The URL can be used to link to this page

Home My WebLink About3880-zFORi~ ~0. 4 TOWN OF SOUT}IOLD BUILDING DEPAi:~TMEN~ 'I'OWN CLEi~K'S OFFICE SOUTHOLD, N. Y. P.I~RTIFI[~ATI~' rlF' rlI~GI.JPANP, y No. Z. 3326 .... Date . .ll~.~....25., .............. 19~. THIS CERTIFIES that the building located at]/~ .~a~;(;~,k& .l~d. ....... Street NIap No ............. Block No ............. Lot No. l~t].~.U~,..~. :~k .......... conforms substantially to the Applicati~on for Building Permit heretof~ore filed in this office dated ........... l~la.~... ].], ....196~. pu~rsuant to which Building Permit No.. ~(~ .~ dated ........... l~l~y'...~, .... 19.68, was issued, anal conforms to all of the require- ments .of the .applicable provisions of the law. The occupancy f~or which this certificate is issued is . ~ivate..o~. ~.].¥- ~weLl.:{.~ .......... ................................ The certificate is issued 1~o . .~hl~. ~:l.~k~ .~:~ ........................................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health App.roval ~' .~;9',. ],~,. R~]:~t..Vi].J~ ' Building Inspector FORM 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) NV 3880 Z Ode ......................... ~Z ......... .~3 ......... , ~9.....~ Permission is hereby granted to: ............ ~oha..l~,ka..,,l'z .................................... ~att~tuek to ...~.d....~...~M... f.~ly...~t~l ~u~ ................................................................................... at premises located at ....~ .~.........l~..~'.~..~...~.]r~.....~ .......................................................................... ............................................... ...~.~.~uek....~;,~., ............................................................................. pursuan,t to application dated ............................ ~,[~:F~ ....... ~,,~. ....... , 19~8..., and approved by the Building Inspector, Fee $...~O.a~J~ ......... Building n~ector ~. S-9 SCHD TO WHOM at SUFFOLK COUNTY DEPARTMENT OF HEALTH Date November 19, 1968 Bldg. Permit No. 3880 disposal facilities IT MAY CONCERN: The sewage for a structure located E. Side ~ratooka Rd. N/ of New Suffolk Ave. (Give deed location) Mattutuck , Southold have been inspected by this department and found to be satisfactory. TOWN OF SOUTHOLD TOWN CLERK'S OFFICE - SOUTHOLD, N. Y. Examined ............. ~ ................, ........ Application No ............................. Approved ~ 19 ........ Permit No. ~ ~ Disapproved a~ ................................................ (Building Inspector)~ APPLICATION FOR BUILDING PERMIT May 13 68 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 adjo n ng prem ses or pub c streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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 shell 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 HEREBY MADE to the 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, housing code, and regulations. John Miska Jr (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....~. er - builder Name of owner of premises .....~..o.~.,....~..~...s,.~..a....~..~. ................................................................................................................. If applicant is o 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.: ...... ~ ............................ Lot No.: ....... ~ ............ Stre,t and Number S/S. .................. ............... Municipality 2. State existing use and occupancy of premises and intended use end occupancy of proposed construction: a. Existing use and occupancy ....... .~.~.¢.a3;1,~ ............................................................................................................. b. Intended use and occupancy . o~e fa~Z~ ~eZl~g 3. Nature of work (check which applicable): New I~uild'ir~g .~ ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .... ~.OQO ....... .'): ............................... Fee ...... .1..0..?..0...0. ........................................................................ (to be paid on filing this application) ............................ Number of dwelling units on each floor ............................ 5. If dwelling, number of dwelling units one If garage, number of cars ............................................................................................................................................. 6. If business, 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 ................................................................................................................. Dimensions of same structure with a. lterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ..Ll~. ....................... Rear ...... .~. ................. Depth ..... ..2.6. .............. Height .................... Number of Stories ..O~f~ .............................................................................................................. 9. Size of lot: Front ..... .~..Q.0. ................ Rear ........ J..0..O.. .................... Depth ......... ].~.0.. ............... 10. Date of Purchase ........ ~C~.~.~. ...................................... N~.me of Former Owner ........................................................ 11. Zone or use district' in which premises are situated ............ E~.~...C1.£S.~ ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... TXQ ............................................. 13. Name of Owner of premises ..~.?....~...J:...S.~.?....~..~. ......... Address ....~..%.~.~...~.~(: .................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..............S~ ............ Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, ond indicate all set-b~ck dimensions from property lines. Give street and black number or description according to deed, and show street names and indicate whether inter or or corner lot. STATE OF NEV~ YORK. ~. c S COUNTY OF ...~.13~'.~.0,,~. ............ ~"~' ' ,Tot~ Miska Jr ................................................................................................. being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above named. He is the o~'D. er - b~l.~].de~' ..................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ma:ke o~d 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 fo~h in the application filed therewith. Sworn to before me this ~ ~ ~ ~ ................... ? ................ ................. , "~' 5~-~~s~uu ~ c~ ~0, ~