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Home My WebLink About3217-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's office Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property ...~?..0.. ~.0.8.~.O~..L..a_{l. ? ................................. I~.a.'~.+rL.~.o.I-~ House No. Street Hamlet County Tax Map No. 1000 Section ....1.'1.~. ..... Block .... .0./I. ........ Lot ...... 0.~.8 ........ Subdivision... ~.a.~.~.~.'~..o. 1~.. ~.~.~.a..~.e.8. ....... Filed Map No../.~./~.~.3...Lot No .... /4..6 ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ...S..e.p.~.o.m.~..or..1.2. .... ,19~..~. pursuant to which Building Permit No ....... .3.2.'1.~.Z. ......... dated .... ~..ep.'l;.~.m.'¢..er..1.2. .......... 19 .~..~, 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..ty.a.~..e..0.n.e.. F..a~.~..ly...L~. ~.3..1.~.n. g ........................ The certificate is issued to ...... E.,d..wg.I'.~. ~.,..Iq:~..rl.e.8..~<. 5v.f.o. ............................ {owner ?~e~q~l~j~] of the aforesaid building. Suffolk County Department of Health Approval . .r.'¢97~. ~r..2.7~..~.9.5.5..~x..~....v.~..~.3.~ ..... UNDERWRITERS CERTIFICATE NO .................. .*?/.F: ............................ Building Inspector Rev 4/79 FOR!~[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PI::RMIT MUST BE KEPT ON THF: PREMI$£$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3217 Z Date ..................... ~l~.t4~b~l~.....]t.~ ....... , 19...(~ Permission ~s hereby granted to: td~...~b:Ltz.. ~ an~a~ta~.. ~n~..~f.C~....Edw~rd Heins ................ t~a%ti~a~k .......................................... to .... ~t4.. ~v-.~e...~.. ~./.1.~g ................................................................................. at premises located at ........~G..~....~j~t,t~tuck...~s~,a~ce~ ........................................................ .................................. l(e~../,,~ ............ F~tt~t~ok-¥ ..... 1~ ~1i[. ................................................ pursuant to apphcation dated ............................. ~rpt ........ ~'2 ....... 19.~.., and approved by the Building Inspector Fee $..~0~.00 .......... ' ' ~ - Building Inspector FORM ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. 1~. Y. P. E:RTI FI P. ATE: nF No..~. 263~,... Date ................ Da:ember... 28, 19..66 THIS CERTIFIES that the building located at .~eaclow. Lari~ ............... Street Mattituek Estates. ~ ~ Map ]No ............. Block No ............ Lot No. 26 ....... Mattitu~}. N,Y., ...... conforms substantially to the Applicati. on for Building Permit heretofore filed in this office dated ............. ~p~ ..... 121966. pursuant to which Building Permit No. ~7..Z.. dated ............. Se-pg.. '12. , 19-66, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . Dri.v. ata .one. famiJ, y. (%we2.1;[ng ......................................... The certificate is issued to .Ed~wa:~d. C.~ .ILine~ .......... 0wnev ...................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval . .I;I$.C,...27.+ .1~.66..by..l~,..V:i~_!a ..... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: Date Bldg. Permit No. at DEC :~ ? 1968 The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. DistrioC ~ngine~r District Engineer FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN CLERK'S OFFICE $OUTHOLD, bi. Y. Approved ....................................... , 19 ........ Permit No ................................ " D,sapproved a/c ............................................................................................. ................................. .............................. Application No....?...~..../.Z .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o Thts application must be completely fdled in by typewriter or m ink and submitted in duplicate to the Buddin, Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and gw~ng a detailed description of layout of propertymust be drawn on the diagram which is part of this apphcation c. The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector w, II ~ssue a Building Permit to the applicant. Suc! perm,t shall be kept on the premises ovmloble for ~nspectlon throughout the progress of the work. e No building shall be occupied or used in whole or ~n part For any purpose whatever until a Certificate of Occuponc; shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE 1o the Budding Department for the ~ssuonce of a Budding Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulottons, for the construcbon of buildings, additions or alterabons, or for removal or demolition, as hereto described The opphcant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, If a corporation) Mattituek (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Contractor Name of owner of premises ..... .~.~9,:~.~t,...g.~...,~f~,9. ......................................................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~/r~ 1. Locabon of land on which proposed work will be done. Map No: ...... ~,J~.t,.%C,~,a~:..~S~,2~ot No: ..26 ............ Street and Number ....... ~t~¢,P.~..~a~ ............ ~.~..~;L~1~¢.~ .................................................................................. Munic~pahty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .v.~¢.an~..J. aztcl. ................................................................................................... b. Intended use and occupancy ..... O~l~...~qJ:g,~.~r......C].~e.3.'li~l~ ........................................................................ 3. Nature of work (check which applicable): New Building .....z~....~. ........ Addition .................. Alteration ................. Repair .................... Removal .................... Demoht,on .................... Other Work (Descr,be) ..................................... 4. Estimated Cost .... ~.~t...C~0~ ....................................... Fee .1~) .................................................................................... (to be paid on filing th~s apphcation) .5 If dwelhng, number of dwelling units ......... O~e ............ Number of dwelhng un,ts on each floor .......................... If garage, number of cars ...............2...oa.~ 6 If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Height ........................... Number of Stories ............................................................................................................. D~mens,ons of some structure with alterations or additions' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8 D~menslons of entire new construction. Front ....... 6~ ................ Rear ...... 66 ................. Depth .~ .................... Height ............................ Number of Stones .... .O,~.~ ................. 9. S,ze of lot Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase .............. ~.c)66 ................................ Name of Former Owner ....... ~.~..t..~.S$ ........................... 11 Zone or use district m which premises ore s~tuoted ........... ?~t~.'?...~l.is.t~ ................................................................ 12 Does proposed construction violate any zoning Iow, ordinance or regulation;~ ......... ..~..O.. ..................................... 13 Name of Owner of premises ..... ~c~,~¢t..~e.~S ...... Address ~r~.e.~...T~.o~ ............ Phone No ................... Name of Architect .................................................... Address ............................................ Phone No ................... Name of Contractor ..~a.~Z..~.b~t,.~..Co~t~.~.~.Address ....... ~$t~.t~te.1~ ............... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex,sting or proposed, and ~ndicate all set-back dimensions fro~ property lines. Give street and block numbers or descnption according to deed, and show street names and ind~cal whether rater,or or corner lot. STATE OF NEW YORK, ~ COUNTY OF .... S~££olJ~ ......... f S.S. ...................... Eaaz,..~,b:bt~. ..................................................... being duly sworn, deposes and says that he ~s the appli (Name of individual s~gning application) above named. He is the .......... ~,.Z~a¢.~a,~ ............................................................................................................... (Contractor, agent, corporate officer, etc.) of sa,d owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s apphcot~on, that all statements contained m this application ~re true to the best of his knowledge and b and that the work will be performed in the manner set forth in the apphcat~on filed therewith. Sworn to before me this ................ ~1~ .... day of ............ ~.p.C~.be.~ ......... , 19.~.. Notary Pubhc, . .......................................................... County (Signature of applicant)