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Home My WebLink About5816-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z..??~ ..... Date ............ ,)'~...2.1. ...... , 1973.. THIS CERTIFIES that the building located at .. ~koaso~. bead ........... Street Map No. [~.a.tt..~at, Block No ........... Lot No. 2.~.... biatC~/;r~ilk., l~.,~', ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... April .. 17.., 19.72. pursuant to which Building Permit No.58.1.6~1... dated ......... April.. ]?..., 1972.., 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 . P~.tvata .one. £ami3,~ .dw~lllng ....................................... The certificate is issued to .l~a~;.t. i tuck .i3si;ate s. Jw.c.. owner ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... J. ume...48...1-973 ............... UNDERWRITERS CERTIFICATE Nc~I. 8~0~9 ...... Ap~.il...'[1~.. ~1~-3 .................. ttOUSE NUMBER...~00 ....... Street... I~1 c~.~$OIa .head. ............................... Bttilding Inspector [ FOIt~W NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 5816 Z Permission is hereby granted to: Mattituck at premises located at .......,JdJ. t,..~,~ ......... J~,~.t~t,~....JJS~J:~li~ ................................................. ................................. .$],g.~.~ggl..Ae. la~ ............ ¥~ t,~t~te, k, ....H. ,X.~ ................................................. pursuant to application dated ..........................A.~z~.~ ....... .~.~. ...... , 19.~..., and approved by the Building Inspector. Building Inspector - , ,-,' AFPROVAL 3-0 F,Eh',OVE EXCESS FILL FROM ABOVE pREMISES 5'( p,[O?r,O~t'lG LOT ~ ~ E..R2/;"!AY CON ,TRU~-TIO C'Jj, SPOOL coNS'I RUCTION CELLAR coNSTRUCTION OTH£R NEW SUFFOLK AVE. UNAUTHORIZED ALTERA?ION OH ~rO "/HIS SURYE¥ I$ A VIOLATION NOTE: I =MONUMENT LOT NOS. REFER TO SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON SEPT, 8,1965 AS MAP NO. 44S~,. YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W, YOUNG SURVEY FOR HUBERT 8~ DORA HOOKEY LOT 24 "MATTITUCK ESTATES"~ MATTITUCK ... ~ ~,~ ~"~ TOWN OF SOUTHOLD,v--~- ~,//~'~/~: ,, , ~T~L~ AU~. IS, 1966 ~;~.~ DEC. ~6, 197~ ~ RIVERHE~ ~N~ 'HICAGO ~1~'. LIC.NO. 12845 SUFFOLK COUNTY HEALTH DEPART~ENT ~AT~ ~IUN 1 ~ 1973 ~. ~. ~..~)_//~ The sewage disposal and ?'a~er su~,p~V facilities for this loc tlo~] have be~n ins~ected by this d~,i~nt a~:d found Chief of General Engineering Services SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference Nolo APPLICATION FOR APPROFALTO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to constmact said systems is requested,pertinent data herewith: Date i-Applicant ~ ~_ ~l ,,,~ / Y ~- Address ~ ....... .~, ~ ~._~,.. ,.. ~, ~ -Section Ha~et ~, ~ ~ ~ ~ .~ ,h,~,~ ,,~,9-Private well? ~r, 3-~bltc ~er ~pply ~me ..... ~s~ee ~o nearest 4-~t Sime: Width ,,,ft. ~n~th ft. (also enter o$ center plot plan below:) 5-~ellf~: Sin~l~ Family ~ ~ ~ F~ly? ~Gellar? ~lab? ~ ~Crawl S~ce? lO-~o~s~ syst~. Septic ~ ~e~st~Cess~ols W ~S~llow ~ols il-Septic ~ i~t~e-~ensions~ Vol~e~als.Len~th ft. Width ft. Liquid depth ft. 12-Precast sections. ~ber~Sq~ Ft. Cess~ols: Block sizeL tncs.~s.H ins. To~l blocks below i~et: ~1 ~2 PLOT PLAN Street /L C~, ~ Capacity %~8~[ls. ,Grade Ind~ ~ate ~th Data ?eet 0 2 ;'/' 6 "~ ~ ~ 10 12 18 No The U~ersi~n~ ~RT~S: "Const~ction of authorized installations will be in acco~ance with the Suffolk County H~lth Departments' curre~ Sta~a~s, ~lletins, a~ amendments thereto, coverin~ Private Se~e Dts~sal Systems". Date J//~/~t Si~ned ."~r~,~ .. / .~../5~ ~ / [ Owner or ~il~er FOR HEAth DE~NT USE ONLy. Bas~ on the info~atio~prese~ herewith, it is the opinion of the Health Department, ~at an adeq~te a~ satisfacto~ Se~e Dis~sal S~tem can be installed on this ~ot. Date ~c-'~ (10/65 Revts.) S-15 lt~U.'M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ou*I'HOLD, N. Y. Examined ............... , 19 ........ Approved " 't ..'~.....~.../...~'.. ~ ........................................ , 19 ........ Pemit No ................ Application No.....-~..~..../....~. ............... Disapproved a/c ..... ............................................. (Building Inspector) APPLICATION FOR' BUILDING 'PERMIT '~ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or 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 of property must be drawn on diagram which is part of this application. c. The won~ 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 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, 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, ordi nancas, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Edward Ab i~,~...g.