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Home My WebLink About3245-zFOElli NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 2,..3'.'.'.'.'.'.'.'.'.'~67... Date ............ Aug....~5. , 19 THIS CERTIFIES that the building located at . · W,$. Ba~ay a.vo &. ~th S~treet Map No. (} ~I.,Tttt;hillBlock No ........ Lot No..h:~.&/t6... ~':';urel..1~..1[, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 8~p.t; · 2.9, 19 (-,6. pursuant to which Building Permit No.. dated ...... 8apt ..... 3.0..., 19 {tS, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. .B=;k~a~;a oae. faatil~. &we~.l.i~$ ................................ The certificate is issued to ... goaeph Rieke.t,t$ .... 0wnel' .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . J.ttlae 20. ]96.~... bY. .1~ ~..V. ill~.. ........ TOW-~ OF $OUTHOLD BUILDING DEPARTMENT TOWN CLEkK'S OFFIGE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTil[ F'ULL COMPLETION OF THE WORK AUTHORIZED) '3 2 ~J 5 Z Dote ....................... :......,,,~. ~.~: ...... 9...,.1~. Permission is hereby granted to: .................. ................ pursucm~ to application dated .'. ................. ~l~t, ........ .J~...:. ........... , 19~1~.., and approved by the Building Inspector. $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. JUN 2. 0 1967 3245 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at n/w/c Bray Ave and ~th St, Mattituck (Give deed location) have been inspected by this department and found to be satisfactory. C~ner : Joseph Ricketts Builder: Mattituck Bldg Corp. District Engineer District Engineer FORM NO. 1 lX)WN OF SOUTHOLD BUILDING DEPARTMENT TOW. CLERK'S OFFICE . SOUT,OLD. N. Approved ........................................ , 19 ........ Permit No ............................. Application No. Disapproved a/c .............................................................................................. ................................. i' Ji ................................. APPLICATION FOR BUILDING PERMIT Date ..... ~...,,~.,~... .................... '.;, 19...~.~... 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 st?ets or areas, and giving a detailed description of layout of property muSt be draWn on the diagram which is p~rt of this apphcation. c. The work covered by this application may not be commenced before issuance of Building PermitJ d. Upon approval of this application, the Building Inspector will issue a Building Permit'to the opplicantl such permit shall be kept on the premises available for inspection throughout the progress of the worE. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shell have been granted by the Building Inspector. APPLICATION IS HEREBY MADE tothe 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. . ~.,~. . TZ T. . .~. .Z-. ~ .~ ,~ ...... ,/& . .,z. . z. ~ ~. z /x:. ~ . . i . . ~ . P. . ,,~. ~. .; .......... (Signature of applicant, or name, if a corporation) .... ~.~.~.~..o. ........... ~...~...~..~.~ ....... ~..y..~ ..................... (Address of applicant) ~Y~-~, /vox'e- /,,/. State whether applicant is owner, lessee, agent, architect, engi~neer, general contractor, electrician, plumber or builder. ......... ................................................................................................. Name of owner of premises ......... J...~....'.,~...~..~.. ..~...~.. ............ /~.../...C...~..~......~.-.....~....,,~ ...................................................... If applicant is a~,zorporote, sigpature~ef djd~ authorized officer. (Name e~d title of cof'porate officer) 1. Location of land on which proposed wore will be done. AAap No.: ....... ~....~.../. ................... Lot Noi: ....~..~....-....~'.~[ Street and Number .~.~#Z.~....-..~..e:~...T.....c.?.~.~:&....~..~.....~.z.~..E.~....~?~T~...~.~.~...~.~Ay..~.r~- Municipality /~! State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V. ~1 .c..~....~.....~.... ....................... b. Intended use and occupancy ..... .~..~.L.C ............ ./~..~..~...~(,~./V... .......... ~..~..e.~..~.~.~..4cT. ............................ i ........... 3. Nature of work (check which applicable): New Buildihg: .................. Addition .................. Alteration .................. Repair .................. Removal ...*. .............. 'Demol tic~.;;.;: ...... ;.~:~;'~. Other Work (Describe) ........................................ 4. Estimated Cost ....... ;.. ~'.~....~- ........... ~/t~'~../t-.~, ....... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~.~ ........ Number of dwelling units on each floor ....... .~.~.R~.. ....... If garage, numar of ~rs ......................... ~.....~ ........................................................................................................ 6. If business, comme~Jal or mixed ~cu~ncy, speci~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ R~r '. ............................... Depth .................... Height ........................ Nu~er of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: ~ront .................................... Rear ............................ ~pth ................................ Height ............................ Number of Stbries ................................ 8. Dimensions of entire new construction: Front . ...... ~.~...~ ................. Rear ..... ~.~...~ ............ D~th ...~.~..~: ........... Height ....~. ......... Number of Stories ............... ~ ................................................................................................... 9. Size of lot: Front ....~e.~...~ ............ Rear ....... ZE.~..~ .................. Depth ...... ~.~..~. ............ 10. Date of Purchase ........................................................ Name of Former ~ner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does pr~osed construction violate any z~ing law, ordinance or regulation.;> ............ ~.~ ....................................... Name of Contractor~.E.(L~..~/~.~..~.~AddressA~..~$~E.~.~.... Phone PLOT DIAG~M L~ate cl~rly and distinctly all buildings, whether existing or pr~o~d, a~ indicate all ~t~k dimensions from pr~e~ lines. Give street and bilk number or description ecco~ing to deed, and sh~ street nam~ and indicate whether interior or comer B y STATE OF N~O)~I~, ~ ¢ ¢ COUNTY OF~ .......... .f ~'~' ' ......(60'~~..~. --~-----.,--w~-~- .......................................... be ng duly sworn, deposes and' says that he is the applicant · (Name of indiv~mdua~ning application) ...... above named. He is the ........................................................................................................ (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 application filed therewith. Sw°mt° bef°re methis ~7~~.~..... ,,r~_/.~. ~, _ ~~ ............ ......... , Notary Public, ~~.'~. .......... County