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Home My WebLink About7471-zFOB,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No..Z~-~.6 ..... Date .............. J'..~...~ ...... , 19.~. THIS CERTIFIES that the building located at . .,S~a~J.&. l~ .&. C~al'dJ.l~al. D~treet Map No..Ma.t.~;,. ]~.s.t~. Block No ........... Lot No, . .16 .... }~$.t.t~l~M~k.. ~1...~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ g~ ....1~, 19.. 7~pursuant to which Building Permit No..~7.1.Z. dated ........... ~,ug...12 .... , 19.7-~, 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~,~;~e..o~e..falalj,~. d¥~ll~a~..~tk .&dd$.tt~ol~ ...................... The certificate is issued to ~. ~lel ~'f',; ~la (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. I[,.R, ............................. UNDERWRITERS CERTIFICATE No. N. ;.R.o ........................................ HOUSE NUMBER ..... ~[~[ ...... Street .. ,tza~a .Rc~ ...... . .M~;.t~;a~k .......... 8.~ Card_f~al Dr .... ............ Building InspectOr FOB~ NO. :g TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE'WORK AUTHORIZED) N? 7~71 Z Permission is hereby granted to: A......y~..!.v.~.. ~.u......~ ........................................... ................. ~.t.~,.t. ue.~ ......................................... to ..... maim..a2,ter&tAo~m..~..e~rA~tZug..~,we~llA~X~ ............................................................. at premises located at ..... ~d:lJ;...$~. ......... ~a~t:Ltuak....~Es.ta.~ae~ ................................................. ........................................... Asa. L'LL,~L. ~.. ~eacLov.. J,,a. ................ at~f~l~ae~ .............................. pursuant to application dated AU~. 12 19.7bt , and approved by the Buildin~ Insp~tor. 00:% SURVEY FOR A. MELVIN ~ GERMAINE AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: J"= 40' MAR. 21, ~969 MAY 8, 1969 AUG. 18, 1969 HANSEN REFERENCE ~ MAP OF SUBDIVISION FOR MATTITUCK ESTATES, INC. FILED SEP. B, 1965~ FILE NO. 4453 BUARANTEEO TO' SOUTHOLD SAVINGS BANK THE TITLE GUARANTEE CO. LAND SURVEYOR N.Y.$. LIC. NO. ~8725 RIVERNEAD~ N.Y. Approved lrO~l~ NO. I -~ TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE ~ SOUTHOLD, N.Y. ~ ]9..?, ,~ Application NO7.. ,~,'....~...1. ................ .~ 19..?~ermit No..~,..,~..'..Z. ,/,..~. ....... Disapproved a/c .................................................................................... APPLICATION FOR B~ILDING PERMIT D. August 1 2,~ 7~ are ................................................ , lY ............ INSTRUCTIONS a. This application must be completely filled in by typewriter o~' in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicatien...~r 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 work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancyu~L~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app cable 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, and to admit authorized inspectors on premises and ir) buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................. 9~.~.]2 ........... Name of owner of premises A. ~;elvin Hansen If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ ..o~..~...e.~ ................................. Plumber's License No ..... 9.~.;~ ................................. Electrician's License No. owner Other Trade's License No .............. .aw~ar. .................... 1. Location of land on which proposed work will be done. Map No.: ..... ?.~..a..t..t...i.~.c..k.....E...s..t...a..t~ No ..... .1..6.. ............... Street and Number ....... ~.:~.fk.1..i..a.....6:-....C..~.:E..d..~D.9,~.....D.I'ik.v..¢ .......... .~j*.fLt~..'{;,~..t..u..¢.~: .................. ~ ~':~ZF' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwelling with b. Intended use and occupancy " with alteration 3. Nature of work (check which applicable): New Building.. ................. Addition ........ ~ ..... Alteratior~ZT,~ ....... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ..1..5.:..0...0. ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .o..~...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 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 ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ....... .1.0D....'t'. .................................... Rear ......... 1..~...0. .......................... Depth .....~,0..0. ................... 10. Date of Purchase ........................................................ Name of Former Owner ....... ~,~.~J,J~(~..~,~.~ ................. 11. Zone or use district in which premises are situated .....~!~!~....r.].iS:~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... .]~.q. ........................................... 13. Will lot be regraded .....t'u:). .................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...~.:...!~!.e...]:~..J:..n.....~..~...Tf..s...e..t2-.. .......... Address .,.~'.~.t...t:.$..~..~.c...~ ....... Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ........... .o.,~.~e.?.. ..................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locote cleorly and distinctly all buildings, whether existing or proposed, ond indicate oll set-bock dimensions from property lines. Give street and block number or description occording to deed, and show street nomes and indicate whether interior or corner lot. STATE OF NEW ~O1~, .. [ ~ S COUNTY OF ..... ~..t~...-.z.~.o.~..~. .......... ~ ~. ..................... ,~.~...t~.~.~.:k~.,,~/~'~s.e~ .................................... being duly sworn, deposes and says that he is the applicon! (Name of individual signing contracO above named. He is the owner- builder (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 all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to befores...~.~:~Dyme thiSof .z~'~ ~', 19...'~. Notary Pu blic~,/~...~.. ~ou nb/ ............. (Signature of applicant) JUDITH T, BOKEN ;q.:~!, y ~uLi~:!, $1a~e of New York C-~mrtnf~ion Expire~ March 30,