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TOWN OF SOUTHOLD
BUiLDiNG DEFARTN~ENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No ~...~1~.(}~. ............ Date ..................... ~Zl~e ....... 3.1., ........... ,
THIS ~iP~t[.FIES that the building located at ,.C~p.t,..~K;Ldd.,J~r. X1/~ ............................. Street
Map No ...lf..~ .......... Block No ...................... Lot No.
conforms substantially to the Appilcahon for Building Permit heretofore filed in this ofhce dated
............... .~...~..~.~I.~t~T~. ............ ~k~. ................ , 19...r~.?. pursuant to which Building Permit No
dated .....~.{Jl~l.l~liJ,l:']/'. ........... l~J ............... , 19..67.., was msued, and conforms to all of the requirements
of the applicable provisions of the law The occupancy for whmh this cerhficate is issued is ........
............... ~.~.~tf~;e ..ome... f~m :i.llr...cl~e 11 ing ...............................................................................
The certificate is issued to ..~l::~'~...~.OD~l:l;~.t~.~ ...... (~e~.) .....................................................
(owner, lessee or tenant)
......................... i giYag; "ig ' lg ' ......... , ...............
FOR~ ~0. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 3358 Z
Permission is hereby granted to:
................. l~a.t~it~l~ ........................................
to ......B~]~.~.. ~..V...O~... ~a~L].~...d~.e~ng .................................................................................
at premises located at ....~,O.tL.~2.....C~ap.t..~dcLEst; ..................................................................
Capt IC~dd Drl~r~ Nattituek
pursuant to application doted ............................ Jal~"~'~ ................. , 19..G~,, and approved by the
Building Inspector.
Fee $],0~00 ............
Building Inspector
S-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
D a t e June 27, 1967
Bldg. Permit No.
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
at n/s Gao. Kidd Drive 200' w/o Luther R~d Mattituck
(Give deed location)
have been inspected by this department and found to be satisfactory.
District Engineer
District Engineer
Builder - Abitz
Owner - H. Constantine
FOE~ I~0. 1
TOWN 01: $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exam,ned ......~.8...~.'g.~ ?. ~..,,...~, ~ ......... 19..6.2....
........................................ , . 33 Z--
Approved l( ' L , 19 ........ Permit No .................................
APPLICATION FOR BUILDING PERMIT
Date .......................... ~..a:.g..~.~..~..~.......]:...~. ....... , 19..6...~. ....
INSTRUCTIONS
a. Th~s applicahon must be completely filled m by typewriter or m ink and submitted in duplicate to the Buildir
Inspector.
b Plot plan showing location of lot and of buildings on premises, relationsMp to adjoining premises or public streets
areas, and g~wng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatio,
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 Bu,ldmg Permit to the applicant. Suc
permit shall be kept on the premises available for inspechon throughout the progress of the work.
e. No budding shall be occupied or used in whole or m part For any purpose whatever until a Certificate of Occupam
shall have been granted by the Budding Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to tk
Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ,
Regulahons, for the canstruchan of buildings, additions or alterations, or for removal or demolition, as herein describe,
The apphcant agrees to comply w,th all applicable laws, ordinances, building code and regulations.
.~----------~' Edw. Abitz Contractor Ina
(S~gnature of apphcant, or name, if a corporation)
~ttituck, N.Y.
(Address of applicant)
State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
Contractor
Name of owner of premises Harry Constantine
If applicant is a corporate, signature of duly authorized officer.
(Name and t~tle of corporate officer)
1. Location of land on wh,ch proposed work will be done Map No ..... ..C].~.P..lg...~.Jr...ct:...~.s.?.. ......... Lot No: ...]]r.~ .........
Street and Number ..... .O.~.~.~...~..C]l,g~...~Z'. ........... .~J~....lS.t~.~J;.g,~ .................................................................................
Mumcipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a ~ J~j -tJ~ e, ~1 ~- ~b~C~ll~r~ y ........ ]~! e,. ,~,...~W, ,e..~,, ,~.$n, ,g ....... . .~..~...e..~. ~... .......................................................................
b Intended use and occupancy .............................................................................................................................
3. Nature of work (check which applicable): New Building ..... ~ ..... Addition .................. Alteration ................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................................
4. Eshmated Cost ...... 7..~.(~.Q .......................................... Fee .... ,%0. ..............................................................................
(to be paid on filing this application)
5. If dwelhng, number of dwelling units ...o.~.~. ................... Number of dwelling units on each floor ..........................
If garage, number of cars .......................... .c~:t%e. .......................................................................................................
6. If bus,ness, commercial or mixed occupancy, specify nature and extent of each type of use .............................
7 D~mensions of existing structures, if any: Front .......................... Rear .......................... Depth .........................
Height ............................ Number of Stories ............................................................................................................
Dimensions of same structure with alterahons or addmons: Front ................................ Rear .............................
Depth .............................. Height .............................. Number of Stones ........................................
8 Dimensions of ant,re new construction' Front ...... ~..~ ................. Rear ...... [~ ................. Depth ........ 2~, ............
Height ............................ Number of Stones ..O~3. ...................
9. Size of lot: Front ...... c)..O.. ................. Rear ............................ Depth ....,%2.Q ....................
10 Date of Purchase ....................... ,%c~6.6 ....................... Name of Former Owner .....................................................
11. Zone or use d~strict m which premises are s~tuated ...... !!~.!!...CtzLs.t, ....................................................................
12 Does proposed construchon wolate any zomng law, ordnance or regulation> ........... ~ ..................................
13 Name of Owner of premises ..~.-.....q.O.~.s...~.ft~..t~-~f~....Address ............................................ Phone No ..................
Name of Architect ...................................................... Address ............................................ Phone No ..................
Name of Contractor ....... ~.t...JL~::Lt,~....ZLD. c, ................ Address ...... ~.t,¢.:J..t,~t¢.~:. ............... Phone No ..................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether ex~sting or proposed, and mdlcate all set-back dimensions frc
property hnes Give street and block numbers or description accordmg to deed, and show street names and indicc
whether interior or corner lot.
STATE OF NEV~ Y_ORI~, ~ S.S.
COUNT OF ..............
......................................... .~.~.~..:....~...b..~...~.~ ................................ being duly sworn, deposes and says that he is the oppli.
(Name of individual sigmng application)
above named He is the ........................ .~Q~c.~O~. .................................................................................................
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authorized to perform or have performed the said work and to moke and
this apphcation; that all statements contained In this apphcatlon are true to the best of his knowledge and b~
and that the work wdl be performed in the manner set forth in the apphcat~on filed therewith.
Sworn to before me th~s
.~. day of ................ ~.~ .......... , 19..~g.
.................. ~ ' ~' ~~..' ~ '' ............. ~'~'~'"~'""~-~'"~'~of appJica~'' ...................
Nota~ Pubhc, JJ../.~...~(. ...... County (S~gnature
~ I MARION A RECENT
~ NOTARY PUodC, ~I~'~ c~ ~',e~v York
No, 52~323~1~0 S~,.t,
Term Expires March 3D,