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Home My WebLink About5419-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy Date .............. ~.U~... THIS CERTIFIES that the building located at .. ][/8.. ][eW. a~tffllk.Ave.. Street Map No. :tX Block No. XX .Lot No. XxX Ylattit~ek conforms substantially to the Application for Building Permit heretofore fil[kl in this office dated ........... Jul. l-.. 22., 19.. ?.~ pursuant to which Building Permit No... dated ............ J..~.... 22, 19. ~.l., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private aocessery (sterage) building The certificate is issued to ...~.~. &.~...N..~.r.t..h~..~.~.g.$..J.r. .... . .0~..e.r. .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N2R.; ............................. ....... .................. Building Inspector k FORM I~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE: SOUTHOLD, N, ¥. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~.,...&~t s.....,~/C...~L~:L~ ~L ~[o~.t~.~ .,J~' ................ H~tu~k ........................ , ................. to ·/~1- .~...ne~.. ~e~ $.~e~r... (...~ ~- ~.~ · .?~ ~ .? i~ ~[.; ......................................................... at premises located at .......... J~ZS..~e.~..,~.~EeJ. k..~,~.. .................................................................... ................................................... [~t.t~u~k- ....... ~,~.~ ............. ! ......................................................... pursuan¢ to application dated ............................. ,T..~J,~[~ ....... ~,,,~..,i,...., 19,..,~f/, and approved by the Building Inspector. Fee $,.~[, I~lO ............. Building Inspector FORM NO, ! · Examined .....~t'....~ ......... , 19.~.~... Approved ........................................, 19 ........ Pemit No ..................................... Disapproved a/c ........ ~...~ Application No ..... . .~.....~...[....~. ............. .............................. (Building Insp;c' o'r? ;i .............. APPLICATION FOP. BUILDING PERMIT Date ........................ ~TD,].~'..... 2.~....., 19....~J. .... 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 for the issuance of o 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, housing code, and regulations. Edw Abitz (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. .......................................................... .a..g .~Ja.l;...O;L ~.Ig~.¢.l: ....................................................................................................... Name of owner of premises ............ lllllar, a...Na~.tJmrlclge If applicant is a corporate, signature of duly authorized officer. .................. iKi;;f;;';;;;;i";i;¥;";f ......... %/ Location of land on which proposed work will be done. Map No.: ......... ,,Il;Z, ......................... Lot No....3;Z3: ............. r Street and Number .......... JJ/..~..~ff.~...~M,t',~..o,l~..~,3~e ................. }J~.~.~kt~13,g~ ..... . ............ / o~ ~ _G" ~ ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwel].i~{~ .............................................................. b. Intended use and occupancy sa~e with accessory building 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ~)00 ............................................................ Fee ...... ~.p.0.0. ....................................................... .* .................. (to be paid on filing this application) 5. If dwelling, number of dwelling units **.~..l~..e. ................ Number of dwelling units on each floor ............................ If garage, number of cars .................................................................................................................... ~ ........................ 6. If business, commercial or mixed occupancy, specify nature and extent of each t~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of ~ntire new construction: Front ............ J~ ..................... Rear ............. 8 ............. Depth ............ ~ .......... Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use d~strJct in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? ....~, .................................................. 13. Name of Owner of premises ..1~..:...~.~.?..t,...~..~.../.~g,.e. ....... Address .....~.i~..~.~.~.~ ................... Phone No ..................... Name of Architect ................................................. ,...Acldress ............................................ Phone No ..................... Name of Contractor .....s....a:~....e. ...................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~YO~ ~-- COUNTY OF .... ~..~. -T;~ ~ ........... ................. ;.~ ........... ;.....;.....~,~..~.'D~.~o~.; ........... ~ ................. being duly s~orn, deposes and so¥~ thor he is the oppiicant ~r~ome o~ JnoiviouoI signing oppdcotion) above named. He is the ......................... ~g.e~'c..e£..~rne~. .............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application, filed therewith. Swam to before me this ................. Notary' Publi~L~-,/J~....~,~-,~..A~.... ~ · ' ........... : ........................ NOTARY pUBUC, state M New yo~k No. 52.812585~, Suffolk Co~l~ Term Expi~'es Mirch 30,