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Home My WebLink About6782-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificnte Of Occupnncy No..Z~(~7..~ ...... Date ............. ;~g~.~.t...$7..., 19.7.~. THIS CERTIFIES that the building located at 8/,q. Pal'k. A~r~ .............. Street Map No. XX .......... Block No. ~ ....... Lot NoXXX..~..fi'~$t~.c~...k.:k.': .......... conforms substantially to the Application for Building Permit heretofore filed in this office 678~.z dated Jill}' 27 19 Z.~. pursuant to which Building Permit No. 678~ · ........ ~u~"3 ....... ' dated ............ Aug...8.~, 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 .P. ~2v. ate..~,9..~&m$;[Y...d.~.e.l.~..~.ng ....................................... The certificate is issued to ... Tkams s..~. Po, t~lc;i~a .~a~ey. ....... .~.~.k~.~:s. ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . D.ee... t%.. ~ 7.~.. bY.. R:..V3,11&... UNDERWRITERS CERTIFICATE No.. I~22070~ ..... At~:]....~...t97g. ........... HOUSE NUMBER .... ~,0~ ...... Street...P.~'tc../~.~ .............................. ...... ....'"' .... FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BI)ILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6782 Z Date ....................... ,&,13~ll~t,.... ~ ............ 19.t~.. Permission is hereby granted to: ~a~k A~ BUild z~w o~ family d~11 ~o ............................................................. ~ .............. .(~],z~.,,,~ ..~..~...~i~z,,1 .................... at premises located at .8.../:.~....?..a..~.~.....A..?.t...~..~i~IIII...ilztlL,~...W/...iI~Iieh. ........ :....,~:,~ ....................... Matt:ti ' ...................................................... ............. ..................................................... ................... ............................... ~ .......................... ~.! ................. ~ ............................................. ...~...,~ ................ ~llJ.~' ~ ]~......., and approvedx by the pumuant to application datt<t ...... ! .................... ~;...~. ....................... Building Inspector. Fee $.....~/..e..,.~?..: ........ Buddin~"Tnspector I THE NEW YORK BOARD OF FIRE UNDERWRITERS --ak BUREAU Of ELECTRICITY ~ 8§ JOHN STREET NEW YORK. NEW YORK 1OO3/3 ~"'"~ ADz'il, 23. '1975 .,,,,,,~c,,.,.,.¥,,.,.,z',,~ 693985 N 220703 THIB' CERTIFIES THAT Thomas Carey, Park Ave., Marratooka & End of Street, Mattituck, L.I. ,v.sexamin~d.n April 18, 1975 FIXTURE FIXTURES .ArGES ~OOKING DECKS OVENS DISH WASHERS EXHAUST FAN 21 56 40 21 DRYERS FURNACE MOTORS SERVICE D~SCONNECT OTHER APPARATUS: FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS S E R V NO OF CC CONC T A W. G 7 1 3/0 1 1/0 *Ranges: 1-13.1kw, 1-10.0kw *Furnaces: 011 1-1/8hp, 2-1/12hp Motor/s: 1-3/4hp Horton Ave., Mattltuck, L.I. 11952 GENE.At This certificate must not be alterea sn any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentrols. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE 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 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. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o 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 August 16 197¥ New Building................xx Addition ..~ .... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Park Ave lqattituck Owner Or Owners Of Property Thomas & Patr±c±a C&z'ey Subdivision _~z.,~.z~.X.. ................................. : ...... : ........ Lot No....~.. Block No....x....X~..... House No ...... .1...0..0 o.y~2z 7/27/73 m, ~ ' Permit No..~..'Z..~.3..~. ........ Date Of Permit 8Z3Z.7.,3 ......Applicant ..~.'..pz..o..~....?..~?..e...~. ........................................ Health Dept. Approval .......................................... Labor Dept. Approval ................................................ Underwriters Approval ................. Planning Board Approval ....N..:..~.... ............................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ......~...:: ............. on above described building and{z~t mee~s/l~pplicable codes and regulations. Construction Appl,ca.t ..... .................................... ','"", ....... Sworn to before me this / · "X '~'"'~'~ day °f '".o'".. "~'"~~...z(/~. ;~ '/ (stamp or seal) Notary .Publi~~...~....x;County ,UD,ZH ,. ,OK~ ~c.~/~/~.~ ' # 7~~'~:~-""~'/ Notary Public, Stato of New York Park Ave. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference APPLICATION FOE APPROVAL TO CONSTRUCT A PRIVATE "~ ~ ~?~ 5. Subdiv. 1. Applicant I~a~ av~;<';4 d46~¥ Phone~- Address ~< ~u¥~ ~ .~T~.~p.¥ . 6. Section 2. Property location~[~ ~/~vT/~-~.(.~;~z~ 7. Lot No. ~ ~;./~ ~ ~e ~ 7~ 8. Private well Villase ~z~m~ Township ~ 9. Public water ~: Public W~'er Compan~ na-e ~' Di.,ance ,o main Lo~ size. ~id~~eet Length /~ fee~ (Enter on cen~er plo~ below) 10' ,erase Dispos~ ~yste~. . A. ~ ~allon septic tank. Precas~ Equivalen~ Block No. SEWAGE DISPOSAL SYSTEM B. Leachiu$ pools: Number ~,Precast~lock Special If private well fill in blanks below: Tank capacity~/~Cale. Pump C.P.M. Total well depth.~~ Depth to Amount~ ~ter in wel Test Data ~et 16 18 The undersisned CERTIFIES: of authorized installations will be in accordance with the Suffolk County Department of ~'~lth~s current stand- ards ~hereto.' D, t e '--..