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Home My WebLink About8921-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17789 Date FEBRUARY 22, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 10290 COUNTY ROAD #48 MATTITUCK~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 2 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 21, 1976 pursuant to which Building Permit No. 8921-Z dated OCT. 18~ 1976 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N417205 - JANUARY 9~ PLUMBERS CERTIFICATION DATED THOMAS P. SIDOR 6-SO-187-6/25/1979 1979 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 BLDG. TOWN OF 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING. ~....VACANT LAND ........ ~o~:o. o~ ~o,o~..tm~< ........ ~,~.~5'. .............. , .............. HOUSE NO. ~ST~EET HAMLET County Tax Map No. 1000 Sectiom ..1¢~. Block ..~. .... Lot ..I ....... Subdivision ....................... Filed Map ........ Lot .......... Permit No..~.~l~1 .... Date of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate .... ~ ......... Fee Submitted: $.. ~,..~.~ ........... ~-:ii- IC7o rev. 10/14/88 TOWN OF SOUTtIOLD OFPICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable r.o complete your Certificate of Occupancy because .of the following reasons. /_// An application for Certificate of Occupancy is aot on fi].e.i~J~~) / / No Underwriters Certificate on file. /~_// The check [:;~not on file.) 4~oc~D~ /_-/ No Health Dept. Approval on file. / / No~' ~ . -- ~lna~ ins[',ectioIl has bcen made. contact ()ur office on this matter. Z Pl ea:;e Thank you for your cooperation. Building Dept. -- certificate on file. all permits iuvolving plumbing being issued after lprJ! 1,1984 ) COUNTY OF SUFFOLK DEPARTMENT OF HEALTtt SERVICES DAVID HARRIS, M.D,, M.P.H, ¥~. Ernest, 2ad£ord 1,[iddl e 2oad ¥~reh 6,' 197~. 6-$0-187 - Dear ~-. Rad?o~'d: A recent check of our files indicates that this office has never issued a final approval for the above referenced job. Please be advised that it is illegal to occupy the building until the fol- lowing paperwork is submitted to this .office and/or the following inspec- tion(s) are completed: .~Well Drillers Certificate k~tater Analysis ~esspool Certification [~'Final Surveys /~'>t) .~bther ..... ±,o ye?.', ~,' ~?'on~?'t;: line snd ,~e!]. locatibn, .. Should you have any questi'ons, please fee] free to contact this office. Very truly yours, ~?~ '~. :' "' cc; Town Building Dcpartment/ ": Date October 19, 1976 Howard Terry, Bldg. Inspector Town of Southold $outhold. New York APp~VED to the Town of Southold pursuant to Section 239-k of the General Municipal Law subject to stated conditions: upon exe,cut!on of permit, reoui~,e,,d 9n.a.e,r ,S,e~ction .136 of th,~ Hi~hwa~ Law,~, for ,~,cc~ss ,,to C~R?,, 27~ .... ,,~ ~UPFOLK COUNTY D~PTe PUBLIC WORKS R.M. KAMM~R~ Co~mm_isaioner TOWN nF SrlUTHE)LD OFFICE DF BUILDING INSPECTOR T[3WN CLERK'~i OFFICE: SDUTHDL[D, N. Y, Mr. D., Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Low of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ..~ ................................... has applied to the Town of Southold for a permit to construct a building (I~eea~"~rit'o~n~e ~tt~c~d p~pla~?~i~nitted in triplicate, dc~'ed ............................................ and titled ..~..~..~'$~I~.~/'...~'~...~].]L~ We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239i(. Very truly yours, Bulldin~ Inspector Town of $outhold, N. Y, Suffolk 'Joumty Dept. ?tfo]Ic Works )/~:.?? v,k Ave o SeDto ,22 1976 Dear ~ir~ copy of an application for building,, ~ermlt ,iwe!~i.~g onto th~ lot as sho~ on The Lot is on ~/~ County Hosd 27~ aoout 770 Ft ~ east of "~':] ~' "-- U tt~!;-~,}~ ' ' ~ ,'~ " ~ ...... ~ (with brid~e ovor ] .[.~..' .) ~., ~i. ~" ~; :'lo, r~n..~ on curve of BT 27. ~o ~ou hav~: ~:r.y plan for '~;~idenin?j or other improvements to Ch :J~ Jn tbir~ area before ~re ~;et a p3ot ~lan to submit TOWN OF $OUTHOLD~/''~/77 ~ d',~J " ~-~ ~ ~_~'~ " ........ ~ Application No .............. ~. ................. 19..~ D pp,o ed ................ E ...... ..................................... .............. ........................... ~ ~d~ ~/z ~-- / (Building Inspector~ .