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Home My WebLink About5999-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certil icnte Occupnncy No.~...1~.6 ..... Date ................ 8ep.%.,..29., 19.~. THIS CERTIFIES that the building located at &l&11a. ~¢l ................. Street Map No. ~t~t .~&% · · Block No ........... Lot No..~. ..... .M~'~;~.t~C.~...~. ~.Y' ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... $~tlF ....~(~., 19.~2, pursuant to which Building Permit No. ~J~.. dated ........... ~T~... ).0., 19. ~.., 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~i¥.a.l~e. ~I~e.. ~'~llY..6.~.~.~1~g ..................................... The certificate is issued to ...~.8~. ,. A.b. it~....~ .~A'Le~./.]~l.d.~.~. ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .l~ept.. 27...1972..by I~,. F:L~I~... UNDERWRITERS CERTIFICATE No.. ~..~. ~9.~. ....................................... HOUSE NUMBER.. '~00 ....... Street .......A..~.~'ll~. ~ .~.~ ............................. Building Inspector { ~'0~ 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) N? 5999 Z Permission is hereby granted to: t: A ............ iL. ......... .,; J..~,,....:.. J .................................... ot premises located at ............. .?....°....°. ...... .~.~.Z.~.,...'/,..~.".~- ........... '~-/~"J" '~"~": .................................... ................................................................................ ~Z..z£1,~..~..u....c...~.. ......................................... : ........... ~,.~..Z.....J..~. .......... ..~..A.~..L.~R~...~.. ........ .z.:.~.Z~...~.~,~..~.. ......................................... pursuant to application dated ................................. ,/..(.~'.........~...~.~.i,~ 19.Z...2t:T., and approved by the Building Inspector. Fee $......?.~...~.. EllaeJiT INCLUDE~ APPROVAL TO REMOVE ,EXCESS FILL FROM ABOVE PREMISES BY REGRADING LOT ~ o~,vr~~(]i~IsTRUCTiON ~ / ~C~[RUCTION ~ C~LL~'R ~TRUCTION~ ~ Build'in~ Inspector FORM NO. I TOWH OF SOUTHOLD Building Department Town Clerks Office Southold, H. 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 dispcsal--(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 of 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 pertirmnt 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 $§.00 3. Copy of certificate of occupancy $1.00 Date Se~t 2~ lg72 New Building .......Y~/. ........... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..~g,a.]_.i~..~.d.r..l~a.~t:~.tl;~, ............................................................................. Owner Or Owners Of Property E~"arJ -Litz o~ar/ ~t~i!f~r to L. Hilsky Subdivision ? a : 1~ ? o ,- .....~.%... No ...... ~.0...0. ~ .~.~.--%.~, C ..... ~.~ .%.~ Lot No. Block No ............. House Permit No. ~.9.9.$. ........ Date Of Permit .~-~{..].Q..Applicant ...~..~.]~.J..%~ ............................................ Health Dept. Approval ...... ~.a~.~.....~.~....1..9.~.~ ....... Labor Dept. Approval ......... .~.~.~ ............................. ~+~+~ ~ 6 ~. ~. Onderwrite~ Appravo~ ............................................ P~onning Bo~d ~oprava~ .~]..[. ................................ Request For Tempora.y Ce~ificote ........................................ Fina~ Ce~ificote .................. ~.x. ................... Fee Submitted $ .~R.O..Q ......................... Construction on above described building and perrpi~meets all ,app~j~cable codes and regulations. ~....~.~.~,~:~....:.. ~-...~T..-/..; , ............................ Sworn to before me this 2 ... J.~t 1 9?2 ........... ~... day of .............. · ........................ (stamp or seal) Notary Public .................................... County YOUNG & YOUNG -* 400 OSTRANDEI~ AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W, YOUNG SURVEY FOR LOT NO. 13 "MATTITUCK MATTITUCK TOWN OF SOUTHOLD SUFF. CO,, N,Y. SCALE= I" = 40' AUG. 16,1972 AUG. 24,197Z EDWARD ABITZ ESTATES, INC." GUARANTEED TO: PROFESS IOI~__~N G I N/~R AND LAND SURVEYOR, N.Y.~..LIC.NO. 12845 RIVERHEAD, N.Y. S . 88° 25' I0.00' 56' N'86°27' W.j Lot I ? NOTE: · =MONUMENT MAP OF SUBDIVISION FILED IN THE OFFICE OF THE CLERK OF SUFF. CO. ON SEPT. 8, 1965 AS MAPNO.4455. YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW ¥O~K AI.J~BI, I W. YOUNG HOWARD W. YOUNG SURVEY FOR EDWARD ABIT; LOT NO. 13 "MATTITUCK ESTATES, MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. SCALE: I" = 40' ~LIG. 16,1972 AUG. 24,1972 LAND RIVERHEAD, N.Y. AND S.88°25'3 I0.00' O 0 Lot 17 NOTE: · · MONUMENT MAP OF SUBDIVIBION FILED IN THE OFFICE OF THE CLERK OF SUFF. CO. ON SEPT. I, 19~5 AS MAP N0.4453. t~ TOWN OF SOUTHOLD ~ ~ ~ ~ ~ BUILDING DEPAKTMENT TOWN a.mc's omc: 4~. -- ..................... .