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Home My WebLink About8320-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy THIS CERTIFIES that the building located at .~.2.9Q..S.~.g.s.~e.e...R.o.~.~. ....... Street Map No....80~ ...... Block No ........... Lot No ....... ./~.6. ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated . November. 28 .... , 19.75. pursuant to which Building Permit No...8..~.2.0.Z. dated . November.. ~ ...... , 19.7~., was issued, and conforms to ~1] of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .l~ive~;e. One Family. Dwe~lin~ ............................. The certificate is issued to ....... .H..e.l.en..G. 9.e..h~..tn.g.e?. .......................... (owner, ~ o~"the aforesaid building. Suffolk County Department o~ Health Approval ..... ~. -.S.O.-. ~./~. ................. UNDERWRITERS CERTIFICATE No ...... .l~f.5...~.6.9..6. ............................... HOUSE NUMBER 2290 ..... Street ...... $~g~.e.e..R. ~.a.d. ..................... ............................................ Matti.tuck,. New. ~ark ............. Building Inspector I;'OR~ NO. 6 TOWN OF $OUTHOLD Building Delmftment Town Cler~ Office Southold, N. ¥. 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 d~sposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industnal buildings, Multiple Residences and similar buildings and installations, a certificate of Code comphance 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 buddings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Cert~hcate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 Date ........ ' ..................................... -c.?...: New Building ...... Old or Pre-existing Building ........................... Vacant Land ........................... Location Of Property .... .~.....'~....~.... . ~ ... ..O'....C:~.. ................... - ./..-Z.. Owner Or Owners Of Property ............. ~... ........ .~. . ..~..~--.~. .................... Subdivision ................................................................ Lot No .......... j~loc, k No ............ House No ............. Permit No . .~..~,..,~.,.~.... Date Of Permit ..L~,~..~.,?/, ?~..~.Applicant Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .......... ~ ........................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~ ....................... Fee Submitted $ ..~..~......~?.. .................. Construction on above described building d~pCrmit, meets all c~blicable codes on, d regulations. Sworn to before me this ................ day of ............................................ .~. ~ ~'.2l~' tstamp or seal) Nqtary Public .................................... County 1/9'6 z.. TME MEW YORK BOARD OF FIRE UNDERWF~ITE, RS r~b' BUREAU OF ELECTRICITY ~ 85 JOHN STPEET, NE~¥ YOF~K, NEW YOrK 100~8 ,,,,,,. April 20, Z977 ,,,,,,,,,,,,,,,, ...... ,,,, 890534 N 333696 THIS CERTIFIES THAT G. Goehringez, Sissbee Rd.~ & Peconic Bay Blvd., {,~ttituck~ L.I. ,,,,,,,. ..... ~,,,.,~,,, April 14, 1977 16 26 I 18 [ 16 [ 5E~ViCB -DISCONNECT - ' Motor/s: 1-3/4bp .... ,,I ! Smoke 1 Post Light Richard G: Relyea ~!mar Dr~ve ~urel, !~Y~ 11948 · This cerhflcate must not be ohered m any manner, return to the ofh~e of th,: Baord 'nco. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number~S~/-/~' APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY I. Applicant Helen Goehrinqer Phone 298-4519 Address 2290 Sigsbee Road, MattituCk, N..Y. 2. Property Location West side of Sigsbee Road Village Mattituc~ 3. Public Water Company Name 4. Lot size: Width 50' feet 10. Township Southo id Length 145" feet Sewage Disposal System: A. 90~allon septic tank: Precast × Equivalent Block B. Leaching pools: __Special__ Number of pools Precast /~0 Block If private well, fill in the fol- lowing blanks: Amounf of water in well 40' A. Tank capacity 85 gallons B. Pump G.P.M. 6 C.'- Total~ell depth 60' D. Depth to ground water 20" E. 11. Mattituck Park 5. Subdiv. Properties, Inc. 6. Section 1 7. Lot Number 46 8. Private Well Yes 9. Public Water No Distance to main (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. Date November 28, 1975 Signed / - ~t_.~.._~ /~-~t..~-~_~_ .... '___~_~__~ ..................... L, ............... ~'_ .............. _--4 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- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE SI NED S-15 Rev. 4/1/73 IPOuM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .............. .......... Approved .................... !Z ................. , ~y ........ Permit No ............... Disapproved a/c ...... ~.....~.....