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Home My WebLink About5682-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z17864 Date March 21, 1989 THIS CERTIFIES that the building .... .Ap.D.I.% .I.O.ll. .................................. Location of Property 680 Bungalow Lane Mattituck /~&~ ~io~ ...................... 's't/e~i ....................... ~/e~ County Tax Map No. I000 Section ...1.2.3 ....... Block ..... .0.2. .......Lot 09 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 9. .e .c.... ! 6. :.. 1. 9. .7.1.. pursuant to which Building Permit No....5.6.8. 2 ~ ............. dated .. p.e. c. :..1.6. ~..1.9.7. ! .......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to THOMAS J. & CLAIRE g. FISHER ..................... ioYn'o'c~ff~ ................. : .... of the aforesaid building. Suffolk County Department of Health Approval .......... ~./.A. ............................ UNDERWRITERS CERTIFICATE NO. lq/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF $0~TN0£D i BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE,KEPT ON THE PREMISE COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL N? 5682 Z Permission is hereby granted to: ...................... ~m~..~.~ ............. ~ ................. ........................ ~a~et~L~e~ ............... : ................. to ..... ~.u.il~,,.e~a ..a(~d~,t~,e~ ..e~..e~;~st;a.ul~,. ~X~ ......................................................... at premises located at ...... JJ~J~gJ~t~..:L4~l:;~ ...................................................................................... ............................ ~e~ ....... ~J6 ....... t-..., 19...~J., and approved pursuan~ to application dated the Building Inspector. Fee $.-,-~'.~00 ........... ~ ¥ ~ ' I:suilal13g Ih~p~ctor TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 18o2 11971 APPLICATION FOR CERTIPICATK OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRK-KXISTTNG 'BUILDING ...... VACANT LAND ........ ' Subd[vision ....................... Filed Hap ........ Lot... ................ App Planning Board Approval ...~/~ ......... Request for Temporary Certificate ....... Final Certificate ................ Fee Submlt ~ed: $ ........... APPLICANT..... ~.~..~. ....... rev. I0/la/88 £×amined ~C.~ l(~ 19Z/ Appr°ved ........................................ , 19 ........ Pemit No ..................................... ~FFLIC~TION FOR BUILDING P£RMIT ·OWN OF :)ou~l. toto ~ ~ ~ . ~ BUILDING DE.P.A. RTMENT o~,<~,/,- ~ ~/,'~'"~'"~, ~ . ~ TOWN CLERK S OFFICE ~ ~/~ _ ~..~ ~- ~ SOUTHOLD, N.Y. ~~,~ -- ~'~ ~ ............. / , . 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 ofproperty 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 fo~ the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk C~unty, New York, arid other oPPli~:able 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, ordlnan~, building code, housing,code, and regulations. ' (Si~ature j~r applicant~ or r~me, if a corporation) ,i.t..] ~;J.i }~;. ;~~tt.:. ,~. ,re..~i.t..! :,t,:..] .~, .~i..~:; r,.....g~ If applicant is a corporate, signature of duly authorized :officer. . .................. i~ a~d title of' Corp~'~a~"~i~'~)~" ' 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ...~.~....~,~c,~~...~.7..~:.i~~~...~..' ........... 2. State existing use and occupancy of ~d inten~anc~ of proposed construction: b. Intended use and occupancy .......... ~.~ ................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ............. Alteration ,..~....; ........ Repair .................. Removal ............... ;.. Demolition .................. Other Work (Describe)........................................ 4. Estimated Cost.'~.~...~i~..,..~&.~ ..................... i.....Fee .,,~....~ ................................................................ ~ .......... (to be paid on filing this application) ~ 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................. If garage, number of cars ...... ./... .............................. ; ....................................................................... ............ ............... 6. If business, commercial or mixed occupancy, specify nature and extent of e~ch 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 ~....~.i...%....'~....~..C....~.... Height ....... ' ............. ; ....... Number of Stories ....../.. ........................ 8. Dimensions of entire new construction: Front .................................... Rear ...... .../....~.../.. ......... Depth ...~....O.. ............. Height Number of Stories 9. Size of lot: Front ....... 2'..~.. ............. / Rear ........ ~'...~<7 .................... / Depth ..................... __ .... ~ , .~//';... ....... / · 10. Date of Purchase .......... .* ............................................. Name of Former Owner ....~'~...~...~ 11. Zone or use district in whicfi premises are situated ..................................................................................................... / -- 12. Does propbsed construction violate any zoning lavt, ordinance or regul, at~,n~ ........................................................... 13. Name of Owner of premises~..~....~.JT~..'..~.?.~.~.~...Address ~.~~ . Phone Noy.~.." .~.../..~/.. Name of Architect ............. .....~..~......~..~ .......... Address .Z..i..~...../. ....................... Phone Nol ..... Name of Contractor~...~.~.....~..~.....~./.~.'~Address .~.'.'.~ ............. Phone Nc~v~..~..-...~'.~..~/ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shew street names and' indicate whether interior or corner lot. , (-' i ~- ~ ..... 't ' STATE Of NE'V~.C)~jII~. COUNTY OF '...~n~.~,....~;. ~ ~; ..... · ..T...~t~;~.~..~?,:- .~...-I'~.~.~=.,~.~ .~_. ........................ being'doly "°m; d.~ and s~. ,~ he is the applicant (Name at inaiviaua~ signingppplication)__ ____ ~ ~ __~ above named. He is the ..... ~.~..~J~.......~JL~.~ ............................................................................. (~ntmctor, ag~t, co~oFate officer, ~c.) of said owner or owners~ and is duly authorized to perform or h~e pe~ed the said ~rk and to ~ke and file this application; that all statements contained in this applic~i~ am tree to ~e best of his ~owledge and belief; and that the work will ~ perfor~d in the manner set fo~h in the ~plic~i~ filed therein. Swam to before me this ................. o, ........... . ....... ~ota~ c~.. ~......~..~~ounw (~igna~e ~f applicant) ~. ~ ~U~TH T. ~N Nota~ Puklic, State of New Yo~ No. 52-0344963 Suf[olk Counl~ Commission Expires M~rch 30, 19~