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Home My WebLink About4545-zFOI~M 1"4'0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. ~67't ...... Date ....... De~...-] ....... , 19.69 THIS CERTIFIES that the building located aW~ ~est B~ .Deep. {iote. D~treet Map No. 'Xx ......... Block No. ~ ...... Lot No. ~.. F~at%tt~A~k. · .]~,Tf., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ i{OV¥ 7"" 19 .~.9 pursuant to which Building Permit No..l+~. 5 ~.. dated .......... 1~o~' .7 .- , 19 6~, 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 .. Private .gar-'ge. (~eces~ory. B.l~lg) .............................. The certificate is issued to .E ,~,..W&rl~eP~- · 0Whet, ............................. of the aforesaid building. Suffolk County Department of Health Approval ouse 500 (owner, lessee or tenant) .... ....................... Building Inspector FOIL~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEP'I~ ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ................ ,~ ,,~ ~:...~..,Sm~...~...~..~.,,~r~ ..................... 1~:t.'1~ ..................................... ............................ ~1,~, .......................................... to ..................... j~,..l~R~aJ~J~...J~g~/iL~.. ~//~.tJ;~J~ ............................................................... ........................................................ ,V,,~'J*.M~olf ................................. :.: ...... ., ....................................... pursuo~ to application dated .............................. ~0.~. ....... ~. ............ , 19..J~., and approved by the Building Inspector. Bu'ld' g Inspector ~ ~Ol~M NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~.....2. ..... ,I 9...~...~. Disapproved a/c .............................................................................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............................... ~...O.?.. ...... .?. ............ , 19..~. 9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted m duplicate to the Buddmc Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o 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 ~ssuance of Building Permit d. Upon approval of this application, the Building Inspector will issue a Building Permit to the apphcant Such perm~ 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 Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demohtion, as herren described The applicant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations ........ .................................. (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 buHde, ......................................................... g.Q~.~a~ ..................................................................................... Name of owner of premmes ........ ~,.~..,.~.a,~.~zt .......................................................................................... 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 · ~ ..................... Lot No X~ ............... Street ~ Number ............ .~./.~q.....~,s.J:...br~.h.._~a~p..~c~a...Ck...D~. ....... ¥~.~¢-¢.tu¢~. ........................ 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Ex,sting use and occupancy ........ ~w~l~fr~ ................................................................................................. b. Intended use and occupancy ................ D.~.~....w.i.l;l'L.arL..a~nah~d..4~ama~e .......................................... 3. Nature of work (check which applicable): New Building ..?.~ ......... Addmon ................ Alteration .~ Repair .................. P, emoval .................. Demolition .................. Other Work (Describe) ....................... I ~o-~ ~ ~ _,~-~ ..... 4. Eshmated Cost ............................................................ tee ....................................................................................... (to be paid on filing this application) 5 If dwelling, number of dwelling units ............................ Number of dwelhng units on each floor ....................... If garage, number of cars ............. D;D,Q ....................................................................................................................... 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 ........................................................................................................... D~mensions of same structure with alterations or additions: Front ....................................Rear ..................... Depth ................................ Height ............................ Number of Stories ................................ 8 Dimensions of entire new construction: Front ............. .1.~, .................. Rear ...... .1...2. ................. Depth ........... .2...0.... Height .................... Number of Stories ......... O:D.f] .................................................................................. 9 Size of lot: Front ............................ Rear .................................. Depth ............................... 10 Dote of Purchase ........................................................ Name of Former Owner ..................................................... 11 Zone or use district in which premises ore situated ........... ~.~..~..t.~.~l,~..S.~ ................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation? ................. :~.0 .................................. 13 Name of Owner of premises ..... ~..,,~.,.~a.~.e,:D, .......... Address ......... ~¢.a.~%~.t:.~.~..~ ............ Phone No .................. Name of Architect ..................................................... Address .......................................... Phone No ................... Name of Contractor .......... .~...,.~.e...:1:.]....]:~.....&....~.o...~. ........ Address ............. ..~.a/.~..J.~.~..?.~ ...... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex,sting or proposed, and red,cate all set-back d~mens~ons frorr property lines Give street and block number or descnpt~on according to deed, and show street names and indicat.- whether interior or comer lot. i~~ ~.~~ STATE OF NEW,q"~FR,~-~ ~, 1. ~ ¢ COUNTY OF .... E ~C .':..':'..":..~.. ........... .f .... ......................... ~..~e~].~ ............................................ being duly sworn, d~oses and says that he ~s the opphcant (Nome of ~nd~viduol s~gn~ng apphcot~on) above named. He ~s the ............... ~¢~.~e.¢~.~ ............................................................................................................ (Contractor, agent, comorate officer, etc.} of sa~d owner or owners, and is duly authorized to perform or have performed the so~d work and to ~ke and fil~ this oppl~cahon; that oil statements contained ,n th~s apphcat~on are true to the best of h~s knowledge and behef, ant tha~ the work wdl be performed m the manner set fo~h m the apphcoti~ filed therewith Swam to before me this ................. .... o, .............. .............. , ........ .................... ~ MARION A PEGENi NOTARY PUBLIC, State of ~ew No, 52-3233]20 Sallolk County Term ~pJres ~ar,:h