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Home My WebLink About214-zNO. 4 TOWN OF SOUTHOLD BUI~.DJNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at .W/.S ..... ~id,~ .~T,~ ........................ Street Map No ...... ~,~,2,'~,~ ............... Black No ...... ~ .......... , ~ ....~.tt.J..-~l~k.t ..... ,t[.,~Zo conforms substantially to the Apphcat,on for Building Permit heretofore filed in this office dated ..................... ~zg~Zl~,~,Z,.~... ~ ....... 19 .~'~., pursuant to wh,ch Budding Permit No .....~....~.~.. ............ , doted ................... ~r~r.. ~.~ . .19.. ~'i~., was issued, and con/:orms to all of the requirements of the apphcabfe prows~ons of the law The occupancy for which this certificate ~s issued is ............ ...................... ~R.I~.A.~'~. I~:ELLZ. ~G .................................................................................... This certificate ~s ,ssued to .... ~['~G~..~I~'~ ...... :.( ..O't~,l~) ...................................................... ~owner, ~essee S'r tenant) of the aforesaid bu,ld~ng 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 WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No '~......~./.~.... Date ... (~~ ...... ..~....? ......... 19..'~....~ Perm,ss,on, s/~i~.t..~..t..o/~ .......................... ~ pursuant to apphcatlon doted . C~ .C:~...... C~- .~. ...... 19 ....~ and opproved by the Building Inspector Building Inspector FORM I~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined...~'--' ~ 19 -~'~'~' ^ r - " " ....... pp oved ........................................ 1 9 ........ Permit Disopproved o?c ................ > .~..... ..................... .~..~ ~ i .' ......... ~'~'i'[~ i~;' "i~'~pec t~';) '' ' APPLICATION FOR BUILDING PERMIT 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 o~ lot and of buildings on premises, reiationship 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 location. 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 a 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 ar)d 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, electrican, plumber or builder. .......... 0.wz~e~. . ............................................................. Name of owner of orem ses Thomas B. and Helen Z. Reeve 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 ................................... Block .................................. Street and Number MaLden :Lane 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. 0~fl..~.~.J-,~....~W.~.:k~.::[-.~.g ....................................................................... b. Intended use and occupency ........... ~.~...e....s....~..b..O...v..~ ...................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..~. ................. Alteration .................... Repair .................... Removal .................... Demolition. ................... Other Work (Describe) .................... 4. Estimated Cost .~...~..2..0. .0. .. Fee ... .. (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units...S%,.,q~.e ........... Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type af use ................................ 7. Dimensions of existing structures, if any: Front..g..~....~..~..:. ............. Rear ..~..g.....~..lg... ............. Depth ..~.~...~..~.: ............ Height ....2.~....~..~.t ........... Number of Stories ..... .2. ....................................................................................................... Dimensions of same structure with alterations or additions: Front ~...~..~.*. .................. Rear ...~..g.....~..~..*. ................ Depth ..~.'Z...,,f'.~., .............. Height ..~.~...~'.$.A .............. Number of Stories ...... ~. ....................... 8. Dimensions of entire new construction: Front.?.,~...~.~.~ .............. Rear ..?..~....~.~.: ............ Depth .]:...~...~..'q.'. .............. Height ...1..?.....~.~.: ............. Number of Stories ...~ ....................... 9. Size of lot: Front ..~.~...f..t., ............. Rear ..... cj.~..~., .......... Depth ....2.?..0.....f..~., ......... 10. Zone or use district in which premises are situated ...... ~.e...s..J:...d..e.~:~.:i:§.]: ........................................... 1 I. Does proposed constructi(~ violate zoning law, ordinance or regulation?......~.,o. ........................................... Thomss a~.y and 12. Name of Owner of premises.~...e.~..e..t3.....~..:....~...e..e..v...e. ...... Address ..~.S.~..'g..JL..t..~...C..~..,....~.]:...~.........Phone NO..8.%..0.% ........... 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 property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~%<~ ),z~ ~j~qJW ~Z ~'-~,~' STATE OF NEW YORK, ) COUNTY OF ~.~.~.,o.~ ........... ) S S.. Thomas B. Reeve ................................................................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the a~.ent (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 U / ~/// .~/~J~ (Singature of applicant) Notary Public~. ......... .~...,,~['~.~.,.'.//-..'~,...i .......... C°urJtJ~LL E. TUTHILL ~..~J~ ~..~/~t~ ]~r~t~rY Public in State of New York ~1 ~- v v~ ~ ,~r~- ~ Residing in Suffolk County