pursuant to which Building Permit No ................. dated ........................................................ , 19 ......... was issued, and conforms to all of the requirements of the applicable provisions of the la~.The occupancy for which this certificate is issued is ........ Private one family dwezz~ng ................................................... ........................ ........................................ The certificate is issued to ..................................................................................................................... (owner, Jessee or tenant) of the aforesaid building. FORH 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? 2813 z Permission is hereby granted to: .............................. ;..~ ....... ......~. ,~,~.~.~ ......................... : ............................................ :~ ............... pursuant to application dated ... ...................... ~. ......... ~ ................ 19.~..;~ .and approve~l by the Building Inspector Fee $~.~.~...i.'.h.~..~ FORM NO. I 'TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE xom,ned ............ App, tion No. / 3 , , ............................ Approved ......~ ......... ~..? ............... , 19 ........ Permit No ............................. D'sapproved a/c~~~ .... ................................................................. ........ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS o. 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 o detailed description 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 premises available for inspection throughout the progress of the work. e. No building shah be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall 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 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, ordinances, building code and regulations. Al. Kne ski (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises L:~l.Dh .~', ~homps.on. .................. 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.: ........ ~.:K..~.~ .................... Lot No.: ......... .~.~ ..... Street and Number A{az'lzt.~e .~.)~'.. i.v.e ......... z.'.~a,t~;£tzl.o~ ................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..d~e,'L1;~qg .............................................................................................................. b. Intended use and occupancy ..... s~me...u&~;1'~..~..&cld.~.~J, om, ......................................................................... 3. Nature of work (check which applicable): New Buildih~ i ................. Addition ....... :)~¢~... Alteration ............... Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ..,.~.~.~..O..O...,?./..].v~. .................................. Fee ....... (to be paid on filing this application) 5. If dv~elling, number of dwelling units ......... oz~e ............ Number of dwelling units on each floor ......................... If ga?age, number of cars .......................................................................................................................................... 6. If b0siness, commercial or mixed occupancy, specify nature and extent of each type of use ......................... 7. Dim?sions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories .............................................................................................................. 1 Dimensions of same structure with a,lterations or additions: Front .................................... Rear ......................... Depth~ ................................ Height .................... ). ...... Number of Stories ................................ 8. Dim~jnsions of entire new construction: Front .3.2. ............................. Rear ....... .'t2. ................ Depth ......... I.D. ....... Height .................... Number of Stories ............o~e ............................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date] of Purchase ........................................................ Nome of Former Owner .................................................... 11. Zon~ or use district in which premises ore situated ......... ~JJL~.~......cl.J,~'J; ................................................................... 12. Doeslproposed construction violate any zoning Iow, ordinance or regulation? ......................... ~ ........................... 13. Na~e of Owner of premises ,,~.o.,.CL'~o:m,~p.~O~ .......... Address ............ ~,~.¢,.-t..~ze,~; .......... Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor ..A.:.....~q~O~$ .............................. Address ............ ~,.t,.t,J..~.~t~ .......... Phone No ................. PLOT DIAGRAM Locate~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property li~s. Give street and block number or description according to deed, and show street names and indict whether i,ntOrior or corner lot ..... ,~ STATE OF J NEW ~YOB~K, _ 1 S S ................. .~.. ....... ~....~(~]c~ ............................................ being duly sworn, deposes and says that he is the applic, [Name of individual signing application) ' above na~ed. He is the .......... .~o~g~e.¢og ................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owDer or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and belief; that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this / Notary PuBlic, (Signature of Corem s~ ~'~ r~p~ros March 30~ 1~ 7