¥. '9 SOUT. , N. ,. App oved .................. ~..., 19......~m,t No ....... ~ ............ .............. ~...~.~ ................................... (Suildin~ I APPLICATION FOR BUILDING PERMIT ~o~e ........ /.~ ..... ~ ~ 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 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 work. /~t e. No building shaft be occupied or used in whole or in pert for any purpose whatever until a Certificate of Occupancy shall have be granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for. the issuance of a Building Permit pursuant to the Building Zond Ordinance of the Tows~ of Southold, Suffo~ 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 cocb, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) ~ State whether applicant is owner, t~, a~nt, archit~t, engin~r, ~neral contr~tor, el~trician, plum~r or builder. .......................................................... E~.~.~..~ ............................................................................................................. Name of o~r of premiss .............. ~.: .................................................................................................................... If applicen~ is a ~o~r~, signa~re of ~ly authoriz~ offi~r. (Name and title of corporate officer) Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existi use and occu an . ..V~..,~ ~' '~V~ 7 a. ng p cy ..........................................~ .................................................................................... b. Intended use and occupancy ............. .0....~.f../-' ................. ~.-~./:~.~..~../..~,..~. ........... ~.....~..~.~.~...../.../~....~.. ................ ,d ~3. Nature of work (check which applicable): New Budding ....................... Addition ..................... Alterat on..,..tj ........ Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Est matedco ....... , ........ F. ....... .../..!. ........ , ..... ..~....~...~...~.. (to be paid on filing this application) 5. If dwelling, number uf 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. DimenSibns 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 ........ ..~....~., .... Rear ......... ..~....~.. ........... ...... Depth .............. ;, ................. Height ........................ ~.~ ................... Number of Stories ......................................................................................... 9. SiZe of lot: Front ..................~..'..~. ............. Rear ....................... .~..?.~....~....~... Depth 2 'J ~'' .~ / Height .................................................... Number of Stories ..................... 10. Date of Purchase ................~...~....~..L.. ........ Name of Former Owner 11. Zone or use district in which premises are situated .............................. .~.........-~....-F..~./...?...L~,.~'~?..!..A.....LT. ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .................. ...../~..~/.~ ~. wi, ~ot be re=aded __~ ......... Y..~.~. ........... Wi, ax== fi" be removed from pr.e~ni~s: ~'/~ Vas [] No 14. Name of Owner of premises., .......... & ........ ~..~.../.. ,~,.~; ............... , ,~,~..~.......~,,~, .~.....,,~../.,.,~.. ,.~,.. ....... (Address) {Phone No,) Name of Architect ............................................................................ {Address) / ~ {Phone No,) Name of Contractor ~- ~4 ~/7" Z-.--_ ~ I (Address) {Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-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 comer lot. STATE OF NEW Y~tRK,//_. /~ ) COUNTY OF ..~ ................... ) .9 (Name of individual signlng contract/ He is the ................................................. ~ .......................................................................................................................................................... {Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly a~t~ri~.l~[~Te~f~r have performed the said work and to make and f e th s app cst on; that e statements c~nteined In this eppllcatl°n I~1!. ~'Y~31~a ~i~{~v~li~°wledge. a'~131~--- outto,~< County and belief; and that the work will be performed in the manner set forth in the application filed there~J#~ai~iee Expim~ March 30. ...................'"~ ff"~' ./.....~..... :.'.~..d ay,// ' z/" ' ~<.,"(?,~°f .,...' .......... : ....... /'~ "~ .~.~ .~..~...., 19'/.~.~..~..., ............. ........ ............................... y-- ~' (~gaamre of ,,ppliamO