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Home My WebLink About5807-zFORM NO. ~ TOWN OF SOUTHOLD BUHDING DEPARTM~NT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No.. ~3~.~ .... Date .. J~l~'. ~6 ................. ,19. THIS CERTIFIES that the building located at .... 62~;[~ .¢o3~ .bal~e..Re, l~e. Street Map No... ¥6~ ...... Block No ...........Lot No .................................. conforr~ substantially to the Application.for Building Permit heretofore filed in this office dated ... AI~,3,. 1~. ......... , 19.~2. pursuant to which Building Permit dated ... ~1~.~. 13.'2.: ...... , 19.72, was issued, and conforms to all of the require- ments of the applicable provisions~f the law. The occupancy for which this certificate is issued is ....... Pr~v~e. g~ub. ~u$~ ........................................ The certificate is issued to . }lai;~.~ .C~..C~,llb~ .lies .......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval .......... ~[,.R., ..................... UNDERWRITERS CERTIFICATE No. HOUSE NUMBER 62~0 Street Cox Lane Range! Cu~ho~le~ Building Inspector FORM 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? 5807 Z Permission is hereby granted to: to ...~l,.ld.. ~...&~.~.t ~,e~_.. e~..e ~'- ~t .~ ~g-..bu~&d.~ ............................................................. at premises located at .......'~..Co~,..L~t~y..~tt~,hc~l~....~, ............................................... pursuant to application dated ............................. ~,p~,~,~.....~.~...., 19.~.., and approved,by the Building Inspector. Fee $....~ ~.e.~ ........ BUILDING DEPARTMENT '/"/73 ~' )~ TOWN CLERK'S OFFICE~7~3 ~ S~THOLD, N.Y. y/~/~ ~ ~ Exam,ned~. / ~ 19 ~ ~ · . ........ ............. , ........ ~prov.~ ........................................ , ~ ........ ~,m,, No...~ ........................... ~ Disapproved a/c ..................................................................... ............................... · ~ ;~ ............................... APPLICATION FOR BUILDING PE~IT ............... ............ ~ Thru ~ hcot~ mu~t bo corn I~t~l fill m b ~wr~t~r or n nk . ' ~' ' p ~ ' ~ ' y ~ ' i i and ~ubmitted in dup~ic~t, ~o th~ 8uildi~ b. Plot plon ~howin~ Ioc~tion o{ lot ~nd of buildino~ ~ pr*mi~*, relotion,hip to od~oinin~ premi*~ or public ~tre~t, ~re~, ~nd ~ivin~ a d~t~il~d d~ription o{ I~out o{prop~ mu*t b~ drown on th~ dioflrom which c. ~ work covered by th~ o~lic~tion moy not b~ comm~m~d b~{or~ i~suanc~ of Buildin~ ~*rmit. d. ~pon opprovol o{ thi~ ~pplicotion, th~ 8uildino In~p~tor will issu~ o Buildin~ P~rmit to th~ opplimnt. ~h p~rmit ~holl be k~pt on th~ pr~mi~ ov~i~bl* {or inspection throughout th~ pr~r~ of th~ work. · . ~o buildlnO ~h~ll b~ ~cupied or u~d in whol~ or in p~ ~or ony pu~o~ whot~v~r until a sh~ll hav~ b~n ~ront~d by th~ Buildin~ ~n~p~ctor. A~P[IC~TIO~ IS HfiRfiBY ~D[ to th~ Buildin~ D~partm*nt for the i~u*nc~ of o 8uildin~ ~*~it pur~uont to th Buildin~ Zon~ Ordin~nc~ o~ th~ To~ o{ Southold, Suffolk Count~, ~w York, and other opplic~bl~ R~ul~ion~, {or th* construction of buildino~, o~iti~ or ~lt~mtion~, or {or mmovol or d~molition, The opplic~nt ~or~ to comply with ~11 ~pplicobl~ ~w~, ordinonc*~, buildinO c~e, hou~in~ c~, Mattituok Ounc Club, Inn. ~'~ ~ (Signature of applicant, or name, if a ~oraton) ~ o/o ~e~ ~ ~ ~e~. ~....~Q~...~.e.*~.~ ~..~,...~.~.,..N~L ....... ~~ ~ e~~ (Add~ssofappllcant) State whe~er applicant is ~ner, less, g , tect, engineer, general contractor, electrician, plumber or builder. O~e~ Mattituo~ Gun Club, ~nc. (Name and title of co~orate officer) il M~ "~6~ north of Mtd~l~.Rd. 1. L~ction of lend on w~ic~ p~o~d work w ne ~one ~ ~o ....... Lot No ' ~OX'S ha~e, ~to~o~e~ N.Y. ............ Street end Number ........ 6.~.~.~ ........................................................................................................................ 2.Me$e existin~ ~e end ~pcn~y of premises end intended ~e end occu~ncy of pr~os~ c~sfruct~: u. ~isiti.~ use o~ ~cuponcy Private Club Indoor Fi~i~ ~ange b. Infended use end ~c~ncy Private club indoor fi~i~ ~an~e and meetin~ ~oom ~ N~ature of work (check which applicable): New Building .................. Addition ~ Alteratior~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ ..$..6,000 4. E~timated Co~t ......................................................... 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 each type of use .~..~..b....~..~..g...e.... 82 7. Dimenslol~s~of existing structures, if any: Front ................... Rear ........ ................... Depth Height ........................~.o Number of Stories I . Dimensio f same structure with alterations or additions: Front 46 Rear 46 Depth ................................ Height ............................ Number of Stories ................................ 23 R 23 82 8. Dimensions of entire new construction: Front .................................... ear ............................ Depth ........................ Height ...1..~ ............. Number of Stories 1 9. Size of lot: Front°...~.....~.~.z....e..u..~ ....... Rear .................................... Depth ................................ 10. Date of Purchase ....... .]:...c).~.~.. ....................................... Home of Former Owner Doroski ~ arming 11. Zone or use district in which premises are situated ..................................................................................................... p z3o 12. Does proposed construction violate any zoning law, ordinance or regulation ............................................................. · . Mattituck Gun Club.Inc., Cutchogue, N.Y. 13. Name of Owner aT premmes ........................................ ~aaress ............................................ Phone No ..................... Same Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~me ....................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly ond distinctly all buildings, whether existing or proposed, ond indicate oil set-b~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW Y~OR~ tS S COUNTY OF ...... ~:.~...~.:.~.f.~...'~.. ........ ~ ' Mathew J Martin . . ................................................................................................. be,ng duly sworn, d~o~s and says t~t he is t~ applicant (Name of individual signing a~lication) -- - above na.med. He is the P~esiaen~ of Hard, tucK Gun Club, Inc. (Contractor, agent, co~orate officer, etc.) of said owner or ~ners, and is duly authorized to perform or h~e performed the said work and to ~ke and file this a~plJcation; that all statements contoJned in this application are true to t~e best of his knowledge and belief; tha~ the wor~ will ~ performed in the manner set fodh in the applJcati~ fil~ therewith. Swam to before me this ............... ...... .................. ............ , ....... .. tw4~q P OF L