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Home My WebLink About6658-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. z~-~99. Date .... 0~; 3 , 19 73 THIS CERTIFIES that the building located atW~.$ Maratooka, Road Street Map No. ~ Block No. ~ ... Lot No. ~ ~t~l~k~ ~,~, conforms substantially to the Application for Building Permit heretofore filed in this office dated gu~a ~ ~ , 19 ~3 pursuant to which Building Permit No. 66~8Z dated . .. J~ .~3. , 19 7~, 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 Private one. family, dwelling .. __The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITkRS CERTIFICATE No pen.dln, g ItOUSI' NUMBER tlf30 Street (owner, lessee or tenant) ... 8.apt . 28. l!aratgoka Building Inspcctol F~RM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 6658~ Z rote .................... ~.~. ......... .~1 ............ ,~.?~.. Permission is hereby granted to: - ' at premises located at ......'J~,/.~-.~ll~it~.-.~ ........................................................................... ............................................................. ltatt~tuek....ll,~. ............................................................... pursuant to application dated ............................ ~t'~ .....~,~ ......... 19..~., and approved by the Building Inspector. Fee $....~*.~). ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS ia], BUREAU OF= ELECTRICri~ .'. :: ' ' ~- 85 JOHN STREET. NEW YORK, NEW Y~R~'10038: z.'s CZ~E~RT~l~"rtO~i^~r 2.5, 1,973 *,J,,~..o. No.o.m. 6"696 N 122988 only tile electr~[ equipment ~s de~crt~ ~elol~ and introduced ~ t~ ~t ~ ~ ~ ~ ~ ~ numar i~ t~a o~ E. Aud~un, w/a ~rat~ ~. 18~e/~%olk Ave.~CC~Cuck,L.l. RANOES ~T.1 K.W. l& ]COOKING DICKS [ OVENS [DISH V I SERVICE DISCONNECT I NO. O~ [ S E n METE. [ ~CC~ /~ w.o. EXHAUST FANS raMMERS AMT.' WA~$ & 2-.751b.-- Jo D. 14~zon:L 227 Wavwt],y Ave. Ked~r~d, L.X.11763 11 m MANA~llI I i ' COlbY 'FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAHNER. 1~0~ NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th,s application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspector w~th the following; for new buildings or new use. 1. Final survey of property with accurate location of aH buildings, property lines, streets, aha 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 F~re Underwriters. 4. Commercial buddings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance fram 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 buddings 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 pertinent in- 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 3. Copy of certificate of occupancy $1.00 $5.00 Date ../. ~.~.~/, .~.~ ......................... New Building / Old or Pre-existing Building Vacant Land Location Of Property ..... ..l~../~. ..... ~.~.~..2"...¢,.o.../.~.~)..~.~ ........... ,¢/~2,~.~.~../..~.~.../..~...:...~:./..: ......... Owner Or Owners Of Property ....... ~'./.,.,~...~,..~..,/,,~...c/~. .............................................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Health Dept. Approval ........ ~.?. ,.~./~ ...... .~. .................... tabor Dopt. Approval ................................................ ..~...~. ........................................ Planning Board Approval ........................................ Underwriters Approval ~,¢'r,' ,,~ ~ ' Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ..... .~.~..~..,o. .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ....~.~..~....~.......~..,.... ~-~ .......................... ~,~ ................ Sworn to before me this ~ /O~Zr ~ ........ 3 .... day of Cr 6' /f (,,,amp or seo, Notary Public .................................... County ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Applicant ~,~/~,/ i-J~a~ Phone ~ ~-- 5. Subdiv. Address ~~/~ ' ~ Property Location ~ ~~~ ~m Village ~q~ ~ ~ ~ ~ c)t 3. Public Water Company Name 4. Lot size: Width )~ feet 10. 11. Township Length ,i~ & feet Sewage Disposal System: A.