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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N,Y. Certificate Of Occupancy No .... z. 97.7.t~ ........ Date ...... Da.c.e.~.~..e.r..6. ............. 1979. '" THIS CERTIFIES that the building ................................................ Location of Property h3~sb ~9..0. %feat Mill Roa, d .M.~.%$1.~.tl~l¢ ,. I~ ~Y, · ' ................ 's't/eet '' Hamlet County Tax Map No. 1000 Section ....I.0.6. ..... Block ...!.0 .......... Lot ..... ~...! ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ff..u..ly..7. ......... , 197.~,. pursuant to which Building Permit No ..... 9.8.48~ ........... dated ... j.tll3r..~.9. ................ 19.7.~1, 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 ......... .......... 2ri.rate. One. Family. Dwelling..-..(1 s~..Floor. .~) .............. The certificate is issued to Howard g, a.n..~..~.~.%?~.o.:!,~..lyl.,..lq. O!.b.e.r~: ............ .................... (owne~ of the aforesaid building. Suffolk County Department of Health Approval .... ~..-.~.0.~8..5...~./.7[.~.~.~...R.,../~.,..V.~.~.l..8 ..... U~DE~Wm~RS CE~m~CAT~ ~O ............ ~.. ~5~5.96 ............................. Building Inspector Re~ 4~9 H.D. Ref. 8-80-85 10/2~/79 R. A. Villa FO~ NO. Z 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? 98 8 Z Date ....~LL~.y,......'19. ................................ , 19.,7..~... Permission is hereby granted to: at premises located at ......................... 'J.5~.Q...I~*~:~..~,~..~Q~ ...................................................... '. ........................................................... I~Ia**l;'t;g.~cw. Jc ,... t~Iew.. A"ax'k ...................................................... :. · pu~Uanf to application dated ............. ~T ~],~r......7, ................. ......... : 19.~.~i., and dpprdv~d by,the- ' Buil~ling Inspector. · , :/.'i FeeL $.3~.,.~0. .......... lo0o-106~0-2.1 ~.S.~ 8-S0-85 Building I~spector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec~ tot 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 insta{la- 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 applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing a~l property lines, streets, buildings and unusual natural or topograph ic featu res. 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: 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 / Date.../. .~..?/,~. ~ ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... Z/~//,~,/~..'~...,~./~'~, .,~ ~./.. Hou~ No. St~et Owner or Owners of Property .~~.. County Tax Map No, 1000 Section ......... Block .,. ~ ........ Lot.. ~.~ ........ Subdivision ................................. Filed Map No ........... Lot No. ~ ........ Permit No.~ . . . ~ .... App licant~~ Health Dept. Approval .......... P.' . ...... Labor Dept, Approval ... ~ .......... Unde~rite, Approval. ~ ~Z~.~ ...... Planning Board Approval ................. Reque~ for Temporary Certificate ..................... Final Certificate ..... '~ ............. Fee Submitted $...~ ................... Construction on above de~ribed building a~mit meets all appl~abl~codes and regulations. ..... ~{~LTON 'The ~ciiities ~eoted by 0 be sat location have -SCALE ~" TEL. TOWN OF ~OLITHOLD OFFICE OF BUILDINIS ~NSPEOTOR TOWN P. LERK'S OFFICE $OIITHOLD, N, Y. 119'71 ] 5CALE- 50':i" ,THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ~r 85 JOHN STREET. NEW YORK, NEW YORK ~lO03E ~t, October 30, '1979 .4pj,,c.t~..~,o.,,.f,.o2o 4 ' N 454596 THIS CERTIFIES THAT ~ .How&~ ~i~'~:;1'490 west ~11 Rd'. ,H&tt~CU~kiN.Y, w~ exami~d on October 25, 1979 ..dyo.~ to bein comptiance ~ith t~ r~uirements of this B~rd. FIXTURE OUTLETS SWITCHES 26 28 25 FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS 26 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTILq' DIMMERS SYSTEMS OTHER APPA~TUS: PanelboGrds:l-125~ 1-GffCZ 1-smoke ge~ector Howard E. Wolbert Box 280 Mattituck,N.Y. 11952 A. W.G. NO. OF HI-LEG OF CC. COND. 2/0 A. W, G. NO. OF NEUTRAL Of HI-LEG OF NEUTRAL 1 2/0 50.00 AMOUNT 11 THIS IS YOU~ MIl FOR SERVICE RENDERED ANO IS NOT A CERTIRCATE OF COMPLIANCE. THIS BIlL PAYABLE AT THE NEW YORK OFFICE, 85 JOHN STREET, NEW YORK, N. Y. 10038 ~OW~ OF SOU~HOLD, NEW YO~ ACTION OF THE ZONTNG BOAI~D OF APPEALS Appeal No. 1830 O~ed February 7, 1974 ACTION OF THE ZONING BOARD OF APPEALS OF THE TOVfN OF SOUTHOLD To Howard L. Wolbert Appellant 6 Highland Avenue Jer~my_Ci~, 5. J. at a meeting of the Zoning Board of Appeals on ~'eb~u~y 28, 1974 was considered and the action indicated below was taken on your ( ) Request for variance due to lack of access to property ( ) Request for a special exception under the Zoning Ordinance ( ~0 Request for a variance to the Zoning Ordinance the appeal ( ) 1. SPECIAL EXCEPTION. By resolution of the Board it was determined that a spec/al · exception ( ) be granted ( ) be den/ed pursuant to Article'. .............. ,... Section .................... S~bsecti.on ........ :_?y_.:.. p~ra~raph .................... ~f the Zoning Ordinance ami the dec/s/on of the Building Inspector ( ) be reversed ( ) he confirmed because VX30 P.M. (E.D.~.To), u~on a~pliuat~on of Howard Wolbert, 6 Highlan~ Avenue, Jersey City, N. J., for ~ 100-30, 100-31 and Bulk Schmdule for permiss~on to divide ElS West ~111 R~d, ~ttitu~k, New york~ ~ea nor~ by J. Ca~l~on;~ east by J. Carl~n; sou~ by W.~ ~i~; %~s~ by West ~i~1 aoaa. Fee ~ai~ $15.00.~ 2. VARIANCE. By resolution of the Board it was deter:n/ned that (a) Strlct application of the Ordinance (would) (would not) produce practical hardship because difficulties or unnecessary (b) The hardship created (is) (is not) u~Jque and (would) (would not) be shared by all properties alike in the iroJmedlate vicinity of this property and in the same use district bec~t~e (c) The variance (does) (does not) observe the spLrit of the Ordinance and (would) change the character of the district because (would not) and therefore, it was further determined that the requested variance ( ) be granted ( ) be den/ed and that the previous decisions of the Building Inspector ( ) be cord/treed ( ) be reversed. FORlV~ ZB4 ZONING BOA.RD OF APPEALS ~arJorio MoDermot~, Secretary appli~a~ r~quemtm permisalon to divide lot with insufficient width an~ area on property l~at~ on thru east sid~ of West Hill Road, Matt~t~, New York. The f~dings of the Board v~i~ce ~ul~ not o~ge ~ e c~aa~er of the ~ea. It would b~ ~ unusual ~dship to r~u~e ~e app~cant to fu~ish more l~d. The B~rd ag=ees with the reasoning of th~ applic~t. Th~ B~ard finds that strict application of the Ordinance would prO~uoe practical diffiuultt~s or ~ces~ary ~roper~ies al~e ~ ~he ~ediate Vitrify of this prope~y and in t~ s~e use district; ~ ~e variance will not the ch~ra~r of ~he ne~g~orho~, ~d w~11. ob~e~e the Avenue~ Jersey City, N. J., ~ G~N~D ~ission to divide lot with insufficient Wi(~th and ~ea O~ pro~rty lo~t~ on ~he east s~de of We~ Mill R~d, Mattituck, New York, as Vote Of the Rca~d~ Ayes:- Messrs: Gillispte, Bergen, Grigonis, Doyen. ~0~ NO. ! TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............. ~t,~,~ --..-.1 ~ ....... , 19...74~. Approved ............. ~,~7..,..~9 ......., l?.,,,,~(~Permlt No ............. ~/~ ............ Disapproved a/c. ................................ .. ~., ......... _. ,-. ::.::~,,:;,. .................................. , (Building Inspoctor) Application No ............... .9~/,t~ ....... APPLICATION FOR BUILDING FERMIT .................... ~. ............................ , 19. INSTRUCTIONS o. 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in, buildings for necessary inspe~ctions. ~/' ' ............ : ............. 'fX;~;Z;;%T ;~i~;';~ ..................... :" ....... State whether applicant is owner, lessee, a~lent, architect, engineer, general contractor, electrician, plumber ~r builder, ....... ......... .............. . ................................. ;: ...................................... Name of owner of premises ... ,~.~..-~'.,.-~,,.~...~.~.'.......~~..~,~.,~,~..~...........~....~.~/f~.~.~ ........................ If applicant is a/,/~orate, signature of duly authorized officer. '~/~ "~ (~'-'~J~ '~.~--¥~x .................... ~ ..................................................... ,~o~-~ ~v ~r~r~ (No'ne and title of corporate officer) ~,-~¢~.j, ~ '" Builder's License No ..................................................... Plumber's License No ................................................. "~, ~:~x/' ~/-~'/ Electrician's License No ,' .- ..... . /~ao ~/~-- J'O ~ ~, I _ , ......... i .................. ~'2'.~ ....... /,._s. ~.,j ,~- s- .s'o - s~ ¢- Uther Trade s License No .............:.'