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Home My WebLink About3613-zFORM NO. 4. TOWN OF SOUTHOLD BUILI)ING ])EPARTMI~NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CEI~TIFIE:ATE OF O00UPANOY No..Z. 29~0 .... Date .............. No.V.,.. 2,7L..., 19.67. THIS CERTIFIES that the building located at W/~...Cox. }~e(~k. l~oad ....... Street Map No..X:E ...... Block No ..... X~ ..... Lot No..~ ...[~,a.ttitl~kl.. ~,Y, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Sept,...l~l. · , 19.(57. pursuant to which Building Permit No..36/3 .Z dated ......... ~ept .'. ~'. , 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..o:2e. £ami3,~r. clw~llir[g ....................................... ~he certificate is issued to .A~zl:h%%~'. ]~,l~twtll, ..... [lwl~e~,. .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~.O.V,.. ~.61. i967...~y. P~ .Villa. Bmldin§ Inspector [ FORM NO. ~ 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) N? 3613 Z Permission is hereby granted to: ....... ~3....3~....C~aa..J~v. o ................................ ....... ~nt~..~v.~r.tchea ...... ~.-'~o .................... to ]~'~,..~o~..or~c...D,-:~',y...d.,~J~§ .................................................................................... ot premises located at ...~./..~....C..~.~..~.~.~.~...~.~,.~. ................................................................................. .............................. ~;.$.~; ~.tme,,k~...~. ,.~., .............................................................................................. pursuont to opplicotion doted .............................. .~.~ .......~. ........ , 19..f~.., ond opproved by the Building Inspector. Fee $ ~Q ,~.~..~ ............ $-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH Da e Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for (Give deed location) a structure located have been inspected by this department and found to be satisfactory. ',,District Engineer FOI~M NO. I Examined ....................................... , 19 ........ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved '* " '~// ~ ~ ........................................ , 19 ........ Permit No ............................. APPLICATION FOR BUILDING PERMIT Dote ............ ...................... , ...... 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 Jot and of buildings on premises, relationship to od oining premises or public streets or areas, end 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 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 H.EREBY 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, end other applicable Laws, Ordinances or Regulations, for the construction of bui dings, additions or a rotations, or for removal or demolition, os herein oescribed. The applicant agrees to comply with all applicable laws, ordinances, .b~lding code~ and regulations.,-, f applicant, or name, if'a co'r'~'~'(~'t'i~'~')' ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~..~..'~..~.~..J~.......~,....~...-~...~..,.~t~....l:../~- ............................................................................................. 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.: ........................ Street and Number ..}..~<......~ ..... .................................. ~.. ............... ............. .t~...:.t.: .................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................................................................... b. tntended use and occupancy .... ~....~...(~.....J~..O.....~...-~-. ............................................................................... 3. NatUre of work (check which applicable): New Building /~qcC,J Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Esti.[.ated, k Cost ............. ~..~/..;~L,2..:? ............................... Fee (to be paid on filing this application) 5. If elhng, number of dwelhng umts ..L. ¢)~.~< ...... Number of dwellin~ units on eoch floor If fl~ro~e, number of c~rs { 6. If fiusiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. ~i~ ensions of existin~ structures, if any: Front ,...~..~2~Cf%%.. Rear ................................Depth He ~lht ........................ Number of Storie~ ........................................................................................... ~....~. ........ Dh~nsions of same structure with alterations or additions: Front ... :'~ ....... Rear Dep:h ...f~Z.~,..fL...~:~ .~.~. Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~q~. .................... Rear ...... u~.~. ............. D~th .~ ........... ~...,.: Hei~ht ....~.':~ ........... Number of Stories .......... 9. Size of lot: Front ...~..,z.,a ....... ,.... Rear .......... ~}~.. -' ~ ~'' ~,..~ .......... Depth ........ ~.~.~....'. ........ 10. Dar, of Purchase ...~:'~'r;.-~..~K~.~ ........................... Name of Former Owner~.~,~,¢¢¢..~f 1 I. Zen or use district in which premises are situated 12. Doe proposed construction violate any zoning law, ordinance or regulation? ....~.O. ................. 13. Nar e of Owner o~ prem,ses~::~.~...~:~.~x/~...Addres~..~.~/~.~,,~ ........ ~one Nar ~e of Architect ...................................................... Address ............................................ Phone No. Nar ,e of ~ntract~a~..i~...~:~...`"~:~.c~;~:~;`~.~a~res~u~;`~:~.~44~./~F~.~.~. Phone N~ PLOT DIAGRAM Locat~ clearly and distinctly all buildings, whether existing or proposed, and indicate ail set-back dimensions fr property dnes. Give street and block number or description according to deed, and show street names and indic whether ir erior or corner Jot. STATE OF NEW YORK, 1 c c 5 ................................ .... ............. ~ ~.... ......................................................... ~ ....... boin~ duly sworn, deposes ond s~ys ~h*~ he is the ~pp~k Name of individual signing application) ~"~-~ ~ abow~ nan ............................................................ ~ ...... .... ......... of said o~ her or owners, and is duly authorized to perform or have performed the said work and to ~ke and this applJ arian; that all statements contained Jn this application are true to the best of his knowledge and belief; that the v )rk will be performed in the manner set forth in the application filed therewith. Sworn roi ~fore me this ~ __ ~ ~ ~/ ............ ....... ....................... NqtoW Ct bHc, Count ~ ' ~ ~ Sufl~k County ~ t 0z ~0" ~" ~ ~ 1, I '~,,I ....... ~" ~~ £ _ L_ J _ _ : _ I I_ _ L I. _ _t L _ I -t; ~ ~ ~ · : .~ ..... I :T,~ ~l : > 1,4' I ~:~ ~P'I '"~ ~"~ - -~ ......... / - ~,'- ...... ~ I'-_ ..... J ~ ...... ~11 '~ / I t_/ ' : 'LAN C~,O S S ~CTiON J Z Phillip NeudeCk N. 89' 00' 20" E. 125,.00' 0 s. sg° 00'20" W. /25.00' Stanley Becket Z C~ 0 WESTPHALIA ROAD VEY FOR · IUR J. BALDWINS~ FRANCES K. BALDWIN MATTITUCK TOWN OF SOUTHOLD SUFF CO., N.Y. SCALE; I"= 40' ,SEPT. 7~ -1967 LAND SURVEYOR N. · . LIC. NO, I~1~ NOTE=e= MONUMENT t Z Phillip Neudec k N. 09° 00' 20" E. 125, 00' ,.,.,l S, 89° 00'20" W, 12 5 . 00' Stonley Becker m WESTPHALIA ROAD SURVEY FOR ARTHUR d. BALDWIN 8, FRANCES MATTITUCK TOWN OF SOUTHOLD SUFF CO., N.Y. SCALE: I" = 40' SEPT 7, 1967 OCT. 4, 1967 K. BALDWIN GUARANTEES SUFFOLK COUNTY FEDERAL SAVINGS ~ LOAN ASSOCIATION iNTER'COUNTy TITLE GUARANTY' ~ MORTGAGE COMPANY PROFESSli~/~q"Af~ ENGI~/,,~-ER AND ~L Ar,ID SURVEYOR