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Home My WebLink About8028-zTOWN OF $OUTHOLD BUr~.t~ING DEPARTU~NT Town Clerk'~ Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the bugai.g located atWavec~c$.t..L.~. ~ ........ ~ Street Map No. 5a].taire. ~,iilock No, .......... Lot No...~ ~.....i~..t;.t.t..'c.u.c.k....NAY... ....... conforms substantially to the Application for Buildln~ Permit heretofore ~ed in thi.~ office dated ............,T.tl~. ~5., 19. ~.5 pursuant to which Building Permit No..8.O.2.8.Z... dated .............. ,Ii,ne...2~, 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 Ls .... Private..one. i'ainl~l.y .d~allLl~[ .................................... The cerfificat~ is issued t~ . ~.r.. (owner, lessee or t~ment) of the ~resaid building. Suffolk County Dep~,-Lment o! Health Approval ...S. ep~.. 3.0... ~. ~?.~..17. y..~.:..~.Z..e.. HOUSE NUMBER ...... ~.~.~ .... Stzeet ....... ~e.v.e. qTO~ ..LO ..................... Bui]d~ng Inspector FOE~ NO. ~ TOWN OF SOfT,OLD 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? 8028 Z Permission is hereby granted to: W~z~ s~ay "B~di~'-'C~'"A'/e' -'Ab:ra~a~ Fa~as ............... G.2~n...~d. ......... ~et~het~. ................ to ~£1d...~w---o~...£am~.t~.. dw.t.~4-ng ..................................................................................... at premises located at "~ot'-'l~-'-'~a'~t'"Alre'"~ta~;~' ............................................................. ............................. ~.f/.~C. ....... ~vwcre~ ~m~ ........ ~'~'~'~z~ pursuant to application dated .........................~4-~e.....2b/ ............ , 19~.~..., and approved by the Building Inspector. Fee $.~..'t .,,.cJ ~ ........... ~01~1 NO. $ TOWN OF $OUTHOLD ~ 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 lC257), 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 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 $5.00 3. Copy of certificate of occupancy $1.00 New Bqilding ....~ .......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Roquest For Tempora~ Ce~ffic~te ........................................ Fin~ Certific~to ......... ~ ................ Fo~ Submitted $ ..~ ............................ Construction on above described building anS..permit Sworn to before me this .......... o, .......... Notary Public ...... .~.~/,. County 0 (stamp or seol)~c~'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 8~ BUREAU OF ELECTRICn'Y r-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~. September 29, 1~75 .~ppt~o,~,,.W,.o-..9,~, N 247829 THIS CERTIFIES THAT xnms ay~ Bldg. Co~'o~, Wavecrest, off Reeve Ave,' & Farm Mattituck, L.I. inthe/ollo~insloeation; [] mesemeht [] lstFI. [] ~nd FI. outside ~t~. e~,~m ~,t ,~.~.a,.t,,.don September ~5, 1975 HXTUIIE FIXTUIIS RANGES eX)Gl(lNG DECKS OVENS DISH WASHIIS 13(HAUST FANS 1 200 CB x 1 2/0 1 2/3 ~Furn&ees: Oil 1-1/Shp, 2-1/12hp mSpeeial receptacles: 1-50amps., 1-30amps. ~o. 50 Robert A. Goo~ale, RR~I, Box 15A, Main Road, ,,,~ ~attituck, L.I. 11952 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number 3. 4. 10. 11. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Address Property Location 6. Section 7. Lot Num'-er 8. Private Well Public Water Company Name Lot size: Width ~:,,0 feet Sewage Disposal System: A.~900'-gallon septic tank: Precast ~/~quival ent Block B. Leaching pools: Number of pools [ Precastq,, 0':~ B1 ock Special __ If priva~well, fill in the fol- ,~:~a n k ~p ac i ty, gal lons ~Dep~o ground water. '~ Amo~of water in well Township ~o~,,~ ~l~:~ 9. Public Water Distance to main Length_;~_;~zL.feet (For Health Services Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' 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 THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- facto~ Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ' SIGNED S-15 Rev. 4/1/73 \5 ~o~ NOTE: · = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AUG. 5. 