~./ ~' ~//~ Si,ned Owner =e.e./Fuil de r FOR HEALTH DEPARTMKNT USE ONLY. Based on ~he informa~ion presented herewith, is the opinion of the Health Department, that an adequat~ and ear.factory Disposal System can be installed on this plot. S-15 Revised 4/1/72 Exominod App ...................................... , 19 ........ Permit No. *r. ................................. Disapproved a/c ..~....~F,-J~-~'- '~.~ ~ ~ ~.~ / a ............... , ...... a. This a~lication must ~ completely fill~ in by ~ewfiter In,tar, with 3 ~ of p~, accurate pl~ pl~ ~ role. F~ a~o~i~ to ~h~ule. b. Plot plan shying I~ation of lot ~ of buildi~s ffi premises, relati~ship to ~joini~ premiss or publ~ str~ ar~s, and oivi~ o d~oil~ d~ripti~ of Io~ ofpr~ must be drown on the diagram which is ~ ~ ~is ~licot~. c. ~e work c~er~ ~ ~is o~licatim my n~ ~ comme~ before i~ua~e of Buildi~ Pemit. d. U~n a~mvol of ~is o~lic~im, the Build~ In--tar will i~ue a Building Permit to the ~licont. Such petal1 shall be ~pt ~ ~ premiss a~ilable ~r In~l~ thr~t t~ ~rk. e. No buildi~ shall be ~cupi~ or uffi in whole or in po~ for any pu~se what,er until o ~if~ of ~c~m~ shall have ~ gmnt~ ~ the Bulldi~ In~r. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pur~lont to ~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordlnancee~t Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descrtbe~,~ The applicant agrees to comply with all applicable laws, ordinances, building code~ housing code, and regulations, and ~ admit authorized inspectors on premises and in buildings for neces?~ary inspec~i6n~. --~ ..../z ~ ~ 0 ~ ! "'~~ .......................................... or .name, ,~ ~'co~,i~i: {Address of opplicom) //.9 State whether opplicont is owner, lessee, ogent, architect, engineer, general contractor, electricion, plumber or builder. ............... . . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on whi$,h proposed work will ~be done. Map N~.: :: .............. .~.....,..~ .............. Lot No ......................... Street and Number ..~q~.,l~..~.~/rf~...~..~..~....~.....~..~...~...~...~..,~.~..~..~...~..~. ..~,/~.,.'~..~.~ ....... : ~T~ ~ Munlci~li~ '" State existing use and ~cupancy of promises and intended use and ~cu~ncy of p~ed con~ti~: a. ~isiti~g ~ a~ ~cupancy ....~.~ .......................................... b. Intended useand~cu~n~y....~,~ ~~ ~;~ ....................... Nature of work (check which applicable): New Building .................. AxJdition .................. Alteration Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) ...... ............... '~ 4. Estimated Cost ........... J ............................................... ~ee ..................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each flOOr .....~.. ..................... If garage,- number of cars .......'~....u~-.....~.. .......................................................................................................................... 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 ............................ Numb r of Stones ........................... ., .... 8. Dimens~_ns_of entire new construction: Front, .?...~..::..:.~ ...... :-;'"':-~.1~ ~R~/.r '~3~, ............... Depth ....-~.....' .............. Height ~,,~&.,~&Z ......Number of Stories .....~..../..~...~.~.....~..~.~..~. ...... ..~.~A...?....'C...~...°. ................................................... Size of lot: Front ..... ~'...~..7.,.~ .................................... Rear /~",~..~., Depth. Name ............... Date of Purchase ..................... f, ..................................................................... Zone or use district in which premises are situated .................................................................................................. Does proposed construction violate any zoning law, ordinance or regulation: .~....~. ................................................ Will lot be regraded ~./.../'~..~ ............ ,¥Vill excess fill be removed frRm premises: ( ) Yes C~) No Name of Owner of premises ..~~~/..~......~......~....~. ..... Addre~..u~.~.~hone N0..~.~.~...~..... Name of Architect ...................... .".: ..................................... Address ................................ Phone No ....................... Name of Contractor ........ ~....~'....~ ............................... Addre~..'~..c~.4b,~l~!~.....F'c'~'.... 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 whether interior or comer lot. 10. .11. 12. 13. 14. S STATE OF NEW Y~RI~,/. IZ'_ I S.S COUNTY OF .~.....)' ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) 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 file this application; that all statements contained in this application are,,.t~ue to the,J~,~ of his knowledge and belief; and that the work will be performed in the manner set forth in the opplicgfion~filed th~/rewi~. Swam to J;[efpJ~ me this ~ /_ //'-~ I J NotaZ;~;~~~unty ........ ~...°~....~.i....; ................................ ~ JUDITH T. BOKEN (Signature of ~pp ica t) Notary public State o{ t4ew yaeit / 62.0344963 Suffolk CountX~lL~ No,- .- r..,.I,~ March ~0, 19..~J A V£/',/U £ H A hi L.O ~',I TO THIS SURV~ IS A VIOLATION ~ENDING INSTITUTION LISTED HEREON, AND THE ASSIGNEES OF THE LENDING INSTI,~ [ ! I 1 i FI ~v£ I I I 5 * SmcTIo~ OF FF~o~T t S~OOL ~