~.::~':~ ............... ~ -- . ~ 1. Location of land on which proposed wgrk will ~e done,.Map No.Z/,~.'.Z.'C,/~.~_'.,,/~....:Z./.Z Lot No ......................... Street and Number . .Z..~.?.?~~ /Z~-'~ ~.'~.'.~.~...~'.-~.Z~.~ ' , Municipality 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 ....... ~.~'.../~... ~/~.~*.~.. ...... ~..~./.~..C.~.....~...... ~..Z-~...~: .~.~.~. · .~'~ .................... Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair ................. ., Removal .................. Demolition .................... Other Work ................................................ .... ~ (Description) 4. Estimated Cost ~..,~-~.;~ .~ ....................................... ee .......................................................................................... (to be p~id on filing this ~pplicetion) / , / 5. If dwelling, number of dwelling units ............................ Number of dwelling units on e~ch floor ........................... I¢ g~r~ge, number of c.ors ............................................................................................................................................. 5. If business, comme~i~l or mixed occupency, specify n~ture qnd extent of e~ch type of use ;: .......................... 7. Dimensions of existing structures, if any: Fron~ ............ Rear ................................ Depth .................... Height .' ....................... Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ...7. ............. ;..;.;.;;Z ....... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~.~ ............... Rear ...... ~ ..... Depth,~ ...... Height~.,(..~::., Number of Stories ........ ~ .................................... : ................................................ %.)..-~, 9. Size of Io~' Front ~ ~ ...... ~ .... Rear Z~ ........ ~..,. Depth ~..~.. ~ ,0. Date of ,brchase ;; ~ ..~. ;;~2~;....:Name ;;'F;rmer Owner~.~..~~r.~ ] ]. Zone or use district in which premises are situated ..................................................................................................... }2. Does proposed construction violate any zoning law, ordinance or regulaHon: ....... ~ .................................... 14. Name of Owner of premise~~~res~/L~4~ Phone No. Name or Arch~tec ..............~ Phone No ....................... ...... / .......... ,...~........' ' t Address ................................ Nome of Contractor ........... ~,.~,~%~. ........ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings,' whether existing or proposed, and indicate all set-~ck dimensions from properly lines. Give street and block number or description according to deed, and show street names and indicate whether interior or :orner lot. N qOaS /4LO' VU STATE OF NEW YORK, It c COLIN-FY OF ........................ : ....... ¢~'~ .............................................................. ' .................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................................................................................................................................................................................. '(Contra6tor, 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 &Il statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public, County ............ ,~.r..,,.r'.../..,,.~.....~,..../.,,..x.....,":,,.,,,.?; .............................. ................................. ' .................. ' ' / '" .... (SigdatdCd of o~p~c/dnt) 4 Ifq SU t_ M.% E c"xlo' 16," D.c. -- LL/ATE P,j ~Ic VEk~T- (~OTH Et~D~ I P___ 10 I~-O o,c, 4" LA. LL",/ COt-. L EF-'T EL E v,~'-T tS"CEOA~, CD,V. 5CA. L.E B APPROVED AS NOTED DATE, 7 ~/¢'* 7 ~ NOTIFY BUILDING DEPARTMENT AT ~ 9AM to 4PM FOR REQUJR. ED INSPECTJON5~ 1, BEFORE BACKFILLING FOUNDA. TION OR START FRAMING 2. FRAMING INSPECTION 4. FINAL WHEN JO~ COMPLETED OR CONSTRUCTION ERROr5 REQUIREMENTS OF N.Y. STATE CODE FP..OLIT F__ LLVA'T'IO ~4 5CA, LE /+"-' 7'-0 LIL/IIdG V K. IIC NL_-_ Id PI L] E-F-FE eft 4LO~ .b F"Lp2' F~LOOR PL~.½ 5CA:,..L ~ ,v,~ ". t~-O'' SLO" I~1- WOLD TIC. L~ WALL ~j ~ECOkL,D F-~ OOR. I " I;0" 4-'0" aa: ~ I-..'.~ -' -~ ~f4 8~"~LOC F~ I1£,. FO L) 1'4 0A,TI OIQ 7LO~ KEYED TO IB"~tO" P,C. FTG -J ~?~" LZLLL~ COLIt~ oL/ ?_'x2'~l' PC_ FTG. -- f~FL. ID(~ IklG r-Lo" ,.5L FILL C©MPA( rILL. ~ A~t. 9~4?ALT FOR ~, ~'~o" /~L o'l F0U klDAT t O~J SC ALE F4 ' '-- I b