1966 AS ~4AP NO. 4682. SURVEY FOR WALLACE Cl MOLE E~ LILLIAN D. MOLE LOT 15 "SALTAIRE ESTATES" MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. GUARANTEED TO: SECURITY TITLE ~ GUARANTY CO. SCALE: I "= 40' MAY 14, 1969 JUNE .9, 1969 PRO F ES SI ONJ~-[NG I N E ~ N D LAND SURVEYOR ~ N.Y.S. LCfii. NO. 12845 RIVERHEAD~ N.Y. ~o~ 9 \5 \ 0 0 NOTE: '~ = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AUG. 3, 196G AS MAP NO. 468:>. SURVEY FOR WALLACE C, MOLE ~ LILLIAN D. MOLE LOT 15 "SALTAIRE ESTATES" MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. GUARANTEED TO: SECURITY TITLE E GUARANTY CO. SCALE= I "= 40' MAY 14, 1969 JUNE .9, 1969 LAN D S U RVEYOR, N.Y.S. L~. NO. 12845 RIVERHEAD,, N.Y. TOWN OF $OUTHOLD ...///. BUILDING DEPARTMEN~ r/~ TOWN CLERK S OFFICE Exam ned ,.~ ~ ..J , ]~ ,~ ~ Application 'Permit No ~. .................... "'~'~ INSTRUCTIONS o. This opplicotion must be completely filled in by typewriter or in ina ond submitted in triplicote to the Buildin9~ Inspector, with 3 sets of plons, occurote plot plon to ~ole. Fee occordinG to schedule. b. Pot plon showin9 Iocotion of lot ond of buildings on premises, relotionship oreos, ond ~ivin9 o detoiled description of Ioyout ofproperty must be drown on the ~iogrom which is c. The worA covered by this opplicotion moy not be commenced before issuonce ' d. Upon opprovol o~ tNis opp~icotion, t~e Bui~dln9 inspector wilt issue o s~oll be ~ept on t~e premises owiloble for inspection tNrougNout t~e wor~. e. No buffdin9 sNoll ~e occupied or used in wNole or in part {or ony purpose wNotever until sholl Nove been 9ronted by the Buildin9 Inspector. APPLICATION IS HEREBY ~ADE to the Buildin9 Deportment for the issuonce of o Buildin~ Permit pursuont Buildin9 Zone Ordinonce of the Town of SouthoM, SuffolA County, New Yor~, ond otNer opplicoble Lows, Ordinonces or Rc9ulotions for tNe construe on o~ bu Id~ngs, odditions or olterotions, or for removol or demolition, The opplicont o~rees to comply with oll opplicob~e ~ows, ordinonces, buildin9 code, housing code, ond regulotions, *o~m ~ outhorized inspectors on premises ond i~ buiMinGs for n~ess~ inspection~ (Signofure of oppiicont, or nome, if o corporotion) ......... ........... (Address of opplicont) State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, electrician, pJumber or buiJder. if applicant is o corporate, signature 9,f/duly authorized officer. (Nome and title of corporate officer) Builder's License No ..................................................... ~ Plumbers License No..~J~J~i ............. ~J~r'.~...~.~..(/ .... ~ ::~,J'~ J Other Trade's License No ............................................... O ·/ ~ ///- , / ¢ Location of land on which prpposed work will be done. Map No.: .....~,(~.~J. ll~.~',,~.,~...//:~Lot No....].~ .......... ~ .... Street and Number ....... N..J.*.~ ............ ~.~.....C~.~/¢..%T..,.~... ........ .~.. ....... 'i..?.....J~ ....... '.~..' .~..~,.:~.....,,.....'.~.~..~.~/~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ............. ~),~**]~...,~*~.",~*~'~'" -- ........ ~**~*-~*.'**~,**J,*~**~]-- ............................................... J 3. Nature of work (check which applicable): New Building.. ....... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition ....................Other Work .................................................... ~ t~ ~-~ / ~ ~ (Description) 4. Estimated Cost .............. ~..~..¢2...0....:..:...;:ff. ................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~../~....L~...Nurnber of dwelling units on each floor If garage, number of cars ....' .,,~m.......~ ............................................................................................................... 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 ..,~¢...~.. ......... Height ...~...~,.¢c~........ Number of Stories .... ~ .................................................................................................... 9. Size of lot: Front ..., ....... J..~..C~ ........................ ~¢. .......Rear ..... ..~i~.~..~.~.~.:.~. ................... --__ .Depth ..~....~.~.~...~...~.. 10. Date of Purchase ...~.~.~l.l./~.l,~.-~.. ...... .~..~..~;..~..~... .......... Name of Former Owner l 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regroded . ....... ~ ............. Will excess fill be removed from premises: ( ) Yes ( 14. Nome of Owner of premises t~g'll~Jr~.