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Home My WebLink About3413-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the build,rig located at L~.t,,.,~,.O~o.O.~/.ig...f~.~lt~...l~D~.~. Street Map No K:i.r~/,tgesstn~ll~ck No ..................... Lot No Ma.ttJ. tu~3c.,...E~...~'.O.[~ ....................... conforrr~s substantially to the Application for Building Permit heretofore filed in this office dated ....................... Mar.c:~l....~.Q~ .................. , 196.].... pursuant to which Building Permit No ....3..4..1...3.....~ dated ..........Ma~q:h.....~0., ................ , 19.6.7..., was ~ssued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which this certificate is issued is ........ · .pr.~ate..on~..famil~'...c1~e11~ug ............................................................................................ The certificate ~s issued to ...... Mr~...&..Mzs.,...J. oB~]~h..~.~t,~t~:~. .................................................... (owner, lessee or tenant) of the aforesaid building· Health De~t. A~0j~roval pencl~ng ~uilding ~nspector [ 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) 3413 Z Permission is hereby granted to: ............ ............... Mattituck at premises located at ..~.t.Q.e.~/.*...]~.~...~ll~.....J~'~l!~.....~ ............................................................ .......................................... ...~.t,.t.t..~.. ~..,..z.. ,. ................................................................................. pursuant to application dated ............................ ...Y~.'~I~. ................. , 19...~..~., and approved by the Building Inspector. NOTE! I~.*0.~,~. approved by t~ Appeals Fee $.~.O...e...O~... ........... Building Inspector FO'R,M ~0, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. Approved ........................................ , 19 ........ Permit No ................................. Disapproved a~-- ~~ APPLICATION FOR BUILDING PERMIT 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 lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 i~or 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. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... q~.~.~'. ...................................................................................................... Name of owner of premises ~J~..~c..~:~s...~'~g.]0~..~.~.t,~.~.~ ............................................................................................... If applicant is a corpo, rate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....~. ~,~'.9.~>~.~.~.~.~ ............ Lot No: ..~,~, .......... Street and Number ......... ..~...~.~..~.~.*.~.~..~9.~`..~....~./..~.....~.JR~.~.D~`8~..~L~.~.~~ ................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .Y.~,.~.~t~,.~../L~.~ .................................................................................................. b. Intended use and occupancy .....0..~?....~.~...~..~..~....~..~.e.]..~.~ ............................................................................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ...~,~'.).QQ.~..~ ................................ Fee ....1Q,.QQ. ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .O..~..~ ............. Number of dwelling units on each floor ............................ If garage, number of cars ....... 2..c&r ........................................................................................................................ 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 ............................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...... .~.9..,~ ......... Rear ....~.9....-....~ .......... Depth ...2~/...~.~ .......... Height ............................ Number of Stories .,~,~. ..................... 10. Date of Purchase .............. ~9.~'. ................................ Name of Former Owner ....~'~L3'.c~§e.~s~e~'. ...................... 11. Zone or use district in which premises are s~tuoted ........ I,~,....r]iS.t~ ....................................................................... 12~ Does proposed construction violate any zoning Iow, ordinance or reguJotion.;) ........... ~ ..................................... 13. Name of Owner of premises ..~.~...~....~.~'.$...~.Q~.~.~,..~lJ~e~ ............ ~L,~..~.~.~.1,t~ ..........I~one No ..................... Name of Architect ~;Lg:.i~'~3J~.&~..]~],d~..J~.~,~J3:],7....Address .......~J.~.z'haa.d ............... Phone No ..................... Name of Contractor ..... ~o,%..~;Ls~3e~'. .................... Address ................. J~'i.~r,~A(~]¢, ..... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicete whether interior or corner lot. / oF COUNTY 01; ........... g.~l~ ............. ~ S.S. .., ............. ~.Q. jj~J~..~.~;td~...q..; ............ ; ........ ; ............... being duly ~orp, ~ep~es and ~ that he is the applicant (Noroe of individual sig~ing application) above ~med. He is the ; · .................................................. (Contractor, agent, co~orote officer, etc.) of said owner or ~ne~, and is duly authorized to ~rform or have performed the said work and to make and file this application; that all state~nts contained in this application are t~e to the best of his knowledge and belief; and that the work will ~ perfo~ed in ~e manner'set fo~h in the application fil~ therewith. Sworn to before me this-- ~/~ Nota~ Publ~ ~ ~,. ~ Coun~'"'"'~'~;~;~;~";~i~;;;~ ............................. '~ '~'"'~']~'~ ........... ~'~';;';0~ ~ ~T IL .. - ' ' ' FOP,~I NO. 2 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? 3~t1~1 ~ Dcrte ........................................................ , 19 ...... pursuan¢ to application dated ........................................................... , 19 ........ , and approved by the Building Inspector. Building Inspector Ca, CD, 7-T RIVERHEAD , '303' OSTRA~D£R AVENUE RiVERHI:AD, N, Y. CO. ~O~Et All piers to be built Of ~8e cement bloc~, tied into main valle ~ade, App!¥ asphalt damp-proefin~ b~!o~ ~rade and ~ celsn% pa~ss , eontabe~e~ Of allf~undntLon