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Home My WebLink About3112-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. P. ERTIFIEIATE: OF QI::IP.U~ANP. Y No.Z .~%9 ..... Date ................ .0.~.~..O.~.~:~'...~.0.., 19.~.~.. THIS CERTIFIES that the building located at .. E/S. ~ineh~. ~ ...... Street Map NO. ~ ........ Block No...~ ...... Lot No~ .... ~Q~*. ~.~ .......... conforms substantially to the Applicati.on for Building Permit heretofore filed in this office dated ......... ~ ...... ] .... , 19.~6. pu~rsuant to which Building Permit No. ~ .~. dated ........ ~ ..... ~ ......19~., 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 ~FiY~..~ .$~11~. ~O~g ........................................... The certificate is issued 9o .~..~a~ ...... ~ ................................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval ........ ~*. ~ .......................... FOI~& NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, 14. Y. BUILDING PEP~MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3112 Z Permission is hereby granted to: A. Re.ll.],F.. &.. ~ons.,.Zn.~ ,,,..A/C., M,%10.. ~e~a,~,.,. - ............... Ma.tti.tu~k~......tC~,Z,. .......................... at premises located at ..F~.~.....~4i~eh~h~..~tVd ................................................................................. .................................... S.o'uA;hc~ld. tr..... ~:,,. ,%*- ......................................................................................... pursuant to application dated ........................... ,TU.f~e ......... .~ ............. 19(~..., and approved by the Building Inspector Fee $.~,aO .............. Building Inspector FOI~M NO. 1 'I~OWN OF SOUTHOLD BU~LDIHG DEPARTMENT mm ned ......... ....... 21 .......... **Z....i ..... Approved ........................................ , 19..~:... Permit No. '~ { { ~ Disapproved a/c .......~- " (Building Ir~spector) ' APPLICATION FOR BUILDING PERMIT Date ................................ ~.~q~.q.... 3 ............ , 19..~ ...... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Bui[din9 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 shell 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, building code and regulations. A. Reilly & Sons Inc (Signature of applicant, or name, if o corporation) M~ttituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, ena, i'neer, general contractor, electrician, plumber or builder. ............................. .o. ~ .¢.~ ~,~.t. or .............................................................................................................. Name of owner of premises ~L,Y.~X'Z~.~,~ ....... ]vZi, l~.,C~;a.r~ ............................................ 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.: ...~x-~Uf~ ......................... [.. Lot Nad .;f-~ ................ Street and Number ..... ~tZn~,~m~,a...B.l.v.d ............................. f~e~t.B.e~_~l. ................................................................ Municipality 2. State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Existing use and occupancy ......... .d..w..e.g,.].-.~Y)~ ....................................................................................................... b. Intended use and occupancy .,..S.~,..w. fb~Z.~..~,l.%~,~.i.g~...D:...A~.i.%~)]a ................................................. 3~ NatUre of work (check which appllcable): New Building .................. Addition ..~:~ ........ Alteration ..... Repc~ir .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estirhated Cost .... ~..~..O.,,O.O....~..Z'..~'~ ............ ~ ..................... Fee ...................................................................................... / , (to be paid on filing this application) 5. If d~veliing, number of dwelling units ............................ Number of dwelling units on each floor ........................ if g~rage, number of cars ......................................................................................................................................... 6. If b,'usiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Dim,,lensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ............................................................................................................. Dim,bnsions of same structure with alterations or additions: Front .................................... Rear ........................ Depih ................................ Height ............................ Number of Stories ................................ 8. Dimlensions of entire new construction: Front ....,~.~ ........................... Rear ....... ~L.~ ................ Depth ....2j::.~ ........ Height .................... Number of Stories ........ C~. ........................................................................................ ......... 9. Sizelof lot: Front ............................ Rear .................................... Depth ................................ 10. Data of Purchase ................. ~..~. ............................. Name of Former Owner .......... N,'L~,~Q~,,S...~.f)~q ............. 11. Zonb or use district in which premises are situated ....... ?.JLY......Cll.s~; ..................................................................... 12. Doe: proposed construction violate any zoning law, ordinance or regulation? ........................................................ 13, Nar~e of Owner of premises ...)~±],c~...Ca.t, az~ ............ Address .......... ~.OLl.t~].d ............... Phone No ................. Nar ~e of Architect ...................................................... Address ............................................ Phone No ................. Nan ~e of Contractor ...~.~..~e.:l].~].~..~c..£~o~.~...~E~Address ........ J~:~.~.'bJ..t,~,~.c~ .............. Phone No ................. PLOT DIAGRAM Locet~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back d'mensi~ns fn property lines. Give street and block number or description according to deed, and show street names and, indic~ whether in~'erior or corner lot. / STATE OFI NEW YORK, tcc COUNT ,'OF ...... ~£D.'I ~ .........J ......................... A:~',n~],d...R~,~3.],~T. ...................................... being duly sworn, deposes and says that he is the applic~ Name of individual signing application) ' above na~ ,~d, He is the ................. ~.C~+~,I.~.~.Q~C ........................................................................................................... (Contractor, agent, corporate officer, etc.) , of sa d OW'her o' owners, and is duly authorized to perform or have performed the so~d work and to make'end ires epphcj:hon; that all statements contained in this application are true to the best of his knowledge and belief; that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to before me this (Signature applicant)