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Home My WebLink About6564-zFOEM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy Map No....~ .... Block No .... ~ .... Lot No...:~X .... [{a.~;ltll~k ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... May .... t0 , 19 ~'3 pursuant to which Building Permit No. 6~.6.~.2; dated ......... May...1.0., 19 ~.3, 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..ome. family .dw~ll.tng ........................... The certificate is issued to . S-,A,Mat~a .Own~- ............... (owner, lessee or tenant) df the aforesaid building. Suffolk County Department of Health Approval ~.Ro ....... UNDERWRITERS CERTIFICATE No.. 1~ .0078Y2 .... J~_~_~ne .20...197~ ............ I-IOUSE NUMBER..~-O~.Y.~'/... Street../~r~_..~....~. I ................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 6561 Z Permission is hereby granted to: ................. ~f,~.C.~..~t~ .................................... ro ..~...~{L~...~td;Lt;L(~ ..on..ez~t ~ ~. ~re~;s.~ ............................................................... at premises located at ..]~0~e..~'.~...~l~..~t~l~E..~) ............................................................. ............................................... ~igsl~..Rd~...Ma~.l~ne...L~ ........... ~tt, i.t~ek- ............................ pursuant to application d~ted ..................... ~ ....... .~.0 ................ 19~.~..., and approved by the Building Inspector. Fee $].~.~..0..0.. ........... FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .....I ...................................... ........ ..... ........... ......... ....... ..... ................................. ................. ~.~~/ ......................................... [ ~ (Budding I~ector) APPLICATION FOR g~ILDING Application No..~....~..¥~.... ~K~... ........ Date May 10 19 ?-~ INSTRUCTIONS a. Th~s apphcat~on must be completely hlled In by typewriter or in ink and submitted In t.phcate to the Budding Inspector, w 3 sets of plans, accurate plot plan to scale Fee according to schedule. b Plot plan showing location of lot and of buddings on premises, relationship to~ adjoining premises or pubhc streets or areas, - giving a detailed description of layout of property must be drawn on d~agram whmh is part of this apphcation. c. The work covered by this apphcat~on may not be commenced before ~ssuance of Budding Permit, d, Upon approval of th~s apphcation, the Budding Inspector will ~ssue a Building Permit to the apphcant Such permit ,shall be kept the premises avadable for inspection throughout the work. e. No building shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of Occupancy shall have b- granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to the Budding Z. Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the constructio, buildings, additions or alteratmns, or for removal or demoht~on, as hereto desc.bed The apphcant agrees to comply w~th afl apphcable la, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary mspectio. (S~gnature of apphcant, or name, ~f a corporation) ~.~.>.~.,V..~.k.. ............................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build Edw Abitz Contactor Name of owner of premises ....~..:..A...,?,.~..,i..n,. ....................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's L~cense No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No ................ ~.:..0..:.W.,:.....°..f..f....?.',.~Ltt~t I~.r...k....P..~.o.P. ....... ~ Mattituck Street and Number ..... E~/~..~igzb¥...R.'~ad ............................................................................................................... Municipahty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ .d..w....e..1...1..i..n..g ....................................................................................................... b. Intended use and occupancy ............. S~3J~,..wil;h..~r~,ad~ll.t.~o~ ................................................................. 3. - Nature of work (check which applicable): New Building ....................... Addition ......... ~ .......Alterati~n......x~... ..... Repair ......................... Removal ......................... Demolition ........................ Other Work ................................... (Description) 4. Estimated Cost ............................................... Fee /~---~-'~'--'-'-~ , . (to be paid on flhng this apphcation) 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 .................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ........................................................... Number of Storms ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ........................................ Depth ............................................. Height ......................................... Number of Stories ....................................... 8. Dimensions of entire new construction: Front ......... 2,~ ........... Rear ........ .2.~ ............... Depth ........ .Lj..~.~ ................. Height ................................................. Number of Stories ....... ~-'ze ......................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth ................................................ 10. Date of Purchase ..................................... Name of Former Owner ........................................................................... 11. Zone or use district in which premises are situated ........ t.[~.~.~....~...i.~.~.. ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... 1~...o. .......................................... 13. Will Iot be regraded ...... ~.o.. ........................ Will excess fill be remov,ed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ...... ~.;,~....I.~[.~.~ ................................... ~,-..a..t..t...i..t..~..9..k' .................................................... (Address) (Phone No.) Name of Architect .................................................................................................................................................... (Address) (Phone No.) Name of Contractor ...E........A...b..i...t..z. ............................ .,M..a..t...t..i...t.?:.c..k.. ........................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate whet er interior or corner lot. STATE OF NEW YORK, Suffolk COUNTY OF .............................. .................................. ~,,.dw~...A,,B~,,~.~. ................... being duly sworn, deposes and says that he is the apphcant above name [Name oJ mdt~Mual stgnmg contract) Contractor He ~s the ............. (Contractor, agent, corporate officer, etc.) of sald owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and file th~s apphcat(on; that statements contained m th)s apphcabon are true to the besl,,of h~s knowledge and behef; and that the work wdl be performed m the man set forth in th(~ apphcatlon flied therew+th 0 Notary Pubhc, ~~, ............ (Signature of apphcant)