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Home My WebLink About5490-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTI~m. NT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...2.6..~.0..R.??.v.e..R..o.a~.. ....... Street Map No....S~..t...M.. ?.e. Block No ........... Lot No....1.~ ............................ conforms substantially to the Application for Building Permit heretofore filed in th~, office dated ...~.ep.t...e~b..e.l,...8 ....... , 19..?l. pursuant to which Building Permit No....~f.?.0.g. dated ...~.ep.t..~..b..~...8 ........ , 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 .... .P?.I..v.a.t.e...~..e..F...a~...1~...l~.q..l~J4~.. .................................... The certificate is issued to ..... .R..U~..a.e..~...F.1..a~.. $.~.. ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... Pendt UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ...~.6..~0. ...... Street ...R.?e.v..e..R.o?..d ............................ Building Inspector FORM NO. I~ 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? 5 90 Z Permission is hereby granted to: at premises Jocated at .......~i~{...:~-...-~..~.J.~..~,l[~ ........................................ -/...,..., ................. ......................................................... · B~eve..t~ .............. ~a~t4~ ............................................... pursuar~t to application dated ............................... ~.e~t;..~ .............. , 19...~'.~, and approved by the Building Inspector. Fee $....~',.OD. .......... [ I v - Buildh~g k,~peCtor-/ FOum NO. 1 TOWN OF SOUTHOLD BUlL.DING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Pemit No. Disapproved o/c ............................................................................................ ....................... (Building I;~specto~:'~' ................... 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 of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty muSt be drown on the dibgram which is part of this ppplJcation. 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, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) Mattituck State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ......... .~..¥:.s...s..e..~...]:....~..].....e~...~..~ .................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) /L~/-/ I. Location of land on which proposed work will be done. Map No.: Sa'It Aire Lot No. 12 Street and Number Reeve Road Mattituck 2. State existing use and occupancy of premises and intended use and occupancy of proposed const!ruetic~n: a. Exisiting use and occupancy ....~.~.;J.~g .......................................................................................................... b. Intended use and occupancy . .. swne with an additio~ .... 3. Nature of work (check which applicable): New Building .................. Addition .....~ ........Alteration ....X~.. ............ [~epair .................. Removal .................. Demoliti°n ....... ~ .......... Other Work (Describe) ........................................ 2 4. Estimated Cost ....... I) .................................................... Fee ...~...:..0..0. .............................................................................. (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ......... .011~ ............ 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 ........... ,.I.P.-.8~.;~ ..... Rear ....... .12e~.../.~.6.. Depth .....1~ ............... Height ..: ................. Number of Stories Olle 9. Size of lot: Front .............. ~G(~) ....... Rear .................................... Depth .......... P.bcI~l .............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district Jn which premises are situated ...... ~..k.!~....(;:l;1,~..~. ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ~ ......... .11.9. ............................................ 13. Name of Owner of premisesP~..'d-..S...s..e.~J,....F.~],.itll;t,gt~),lil...Address ..... .t4...a..~..~. ........ : .................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..... ..~..*.....S..~,II~.(I. ........................... Address ......... .~.~..~.t...i..t,..~.C.~:. ............ 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 show street names and indicate whether interior or corner lot. STATE OF NEW YDRK- t-- COUNTY OF ....... ........ ............................................... ~;~1.~1..~. ......................... being duly sworn, deposes and soys t~t He is the opplic~nt ~ome of individual signing opplicotion) above nomed~ He is the .............................. ~.~.~.~. .................................................................................................. (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to peHorm or have 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 tha~ ~e work will ~ performed in the manner set forth in the applicati~ filed therewith~ Swam to before me this .................... ~"~ nne ~~ ~ *y of .............. ~ep~.~.........~. 19__7.1 .......... ~ ~'"'~'~'~ a~ r ~ELIZABETH ANN NEVILLE ~ ................. NOTARY pUBLiC, State of New Yor[ No. 52-8125850, Suit0ik T~rm E~pi~s March 30,