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Home My WebLink About4069-zFO~M NO.~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...~.3~.~[2... Date ............... ~ .... ~., 19. ~ THIS CERTIFIES that the building located at 3~'~. · .¥eS.~]l~l~]J~. ~[11~I[.. Street Map No..l ........ Block No .... ~a[ .... Lot No. ~... ~l~ttt.~llek..iici[., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 8ep~..5.., 19 .~. pursuant to which Building Permit No.. lN~ ~ dated ....... aept.. ~ ...... , 19.~1~, 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 .. ~11~t$ .&ee$~el'~ .kl~-l~. · .(.~l*e$11]lO~ll) ...................... The certificate is issued to .lltll,~l~l. & .~1.. ~l~l':l, lOI[ ....... l~]a~l~.ll ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....... ]l~ ........................ ..... ~' ' '~d~n~'~ .......... POIDI NO. t TOWN Oil SOUTIIOLD BUILDfl~ DEPARTMENT TOWN CLERK'~ OFFICE . SOUTHOLD, N. Y. BUILDING PERMIT CFI-tiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 4069 Z Permission is h~reby granted to: ......... ~(~1,~ .~ ..lh~,S~_..~, ..W~# ........ ................ ...h....t..t.,.Lt.~A ......................................... pursuant to application dated ..................................... ~IL...~IfL.., 19..~., and approved by the Building Inspector. ~..o O0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ^ppl,=,on ....... Disapproved APFLIGATION FOR BUILDING PERMIT Date ............... . .~..e.]~.t..e..m...b..e...~.....2..6. ................ , 19_§.8.. ..... 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 port 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 H.EREB¥ MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions o~ alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all appli~'able laws, ordinances, building code, housing code, and regulations. (Signature of ~l~phcant, or name, if a corporation) 3535 Westphalia Rd., Mattituck, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises ..~.~.~.?:.~.~...m..~.~..*~.~..~..`~.?.~.~.~.n.~.~.~.?.~:~.~.~.....~..~.~~.~.~ ....................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) XX XX l. Lo~ation of ~and an which proposed work wi~ be done. Map No.: ........................................ Lot No.: ........................ Street and Number 3535 Westphalia Rd. Mattttuck, N.Y. Mun~cipolity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...8.~..n.S.~.e....~,m.~.~.7....~..e..s.~.~.e...n..c..e. ......................................................................... b. Intended use and occupancy ..~..d.....L.~g.~..~X..~..e.~/~.9.~.~. ......................................................................... 3. Nature of work (check which applicable): New Building ..... [ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .~.950~.00 ...... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~.~ ............ Number of dwelling units on each floor ............................ NA If garage, number of cars .............................. r./. ............................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..... .~./..A. ................ Height 32 t Number of Stories Dimensions of same structure with alterations or additions: Front ....n..o.....c..h...a..n.E~.e..s. .......... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ .~.. ......................... Rear .....1..~.! ................. Depth Height g t Number of Stories 1 9. Size of lot: Front .....~..0.,,0.t. ............... Rear ....... ~..~. ...................... Depth ..... .5..0...0..t. .................. 10. Date of Puwhase Nlam~ ,~f I~ .... c~ .... C.R. Bennett & V.C. 11. Zone or use d str ct n wh ch prom ses are s tuated ~,!~..~ 1d.ed..rial 12. Does propbsed construction violate any zoning law, ordinance or regulation:~ No 13. Name of Owner of premises W. 1~.. Harrison Address 3535 West,.hallo Rd.Phone ,. 298-865? Mattituck, N.Y. Name of Architect ................... ~.~a ......................... Address ............................................ Phone No ..................... Name same of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. W ~; 5-~ ? /-/ ,~ z- / /4 /~ o,~D , ~ "I~'~ STATE OF COUNTY OF S.S. : ......... being deposes and says that he is the applicant (Name of individual signing 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. Sworn to before me this ............. day o, .......... ............. , . Notary Public, . ........................................................... County (Signature of applicant)