~..~M~...l(Ml~r~dress No. Name of Architect ............................................ ~ ............... Address ................................Phone No ...... Name of Contractor ~,iL .~..19~...~.. ~ ~.'0..;.~.~ Address 1.~.~...~i./-~.....~.. Phone ....................... PLOT DIAGRAM ,,~ ¢~ ~'~' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ail set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~.~.QRK, ,~/,. /// ~ S S (Name of individual signing contracfl abow~ named. , ~ ~ ~ of soid owner or owners, ~nd is duly ~uIhodzed ~o por~orm or h~vo performed tho so~d work on~ to moke on~ file this opplicotion; thor oH statements contained in this ~ppl[cotion ore true to th~ best of his knowledge end belief~ end tha~ ~he w~rk will be performed in the m~nner set fo~h in the oppHcation filed therewith. ~0 52-8125850, SUI~Ik COIl~llyff~ lvOll~ NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined ........ .c.~..,~.,...., 19.2.~V Application No. ~proved ...~......~.~ ......... '~"7'"" 19~2.~. Permit No..~. ....... ~. .............. Disapproved a/c ...~~ ............... ~ ' (Bufldi~ Ins~ctor) 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 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 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 taws, ordinances, building code, housing code, and regulations, and to necessary inspections. admit authorized inspectors on premises and in, buildings for (Signature of applicant, or name, if a corporation) ........ ........... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiida~'~. ~ ........................... ...................................................... . If applicant is a corporate, signamm~uly authorized officer. .... ~ ~-(N~e and tide of corporate officer) Builder's License No ..................................................... Plumber's License No. Electdcian's License No. , . Other Trade s L.cense No ............................................... 1. Location of land on which proposed work will be done. Map No.: ...~.~,'~l~ot No ..... I.~. ....... ~.~, Street and Number ........ ~..J.~......~..~.,.~ ........ ~ ~ ~umc~pau~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy .............. f~)./'~ ~[; ·. · · .~..lt"~.."./~'1 ........ ~../~. ~'~/~ ............................................... 3. Nature of work (check which applicable): New Building' .......~. ......... Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................... Other Work ................................................. .. (Description) 4. EstimatedCost J J J J J~J ~JJJ J~. ~l~ J J,j ji~ .................. Fee ..~../r(~.~.~ , (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~..~...~...Number of dwelling units on each floor,~-,S../~l~ If garage, number of cars ...~....~. ................................................................................................................ 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 ..~..~m',. ......... 10. Date of Purchase ...'.."~.~.I~1~. .......~...~...].L .......... Name of Former Owner [~ ....... ~r:r,,~[..~r. ....... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded . ......~..~ ............. Will excess fill be removed from premises: ( ) Yes ( ~ Name of Architect ......................................... : ................... Address ................................ Phone No ........~, ............. Locate clearly and distinctly all 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. STATE OF NEW .,,~:O~ RK, // ..~J' IS S .................. .~.~l~..,...~,~.~..r~....~rff...~'.~ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing.contract) above named. G~ 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 the best of his knowledge and belief; and that the work will be performed in th~ manner set fo~h in the application filed therewith. Sworm~fCre me this ~- r, ' ~' ~ [LIZABETH N[?~L~ , , NOTARY PUBLIC, State o1 New ~or~ J ]erm Expires Ma~cl~ 30, lg LE\/A APPROVED A~S NOTED ~ : f 'PO~.W I CO T £ ,/ LA '0 0 0 C I P KLOOK - CROSS, P,, G