HomeMy WebLinkAbout3985-zFO~M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No..Z...3~15 ............. Date .....l~o.~.elt~o~...~,. ........................ , 19..6..8....
THIS CERTIFIES that the building located at ..~z, al:La..J~r.:Lv~ ...................................... Street
Map No. ~.tt;/tlzCk Block No ....................... Lot No...~,.~..1.O.....J~..~.~.~.u...c..k.x....~...e..'ff.....Y..o..~.~....
Estates
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.................... ~l~cju~_..9., ........................ , 19..68.. pursuant to which Building Permit No...~..9..8...5.....~.
dated .......... Aug~ts.~..9., ....................... , 19...6fL, was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
..... .pr~Lvate ..~e...~amJ,l,y...~ll ~,~g .........................................................................................
The certificate is issued to ....... ~lJ~.ew...J,...H;Lr~l~ ...................................................
(owner, lessee or tenant) .......
of the aforesaid building.
Health Dept. A~roval, October 30, 1968, Robert V~lla
Building Inspector
FOF,~ NO. ~
TOWN OF $OUTNOLD
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? 3985 z
Permission is hereby granted to:
at premises located at ~ 9 ~ 'J 10 ~f~t,~L'~lS]l~ Jll~, fl
.............................. ~..~4 ............ ~.~_~.....~...~.... .......................................................
pursuan¢ to application dated ............................ .~....'~ ........... ~. .......... , 19.....~..., and approved by the
Building Inspector.
Fee $~.,0.,~0~,., ...........
S-9
SCHD
SUFFOLK COUNTY DEPARTHEHT OF HEALTH
Date October ~0, 1968
Bldg. Permit No. 398~Z
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
at 1~0' N. Cardinal Dr. N/S Azalea
(Give deed location)
Mattituck~ Southold
have been inspected by this department and found to be satisfactory.
~rner- A. Himes
BuilderO E. G. AbitB
District Englne~F
District Engineer
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
,~UTHOLD, N. Y.
Approved ........................................ , 19 ........ Permit No .........................
Disapproved a/c .......................................................
APPLICATION FOR BUILDING PERMIT
August 9 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 adjoining premises or public 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 issue.hca 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 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.
Edw. Abitz Contractor
(Signature of applicant, or name, if a corporation)
Mattituck
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder.
aontractor.
Andrew J. Hines
Name of owner of premises 26 buckingham Dr Huntington
If applicant is 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.: Matt Est - - ,, 9 &
........................................ LOT INa.: ........................
Street and Number zalla Drive Mattltuok
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... .~..~.¢.~,~..],~, ........................................
b. Intended use and occupancy ode family dwelling
3. Nature of work (check which applicable): New Building .... ~,~r.... Addition ..................Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ........2.~.~O.0.O...R~:~ ............................ Fee .....~Q,D.O ..........................................................................
(to be paid on filing this application)
,5. If dwelling, number of dwelling units ........ .o.b.e. ............. Number of dwelling units on each floor ............................
If garage, number of cars .........t~'.O. ............................................................................................... :.'. ...........................
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 alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ....~..0. ............................ Rear ........... 7..0. ............ Depth ~.-...6. ..............
Height .................... Number of Stories ...... .Q~.~. ........................................................................................................
9. Size of lot: Front ............................ Rear .................................... Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
! 1. Zone or use district in which premises are situated ........ '.~.~.~.~...~.~,~.~- ..........................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ..~..O. ...........................................
13. Name of Owner of premises .~.~'.~.!ff...]~[~k~. ........... Address ......,~!g~'n-g.~P~ .............Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor ......~..:....~.~..~.~ ............................ Address ......... ~.~.i_.~.~.c..~ ............. 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.
STATE al NEW YORK, ~ S S
COUNTY OF ....... .~.l~f. fPi~ ....... ,f ' '
Edward Abitz
................................................................................................. being duly sworn, deposes and soys that he is the applicant
(Name of individual signing application)
above named. He is the Col~tra¢tor ......................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or hove 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 apptication~4~e~ therewith.
Sworn to before me this
..................... ~. day of .............. ..~..~...~..~. ?..~ ............... , 19....~,.8.
_ ....... ..................................
Notary Public, ..~./~.....~..,.....f.~.~.~ County (Signature of app4~cont)
MARION · REGENT
NOTARY PUBL C, S ate ol Ne~''
~o. 52-3233120 Suffolk C
Term ~pires I~tarch %, ~'~