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Home My WebLink About3262-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING D]~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BERTIFIE:ATE DF DrI. BUPANBY No. Z 21~80 Date .O~te~e~' 20 . , 19 67 THIS CERTIFIES that the building located at ~daz D~il~e. Street Map No. ,Sho~e Ac~tock No ~X Lot No. ~7, 18, 19, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated . Octobe~ ]~l , 19 66 pursuant to which Building Permit No. 3262. Z dated Oc%~ob~ ll , 19 66% was issued, and conforms to all of the require- ments of the appiicable provisions of the law. The occupancy for which this certificate is issued is &d~[it:.;[.o.n..t.o..o177..~.a..l~.~..]..y...d~..e.]..~.~.~.g ................................ The certificate is issued to . . ]~..s.:..W.~.i..1 .~.a~...~..~.;l..t~. ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Iq/R ..................... Building Insl~ctor FORM NO. 2 TOWN OF $OUTHOLD 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) 3262 Z Permission is hereby granted to: ............ .~..,..,....~..z.~.~..,..:.....s..=.~..t.~. ................ .............. NaJ=.tiJmck ........................................... to ~..~....e...~,Z.~t..e.~.~.o..a..~.....~.,,~...~.~.~.a.....~.....~.d..aA~.o.~...o.~...~....~.~aL~l~..~ .... at premises located at .......~.t~J...;J,~,~],J~"l ¢~.....J~30.tt.g..JJ.l~.B~, .................................................... .......................... g.~da~..J~rl~s .......... ~/a~.ti.tuek ............................................................................ pursuant to opp[ication dated ........................ JJl~.J; ............ :1,1. ............ , 19...~., and approved by the Building Inspector. Fee $..~..?..0..0. .............. FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved t - 19 ........ Permit No " Application No. ~ ~-~ ~ APPLICATION FOR BUILDING PERMIT Date October 11 19....6...~... INSTRUCTIONS o Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Bu~ldin. Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and gwmg a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatior c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of th~s application, the Buzlding Inspector w~ll ~ssue a Building Permit to the applicant Suc permit shall be kept an the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or m part i~or any purpose whatever untda Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to th Bu~ld~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbec The apphcant agrees to comply w~th all apphcable laws, ordinances, building code and regulations. William Smith Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, ~ng~neer, general contractor, electrician, plumber or bu~Ide Nome of owner of premises .... l~$...ld&l~lll.,.~II~.:~ ........................................................................................................ If applicant ~s 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 Shore Acres Lot No: 17 t 18 ~l Street and Number ......... (~.(t.a.~...D~i.Y..e .......... ~.J~.~i.~l~J~ .................................................................................. Municipality 2 State exzstmg use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... zell mg ...................................................................................................... b. Intended use and occupancy ........... ,~a~e....~.i.~h...a'l~e~.aJ~iDzl..~c..B. df]J.J~.~.c~l. ...................................... 3 Nature of work (check which applicable). New Building,. ................. Addition .....~.. Alteration~/..:...~.. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ................... : ................ 4. Estimated Cost ..... .~O~D,~...~f~I .................................... Fee ...... .~ ......................................................................... ~ ...... (to be pa~d on fihng this application) 5. If dwelhng, number of dwelling units ..... o~'te ................ Number of dwelling un,ts on each floor .......................... If garage, number of cars .......................................................................................................................................... 6 If business, commerctal or mixed occupancy, specify nature and extent af each type of use .............................. 7 Dm~ensions of existing structures, if any: Front ....................,~. Rear ..........3.8. ........... Depth ......... ~.6 ............ Height ............................ Number of Stones ............................................................................................................. Dtmens~ons of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stones ........................................ 8 D~mens~ons of entire new construction: Front ........ ~ .................. Rear ..~ ....................... Depth ..'IQ ................... Height ............................ Number of Stories ..... .O..~..~ ................ 9 S~ze of lot' Front ........................... Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... fl fl ................... 11. Zone or use distr,ct ~n which premises are s~tuated .......... ~....~i~t ................................................. 12. Does proposed construction wolate any zoning law, ordinance or regulation? ........ ~9. ....................................... 13 Name of Owner of premises .~Z'.~..~.o...~o...$z~.i.~hAddress ............... ~tJ~.i.~;~,lc ...... Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor .~.~,t~...~J~.~LTL ................... Address .......... zv~:t£~Ctc ........... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex,sting or proposed, and indicate all set-back dimensions fro~ property hnes. G~ve street and block numbers or description according to deed, and show street names and ~nd~ca~ whether interior or corner lot. S'FATE OF NEW YORK, ~ COUNTY OF ...~.£c~I~ ........ f S S. ................... .~:i~m,..~m,~.+~ .............................................. being duly sworn, deposes and says that he is the applic~ (Name of individual s~gnmg apphcation) above named. He ~s the ......................... a~e~..~.£..~cz).~z'. .......................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d o~ner or owners, and ~s duly authorized to perform or have performed the said work and to make and , this apphcat~on, that all statements contained m this application are true to the best of his knowledge and bali and that the work wdl be performed in the manner set forth in the application filed therewith.~,~} Sworn to be fo re me th,s......,..-........,.................-......., 6..x~ ...~-...~~· '~ ................. .1..~ ... day of October 19 ..... ..6. Notary Pubhc,~r~~....~.~...~f~../~..~.~¥ Coun~ (S,gnature of applicant) NOTJ~Ji~Y PUBLIC, Sta',~ ct ['tew Yor~, No 52 3233120 Su[[alk Couf~tY Term Expirr*s r,~,arch 33, 19~...~