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Home My WebLink About3622-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I::E:RTIFIOATE~ OF' Or.I::UPANr. Y Noel.. '29~ .... Date ............ ,~j. .... t~" ', 19. ~ THIS CERTIFIES that the building lo~l~ at ~..~d ................ S~eet ~ap No.~,. ~r~o ............. Lot ~o. 9~' ..... ~i~k~' ~,~-.' ..... confo~s substantially ~o the Applicati.on for Building Permit heretof~ fil~ in this office dated ............ ~ep'~ .... 3~., 19. (~ pursuant to whi~ Building Permit No..~2. · dated ......... ~e~ .... 1~ ..... 19~., was issued, and co~orms to all of the require- men~ .of the .applicable provisions of the law. The .~cupancy for which this ce~icate is issued is . .. ~rivate :0~' f'ami'2y' dwe'lliug ........................................ The ce~ificate is issued ~o ...~,..F~2 ....... ~e~ .............................. (owner, lessee or tenant) of the ~or~aid building. .Suffolk County Department of Health Approval ...... ~ ............................. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEI~MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3622 Z Perm!sslon is hereby' granted to: .... ~.t~.~;~.~l,~,~..... M~..~T.~ ,~.e'etm~. ..... .~ ...; . ..~.~.t.,~,.,.~t~... .... at premises lOcated at .~(~.~.,9~.~,....~.~.~.~.tJOJ~,.~..~It{)~l~ ................ ....... ; ; . ................................... .~l,~.....~.~,~t~..~.~ ....... ;...~.~.~IL.... ................................................. ' pursucm¢ to application dated ..................... ~ ........ ~e~ ....... ~.~ ...... , 19;.~,~.., and approved by the Building, [nsp~ector ' Building InSpect'o~ '~/, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , Permit No ............................. Application No. ~ Disapproved a/c .~ ................. - APPLICATION FOR BUILDING PERMIT Date September 13 , 67 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submiffed 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 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 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 and regulations. Walter Kessler (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 builder. Contractor Name of owner of premises .......... .g..*. ........ .~..e...e..~..~.y. ................................................................................................................ 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 Park ProPLot No.: 95' Street and Number ..S..i..~?.'.~).y....~.o...a..d. .......... ~!..a.[b.~t.~.t...u..c..k.. .......................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy dwelling b. Intended use and occupancy same with a~3. addition 4. 5. 6. Nathre of work (check which applicable): New Building .................. Addition .... ..~..~...~. ...... Altera.tion Repair .................. Removal .................. Demolitian .................. Other Work (Describe) Esti .¢nated! Cost .... ~. ~..0..O..0....~./..~. .................................. Fee ..... ~'.. .......................... ! (to be paid on filing this application) If dlwelling, number of dwelling units ....g,g,e. ................. Number of dwelling units on each floor If gprage, number of cars ..................................... If I,usiness, commercial or mixed occupancy, specify nature and extent of each type of use Din ensions of existing structures, if any: Front ............................ Rear ................................ Depth Hei Iht ........................ Number of Stories Dirt ensions of same structure with alterations or additions: Front .................................... Rear Del:~h ................................ Height ............................ Number of Stories ................................ Dirt ensions of entire new construction: Front ......... 12, ...................... Rear ....3~2 ................... Depth ....16 ........... Hei Iht .................... Number of Stories ..............~nm, ............................................ Size of lot: Front ......... ~D .............. Rear .................................... Depth ...~L~.0 ...................... Dar of Purchase ........................................................ Name of Former Owner Zor ~ or use district in which premises are situated .!!~.~]...cl.J~~.~ ......................... Doe proposed construction violate any zoning law, ordinance or regulation? ........... n~ .................. Narpe of Owner of premises .~.......~.e...e..t'.)...e.~ .................. Address ..~.a.¢..~.~!~¢.~ .................... Phone No. Nar~e of Architect ...................................................... Address ............................................ Phone No. Nar ~e of Contractor ...~...]~.~.~.f.~-.~.:~ ......................... Address ............ ~ft.~.t~.~l~ ..........Phone No. PLOT DIAGRAM ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr nes. Give street and block number or description according to deed, and show street names and 10. 11. 12. 13. kocat, property Ii whether in erior or corner Jot. STATE afl NEW,YORK, ~ c ~ COUNTY Jar ..~4[~.OJ.k ............. ~' ~'~' ' ~alter Kessler .. .. . , ...... ~ ..................................... emg duly sworn, deposes and says that he is the appJic ~(Nome of individual signing application) above nar~ed. He is the ....................... ~.O~.~.~.Q~. .... (Contractor, agent, corporate officer, etc.) of said ay net or owners, and is duly authorized to perform or have performed the said work and to make and this applkotion; that oil statements contained in this application ore true fo the best of his knowledge and belief; that the w)rk will be performed in the manner set fo~h in the application filed therewith. Sworn to k.efore me this ................ j.]:~, day of,. ................... ..~:~ ............. , 19..~.~. Notary Public, ~.,~ty' :~ .~: (Sig of applicant) ti ~9.fl618100 SLAIOIk ~unt~ /