°~t ~:ac.1;or...Iz~c, ...................................... (Signature of applicant, or name, if a corporation) Matti.tuck...../1..I. ................................................. (Address of applicant) State whether applicant is owner, lessee, agent, amhitact, engineer, general contractor, electrician, plumber or builder. ................................................. ....................................................................................................................... Name of owner of premises ..... ~a.tt;Ltt~..l~.a~,~f,~..,~ ........................................................................................ If applicant is a corporate, signature of duly authorized officer. {Nama and title of corporata officar} 1. Location of land on which proposed work will be done. Map No.: ..~d~.~Lt..~tLot No....~-~ .................................... Street and Number .......l~os~om..~e,1;lcL ............. ~.{t.~.~L~;LL~;.....~.,.~, ....... ~ .......................................................... ~00 ~ MunicipaliW 2. S~ta exi~ing u~ and o~u~ncy of premims and intended u~ and ~cupancy of propo~d con,ruction: a. Exi~ing u~ and ~upancy ....~.~ .................................................................................................................. b. Intoned u~ and occupancy ....... o~..~..~.~ ............................................................................. 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration.....,......~.. Repair ........... · ........... Removal Demolition Other Work .................................... (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units DXt~ .......... Number of dwelling units on each flOor ......................................... If garage, number of cars ............ ~(> ............. .'J ...... ~.;...~ ........................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth .....:. ............................ Height ....~ ...................................................... Number of Stories ..., ........................................................................ Dimensions of same structure with alterations or 'additions: Front ............ !....~ ........ Rear ......................................... ............................................. Height ........................ ,.~, ............. Numberpf Stories ............................. Depth 8. D~menmons of ent.re new construction Front ........ ~ ........ Rear ...... ~ ..............Depth ........,~..........~..~...!...... Height ................................................. Number of Stories ...... ~ ..................................... : ..................................... Height .................................................... Number of Stories ...................................................................................... 10. Date of Pumhasa ..................................... Name of Former Owner ............................................................................ 11. Zone or usa district in which premises are situated ............ ."..A~.."...~I,§.1;;. ...................................................................... 12. Does proposad construction violate any zoning law, ordinance or regulation: ........... ~ ............................................ 13. Will lot be regraded _.--~V,e.a ....................... Will excess fill be removed frompremisas: [7~ Yes [ ] No (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) E A~ z t4at t~tuc,~ Name of Contractor ............,....,~.~,.'1;,~ (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 or corner lot. STATE OF NEW YORK, COUNTY OF ...................... ~....L~....~. o. ~. ............ ) ............................................ ..~._~..~..a..~..d.....~..~.~L..t.~.. ............................ being duly sworn, deposes and says that he is the applicant above named. (Name o£ individual signing contract) He is the ........ :.. ......................................... .C..o~.~...~..C...~.~.~. ................................................................................................................................. (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 application are true to tbe~o$.h~L~wiedge and belief: and that the work will be performed in the manner set forth in the application filed therewith. I~otur¥ Public, Slate o~ New York ...................... ............ o.y ............... __ , , ................................. Lot 24 NEW 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ' ' ~ OIVISIO~ CHICAGO ~ ~A~c. I "=5~' TITLE INSURANCE CO. FILED IN ~E OFFICE OF THE CLERK 0 MAP NO. 445~.