The URL can be used to link to this page

Home My WebLink About5400-z FOI~I NO. 4 TOWN OF SOUTItOL~ BUILDING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .P.~.~..~.~ .................. Street Map No..XX. .......... Block No...~ ...... Lot No. X~ ..... l~at;.~itu~k..]N.~X o ...... conforms substantially to the Application for Building Per, mit heretofore filed in this office dated .......... .~.~tly...~..l~.., 19 .?.~. pursuant to which Building Permit No..~1~00~.. dated ............ ,I.~t~.... J~, 19. ?J., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .pri.~ate..one. 'f~mi'~F .d~e.~ting .......... ............................. The certificate is issued to . .Ma:t~olm. ~uthill. ·..Owner ........................... (oWner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval House ~ 2680 Building InspectOr 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? 5~100Z D~e ................. ~..~j .................... Permission is gronte /,to' Fee $....~.: .................. FOILM NO, ! 'I~OWN OF soUTHOLD BUILDING DEpARTMEN1 TOWN CLERK's OFFICE i roYe(3 ........................................ , Permit ................. ............. i ........................... (Building Inspector) Application No.... ,.--~,,,~,'.,,0..,~, ........ APPLICATION FOR BUILDING ~ERMIT D(3t, ....... INSTRUCTIONS (3, This (3pplication mus~ be completely filled in by typewriter or in !nk and submitted in duplic(3te to the Building~1 Inspector. b. Plot plan showing Iocahon of lot and of butldmgs on premrses, relationship to adioimng premtses or public streets or areas, and giving (3 detailed description of layout of property must be drawn~on the di(3gram which is p~rt of this application._ c. The work covered by this (3ppJicotion m(3y not be commenced bsfoie issuance ~3f Building Permit. d. Upon approval of this application, the Building Inspector will issue.', o Building Permit to the appllc(3nt. Such permit'''1 shall be kept on the premises available for inspection throughout the progr.~ss o~ the wark. e. No building sh~ll be occupied or used in whole or in part for any p?pose whataver until (3 Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department ~or the issuance of (3 .Building Permit pur~u(3nt to the Bud ng Zone Ordinance of the Town of Southold, Suffolk County, New ~ork, ~.nd Cithe (3pplicoble Lows, Ordinances or Regulations for the construction of buildings, additions or alterations, lot ilar removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, bui ding code, housing code, and ragu (3tions. (SignatUre cf app cant, or nome f (3 corporat on) (Add['ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contr(3ctOr, electrician, plumber or builder. If apl~cont is a co~'porqt, q, signature-~of du~.jquthorized officer, (Name and ~titJe'of ~'~rporote of, icer) I. Location of land on which proposed work will be done. Mop No.: ,.. ...................................... Lot No.: ........................ Municipality 2. State existing use agd occupancy of premises and intended use ar~'d occupancy,,,.~, of prop(3sed construction: 3, Nature of wo~k (check whicl~ applicable): New Building .................. Addition '"X ........ Alteration ............. Repair .................. ~,emoval .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ........... I..~.t..O.(~O., ............................. 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 inature and extent of each type of use ............................ 7. Dimensions of existJrlg structures, if any: Front ....,.~..'~, ............. Rear ........ ~....~ ................. Depth ...~.~;~ .......... Height ......~..~,I ......... Number of Stories ................~.14~'.~. ......................... ; ........................................ , ............... Dimensions of sgme structure with alterations or additions: Front ....... ~."7. ....................... Rear ...~...~. .................... Depth .......~, .~.'~ ................ Height ........~.:~...,::... Number of Stories .......~ .............. t 8. Dimensions of entire new const'ruction: Front ........ ..~...~.....i, ................ Rear ...... [.~..'. ............... Depth ....~....~.. .............. Height ..,1..~ .......... Number of Stories .............~....~ ............................................................................................. 9. Size of lot: Front ..... L.~,.~ ............. Rear ....... 1..1~1 ................... Depth ..... j..~..~ ................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in ~hich premises ore situated ..................................................................................................... 12. Does proposed constructlon ~iolate any zoning law, ordinance or regulation? ....... [.~...~. ............................................ 13. Name of Owner of premises~./~,..L/.~..).%.~'.t~!.~.~-...Address ...~./~'~..L~..~..~..I~ ............ Phone No ..................... Name of Architect ................................................ Address .... Phone No .................... Nome of Contractor ~//,.~..~.~)...~.~.~..~.~'~ddress iiii~.'~i.~.'i~ii~i~,,~iii..i.. Phone No.~.~..~.:...~..~!~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Jot. STATE OF NE~V YgRK, COUNTY OF~ .~.g.~.".L".~l~.....7,~J'~"~' J .................. ~.'~t~l~J~..~.~...~,,i~....~.~...~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .......................................... .~..~..~...~.~..J~.~.~ .......................................... (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 in the manner set forth in the application filed therewith. Sworn to befo~ me this 19.~/ / ........ o, ........ ......... ~. ~, ~~~ / ~.~~....L.~.,..~..~...~ ........................ hlotar/ Public ~~.Z.:~..~... Cou~h, (Si~notu~ of applico~ ' Notary pubhc, Slate of Now yo~i~ No.52-0344963 SufFolk Co.ntv HAROLD R. REEVE AND SONS INC. BUILDING CONSTRUCTION