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Home My WebLink About6081-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~]. ..... Date ............ 110~ .... ~- ......, 19. THIS CERTIFIES that the building located at iii~lby ~,~ ............... Street Map No. ~tit;. ]~ .l~,t~iock No ........... Lot No. ~1 ...... ]~t;l;l~llt..ll.]~ ....... conforms substantially to the Application for Building Permit hereto£ore filed in this office dated ............ AW..28.., 19.72. pursuant to which Building Permit No. dated ........... &~l~ ...... , 19.72, 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 .. l~.~'&.tie .01~ .£11~k~. ~1~.~1,~ ...................................... The certificate is issued to .. ~ll~e. ~'O~-~ ....... 0¥1~i~ ........................ (owner, lessee or tenant) o~ the aforesaid building. Suffolk County Department of Health Approval ... lil..~, ............................ UNDERWRITERS CERTIFICATE No... 11[~It~ .......................................... HOUSE NUMBER...'~.$7~ ...... Street ........8't ~v~b~. 1:1~1111 ............................ Building Inspector FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PHEMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6081 Z Date .................. ~l~ ......... ;~ ............... , 19:.~. Permission is hereby granted to: ......... A ...Re&:[ .~..&..aeae...I. ne..&~.....~a~eae ................. I~e~t~,lm~ ......................................... at premises located at .....¥,~..lli ......... 1~t,45~.,lr~131~[..[1~,~1~ ................................................................ ...................................... ~i6~.~ ...... IL:l,llb',/..aeaa ......... Ila~t~tla1~ ............................................... pursuant to application dated .......................... &~ .......~- ......... , 19~1~..., and approved by the Building Inspector. Fee $ ].~'.e.O0. ........... ' ' ' Building Inspector FO]gM NO. ~ TOWN OF $OUTHOLD Building Depmtment Town Cledm Office Southold, N. Y. 11971 APPLICATION 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 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 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 o'f 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 in- formation required to prepare a certificate. C. Fees: I. 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 ........ .~. '. '. ~/...'...~. ....................... New Building .................... Old or Pre-existing Building ...... .~. .................... Vacant Land ............................ Location Of Property ................ e/.JJ..~,~fi.~.~...~..~.t ........ ~.~.~,~.~.~g.]¢..~...~.~.~,.*. .................................... Owner Or Owners Of Property ............ ~u:.~..e..~...e.....~..a....~..~...o..~...~. ........................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No 6081 ~. Date Of Permit ..8../...2..1.../'.~..2...Applioant ...................... ........ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ~ . .. Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this Applicant ..~.~...~,~.~,~....~7;k~,...~...~.,.....~..~u...~~ ................ day of ............................................ (stamp or seal) Notary Public .................................... County TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined 19 ........ Approved ....... ..'<..-~:~lc. ...................... , lY.L...... Pemit No ..................................... Disapproved a/c ............................................................................................ Application No ............~ ...........F I ,- ;' ...... .......................... .~c~--I- APPLICATION FOR "UILDING PERMIT ! ~ ~ ,I.~' ~ August 28 1~...~....~ ¢ ~ ~e Date .............................................. , ~. This a~licatio ~ comCetel~ fill*d in b~ ~writer or in ink and submi~od in triplicate to the Buildin~ Inspector, wit~ 3 ~*t~ of Can*, aceur~to plot pbn to *cal~. Fcc aeeordin~ to ~ehedule. b. Plot ~lan ~howin~ location of lot and of buildin~ on ~remi~e% rel~tionshi~ to adioinin~ ~romi~e~ or public ~trcet* or ar*a% an~ ~Nin~ a detailed d~eri~tion of la,out of ~ro~rW mu~t ~ dra~n on die,ram which i* part of thi~ a~plication. e. Th~ ~ork eo~r~d b~ thi~ a~plication m~ not ~ eommen~d befor~ i*~uan~ of ~uildin~ Permit. d. H~on a~ro~al of thi~ a~¢ication, the Buildin~ Inspector will i~u~ a Buildinfl ~ermi~ to ibe a~licant. Such. ~rmit sh~ll b0 ke~[on th~ ~r~mi~o, a~i~abl, for in~ction throughout tbe work. ' · ~. ~o buildin~ ~h~ll ~ oeeu~i~d or u~d in ~hole or in ~art for an~ ~ur~o~* what~r until a ~ificate of ~r~nt~ b~ tbe Buildinfl In~ctor. 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, as herein described. The applicant agrees to comply with all applicable laws. ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. A. Reilly & Sons inc (Signature of applicant, or name, if a corporation) ........... t~,.t.~£tuc~c ................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ............................................................. Co~t~c~= ........................................................................................................... Name of owner of premises .W.u~er~..Cz=~.%.t ............................................................................................................. If applicant is a corporate, signature of duly authorized officer· (Name and title of corporate officer) ~,~at,t,. PTa 7Z. ............................ 1. Location of land on which propo~d work will be done. Map No.: ................... No ............. 16 Si sb R ad Ma ' ~~ ~ Street and Numar ....~.....[....~.....~ ........................ ~ ................................................................................ Municipali~ 2. State exi~ing um and occupancy of premiss and intended use and ~cupancy of propo~d con,ruction: a. Exi~ing u~ and ~cupancv ....~.~ea~ ............................................................................................................ b. Intended u~ and ~upancy ............ ~..~.~..~..~..~.~&~ .................................................................... ~ Nature of work (check which applicable): New Building ....................... Addition ......~ ..... Alteration ............... Repair ...... Removal.. .......... ...... .... ... Demolition ........................ Other Work ...................... ................... (Description) 4. Estimated Cost .................. .br.t DDO...+. ............ ~ee ............................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...c~ae ....... 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: Front 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 .......... 28 .......... Rear ......... 2.8 .............. Depth ...[P-- ......................... Height ................................................. Number of Stories ....OD.~t .............................................................................. 9. Size of lot: Front .....~ ............................. Rear .......................................... Depth ........................ Height .................................................... Number of Stories ............. 10. Date of Purchase ..................................... Name of Former Owner /-/ -'-/--7-f J:"~ 7' .... "A." d"' S~ 11. 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 --J3~ ............................ Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ....... F~ii~..(~D.3:z'~],~L .............................................................................................. (Address) (Phone No.) Name of Architect (Address) (Phone No.) Name of Contractor ..... .~.,..,~,~.il.]~..~;..~.arL%..I.~c .............................................................................................. (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior r corner lot. I STATE OF NEW YORK, ) COUNTY OF ................. .~.....~....~...O...~... ................. ....................... ,~ ~ ~l[~ ....................................... being duly sworn, deposes and says that he is the applicant above named. ...... (Name of individual signing contract/ · contractor ............ He is tl~e ........................................................................................................................................................................... (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 applicatiop..ate, tr~k-k*L~lthe best of his knowledge and belief; and that the work will be performed in the manner set forth in the app cation filed the3UDUU~' ~'~w rpeu~l~hs ore o~ New york 2'~ 52-0344963 Su{fo[k Coun~_.,~, Lot 44 N 86~ NO TE' · = MONUMENT SUBDI VISION MAP FILED IN THE OFFICE .EWS,ONS YOUNG & YOUNG SURVEY FOR: EDWARDG ABITZ LOT 45 "MATTITUCK ESTATE~~ MATTITUCK TOWN OF SOUTHOLD ~,k% SCALE I" = 40' I DATE: MAY 18,1972