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Home My WebLink About1174-zFOR~ 1~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF'OCCUPANCY November 29 60 No ......................... Date ............................................................ 19 ...... · E/~ ~o~¥£1ower Rd THIS CERTIFIES that the building located a~ ...................................................................... Street mason xx x~ Mattituek~ N.~. Map No ....................... Block No ..................... Lot No ............................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office August 1~ 60 Zll?~ dated .............................................. , 19 ........pursuaut to which Building Permit No ......................... August 1% 60 dated ................................................. 19 ......... was issued, and conforms to all of the requirements of the ap~)iicable provisions of ~the law. The occupancy for which this certificate is issued is ~riva~e one fam_ly dwelling George Kriek Owner This certificate is issued to .......................................................................................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. 2 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? 117 , Z Date ....................... j¥.~g~B.~......~.,~ ........... 19...60 Permission is hereby granted to: A. · .P~el~L~ · 4~. ~ on...]~ue..... ~/C.... ~eo~. ~ ..tf~..~ ek ......... ~.{a.~i-~u~l¢. ~ · .... ~ ~..hS,. ................................ to. ·. -~Bui. ld...ne, r ..or~e · .gm~ii~ ·. ~ett.~.ng .................................................................................. at premises located at .,~/.~....~.~)~Ol~...~qO~l~J .............................................................................. ...................................................... ~.~a,t~zl.tmp_~,.... ~..g', ....................................... , ............................. pursuant to application dated .............................. /[~gl'~$.~.....~.~ .......... 19~.., and approved by the Building Inspector Fee $1.0. ~.0 ............ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall .~outhold, N.Y. 11971 APPLICATI~)N FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted~=~l~ee~eto 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 equelk 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple I~esidences end 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, ~r buildings and "pre-ex[st[n(j" land use~: 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/ landuse--[~re-Exist, ing C.0. $15.00 3. Copy of certificate of occupancy $1.00 Vacant, land C.O. $ 5.00 ', Date April 23, 1986 New Building ............. Old or Pre-existing Building ...x ......... Vacant Land ............. Location of Property I Mayflower Road Mattituck House No.; Street Ham/et ~, Arnold Blair Owner or Owners of Property ............................................................ I' County Tax Map No. 1000Section . ,~0,7,, ...... Block 8 26 ............ t ....... Lot ................ f Subdivision .............. !i .................. Filed Map No .... ; ...... Lot No .............. Permit No ............ ' Date of Permit .......... Applicant ............ ...................... Health Dept, Approval ....... , .................. Labor Dept Approval Underwriters Approval 'l ~ ~" Planning Board' Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 1.00~ ' Construction on above d~scribed building an{~ permit meets all ~Pl~licx~bl~ codes and ragu lations. ~-~::~c~l coOv (5~' Applicant . ' ~ ~'~ IrvinJ~3 L. Price, ~r., Attorney/Agent Rev. 10-10-78 2 FOR~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~-'/~'.,.d~,.l~,,..~.,. Approved ......... .~.~.~5'. ~.~.. ~. Per mit No ........ ...'~...~../....~....~:. Disapproved a/c .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT - 6 o Date ................... ~~ ............. 19 ............ U INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su~omitted in duplicate to the Building Inspector. b. Plat 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 of property must be drawn on the diagram which is part of this location. 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 issuanoe 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 and regulations. ...... ........ ....... ....... (Signature of applicant, or name, if a corporation) ......... ......... ........................ (Address of applicant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......... ~....,:2'~ ..................................................................................................................... ~f applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ..~.~ ....... Lot No: ..X;......7~.. .......... Street and Number .....~'..~...~.. ...... ~....6~....~~.....~.: .............. ~.~ (,,/ Municipality 2. State existing use and occupancy of.,pr, emises and inte~ed, use and occupancy of proposed construction: a. Existing use and occupancy.....,~/.....~¢-..~,.,..(.:.~c::~...,i,~.....~..~/~'-7~-/ .................................................................................. b. Intended use and occupancy ........... ~'...~,..~?~L¢'~' .............................................................................. property lines. Give str whether interior or co~ 3. Nature of work (check which applicable): New Building......~.~. ....... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... ~ther Work (Describe) .................... 4. Estimated Cost..L.~..,...~....a....°.. ....................................... Fee ...L..o..:.~. ................................. (to be paid on filing this appli~a;~i~) '" 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 nature and extent of each type of use ......................... 7. Dimensions of existing structures, if any: F~oht ............................ 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 ......... .~.~....(~ ....... Rear ..... ~.....~....~..r....~..... Depth ~'e~/ Height ............................ Numbe¥ of 'S}ories .~ .......... 9. Size of lot: Front ...... I....tZ~... ............. Rear ....../.....~..~ ............. Depth .../..~.~...O. ................ )0. Date of Purchase ............. .......................... Nome of Former Owner ..../~1...~....~....~.~.: ........... ] 1. Zone or use district in which premises ore situated ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ...~.....D.. ............................ 13. Nome of Owner of premises...~...Cr......~........c~, ddress ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor...~..'...~...~..~7..;...~¢.. ........ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set- ,ack dimensions from et and block numbers or description according to deed, and show stree names and indicate ~er lot. STATE OF NE~L,Y. OJ~J~, 114. ) S S COUNTY OF .,~t-.~,~/..' ...... ) ~' (Name of individual signing appli~g~ion) . above named. He is the ............................... ~...~..:.~ ................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or ownem, and is duly authorized to ~rform or h~e peHormed the said work and to make and file this aDolJcation; that all statements contained in this application are true to the ~st of ~is ~owledge and belief; and th'a't the work will be performed in the ~nner set fo~h in the application fil~themwith. Sworn to befo~ me this ~UD-- ~ ~ I~ ~ .. ................ L.~ do~ of ............. ~~..~2]~fol~ew York // (Si~Sture o~pplicant)