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HomeMy WebLinkAbout3339-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the build,ng located at ....~..~t . ..~...~..~.~.....A.T..9 ............................. Street Map No .... ~r~ ............. Block No ...........XX ... Lot No ~ ....... Ll~.~*'tllllt. I,X, ..................... conforms substantially to the Apphcahon for Budding Permit heretofore filed in this office dated .................................. .D~O~ ....... 1}+. ...... , 19..~. pursuant to which Bulld,ng Permit No . ..~3.~t..~ dated ............................ DBa,....1~. ·., 19 .6i~, was ~ssued, and conforms to oil of the requirements of the applicable prows,ohs of the law The occupancy for wh,ch th~s certihcate is issued is ........ ..Pr. lva.~e, o_~e..fa~ l~...dwell~n~ ........................................................................................ The cert,ficate is issued to Mattltuck..Bl~ldinE. Cn~, ......... ~ne~ ................................. (owner, lessee or tenant) of the aforesaM building ~.D.Approval June 19, 1969' by R. ¥~!la Building Inspector k FOR~ 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? 3339 Z Permission is hereby granted to: ................. 1,.~ ~.t.:l,.1;.~.. ,~,,1 ~...C. ca'~ ....... ...................... ~l;]~...Roa~ .................................. ( P .0. Ma.t t.it~,~ok.) .......L~'.....u~/...e..1..L ...~.t.~.t ...................... to .. ~u~Llct ..new...o~e.. J:am~l~..,~wellJ. z~ ................................................................................. at premises located at .....~./.~.'.......~.~lj~.,.~.~..I[I. ........................................................................................ ........................................ La~el,..N,.~ ........................................................................................... pursuant to application dated ............................ ~O~[....,],~ ............... , 19..~(~, and approved by the Building Inspector. Fee $...~,0.~...0~. ......... FORM NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 3340 Z Permission is hereby granted to: ................... ~t,.t,~..~tm ~.. 1~1,~1,~ .. ~ t*~. ..... ..................... ~LI~...I~.~ .................................. ( ~. 4~ .~a.i;t £tt~.k.)..... I~u~e~. ........................... to ..~.u:i.3,d...~l~a.e,,h~l..~'~,+~...g~;~g~m .................................................................................. ............................................. (,It~u~e...~ r .~:Lt...~...3j39Z) ............................................................... at premises located at ....~/.J~.....J~..~...~.~.~ ......................................................................................... .................................................... Ia~.el~.....l~.,.X, ............................................................................. pursuan~ to application dated ....................... Ilea ......... ]~ ............... , 19..~6., and approved by the 5ui]ding Inspector. Fee $...~.,.0~). ........... $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. 3~ ~ TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (~Gi e -dee~ %-'~ r ~/~ ~-~. '~oCatio~') have been inspected by this department and found to be satisfactory. nt mtrict Engines~ District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ............. .............. ............................... ................................. APPLICATION FOR BUILDING PERMIT Date ............................................................ , INSTRUCTIONS o. Th~s application must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Buildil Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo,ning premises or public streets areas, and giving a detaded description of layout of propertymust be drawn on the d~agram which is part of this apphcati- c The work covered by this application may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector will issue a Build,rig Permit to the applicant. Su permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occup,ed or used in whole or m part For any purpose whatever until a Certificate of Occupon shall have been granted by the Btzilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the censtruct~on of buddings, addmons or alterations, or for removal or demolition, as herein describ, The apphcant agrees to comply w~th all applicable laws, ordinances, building code and regulations. (Signature of apphcant, or name, if a corporation) (Address of applicant) State whether opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build .................... ............. ............ /..;i'.. ............................................................................ Name of owner of premises .................... ~..L.~.....~..../....~....~.....c:..!..(, ........... /~....~...;...ln.~..../../'J..../~.. ....... ..C....~,j,~,...~, ............ If applicant ~s~a co~orate, sign~ture~f d~,y' authorized officer. 1. /ocat on of and on wh c_~_pr~po_s.ed work w I be done Map No ................... Lot No' .... l?/tST~ ~ / ~ e . ' ................. Street and Number~. jt~ ~.. ./~ !~. ~' ,~. ~.~0" ........ y. ............................................ . ....................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o Existing use and occupancy ...................... .~......~.../}~.../~. ................................................................................ b Intended use and occupancy ..... J~.../~....~.'~ ......... ~..~..~....~I...(...~...1~.. .......... ~....~.....~.~...L...~.....J...~/...~.. ............... 3 Nature of work (check which applicable). New Building ~'- Addmon .................. Alteration Repair .................... Removal .................... Demohhon .................... Other Work (Describe) ...................................... 4 Eshmated Cost ...... .~......~...~...~....~...~...~...~.. £...e. ............ Fee ~1~'-/'' (to be pa~d on fihng th~s application) 5 If dwelhng, number of dwelling umts ........ ~...~...~...'~. ...... Number of dwelling umts on each floor ..... ..~...~...~..~.. ........ If garage, number of cars ........... ..~...../~.~..~. ................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use -~ 7. D~mens~ons of ex~sting structures, ff any: Front ..........................Rear .......................... Depth ............................ Height ........................... Number of Stories ............................................................................................................... Dimensions of same structure with alterahons or additions: Front ................................ Rear ................................ Depth .............................. Height ............................. Number of Stones ........................................ 8. D,mensions of ent,re new construchon. Front ..... .~...~.-. ...... ~... .... Rear ....~..~.Z ..... .~. ....... Depth ...~...~...~...~...:.f .... Height .......~.~....~ .......... Number of Stories ..... .~...~....~.~.. ....... 9. S~ze of lot: Front ....... ~...,~....~ .......... Rear...~...'.~.. .............. Depth .....~...~.....~.. ............... 10. Date of Purchase ...~....~..../~ ........ ,Z.~....~...~.. .................. Name of Former Owner ..~..~./~.~.,~..~.:/~...'.~..~/.~.~. ............ 11. Zone or use district ~n which premises are s~tuated ................................................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulahon? .......... /~..~.. .................................. 13 Name of Owner of premises ~l~.~lZizC..~..l~.(Rlc..tl.'tl~.~?ess .~.~'.A..~.,~..i~..D..t.../~'/.&T/'./.[.~...KPhone No..~...Z..~.../..~..,~ Name of Architect ................ ~.../...\.~.~..~ ................... Address ............................................ Phone No .................... Name of Contractor ..............~..~../~IL..~.'.. .................. Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~stmg or proposed, and indicate all set-back dimensions fron property hnes G~ve street and block numbers or descriphon according to deed, and show street names and ind~cah whether interior or corner lot. STATE OF NEW.4.Y,..xO~K~..4~ ] S S COUN'FY..,~"~' ~,~-~Of ~.~ ........... ~ ' '~ . ~ ~ ....... ' ~ ,rig app~o~,on, above named. He is the ........................... (Con ~ag~nt, corporat~'~i'~"~)' ............................. of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and ill- th~s apphcation; 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 apphcation flied therewith. Sworn to ~e me th,s _. ~ ~ ~, / ~~ .................................... : ........ ............. .............