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Home My WebLink About4636-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~3~1+9 Date ;~une · 26 , 19 THIS CERTIFIES that the building located at Eaatwood & So~h ONoss Street Map No. Eastwo~ E~ck No. ~eI' Lot No. 15 Cutchogue conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ~h .... 3 , 19~ pursuant to which Building Permit No. dated ~ .14aFeh 3' , 19 ~0 , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is . ~i~te ~e..family d~ll~g ........................ The certificate is issued to ~oS, Picketing, & Wi~e ~ers . (owner, lessee or ten,t) of the afores~d building. Suffolk County Department of Health Approval g~e. ~ 19~0. by. R, Villa House # 87~ Eastwood 2~0 South Cross FOEM NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4636 Z Permission is hereby granted to: ......... &t..~..~..~.~..~m~.~g.....~ P~e~eit~lt & ..................... ..~..~.~..~., ~ ..................................... to ........... ~.~s~3..¢ ..~e~...a~....~.m~....¢w~ ~r~ ........................................................................ at premises located at .................... ...~....~...~..~.......~..~..,ll...~...~...~...~..~....~..~..~.....~. ......................................... .............................................. r~u~oe~..~r..&. ~o~ta..C~.o~..aea~ ............. !~at4~ll~ .... pursucmt to application doted .............................. ~.~ ....... ~ ............. , 19..~., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTHE~IT OF HEALTH TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give~eed location) have been inspected by this department and found to be satisfactory. District Enginee¥ District Engineer FO~I~ NO. I 'rOWN OF SOuTHOLD BUILDING DEPARTMENT · TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No .......................... Disapproved a/c ...... ~ .................................................................... ................... ........ i .......................... (Building Inspector) APPLICATION FOR BUILDING PERMII' a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir~ ~ Inspector. ' b. Plot plan showing location of lot end of buildings on premises, relationship to adjoining premises or public streets o~ ~ areas, and giving o detailed description of layout of property must be drown on the diagram which is port 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 port for any purpose whatever until a Certificate of Occupancy ~ shall have been grant~cl by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the rtl 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 alterati0ns, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. A. Reilly & Sons Inc (Signature of applicont, or name, if o corporation) Mattituck N .Y. (Address of appficont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................... ..................................................................................................................... Name of owner of premises .....T..~. °.~....~...i..c..~...e..~..~.,~.,~...~....~.~..~..~, ............................................................................................. ~ tY If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) ,, .. Eastwo0d sec I 15 Location of land on which proposed work will be done. ~nap ~o.: ........................................ Lot No.: ........................ Street--a ~l,--k.. Eastwo~d Drive & South Cross Road CutchoRue '""~' ~""-J '~'"'~ ~'~'"'"~ ................... ~'~ ;'"'"'" '"~_"~'~'"'~/ .......................................................................Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant b. Intended use and occupqncy .............. o.n..e....f..,.a~...l...1..y....~e..1...1..i...D:$ ............. ..................... 3. Nature of work (check which applicable): New Building ...~ ........ Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......... .2.4~e.Q~.0...~+ .............................. Fee ....!.~..e..0.~. ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .o..~...e. ............... 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 ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .~..~..-..6. ..................... I~ear ......... ..-..6. ............ Depth ........ ..2..6. ........... Height .................... Number of Stories ......... .o.b.e. ...................................................................................................... 9. Size of lot: Front ........ .1..LI...0 ............. Rear ......... ~.If.Q .................... Depth ....... .1.~0. ................. 10. Date of Purchase ............~.C~. ................................... Name of Former Owner ...... .~........~..~..e.~.e. .............................. 11. Zone or use district in which premises are situated ...... t!~?....c~Ls.t ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ~..~. .......................................... 13. Name of Owner of premises ...~...~.g..~.....~.~.g.~.~.~.;~l,g....Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~..~,e.'i~-].~r...~..~DZ~ ...........Address ......... ~,.~L.[13.¢~ ............. 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 shc street names and indicate whether interior or corner lot. STATE OF NEV~,¥J:~. ~ e e COUNTY OF ..~....~....~..u....~.. .............. ~'~.~. ................. · ;~ ........... ;.....:....~.~.-~J..~,.~.~.:.....: ................. being duly sworn, deposes and says that he is the applicant tr~ame or inaiviaua~ signing application; above named. He is the ................................ g~l;:&a.l~O~. ................................................................................................ (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 Jn the manner set forth in the application filed therewith. Sworn to before me this ................. ~..... day of .............. ~......J4,~k~gh ......... , 19..~.0.. ~,~ /1'__ . ...................... .............................................. Notary Public,~.LvJZ. lJ,,~...~.~/~. Countyy~ (Signature/f applicant) " ~LIZA~IETfl ANN NEVILLE -- ]NOTARy PUBLIC, State of New York No. 52-8125850, Suffolk Cou, p~y,. Term Expires March 30,