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Home My WebLink About2939-zFOI~M 1~0. 4 TOWN OF SOUTHOLD RUILDING DEPARTMENT '~'OWN CL~ERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ,~/~..WOS~ conforms substantially go the ~pl~ati, on for Building Permit heretof,o~e filed in this office dated 2..~ ~ ..... ~OV0~0.~ .... ~. 6~ pu~rsu'ant to which Building Permit No. ~. dated:.... ~ ...... ~O~O~b~" ~¢~'~' was issued, and conforms to all of the require- men~s ,of the .applicable provis~on~ of the law. The .occupancy ~or which this certificate (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appr~oval ' ApeX' 20~' '~966 .... by 'h' 'ViIla' · · ~ Building Inspector ' FOP~ 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? 2939 Z Permission is hereby granted to: (l®°r g e...~:... ~ .e.....n~.~ .... AZ..CE ...~o~.th.. ~Vork.. ~[Ol~S ~'~ OUlld gatt:l, tuak to ..~t~14...ue.w...one.. £a~ ~... dwe3, Z~n~ .................................................................................... et premises located at ....Et/...S. ....... ~.e..$..tr...~.~'~l~c~,..D. ee~..~lole..~.e, etLD.,t.~v.® ............................. ................................................... ~..t..t..t..t.~.~. .............. ~...~.. .................................................................. pursuant to application dated ............................... .N..o..v...e..~...b..e.~...~,.~ .... 19~.~...., and approved by the Building Inspector Fee $..]...O.n...O~. .......... Building Inspector SUFFOLK COUNTT DEPARI~ENT OF HEkLTH Dat ~._~~ Nldg. Permit No,._..___.___ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~/~ W~t~r~ ~nd of Deen Hole Drive, Mattitn~ · - (Give~ ~n) have been inspected by this Department and fouad to be satisfactory, District Enginoe~, ' ' ' District' "Engineer FOI~M NO, I 'IN:)WN OF SOUTHOLD BUILDING DEPARTMENT TO~N CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............................................... ' '' 19..!. .... Permit No. (':~ Approved ........................................ , ............................ Disapproved o/c ............................................. ~ ...... ,~ .................................... APPLICATION FOR BUILDING PERMIT Date ................................. ~o~,e.~l~ ftC..... ~ ,It· 19..,6~. .... 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 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 shall 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, Ordirmnces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant (~grees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ........... Ma.it &tuek. ................................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................... A~en.t ..~..F~ner ........................................................................................................ Name of owner of premises ....Cha~,es...L,...l~ker ....................................................................................................... If applicant is o 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 ..]~.,/~.....~l~..~ra~zo~'-l)~.,t3~..l{ole..~l"~e...~.....~.~ ...................................... ~v~unicipolity State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ V~,t3~l~.t,...'t~; ................................................................................................... b. ~ntended use and occupancy ........... o~e...~ai33~3,.3/'..~e.~.~.],r,~ ........................................................................ 3. Naiure of work (check which applicable): New Buildin~ ...~1~1~ ..... Addition .................. Altera.tion Repair .................. Removal .................. Demolition ............... '... Other Work (Describe) 4. Esti,mated Cost ......~+~...9.~..~/~/1 ........................... Fee ....... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ X~I/II ............ Number of dwelling units on each floor If ~jarage, number of cars ........... 6. If ~usiness, commercial or mixed occupancy, specify nature and extent of each typo of use 7. Dirgensions of existing structures, Jf 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 ......... .~6 ...................... Rear.~6 ....................... Depth ....~.~. ....... Height .................... Number of Stories ....... ~ .................................................................................................. 9. Siz~ of lot: Front ...... '102 .............. Rear ......... '10.0 ................... Depth .....].~.~ ................... 10. Date of Purchase ..................7[~:~ .............................. Name of Former Owner ....... 11. Zone or use district in whic,h premises are situated ...... 12. Does proposed construction'violate any zoning law, ordinance or regulation? 13. Name. of Owner of premises ..... ~,..~Qkel· .............Address ............................................ Phone No. Na~e of Contractor .................. Ila~e ......................... Address .....i~l~.t, tzt.t,1/~: ................. Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property I~nes. Give street and block number or description according to deed, and show street names and indic whether interior or corner lot. STATE aFl NEW YORK, / c c COUNTY OF ...~,~[',~.o~]r~ ...........~ ~"~' .................. i ..................... (~1~...]~,...~1~ ............................. being duly sworn, deposes and soys that he is the applicc IName of ind vidual sign ng opp ication) above na~ed. He is the ....... ~.....~..~i~ili~,..&..OiD~,~,O.~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 this application; that all statements conta,ined in this application are true to the best of his knowledge and belief; that the wc}rk will be performed in the manner set forth in the application filed therewith. Sworn to b6fore me this ................. day of ............... .......... , Term Expires March 30,