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Home My WebLink About4139-zFORi~ NO. 4 TOWN OF SOUTHOILJD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...N/~8.. O.~.e..g.~..e.. L.a. ....... Street Map No. XX Block No. xx .Lot No. XXx Mattituck N .Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~T..~...y...1.8..' 19.6.8.. pursuant to whichBmuildi~g Permit ~o~ ~1.~9~ . dated ......... 4.t~..Y. .... 1.~}..., 19.6..8., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occgpancy for which this certificate is issued is . .P .r.i.v.a.t. 9..g.d.r..ag?.. ~ .a.o.qe..s.s.o.~.y..u. 99.) .... ............................... The certificate is issued to Austin B. guthill ~wner (owner, lessee or tenant) of the aforesaid building. NoRo Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No. N.R. HOUSE NUMBER .... 2.8.00 ...... Street ...0.1.~..J..u~..o, ..L.~ ........................... Building Inspector FO17~I NO. 2 TOWN OF $oUTHOLD BUILDING Di~PARTMENT TOWN CLERK'S OFFI¢£ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 4139 Permission is hereby granted to: ...... ~ ..~...~ ~.. ~ .,... %~,.~,1 ................................ .... -- B].~ ................................................... to .~u~l~..~r.i~%'~ ''~a~ag~ ''~''~'~°~'a~ ' ~ ~ ( approvec~ by D~ a.c, pealS) .............................................................. at premises located ot ..... ~J~...-.~-..~-g'~eL']'~t'~l~'''''~''g~'''''~ ......................................... ...... . ...... ~.t&~,.~; ....... R.~ ............................................................................ pursuan,t to application dated ................. ~],~......1.J~...;....., 19.~J~.., and approved by the Building Inspector. Fee $....~..?..0...0. .......... .......... T .... Building Inspector Examined Approved Disapproved o/c FOBM NO. I T~WN OF SOUTHOLD BUILDIN$ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. APPLICATION FOR BUILDING PERMIT 3 .......... ............ , ..... INSTRUCTIONS o. 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 drown ~n 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 shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to ~he 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 ali applicable laws, ordinances, buiiding cgd~e, housing code, anfkreguk~tions. (Signature of applicant, e~ ne..m~z, if~c,~pe~t~n) (Address of applicant) State whether applicant is owner, lessee, agent, arch tect, engineer, general contractor, electrician, plumber or builder. ....................................................................................................................................................................... ~f 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 dona. Map No.: ................ ................. Lot No.:. ....................... -- ~" -- Munici~lity / 2.State existing use and occupancy of premises and intended use and occupancy of propos~ construction[ a. Existing use and occupancy ~% ~ ~ ~ b. Intended use and occupancy-..~.~./~.....~.~...~.~......~.-.~.~.~.~J~ ....... ~.~,Q~., ............. O I New Building ...... ~ ......... Addi~ Alteration .................. 3. Nature of work (check which applicab e): .................. Repair Removal Demolition .................. Other Work (Describe) ........................................ ~.~ .i..~?.~.~.. ~ ........................... Fee .........:...~'. ............................................................ 4. Estimated Cost " (to be paid on filing this app ication) 5. If dwelling, number of dwelling units ....... ~..~... ............... Number of dwelling units on each floor ........ ~ ............. If garage, number of cars ..... OZ~.~-~..-...~.-I.} ................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... ~7 .......... 7. DimenS ons of existing structures, Jf any: Front .....~ ............... Rear ...~ .................. Depth ...~....'~.. .......... Height ~./. ........ Number of Stories ...........~ ............................................................................... Dimensions of same structure with alterations ar additions: Front .................................... Rear ............................ Denth He ght . Number of Star es ................................ ~' ' ...................... ~" "~ onst r u ct i~'~'" ~'~'~' ......... 8. Dimensions of entire w : .......................................... Height .................... Number of Stories ................. ~...../~..~......~!'~ ............................................................................. ci~ ,~f lot Front ............................... 9. Date of Purchase i/ }~l~..~ Name of Former Owner .~...,~/~.4'/.~. .......... ~/.~.....~. ................. 10. · ....... 11. Zone or use district in which premises are situated ........ ./~./~....~./. .......................................... proposed construction violate any zoning law, ordinance or regulation:~ ~.~..'~..tl~../~.~.'....~.~'Z'U'/~/- ]-/~.~..~. 12. Does .......................... 13. Name of Owner of premises/~.~.,r./'~/ .~.,...?.~..~.../~.~....Address ..../~.~/~.~.j:L~./Z.rJ~:....~...~.. Phone Nc~'..~...'T..~..~..~./~ Name of Architect ~ Address ............................................ Phone No ..... ~ ......... Name of Contractor ...... ~ . .... Address ............................................ Phone No ........... --:. ......... Locate clearly and distinctly all bu Idings, whether ex sting or proposed, and indicate all set-back dimensions from property lines. Give street and block number or descrip ion according to deed, and show street names and indicate whether interior or corner Jot. STATE oF NEW_YORK, COUNTY OF .~l~.~'. ........ ~ ~'~' ......... ........... (Nome of individu~l"signing qpplic~tion) obove homed. He is the ......................................................................................................................................................... (Contractor, ogent, corporate officer, etc.) of said owner or owners, ond is duly outhorized to perform or hove performed the s~id work ~nd to m.~ke ond file this application; that ali 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 ~re me this ~.~ .......... day of ........ ~. ................. , 19~ .... /.~~_..~.. ~~ .......... . . .............. ~ ~.~.~.-.~. ~.~ ................. Notar P [lc, . ................ ~.~.~...=~u..v.~xi~unty (Signature of applicant)