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Home My WebLink AboutZ-11074FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 1.1 a7.4 .......... Date ................... 19 8.2 THIS CERTIFIES that the building s ...(2 )........................................ . Location of Property Itonl aiPX .4veAge............ k House No. Street Hamlet County Tax Map No. 1000 Section . 0.0.9 .......Block ....0.5 • • • • • . • • •Lot . • 1).0.4 ........... Subdivision.. X............................Filed Map No. . X ...... Lot No. .X ........... Requirements for a private one -family duelling, store & accessory building conforms substantially to the Appli�oat4en- -filad- in- tWs-offer-dated built prior to Certificate of Occupancy . 6p r.i l . 2.3........ , 19 5 7. pursuant to which Btdlciin -Pemit No./...w 110.7.4 ........... dated ... July. .1.2 ................. 19 .8 2, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ..a....... one-i'arnily. d:�I 11� rbu',. k Ejs Qr'p.,, . �41A .4P. AqQ The certificate is issued to , (owner, ksseaor -tenanS) ' t e s t a m e n t of Olga of the aforesaid building. Wad d i n g t o n s Suffolk County Department of Health Approval ... 11.4i;1 ................................... UNDERWRITERS CERTIFICATE NO........... n./.a................................... *Acct' additmmn, B.F. '11638Za-®C.O. Z1557o L%/'/��fr�.i � •%gra-,�'/L_, ....................................... Building Inspector Rov. 1181 N OTE : C00KDINATE DISTA14C'E3 AKE VIEASUKED FUM U.5.COA5T AND GEODETIC 5L) ZVEY TCIANCULATIOM STATIOW ARBA: 7952 *- S-Q.FT. 0 �N '4- u 170_ 'c wV R�QsIf 38.ii ►,' oq� o ;61j Id � i A/•4<0e IL � 2 N 0 A c'!.� 1 F 12 37704,{_''. 400` : seLAI.I OF NOrEE P FK,OFEeTY DN THE SOU'TF{E.P�LY SIDE OF MOVITAUK, ANUlUE, FISHERS y�� LSLAND,N�vV YOKK, BBLowsiNfi TO L0015 MACLEOD VAMDEK5u L "U5T 1938 BY L.E.IDWI-L LOTS 5 ANo 6 / Y7 / ELAN OF PKOPEICTY TO BE cow V EYED To JOAN C'IZOF -r F15HEZ5 15LA,ND NEW YOZIC SCA.L E : 1's = Z•O FT. CHA,NDLEz,PALMEIZ .No KW ICH , Cotylr--CTICU'L JUNE 14, 1�8Z_ 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: 1. 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 $5.00 3. Copy of certificate of occupancy $1.00 Date .. June 10, 1982 New Building ............. Old or Pre-existing Building(X) . _.._ X z -Vacant Land ............. Y Montauk Avenue Fisher's Island Location of Property House No, David Waddington, as exdE iMr of the -Last Will and Hamlet Owner or Owners of Property ,Testament of Olga Waddington County Tax Map No. 1000 Section .. -9, .......... Block .. - .. 5 ........ Lot ......4......... . Subdivision .................................Filed Map No. ......... ,Lot No. ............. Permit No. .......... Date of Permit ..........Applicant .................................. Health Dept. Approval ........................Labor Dept. Approval ......................,. . Underwriters Approval ................... ...Planning Board Approval .................. Request for Temporary Certificate .....................Final Certificate .... X..:......... - Fee Submitted $ .5.00 „ • . . Construction on above described building and permit -meets all applicable cndasAae recurons. Applicant . ,.;0 Rev. 10.10-78 L� at d z z C a„ L,L c�x�41 3 u OCC4 z lL-57 LYL.. t M .. - ..... ` 7_ rid -T T STATE OF NEW YORK: . ss. COUNTY OF SUFFOLK: DAVID WADDINGTON, being duly sworn, deposes and says: That I am the executor of the Last Will and Testament of Olga Waddington, deceased, who died on May 28, 1977. At the time of Olga Waddington's death she was the owner of a parcel of land on the westerly side of Montauk Avenue, Fisher's Island, New York. My father, Robert Waddington who died on January 4, 1976, acquired this property on November 27, 1939 and subsequently transferred it into both of my parents, Robert Waddington and Olga Waddington on September 16, 1955. Located on the property, which is zoned "B-1" General Business, is a two-story frame dwelling in good condition which has been used as a residence and store since 1939. The application is made for the purpose of obtaining a pre-existing Certificate of Occupancy from the Building Department of the Town of Southold. Sworn to before me this 10th day of June, 1982. { -a� Notary Public BARBARA DIACHUN Notary Public, State of New York No. 52.4635190 Suffolk County Commission Expires March 30„ 19 $14