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Home My WebLink About3457-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z 18957 Date APRIL 5, 1990 THIS CERTIFIES that %he building. ONE FAMILY DWELLING Location of Propert~ 4605 House No. Street County Tax Map No. 1000 Section 107 Block 4 Lot Subdivision Filed Map No. Lot No. WI CKHAM AVENUE MATTITUCK Hamlet 9.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1, 1967 pursuant to which Building Permit No. 3457 Z dated MAY 1, 1967 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY D~ELLING ~IT~ ATTAC~EB C, AI~AC, E. The certificate is issued to RALPH W. TUTHILL, JR. (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NOV. 8~ 1967 by R. VILLA UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED THIS CERTIFICATE OF OCCUPANCY IS AN UPDATE OF Rev. 1/81 CERTIFICATE OF OCCUPANCY # Z2929. FORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF DP. DUPANEIY No. Z 2929 .... Date ............. tVOVe~lbe~'- - 9" 1967' THIS CERTIFIES that the building located at i:~. l~Oad, l~, · tgll~l~,,b, illn .AV~qtreet Map No.lg~;~ ...... Block No... ~ ...... Lot No. ~... ~;i;i.t~Ok.t~. -l~;~.~ ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~i~'... ~ ... , 19 (~. pursuant to which Building Permit No. ~14~'~. ~ dated .......... ~,~y .... l ..... , 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 .priVate. olle. i'a~ai.~.y, tl~,e~$i~.g ..................................... '.. The certificate is issued to . tlaly~k .¥~. D'aI,I~£Z~L .ill' .... i~a~;~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .i~o~z.,~ .lj~, ~L967...by. Jt, i .¥fkL~a .... Building Inspector ~ FORiYI NO. :B TOWN OF SOUTHOLD 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? 3 57 Z Permission is hereby granted to: H.R.Reeve & 8on~ Ino i/C l~lph W, Tuth~ll .................. Ilst, ti.~to~ ........................................ to ,alg~ld.. ~ ..~ .~.. ~~ .................................................................................... at premises located at ...llaO.eM~s...O~.~..Ji~'..~,Ck~..&lrlR .......................................................... .................................. ~i~...L~.,.~.~. ......................................................................................... pursua:nl' to application dated ........................... AJ)i',iL1, ......... 1~1 ...... , 1~....., and approved by the Building Inspector. ~l Jl~l~L~t ~11~11~ ~:l~l~'~ ~ :~.,~, &JI~"OY~ 0~' &eeess Fee .~.~.~. ............bOrOI'O O~:L~,e&t,O or O~CtipK~l~ 10 :L8111~. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit TO WHOM IT MAY CONCERN: The sewage disposal facilities (Give deed location) for a structure located have been inspected by this department and found to be satisfactory. District Engineer FO~M NO. I TOWN OF SOUTHOLD I~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....... , App,ca,on ........... Approved ........ ~.~....~......, 19~Z. Permit No.~.~g.~ ............. ................... (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT Date ............... l..'~ .~...~..J .~,..... [ 1 ............... , ] 9..~...~. .... 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 o 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, building code and regulations. ...t.4. (Signature of applicant, or name, if a corporation) ....... .................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. .....................................--~ ~,.~,~ r~.~ .C...~.~.'c..,~..¢,.r.o~ ................... Name of owner of premises ........................ i...I..~.. L.~I,I?.I~.......~.~...'JT.~...i,.~....~.....JJ[I,~..: ....................................................... If applicon' is a corporate, signature of duly authorized officer. ....... (Name and title of corporq~fc~officer) 1. Location of land on which proposed work will be done. Mop No.: ........................................Lot No.: ........................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. ..~.i~.C~.I?.,...~,~.J~.~ .......................................................................... b. Intended use and occupancy .......... 0~[1~ ........TJ~"./.~I~II..I~.~.......T~:~/.J).~../~/..~. ............................................. 3. Nature of work (check which applicable): New Building ...------~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... ..~.....~..~'~..~..¢~...:....'~.. .................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... 1 .................. 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 ....N,~ ............... 7. Dimensions of ~structures, J! a~ny.'.~t ................... ~ ..................... ~th .................... Height .~ ........ Number .~.ories .......... ~..~ .................... f ...... ~. ................................. ~t. ~h, alterations_~,~i~t,ions,: Fro,nt~;._; ...... ~ .......... Rear ............................ peCth ~eight .............. ~ ......... Number of Stories .~. ...................... · ~, 8. Dimensions of entire new construction: Front ..... /~1~..'~...'..¢~.. ............... Rear .,..~.Z.~.~. ......... Depth .3.~...=..~t ......... Height ...L~..'. ......... Number of Stories .................. .~.~.~. ...................................................................................... 9. Size of lot: Front ......~.~.~. .............. Rear ....... I.~.~.~. .................. Depth ....~.~..~..!. ............... 10. Date of Purchase .................... ~ .......................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violal~ any zoning law, ordinance or regulation? ...... ~.4~. .............................................. 13. Name of Owner of premises~V.e~...~.lTH.'.~...~i~,....Address ....~.J,~.'D:'.J..?..¢~...!.¢ ................. Phone No.~..~..'....~..~..~.~. Name of Architect ............. .' ........................ .' ............... Address .......... .'.".'i.....:;7.......' ............... Phone No ...... ;. .......... '... Name of ContractorlJl~ll~.~..~.~.:...~".~...v~....~'.[~.(J/..~....Address .....l~/&'.'E'...I.."'[..¢.~l..~, .............. Phone No..~.~.~..'...~.?..!.~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street end block number or description according to deed, and show street names (3nd indicate whether interior or corner lot. STATE OF NEW_YORK, ~ ¢ c COUNTY OF .~:x~,l.~...~'.~.~,.~,~ ........ ,~ .... .......... ~.~.....~..,...~.~.¢~.....J'~.., .............. being duly sworn, deposes and says that he is the applicant (Name of individual signi6g~ap'plication) above named. He is the ........................................ ~.~~....~.~.Z~.E~ ................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to ~ke and .file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworntobeforemethis ~ ~~/~~,./~ ~/ ......... zz ........... .................... ,.., 7-- '~ NO r~8~//780 '!