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Home My WebLink About9965-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N. Y. Certi icnte Occuonncy No...Z.94G'1 ..... Date ..... March. · 9 .............. , 19.. 79 7~5 Reeve Ave THIS CERTIFIES that the building located at . 2005. New .Suf. folk. ~ve. ~. ~ Map No...1.1/~ ...... Block No ........... Lot No ......... .1.1. ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... October.. 2 ...... , 19..78 pursuant to which Building Permit No.. 996DZ. dated .... Octobez~.. D ....... , 19..78 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 ....... Private- One-F. amity..Dwelling-wi.th .Addition ................ The certificate is issued to ............ vTol'~ .$~.an~on .............................. (owner, x~ of the aforesaid building. Suffolk County Department of Health Approval ............ N/l{ .................... UNDERWRITERS CERTIFICATE No ....... N.~.~,q.935 .............................. 735 Reeve Ave HOUSE NUMBER . .2005 ....... Street ...... N.e.w .Suffolk Ave ............ ' ...... ............................................ Matti.t.uck,. New. Y. Qrk ............. Building Inspector County Tax Number 1000-11~-9-11 FO~i~ NO. 2 TOW~ Or SOo'mOLD BUILDING 'DEPARTMENT TOWN GL£RK's OFFIGE SOUT~LD, N,. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) ~,~tN? 9965 Z ,J~etmission is hereby granted to: ..................... ............................... ~o ...:.Z~.~ ........ ~ ........... ~...:.....,g.~.~'. ......... ~.~..~u..~.'./..~ ........ ~.~/~:..L...L..../.~ ............... at premises located ,t .......................................... ;.. ............ ; .............. ;. ...................................... , p~[suOnt tO qppl,qat,on ~ate~ ':,.;..;.,,..,,;, .,,......,,..~;,.~Z~.~,;}~; J,~-;~:~-'gnd opproyod by the Building In~pectbr. ' - ~ .~: . -. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4, Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3, Copy of certificate of occupancy $1,00 $5.00 Date Maro~ 7, 1979 ~.ddition New Building ............. Old or Pre-existing Building ............ Vacant Land ............. 735 Reeve Avenue Mat%~tuck Location of Property ................................................................... House No, Street Hamlet Owner or Owners of Property .. i'Ll. & Mrs. John Salomon County Tax Map No. 1000 Section ............... Block , 9 Lot.. ll Subdivision ................................. Map No. ll4 Lot No. ll Permit No...??~.?~... Date of Permit ~0../'5../78....Applicant. ~¥~.e.~.e, .~.o.r.~9.~L ~. ~9.~.~..T.~9: ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval XX~× .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ~XX~X Fee Submitted $5.00 Construction on above described building anl~,~er~it meets alt ~pplic~ble codes and regulations. Applicant. ~ .~.~..A]~:~..~...,...~. ~ .................. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 (]NI)I ).NV :10 g~;:lld' 9NI NOI.L3~ DNIWYU:I, II '¥C]N~10:1 9N Tll J.V J.N:a WJ.U'9'd3CI ~ J~ L L I~r~ / TOWN OF $OUTHOLD BUILDING DEPA RTMI-"HT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................................................ ................ ................................. ~.......~-------~. .................................................................. .......... .... ~~2~ ........ ~...~ .......................... (Buildin~ Insp~cto~ Application No ........................... APPLICATION FOR BUILDING PERMIT Date ..... ..~....~.....~.. ...... . .~... .................... 19..~'.~? ..... INSTR, UCTIONS o. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. 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 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 shall be kept on the premises available for inspection throughout 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 hove 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, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ....... .............. (Signature of applicant, or name, if a corporation) .~....~~...~ ........ ~....z~..~ ........... (Address of applicant) State whether applicant is owner, lessee, agent, architect; engineer, general contractor, electrician, plumber or builder. ......................... .~.~..~.~. ~..~..~. ....... ~ ............................................................................................................................ Name of owner of premises ........ ~/~..4~......~/~Y~.~.../../.. .............................................................................................. .... ~~":'~i'~;';i ......... If ap nt ~ ~ e, ' n~ure o y authorized officer. Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... , Z~///~ ~ // ~ x, // Street and Numbe .... ~,: ...~**~**~ ..................................................................................................................... Municipollty 2. State existing use and occupancy of premises and in.~er)~use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ~d/ ................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building,. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior. .................... Other Work ..................................................... (Description) 4. Estimated Cost ...... ~....~.....~).. ................................. 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, spe~fy nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ......~ ............ Rear ................................ Depth ...,~.....o~... ....... 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 ......... ?...'~.. ..................... Rear ....... .~..'.'~... ............... Depth .....~:..~ .............. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ......................................................../7'2_~'-~ ~,~,7 Rear ......................................... ~'-~/, / ~'~/'~/-;,~Depth' ................................ ]0. Date of Purchase ...~a,~..~-f~,.-.~'o4,~,~¢~.,. ..................... Nome of Former Owner ....%~...~..~.~...,.~./.~..~.,~.,.,'.~¢~ .............. 1 1. Zone or use district in which premises are situated ...' ........................ /.....~.. ................................................................. 12, Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ -.%~ 13. Will lot be regraded ......~'.......~...~ ..... Will .excess fill be removed from premises: P~Yes ( ) No A h' ~'~*'t ~' Name of rc ~tect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ 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. STAT~j OF NE%~0Y~PA(../~ ~f) /~ c c . , being deposes and says that he is the applicam ~~ rac~ duly sworn, aboven~med. ~ ~ .... ~e is tho ......... ~ .... ~ ................................................................................................................. ~tor, o~ont, corporoto officor~ otc.) o{ said owner or ownors, ond is duly outhorizod to pot{otto or h*vo por~ormod the soid work ond to m. ko ~nd file this opplic~tion; th*t oli stotemonts contained in this opplic~fi~[%truo to tho host o~is knowledoo ond be[io{; ond thor th* work.will bo porformod in tho m~nnor sot {o~h in tho ~lic~on Sworn to bef~e me this ~ /~ ~" /J ~ ~ ?~/ ,