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Home My WebLink AboutLipco-Agway Labor CampSUPERVISOR'S OFFICE 16 South Street Greenpor~. N. Y. Te~. Greenporf 7-0550 BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOV~N CLERK'S OFFICE Mei. Street Southo]d. N. Y. Tel. Southold 5-3783 BUILDING rNSPECTOR'S OFFICE I~BOR CEBTIFICATE OF OCCUPANCY No. 1R1 Date A1~1~ 28 1968 THIS CERTIFIES that the building located a+ a./~ 8am~ A'~e (between T.Z_R~__ & ~t A~e) Map No. ~ , B~ck No. ~ , Lot No. in the To~ of Southold, .conforms substantially fo the approved plans and specifications heretofore fl~d in this office with Application for Building Permff dated ~ ~1 19~ pursuant to which Building Permit No.M ~g~ 1~ , dated M~ ~ 19 ~, was issued, end conforms to all of the require- ments of the epplicab~ provisions of +he law. ~e occupancy for which this ce~ificete is issued is Co~ereSa~ labor ea~ (Dor~atory) This certificate is issued fo T-~.~e~ ~, A~a~ ~e o~ the aforesaid building. (owner, lessee or tenant) Bu~ldlng Inspecfo/ (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construct;on in compliance with the Multiple Res;dance Law and with other laws, ordinances.or regulations affecting the premises, and in conformity with +he approved plans and spe¢~ficatlons.) FORM NO. 1 ·OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................... ~ ~' .[..., 19 ........ ~ ~- Approved ....................... .? .............. , 19..~.~.... Permit No. ~,~,....!....~....~. .... Disapproved o/c ...~ .................... APPLICATION FOR BUILDING PERMIT Dote ......................... .~. ?.~ ....... .2.). ................ , 19....~..8. ..... 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 of property 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. (Signature of applicant, or name, if a corporation) Mattituck N .Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner - builder Name of owner of premises .....L..i.p..qq...-....~.~....a.~.*...~,P,..q ....................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: XX Lot No.: :xx Street and Number o/o oollnd ~,ve~ k~ttztuck ~,.Y. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~.Q~'...Q.~..~.~) ...................................................................................................... b. Intended use and occupancy same ~,:ith addition & Alteration 3. Nature of work (check which opplicable): New Buitding .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... ..2.,~..c)..0..0...,~+ ..................................... Fee ...'l..J:...~..O...O. ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~.~...Qf~.¢.'0~).~.~l~mber of dwelling units on each floor ........ 9..~..e. .............. If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature end extent of each type 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 entire new construction: Front .......... J..LL- ..................... Rear ...... .J...~. ................. Depth ....~.~..-..~. ........... Height .................... Number of Stories .....o..~...e. ........................................................................................................... 9. Size of lot: Front ............................ Reor .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..... ]?.~.~. ....... .~.~..~. ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ..~..o. ................................................ 13. Name of Owner of premises ..Tb'ipg.Q,,&g~'~'. ........... Address ......!~....~..t,..~..~..~..g,,l¢ ................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~.~..~.~Z)-o~.sj'r-~ .............. Address ....~.~...m..e...s.~..o.?...~. .................. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names end indicate whether interior or corner lot. STATE 0F NEW~YQ~ S~ ~ cou, ............ / ................... ........................ b~ ng du y sworn d~oses and says that he is the applicant (Name of individual signing application) ~e~¢ o~ o~e~ ............................................................. above named. He is the .................................................................... ~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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ ................ ..................... . ..... ............................. No. 52-0618100 Suffolk ~mm~sion ~pl~es ~arch 30, TOWN OF $OUTHOLD Multiple Residence Law Permit PERMIT NO. JJeJJe 176 J/~]r LOCATION 8,~ 801~d A~ 21 ~9 68 APPLICATION NO. 1~ ){Ay 21 ~9 68 Y~ttltuek N.Y. Application having on ~/~.~r 21 , 19 6~ , for a permit been made covering construction on a (new, altered, o~ conv~ad) multiple residence bu~ldlng, by or in beheff of ~tttt~ application having Seen *xami~d and recommended for approval on / ~ 21 , I~ ~ . PERMIT is hereby issued for fha pe~orman~ of the ~O~J~ : JarchJfec~urel, sf~cf~rat, mechanical, etc.) work described in the above numbered application and any accompanying plans~end specifications. If no work is pe~or~d w~fhin one year from fha time of ifs issuance, fhls PER~IT ~all expire by llmifefion, Approved ~ 21 I<~ 68 Fee pa~d ffiled estimate $ 2,900. i':haal cost J~ditlo~al flee due Enforcement Officer