~ APPLICATION FOR BUILDING PERMIT ............. ......... INSTRUCTIONS a. Thts application must be completely filled in by typewriter or 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 prem,ses, relationship to adjoimng 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 wdl ~ssue a Budding Permit to the applicant. Such permi, 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 Occupanc} 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 th, Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, 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 t, admit authorized inspectors on premises and in, buildings for necessary inspections, ""~"" ~g'~"(S ) ignature of applicant, or name, if a corp~ation 2290 Sigsbee Rd~, Mattituck, N.Y. 119' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Owner Name of owner of premises .....~..e..~..?.D.....G:':~....e..~...~..:Jr.~g.?..~. .................................................................................................... If applicant ~s 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. Locahon of land on wh,ch proposed work will be done. Mop No · . .................................. Lot No....~....~.. ............. Street and Number ........ ..S..i..g..?..~..?.?.....~..o..?..c]..~......~.?.~..~..i.~.?.?...~. ................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructmn: o Ex,s~ting use and occupancy None b. Intended use and occupancy ............... .~...e.?...i.~?...~..c..e. .......................................................................................... 3. Nature of work (check which applicable). New Build~ng .... .~. ............ Addtt~on .................. Alteration ................ Repair ................. Removal ................ Demolmor. ........... Other Work ............................................... (Description) 4 Estimated Cost ............. $ ~.~,.0.Q.0. ........................ Fee ..... $.2,5.,.0.0. .................................................................. (to be pa~d on filing thru apphcation) 5 If dwelling, number of dwelhng units ....... .O..~...e. ............ Number of dwelling umts on each floor .... None None If garage, number of cars ......................................................................................................................... None 6 If business, commerciaJ or mixed occupancy, specify nature and extent of each type of use .......................... 7 D,mens,ons of ex,sting structures, ,f any' Front ... 2.0..~ ............... Rear ......... .2..0..~ ................. Depth ...'...8..~. ......... Height ..... l: ............... Number of Star,es ..O. il.~. ................................................................................................... D~mensions of same structure with alteratmns or addmons: Front None Rear Depth .............................. Hmght ......................... Number of Stones ............................... 8 Dimensions of ent,re new construction' Front ...2...~.:.....2.~ .................... Rear ....2.~..~.....2.]'. ........... Depth .3..5..:....5.". ...... Height ~l.5.: .......... Number of Stones ....... .Q~ .............................................................................................. 9 Size of lot Front ......... 5.0.: ................................. Rear ...........~.0.' ......................... Depth ...$.~.~ ................... 10 Date of Purchase ......... ..~...bq...g..t...$.g...~. .............. Name of Former Owner Sid Tuthill 1 1. Zone or use distnct In which premises are s~tuated ...... ¢Z2 12 Does proposed construction wolate any zoning law, ordinance or regulahon: ..... .N...o. ............................................. 13. Will lot be regraded .... .¥..e...~ ............... Will excess fill be removed from premises: (X) Yes ( ) No 14 Name of Owner of premmses ............. .S.~..~..e. ....................... Address ...... ~]..~.?. ................. Phone No...2..g..8..Z.~..5.~..g, Name of Architect ........................................... Address ................................ Phone No ..................... Nome of Contractor ............. ~.~ro.e. .................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all braidings, whether exmsting or proposed, and In&cate all set-back dimensions fror property hnes Gwe street and block number or description according to deed, and show street names and indlcat whether interior or corner lot STATE OF NE'~Y~QR, J(, ~ S S COUNT~ ............... (Nar~e of indw~du~t~ sigr~i~"~'~;;f'~'~} ............... being duly sworn, deposes and says that he ,s the opphcar above named He ~s the ...................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to oerform or have performed the said work and to make and fil this opphcahon; that all statements canto,ned in th~s application are true to the best of his knowledge and belief; on ti,aT the work will be performed ~n the manner set forth ~n the apphcatlon filed therewith. Sworn toJ?efore me this ~ ....... ....... .... . ....... , , ST.~qLEY SI~D/ESKI ~ -/~' (Signo ure o applicant) ~_~ bl'olm~ Pubhc. Sta' ' ~'f Now York 1~O. 520041175 Suffolk County My comxm*s<,n expires Mar. 30, .jo ! 1