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HomeMy WebLinkAbout2129-z ",yFFp� r t Town of Southold Annex 7/18/2013 ti;tpD P.O. Box 1179 k 54375 Main Road �N© ;,. Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36404 Date: 7/18/2013 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 375 Raccoon Rd, Mattituck, SCTM #: 473889 Sec/Block/Lot: 106.40-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/26/1963 pursuant to which Building Permit No. 2129 dated 7/26/1963 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: one family dwelling with attached two car garage This Certificate of Occupancy has been undated to include the garage. It replaces COZ-1707. issued 10/9/61. The certificate is issued to Evelyn,Cangero (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL by R. Villa 10/3/63 ELECTRICAL CERTIFICATE NO. NA PLUMBERS CERTIFICATION DATED NA t A or d Si attire FORM 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) N92129 Date ........................ .....26............. . 1963... Permission is hereby',gronted to: A. Rellly-&-ftft"Awt"Wk�...Wartekhberg*........... ............................................ ................................. ......I...........I......... ...... to ....... ......—*. ..... .......................... ....................................... ............I........................ .................................. ....... at premises located a.0.0.A 09L 4 .............................I........... i�a.............I......... ...... ........... .......... .......... ........................... ...................... .............................. ...................................... ...............................................................I.......I............ pursuant, to app I�Ication cloeO ............................zaie.........26............19... and approved by the 63' Building Inspe tot. Fee it Ilk, ......... ............ ................ mullng nspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations,a certificate of Code Compliance from.architect or engineer responsible for the building. 6. Submit'Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy -New dwelling$50.00,Additions to dwelling$50.00, Alterations to dwelling$50.00, Swimming pool $50.00, Accessory building$50.00, Additions to accessory building$50.00, Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00/x/ `lla[e. / �3 i New Construction: Old or Pre-existing Building: (check one) Location of Property House No. Street Hamlet Owner or Owners of Prop Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: -�Sk�o� Lr�1�S Health Dept.Approval Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one Fee Submitted: $ Applicant Signature TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET , 3 = VILLAGE DIST. - SUB. LOT a12��[+'>' t� ��C�2Qf. +1 -D1&- mATi TvciC 1Ese ORMER 0�1 Z ,QWNER ! A, E ACR. C1 ✓Ckli¢( aftf0� �/cas fJ t�1 tf — 4trr a cY �� S W r TYPE OF BUILDING i S i• W 1 L d t� t� WEreTEN�ira. l+�.e 'C kup4 S. ' zQ SEAS. jVL. (FARM ;COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE l REMARKS 20 1 p / z syr �+ � (� I 1I/• � FAh1�L'/ Z W 1N W � ' •NFI FK � I�0 F. �. CfPTr�Yl3rIP9 !' 39 � i £S 2 J?� t-/ it S-L 1175 34S- Wer ero -�. - IV L� r)<4 =4bll o C7 >r a v S'd'od ov �Dc , , � , -ThUrna un e,ro rs� If s� 90-6 5800 j /,-700 / 3 7 NIBM— O� sA s 0 3 --- FARM Acre Value Per Value Acre Tiflable 1 T fllabfe 2 • Tillable 3 Woodland j Swampland FRONTAGE ON WATER Brushlond j FRONTAGE ON ROAD /Z�f 1 House Plot DEPTH V BULKHEAD Total DOCK q F ■■/■■■ ■HmN■■■■N■■!■■V �■■ .� .....�_��_,■■■■■/■■■iii :� -- �■■i■■■Ifff■n>ul■■■f>tf■■■■■n■■■ - _ , ■■■1i1■ It■iii■■■■!�!'Qii!'i■■■■■■ ■■■/�I■■■n1i1■■■il■■■1■■/ IA Bldg. DinetteCOLOR TRIM oors Extens Basement ion 0 Fxt. Wolls Interior Finish LR. Heat . . .. -POM flow, Recreation Roori Dj(>372- Dormer Porch DrivewcY patio - 0. B. NO. 4 TOWN OF SOU'rHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ....... Z.....:I..~O~/. .... Date ...................... ~J(l.~ohe~......0. .......... I9...63. THIS CERTIFIES that the building located at ...~,~OOO~..~Oa~l, ................................... Street ., Wertenberg Map ,~o ....................... Block No .......~ ........ Lot No...~ ....... ~t.~i.~tO~...N~.Yo ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~ ........................ ~.'~l.~ ......... ~6......' ........ , 19.~.3.. pursuant to which Building Permit No ..... Z~ dated ....................... ~.~.'1.~ ....... ~ ........... , 19..~., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ .............. Pr.i.va~e .. ane...£am£1~...d:~elling ............................................................................. The certificate is issued to ...W.i.~..~.~.slll~..l/~e~,.%e~bo~tg..; .......................... ~e~. ............................. Lowner, essee or tenc~nt) of the aforesaid building. H.D. approval October 3, 1963 FOI~M NO. 2 TOWN OF $OUTHOLD 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? 2129 Permission is her~b¥~granted to: A. Re~i~"~"~'or~"A)tg" ~',;"'l~e.~'~c'O~'g ............. ,/i .............. NJ~%;:~['~ ..................... ~I~ new :6~ ~tly ~tI~ , at premises I~ated, ,.?,, ~ '~eoon~ ~, ~aw~ Ezta~ez .................................. ~ ........ ::~,, .......... ~.~ ................................................................................... pu rsuont, to~ opp/[~cation ~do~ed~ ............................ ~ ......... ~. ............ 