~ ~ 2 / APPLICATION FOR BUILDING PEEMIT · INSTRUCTIONS g~ a. This application must be completely filled in by typewriter ox in ink and submitted in triplicate to the Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the 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 this'application, the Building Inspector will issue (~ Buildirig 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 ar 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessa,!~ inspections. · ~ (Signature of applicant, or name,Xlf~/corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~, .................................................. .o,~, ...................................................................................................................................... Name of owner of premises if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Bui!der's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ..~.~.9.1..~....g.9...~..~Z..~..o~...C..e....2.Z....~.o..'z~..b....[~...~). ........................................ ..~i[..~..'~...O..E. ............. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ..~..~..q.er.~..~..,.~.l~....¢l,.,, ................................................................................................. b. Intended use and occupancy ......~..e.R~.~..e..~..~..~...e~......a~...~....A~.~..J:.~.tt,..t~'...~..]: ................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ........ ~..o...~.....s....~..a.~ .]:.d..:I:...~ ......... . .... ,,~_ ~ ? _ r(DescriptiOn) ~. Estimated Cast ...~...~.~.0..0.,0..,...0~.. ..................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number' of dwelling units ......0..a..e. ................. Number of dwelling units on each floor ..]:.-.~.t¢..o...~.......0..~.?..., If garage, number of cars ..~..o...~[~([.e.... ...................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .]~{~.:J,.~.~.P..~.~...~.. ..... 7. Dimensions of existing structures, if any: Front ...2~..£eef, ...........Rear ..3.~..£~{~ ................ Depth .....~;~..~.e.f~. Height ........................ Number of Stories ..O.~.e...~.o...3~.:. ........................................................................................... ., / Dirnensions of same structure wirn/alterorions or additions: Front ...~l~..~...~..e..e.} ........ Rear ...~.}...~..e..e..t,, ........... Depth ..,~..~.e..~ ............... Height ............................ Number of Stories ...0...~..e_. ...................... 8. Dimensions of ~ntire new construction: Front .................................... Rear ............................ Depth ........................ Height ..~:~z, Number of Stories ..................................................................................................................... 9. Size of lot: I-rot'It ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ..[...a.~...e.?..~.~.e.~...3.~..?~.. ........................... Name of Former Owner .~L,~..~.~.b..a~.,~...~.~..~.8..°..z'.. ...... 11, Zone or use district in which premises are situated .....~..O~..~..~..~.?...e~......a~...~...?..e.~[~.e..~..~..[..,l~..... ....................................... 12, Does proposed construction violate any zoning law, ordinance or regulation: .... ..~..o..,. ............................................. 13. Will tot be regraded ......~.o.. ................. Will excess fill be removed from premises: ( ) Yes (X) No 14. Nome of Owner of premises J~.~..~.....~..~....~l~.. ................. Address ~..s..~.~..~._e~'..~.9.,a.~..~.:..Z~Phone No./t.?..?.-.~..O~,./,. ...... Nome of Architect ..~.9.~e. ................................................... Address ................................ Phone No ....................... Name of Contractor .:F.~Cl~)~...~.~,..e.~.~,,,,.~..,o~,,~,.e,,,~,o,y~?, ....... Address .~.~.t'.~.t'..~...o~.~..~.t~.;.. Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oil 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. .S COUN~ ............ being duly sworn, deposes and says that he is the applicam of signing contract) ' 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 oil statements contained in this application are true to the best of his knowledge and belief; and that the work will be performean the manner set forth in the application filed therewith. Sworn,to before me this ~' ., ~__~ ' (Signature of applicant) //