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Home My WebLink About5974-zFOF,,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. g?~5. ...... Date ........... bial~., g ......... , 19..77 THIS CERTIFIES that the building located at ...Lup?eola. ia2 .l~oa~l ........ Street Map No... ~x ....... Block No..xx ....... Lot No, · .x,x... lqatti, tuek...N ..Y.~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Jmm. 28., 19.72. pursuant to which Building Permit No..[971+7,. dated ........... Jtme. 28 .... , 1972.., 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 . Pr. irate..one..i:ami.l.y .d~e[l~ltng. ~ith. ~ddl.ti. oa ...................... The certificate is issued to .Geo.~,ge. &- -Frances. K.x, eiS.5n~. · · 0maers ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N oR., ................................ UNDERWRITERS CERTIFICATE No..N~2621 .~ ..... Feb .23...1.97.~ ................ HOUSE NUMBER ..... ~.~ ..... Street .. Lupron..P.t. ~oad ..... ~ia.ttitu~k ....... Building Inspector \ FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Nm, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PPd~MISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5974 Z Dote.. , ~vaae 28 , ]9..?~, Permission is hereby granted to: ; .......... .~o~:~e..~.eJjL$~;~f~..&.~i£e ................ .................. ~-tu~k .................... ~ ................... ro .~.!~...~...a...a.~..~.~..o.~...o.~...e...x.~..s.~..~.z.;,~....a.~.~!~L, ........................................................... at premises Iocoted at ...L~j~(~S...~...~. .................................................................................... ................................................. ){e,%.t,~.o~ ...................... .................................. ~ ................................ pursuont to opplicotion doted ............................ ~.Z.~....~.: ......, 19..~.., ond opproved by the Building Inspector. THEiI, NEWi,YORK BOARD OF' FIRE UNDERWRITERS STREET, NEW YORK, NEW YORK 10038 Lupton~?oint Rd., Ma~ratona Rd., Mattituck, L.I. ~;c~'ion , Block ~t 2nd FL 11:0 U ]~~~e~'~'the` Boardqf incorrect. ,n,pectors may be identif'ed by 'h~ ¢redenti~s. \ FOB, M NO. 1 TOWN OF SOUTNOLD ~ / hpplicati~ No ............. ~....~ ....... APPLICATION FOR BUILDING PE~IT ~ NST~U~ONSr ~. Thi~ a~lie~tion mu~t ~ complot~l~ fill~d in b~ t~writ~r or in ink ~nd ~ubmitt~d in tri~limt~ to th* 3 ~t* of ~l~n~, aeeurat~ ~lot plan to *cal~. ~ee ~ordinfl to ~hedul~. ~. Th~ ~or~ eo~r~d b~ thi* ~p~fieation m~ not ~ ~mm~n~d b~or~ i~uan~ of Buildin~ ~rmit. th~ ~r~mi~ ~il~l~ for in~etion throughout the ~ork. ~r*n~d b~ th~ 8ui~din~ In~ctor. ~?~IC~TIO~ IS Hfi~fiSY M~D[ to th~ 8uildin~ D~*rtm~nt for th~ i~uan~ of a 8uildin~ ~rmit ~umu*nt to t~ 8uildin~ ~o~ Ordinan~ of th* To~n ~ ~uthold, Suffolk ~ount~, ~ York, *nd other a~limbl* ~, Ordin~n~ or State whether applicant is owner, I~, a~nt, a~hit~t, engin~r, ~ner~l ~ontr~¢tor, el~trici~n, plum~r or builder. Name of owner of premiss ~ ~ ................................................. If appli~ent is ~ eor~r~te, sight, re of duly authorized officer. (Name and title of corporate offmer) 1. Location of lend on which proposed work will be done. Map No.: ................................................... ~. Lot No ............. Street and Number ..~'t~.~...O..~..!.~..~..O.~'~'.~., ........................................ *~r~*t~L~*'''J''O'W''x~'pk' .............. <~ ~-,~ Municipality 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. .~.?.~.?..~.~.?......~...e.~..~.~..Z2.~ ................................................................................. b. Intended use and occupancy ........... :~,~.~.?J~..ll~el 1 ~J2~ ................................................................................. *3. ~*~ature of work (check which applicable): New Building ....................... Addition ..................... Alteration ..... Removal Demolition Other Work Repair ............. . //~ ~ ( Descri pti on ) 4. Estimated Cost :....~..&.e.~..q.~.~ ..................... ~.... Fee .~..~....-.....~: ................................................................................ (to be paid on filing this application) umts ................. Number of dwelling unitS on each floor ......................................... 5. If dwelling, number of dwelling ' f garage, number of cars ...................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of eaCh type of use ..... .-.. ............................. 7. Dimensions of existing structures, if any: Front ...... ~..0..t. ........ Rear ...... ..~.~).J. ...... ~. ...... Depth 2~ ! Height ........................................................... Number of Stories ............................................................................. eo, .... !.9.!. ....................... Dimensions of same structure with alterations or additions: Front .......................... Rear ........... 2~ * 22t 2 Depth ............................................. Height ......................................... Number of Stories ........................................ Rear ......... .~. ................ Depth ....... ..~.~.? ................... 8. Dimensions of entire new construction: Front ..... ..~..0..? ............. 2 ! Height 2.0.! ~ Number of Stories ~ .................. 9. Size of lot: Front 1005 &0 t 3.~0! ...................................... Rear .......................................... Depth .................................................. 10. Date of Purchase ...... .]:. .9. . ~ .9. ...................... Name of Former Owner :....~v.....W...e..e...8..e. .................................................... 11. Zone or use district in which premises are situated ........ .R...e...8.[.(...e.~.~.~..a..]... .................................................................. 12. Does proposed construction violate any zoning law, ordinanca or regulation: .......... .~...O. ............................................. 13. Wili Iotberegraded ~ ........ , . . Will excass fill be mmoved from premises: [ ] Yes ~] No ~98~I02P/ 14. Name of Owner of premises ............ ~! ........................ · ........ ~ · ~ ........... (Address) (Phone No.) Name of Architect ............................................................................. (Address) (Phone No.) Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from wheth- property lines. Give street and block number or description according to deed, and show er interior or corner lot. sTATE OF NEW~ ) .~ couNT .............. : .................. i .......................................................................................................... being duly sworn, de~s and ~ys that be is the appli~nt abo~ name. (Na~ of i~iVid,,~; si~g con.t) He ia tbe .... ................................................... .......; ........................................... .~ ..................................... ~ .............................................................. ( ~n~ctor, ~t, co~mte offi~r, etc.) of said owner or owners, and is du~r~ ~fform ~r hM ~ffor~d t~rk and to ~ke and file ~is a~li~tion; ~ all s~te~n~ ~n~ined in ~is ~;4ra~te~Mst of his knowle~ a~iief; and that t~ work will ~ ~ffor~ in t~ ~n~r Mt fo~h in tbe ap~i~tion f~ ~3 Suffolk Coun~ · ~ ~. co=~,,,,, bpi,,, ~,~ ~0, ............. ................. o, ....................... .... . ................................ . ....