19... ~, ond ,pproved by the ~t ~ r~ ~ / 1 ~' ~u~lding nsp ctor / s-9 S'UF~'OLK COUNTY DEPARTMENT OF HEALTH Date Building Permit No. Z2129 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Hideaway Estates~ Mattituck ............. Give deed location) have been inspected by this Department and found to be satisfactory. ,D,i~t ~ict Engineer District Engineer TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPUGATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building inspector with the following; for new buildings ar new use: 1. Final survey of property with accurate location of alt 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 installations, 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 df property 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 formation 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 / ~) -- /'~ -- 7..,~..... Date ........................................... New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ..~--.~ Request For Temporary O~rtificate ........................................ Final Certificate .... ~ ............... Fee Submitted $ ./../..,~.~..2/ ..................... ///~ Construction on above described building and permit m~et~ all applicable caddie')and regulations. Applicant .................... ~...:,, .. - .,.~:;~, ..... =.,.-.~ ............ Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County 175.0' FOP~M NO, 1 TOWN OF $OUTHOLD BUILDIIqG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ i ..... , 19...) Approved ........................................ ,19 ........ Permit No....~.~..'...'"~..~ ...... .................... ................................ (BuHdin~ Inspec~d App)ication No...~../..~..:..~ ............ APPLICATION FOR BUILDING PERMIT Date ..................... ~.tt,~ ,~ ....... 26 .............. 19..63 ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 of property 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 thi~ 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 pa rt for any purpose whatever until o Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New `york, bnd other applicable Lows, 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 oil applicable lows, ordinances ond regubtions. .A....R~ill¥..&..B on..Ymc .................................................. (Sign.ature of applicant, or nome, if o corporation) ................ ~%~iress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................................... oon.t.r, aoto~ ................................................ .....; ........................................................... Name of owner of premises ...,~:L].~.JLalll..~r~'~e~)o:P.~ ..................................... '. ............................................................... If 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: lt~/f~rt]0e:P~...0,D....~e.... Lot No: ...6 .............. Street and Number ..'~0tOO~..l~OS.(~. ............ ~t~.'l~,.~t~,~i~:~.....~r,~ ................................................................... Municipality 2. State existing use and occupancy of pret'nises and intended use and occupanqy of proposed construction: a. Existing use and occupancy ...... ~,CH~rt~...].o'l~ ............................................... ' ...................................................... b. Intended use and occupancy ...... O~I~...~'~L~..,c~e~:I~L,~ ............................................................................. property lines. Give street and block whether interior or corner lot. 3. Nature of work (check which applicable): New Building ....... ~Addition .................. Alteration Repbir .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...... .~,~.i, O00. ...................................... Fee ....... (to be paid on filing this application) 5. If al,welling, number of dwelling units ........... ~l'~e ........... Number of dwelling units on each floor If garage, number of cars ............ 6. If ~usiness, 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 oddit,ons: Front ................................ Rear Dep,th ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front .............. 6~ ............. Rear ....68 ................... Depth Height ............................ Number of Stor,e~....0.,~l~ ...................... 9. Size of lot: Front .......:1,',:;1~ ................. Rear ....... 1.2.~ .............. Depth .Z~..~/...'t.~..~ .................... 10. Date of Purchase ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated ........ II.~lt..~L.l~*~, ~2. Does proposed construction violate (]ny zoning law, ordinance or regulation? ...... 13. Name of Owner of premises .'~'"~:~:lEe~l~e~.ll ....... Address ...... ~,~.~.%~1.~ ................ Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ..../b~,..~e~.].:.]..~ .......................... Address ...... ~ii~,-t~.t,l,t(l:~ ................ Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f numbers or description according to deed, and show street names and indic STATE OF NEW YORK, ) COUNTY jOF ~1t~.~'~,.~ .......... ) S.S. ................. ;.....~O~'~..~I.e~IZL~.~ .......................................... being duly sworn, deposes and says that he is the (Nome of individual signing application) above named. He is the ........... ~¢~ ........ (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 this application; that oll statemen~n~n~ig~ in this application are true to the best of his knowledge and be and that thb work will be perfor,me~[~st~o~k set forth in the ~p[icq~n .f~ed~herew~. Sworn tobJefore me this h~ 52{)344963 S.ffekOa.~ // ' homm~ss,en Expires March 30 l(~ ~ ................ of..: ............................ .,. .