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Home My WebLink About5114-zFORi~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT T~wn Clerk's Office Southold, N, Y. Certificate Of Occupancy No. Z h, lO0 · Date THIS CERTIFIES that the building located at Map No. ~ Block No. ~ Lot No. Jan. 7' ,19.71 New Suf£ol.k Ave . Street ~x Cutchogue N.~. · conforms substantially to the Application for Building Permit heretofore filed in this office dated gall . ? , 19. Fi pursuant to which Building Permit No. dated '~ala ~ , 19 ~/1, 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 Priva~;e one farai'qy dwelling ....................... The certificate is issued to Fr~k ~eaman ..... Ow~el- (owner, lessee or tenant of the aforesaid building. Suffolk County Department of Health Approval .N,R, ........ ....... t 'Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 511~ z Permission is hereby granted to: ............... l.,..l~l,X~..,~..~..,T.~.,ts/~..~ ~ at premises l~cated ai ......... ~J~JJ~..~Jill~..~ll~O~Jl~..Ji,~ ..................................................................... .............. : ............... ~ ............................. ~ ...... ]~ .............................................................. pursuan¢ to application dated ............................... ~[t ......~' ........... , 19...~, and approved by the Building I nspector~f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. ..... " Approved ........................................ , I9 ........ Permit No ............. Disapproved a/c .............................................................................................. Application No.....~'../..~...~..~. APPLICATION FOR BUILDING PERMIT ate ....................... ...................... , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to I'he Buildh Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets. areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatio c. The work covered by this application may nat be commenced b,fore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on the premises available for inspection throughout th~ progress of the work. e. No building shall be occupied or used in whole or in part far any purpose whatever until a Certificate of Occupan, 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 t~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws~ Ordinances . Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein descnbe. The applicant agrees to comply with all applicable laws, ordinances, building code, hous!ng code, and regulations. A. Rmilly & Sons (Signature cf applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bullde ............................ .......................................................................................................................................... Nome of owner of premises ........ .~...~..a.....z~......~..e...a...~..a....~. ............................................................................................................ if applicant is a corporate, s~gnature of duly authorized officer. (Name and title 'of corporQte officer) 1. Location of land on which proposed work will be done. Map No.: ........................................Lot No.: ..................... Street and Number ........ ~ ./.~....~[fL~.,.i~.13~.:~,,l,]~..~.~ .......... (~.~.~g~?~,13,~ ............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~,~.e.,~..l...i..~.g. ........................................................................................................ b. Intended use and occu[,an~', sa, me uith ~n aacess,9.~-. ~dd~t~oFA . 3. Nature of wo~k (check whici~ applicable)' New Budding .................. Addition ..~ .... Alterahon ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................. 4. Estimated Cost ................ ~.00 ..................................... Fee ..... ~'.~.0.Q ..................................................................... (to be pa~d on fi'lng th~s application) 5. If dwelling, number of dwelhng umts ....... O~ .............. Number of dwelling umts 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 D,nensions of entire new construction: Front ............ .LI:. ..................... Rear ....~. ...................... Depth ..... .br.. ............. Height .................... Number of Stories ........ o~e. .............................................................. 9. Size of lot. Front ............................ Rear ................................... Depth ............................... 10. Date of Purchase ........................................................ Name of Former Owner ..................................................... 11. Zone or use district in which premises are situated ..... !!A~....~.i...S..~. ........................................................................... 12 Does proposed construct,on ~iol~te any zomng law, ordinance or regulation? . ~ ................................................. 13 Name of Owner of premises ..~.,...~..e.a...~..~.~ ................ Address ......... .0.~.9..h..°..~.~..e.. ............ Phone No ................... Name of Architect .................................................... Address ...................................... Phone No ................... A. Reillv & S .~, Mattituck Nome of Contractor ........................ ¢. .......................... ~¢~aress ............................................ Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and red,cate all set-back d~mens~ons fron property lines Give street and block number or description according to deed, and show street names and indica,.- whether interior or corner lot. STATE OF NEW~YOJ~... t ¢ ¢ COUNTY OF ...~...~...Z.i.O.~.~. ............ ~ .... No~m~u ~e ~ll¥ .............................................................................................. being duly sworn, deposes and says that he is the apphcar (Name of individual signing applicotlon) above homed He is the .................................... ~¢.:~aC.t,~)~' .......................................................................................... (Contractor, ogent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sold work and to make ond fi, this opplication, that alt statements contained m this opphcotion are true to the best of his knowledge and belief; or ti,at the work will be performed in the manner set forth in the appJicatioj~ fil~l, therewith Swam to before me this /% fz~'~. 72/'.7 t~.~?~-,_ _ ~_~ 7 day of Januar~ 19 71 ~-// .................. ............................................ Notan/ Publi ....... County ant) v ELIZABETH ANN NEVILLE NOT~RY PUSLIO, State of New York No 52-5125850, Su~'folk Term E~p,res ~4arch 30,