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Home My WebLink About10008-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildlng Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z17508 ................. Date November 14, 1988 THIS CERTIFIES that the building ADDITION Location of Property 335 SOUTH DRIVE MATTITUCK h~,;s~ h/d ........................................................ Street Hamlet County Tax Map No. 1000 Section ...1.0.6 ....... Block .... I .l .......... Lot 19 Subdivision SHORE ACRES Filed ............................... Map No ......... Lot No.E ............. conforms substautially to the Application for Building Permit heretofore filed in this office dated OCT. 31, 1978 pursuant to which Building Pemfit No. 10008Z dated NOV. 8, . 1978 was issued, and conforms to alt of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITI'ON TO A ONE FAMILY DWELLING ' The certificate is issued to VELJKO J. KRSTIILOVIC, M.D. ..................... /o¥.~), '~;~;~'O¢&~;l~;~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ........ .~/.A. UNDERWRITERS CERTIFICATE NO. N432769 May 7, 1979 ' PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FOI~M NO. 2 TOWN OF SOUTHOLD 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? 10008 Z Date ........................................................ , 19 ........ Permission is hereby granted to: .... ~/~'"'"i;'~-"'Z:;TC~'?~ ....... t..~.~.~...~..u..J.- ~; at premises located at ............................... .j,~/.~..-~.7.-,,r. C1t~.~... .................................................. ........ ": ........................ / .................................................. '~"r ........ ~ ........ 7/. ,.~.-. ................................ pursuant to application dated ........................................................ , 19 ......... and approved by the Building Inspector. ee, .......... / OOO-- I~(~- t'~ I~ Building Inspector FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUF Instructions A. This application must be filled in typewriter OR ink, and submitted ~. ~.-...~a to the Building Inspec- tor 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 tions, 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 app cab e 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ I00.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land CoO. $ 20.00 5.Updated C.O. $ 50.00 Oate ../.~.z../~,./.~.~.~. .......... N ~ P i ti gB ildi I/ V La d ewC°nstruction..,... or re-exs n u ng ............ acant n ............. Locat,onofProperty~r:.~."'7: ..-,.~.'.¢ryZ~,~. ~. .:¢[ .~./f .~.~. ,/'/q/f . . ~,~."~ ' ' "'--' '' ........... Owner or Owners of Property ~ County Tax Map No. 1000 Section .... ,~.¢2~. ....... Block .../~. .......... Lot., ,/.f .......... Subdivision...~(-~.../~"~ ................ Filed Map No ........... Lot No ..... E~. ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate ................. Final Certificate~..L~"../, Fee Subm,tted ....... Construction on above described building a.G~ermit ~eets a~plicable codes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS .' I' ~~''' ~ ' 85 JOHN STREET, NEW YORK, NEW YORK '10038 * .. ' BUREAU OF ELECTRICITY ' /}ate ?,ay 7, 1979 zlpplicationNo, onfile o~Jy the electr~al equipment ~ ~sc~bed ~ a~ i.trodueed by t~ appllean~ ~med on the a~e application number in the ~remlses of .. . Vel.jko Krstulov~c~ 3~5 South [}r., Ha'l'tltuck, in t~e foliowi.g location; ~ Baseme.t ~ Zst Fl. ~ 2nd FL ' - f ~ct~on Block ~ examined on ~'~ ~ ~ ~ , ~ 9 7 9 and found to ~e in compliance with the requirements o~ this Board. FIXTURE FIXTURES RANGES :OOKINGDECK: OVENS DISH WASHERS EXHAUST FANS "SERVICE DISCONNECT NO. OF ......... ~ S '" E- ' ,- R ~ V I ~ C E / ' I 200 C~* x I 3/0 , ~ , I "3/0 '~ ' ~z r2~ ~ ~ ,,~OEDEE TO THE ORDER OF:~H~E" ~W l~iO0 , ,' YORK ~ARD OF FIRE U~D~RWRTERS ..' ~30govlo. , ~, . , . .,; , - ~ ~ ~ ~ ~ ~lHl~ ~ Y~uR B~L~ F~R $ERV~ RENDERED AND ~ N~T A ~ERT~FICATE ~F C~M~L ANCE~ TH~S B~£L PAYABLE T E ~ ............................. A ?H NEWYORKOFFICE R~JOHN$?REE?,NEWYORK~ N Y 10038 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST I- ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INsuLATioN [ ] FRAMING [,~]~L REMARKS: ~'~ DATE ,NSP,~CTO _~ I~OBM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~SOUTHOLD, N. Y. £xomined ..................................... [~ ........ Disapproved a/c (Building Inspector) Application No ............................... APPLICATION FOR BUILDING PERMIT Date ....................................... ]9 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building Inspector, with 3 sere 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, (3nd giving a detailed description of layout of property 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 hove been granted by the Building Inspector, APPLICATION IS HEREBY MADE to the Building Deportment 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to on ~' inspections. , admit authorized inspectors premises and in buildings for necessap/ .......... ............... (Signature of applicant, or name, ifa corporation) (Address of applicant) APPP, OVED AS NOTI~D :. State whether applicant is owner, lessee, agent, architect, engineer, gener~Acl~..tractor, electrician, plumber or builder. ................ .... N~me o~ owner o~ premises ,,,,~ ...... ~ .......~,,~ff ........... ~,,; ........ ~.~.,~M~.,~.~,,1,,~ ........... ~..,,.~ ............................. - ,O 9A/~l fo 4PM FOR ~EQL4[R. If applicant is a corporate, signature of duly authorized officer. ED INSPECTIONS: (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electricion's License No ............................. ~ ............... 3. ~[FORE COV~ ;?J.:: ~%-'; ~ OF ANY KIH~ O~ CONST':::UCilCg~ :2, q~'t -: j 5. ALL COHSiSLUCTH2~.i h%Lf ?LZZT Other Trode's License No ............................................... AND TOW,~J Location of land on which proposed work will,be done. Map No.: ...... ../~,...! ........................... Lot No ......................... Street and Number ...~.iI~.T....~.......~/~.L?....~. ............................................................................................................ Municipality Slate existing use and occupancy o~ premises and in~ended use and occupancy of proposed construction: e. Exisiting use ~nd occupency ............................... ~ ........................................................................................... b. Intended use ond occuponcy ............................... .~ ........................................................................................... 3. Nature of work (check which applicable): New Building'· ................. Addition ...... ..~... ....... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Wark ................................................ .... (Description) 4. Estimated Cost ............................................................ Fee ~ ~ · (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... I ................ Number of dwelling units on each floor ............................ 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 ....~.~,.~......~..~..~..~R~ar ................................ 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 ................ I-[eight ...~....&'~....~.' ....... Number of Stories I ................ 9. Size of lot: Front ......... ,~,.1~...~. ........ ~../~.)..~.'.~.. ........ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..............r~..,~..~..J..¢~....~..~tl...,~...~..~.. ............................................ 12, Does proposed construction violate any zoning Iaw, ordinance or regulation: ................ ~l...C~ .............................. 13. Will lot be regraded ......~.~/,~..~. ......... Will excess fill be removed from premises: ( ) Yes (~) No 14, Name of Owner of premises ....~..~..~.~..~./,,,..O..~.~,..)......~.~. Address ~....~..~..~..~....~...~... Phone No..~..7..~..Z...~.~.j~:~ p- ,, . ..................... Name of Architect .............................................................. Address ........................... none ~1o, Name of Contractor ............................................................ Address ................................ 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. STATE OF NEW,,~.ORK, ' ~- ~ S S COUNTY OF ....~.(.~ ../~.'.~'..O..~.,._f ' ............ ~J.C~..~...../,.~....~...../..~....~r/.~..O.~.. ........................ being duly sworn, deposes and says that he is the applicam '' ~-- ----(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 eppHcation; that al~ statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~ ~(Signature o~pplicant) ~ ~ gAgg~ ~. CO~IIOY ~OT~RY ~UBL[C, State ~[ NeW Yor~ Su/{oll: Courtly Nb. 52-57~888 ~m ~mmiss~o~ Expi~s March ~B, ~ APPROVEP AS NOTED DATE: -- FEE: /'-'~' BY:~~'''~ i~O'J'~ J:'( ~'65'2660