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Home My WebLink About4703-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. us~TIFI2ATE OF OCCUPAHCY No Z-24758 Date NOVEMBER 20~ 1996 THIS CERTIFIES that the building ADDITION Location of Property 215 MEDAY A~BU~ MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 8 Lot 11 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23~ 1970 pursuant to which Building Permit No. 4703-Z dated APRIL 23~ 1970 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 C~%~A~E & OPEN ~ ADDITION TO EXISTIN~ O~E FAMILY D~.~N~ AP APPLIED FOR. The certificate is issued to RICHARD W. & CA.rHKwINE Iq~i~NCZYK of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPART/v~ENT TOWN CLERK'S OFFIGE SOUTHOLD, N. ¥. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4703 Z Permission is hereby granted to: l~,~,,~eeve & SCm~ ;[ne A/C Joseph ;Fa3aane~ ~at~it~k to ~.u. ild an ~t~on .(~ara ....... pursuan,t to application dated ....................... ,~;~ ....... ~ ...... :....., 19...~.~t., and approved by the Building Inspector, FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... Approved ........................................ , 19.....LL. Permit No../;-~..~..~..~ Disapproved a/c ...... ~ .................................................. _ Application No ..... ~..,~..)..~ ............ APPLICATION FOR BUILDING PERMIT Date ..~..~..,~/..~ ........ ~.,.~ .................... 19.7~...' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building nspector. b. Plot plan showing location of lot and of buildings on premises, relationsh p to adjo n ng premises or public streets or ~reas, 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 ~hall 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 ~hall 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 ~uilding Zone Ordinance of the Town of Southold, Sulfa k County, New York, and other applicab e Laws, Ordinances or ~egulati0ns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described I he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and reguljations. (Signature of applicant, or name, if a corporation) ............... (Address of applicant) ~/ J / ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ,Ia me of ow ne rof pre m ises .......... J4~..~2:~...~..~.. ........ ~.~- ,*~R.~. ~ ~./~ .......................................... {~m~ ond titl~ o~ corpor~to 1. k~otion o{ I~nd on which proposed work will be done~ ~ .: ...........~ ...... &.. Stre~ Number ......... ............................. ................... ~unici~li~ 2. Store existing use ~nd ~cupancy of p~s ond intended use ond ~cuponcy of pr~os~ construction: o. ~isting use and ~cupancy ........ b. Intended use ond ~cupancy 3. Nature of work (check which applicable): New Building .................. Addition /// Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ................................... . ..~.: ......... Fee ..................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~ ............... 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 ......... ~'7 .............Depth .....,~.'~..... Height .....~...~.. ........ Number of Stories ......... ~./~..-~, ...................................................................... : .................. Dimensions of ~ame structure with alterations or additions: Front ........ 4'2~' ................... Rear .....~ ........... 8. Dimensions of entire new construction: Front ......... '4"'~' ................... Rear ......... ..~,'~ ........... Depth ....~... Height ...... N.mber of Stor es ......... ............................................................................................ 10. Date of Purchase ....... ~.~...~'...'~..~... ......... J..~1~..-~ ........ Name of Former Owner ..../.~./.,~.~...~../~'.~::~1 ......... tl. Zone or use district in which premises are situated ........................~ .~.~...Z~).~..~'Z~ .~.,~r./- ........................... 12. Does proposed construction violate amL zoning law, ordinance or regulation? .....~....V...~.. ....................................... Name of Architect .............~, ........... ;._../~.,...._ ............... Address ..................... ~/ ..................... Phone No ............... PLOT DIAGRAM koca~:e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f, property lines. Give street and block number or description according to deed, and show street names and indic whether interior or corner lot. COUNTY OF ..~~......f ' / ...~ .~.~'~..~...~...~'.~....~... -~.~...~.~'.']..J..~.. ................... being duly sworn, deposes and says that he is the applicc (Name of individual signing application) above named. He is the .............................................. ~....~..~)....~../~..~-~.. ....................................................... (Contractor, ag~'~nt, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f this application; that all statements contained in this application are true to the best of his knowledge and belief; thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this /} . Notary Public, .x<.../.~.....~ ........... ~..~ .................... County (Signature o~ app ic I~TAR'! PUBLIC, Sf,~% et ~l.~w York RESIDING IN SUFADLK No. S2-5~J95900 CemrnL~sJoa Expires MarcA 3~, ~.~...~.~/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF CCC ~PANCY This application must be filled ]n by typewriter OR ink ~nd submitted to the building inspector with the following: for new building or new u~e: 1. Final survey of property with accurate location of a~l buildings, property lines, streets, and unusual natural or topographic features!. 2. Final Approval from Health Dept. of water supply andisewerageydisposal(S-~ form). 3. Approval of electrical installation from Board of Fi~e Underwriters. 4. Sworn statement from plumber certifying that the sol~er ~sed in system contains less than 2/10 of 1% lead. 5. Commercial buildi9g, industrial building, multiple r~sidences and similar buildings and installations, a certificate of Code Compliance {rom architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site pla~ requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-exist__.iqg" ].and uses: ~ate purvey of~oi!er~y showing all propert~ lin~s, streets, building and unusual na~r--~or topographic features. 2. A properly completed a~j!p_%.iqa%~on and a consent to~in~eazt signed by the applicant. If a Certificate of Occupancy is denied~--~iding Inspector shall state the reasons therefor in writing to the applicant. C. ~s ~ Certificate of Occupancy - New dwelling $25.00~4!~ions to dwe!!~ng $25.0~ Alterations to dwelling $25.00, Swimming pool $25.00i~ Accessory building $25.00, Additions to accessory building $25.00. Businessesi$50.00. 2. Certificate of Occupancy on ~~d_in~ - ~100 O0 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15i00, Commercial $15.00 Date .~.~.'i .L..~]. Z.~.?~. . .................. ~ew Construction ........... Old Or Pre-existing Building~...i. .......... Location of Proper~y..~../..~.~....~-.-..~...~.K..~-?~V-.~..,... - .~..~'.'T.~./-~...~.~.~.:. Hamlc/t , House No. Street bnwer or Owners of Property. . /.I. p .IL. ~onuty Tax Map No 1000, Section ........... Block ....... .~ ..... . Lot ...... ............ bdi ision Filed Map ' Lot ...... .~/~-~ 70 . .Applicgn . .~...~.~.Y.~. ~ermit No. .~. .Date Of Permit ......... ..... ~{ealth Dept. Approval .......................... Underwriters Approval ......................... 'lanning Board Approval ......................... ~,equest for: Temporary Certificate ........... Final Cert'tcat~ ........ Fee Submitted: .................... ¸tI I:I~,ROED R. REEVE AND SONS BUILDING CONSTRUCT ON