(~-gallon septic tank: Precast ~Equivalent B. Leaching pools: Number of pools :Z Precast~Block , Special Block If private well, fill in the following blanks: A. Tank capacity ~ ~ gallons B. Pump G.P.M. /~ C. Total well depth D. Depth to ground water ~ E. Amount of water in well 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main (For Health Dept. Us~) I-- '--4 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this pl.ot. APPROVAL DATE S-15 Rev, 4/1/73 12/27/1999 11:46 DATE: TO: FAX #.. FROM: RE: 5167347782 DEBORAH DOTY PAGE DEBORAH DOTY ATTOFdN'EY AT 670 ~VEST CREEK AVF. NUE P.O. Box 11~1 CUTCHOGUE, NY 11935-0~76 631-734-66'~ , z -( 999 December 27, 1999 SoutholdBuildingDepartment 631-765-1823 Deborah Dory Audioun, 1350 Marratooka Road, Mattituck, NY (SCTM #1000-123-1-3.4) TOTAL NUMBER OF PAOES INCLUDING THIS PAGE 3 . If you do not receive all of the pages, please call thls office as soon as possible. MESSAGE: Dear Pat: As we discussed on the telephone this morning, transmitl~d hercwith arc copies of (a) Certificate of Occupa~y #Z5499 dated Octol~r 3, 1973 and (b) tl~ survey bearing Suffolk County Department of Health Services approval dated September 28, 1973. 81 A~D)OUN ( ~L t '-4 ~amin~ ...~ .................... 19 ........ ~licgti ....... , .~ .... ,, ................... ,, O~ olc ......................................... ~ ..................... ~~ ~ ' ~ ~ /' ~ ~ . ........................................................................ T"'~ ............ ~ ./...j... ' ~t, ................... ~.....!~. ........ , w.Z}. ..... I~$TRH~IO~$ b. ~lot plon ~h~i~ I~aIi~ of Io~ ~ o{ ~i~i~ ~ pr*mi~, r~l~ion~hip to ~ioinino pramise~ or public ~r~ o~ ~r~, ~nd ¢ivi~ ~ d~tuil~ d~ripti~ o{ I~ o{~ mu~t be dm~n on th~ diagram ~hich e. ~o buildin~ ~ho, be ~cupi~ or u~ in ~o1~ or in pa ~ {or on~ pu~o~ ~v~r until a ~oll how ~n ~mnt~ ~ ~h~ Buildl~ In--or. ~. ~pplicont agra, to comply with ~11 ~lic~bl* I~, ordi~, ~ildi~ c~, h~i~ ~, A. Reilly & Sons Ino (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...$.~.~.~'A;~..~]~;~.9,1l~ .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... P~umber's Ucense No ....... ~.:...~,o.~......0.~.~..~.e.~. Electrician's License No...~a,~QD~..,~I1J~, ............. Other Trade's License No ............................................... Map No · Audion Location of land on which proposed work will be done ........................................... Lot No....2. .................... Street and Number ....... ~/.~...~a.Z'&~O.Q~I...~QB,cl. ........... ]/~i.t.t:l.~--~Ok .............................................................. ) ~/~ 0 Murtt~ipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy V&OZlt b. Intended use and occupancy ....... OD. el..~'a.lll;l~..d.we.].'l.t13g ........................................................................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost .................... .~...0..~...0~...0........_+. .................. Fee ......~.?.....~.0.. ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .....o..n..e. ................. Number of dwelling units on each floor ............................ If garage, number of cars ....... .O.~..~ ................................................................................................................................ 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 ........... ~'.~. .................... Rear ....... ~. ................ Depth .3:{...~.../.~.~.... Height .................... Number of Stories ............one .................................................................................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of PurChase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ .~!A.~!...~J,E.t;. ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... D.~ ............................................... 13. Will lot be regradedl ......,~,O, ................. Will excess fill be removed from premises: ( ) Yes (X) No 14. Name of Owner of premises .~.e...Jk120,,1,Ql& ............................ Address ....... ~/~a~.~;L~13,0~... Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor A.~ ~[a;L].i~. ~..~onR ................ Address .....~a.~.~:l;~l~ ..... 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 corner lot. See filed plans STATE OF NEW YORK_ .. t c e COUNTY OF ....... ~..u~..~.o....a~.. ........ ~.~ ....................... .]~.~ll~:L.,~J.~,,~ .......... : ............................... being duly sworn, d~oses and says that he is the applicant (Name of individual signing c~trac~ ~ove name. 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 ~d to ~ke end file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will ~ performed in the manner set fo~h in the application filed therewith. Swam to before me this ................ o, ....... .................... . Noto~ Public, .~~~.. Coun~ .... ~nature appli~n' TERRI LIE E~K ~ pUbLIC, State of New Yo~k I- // A. kEILLY ,~ATTITI.,k K, L. L MA~. 8602 APPROVED AS NOTED DATE: ~._~t,2~,...k_. / ~.~ /~7~' NOTIFY BUILDING DEPARTMENT 765-2660 gAM TO 4PM FOR REQU~3., ED INSPECTIONS: 1 BEFORE BACKFILLING POUNDA, TION OR START FRAMING )_. BD-ORE COYERiNG PtPJ:LINE