The URL can be used to link to this page

Home My WebLink About9907-z1~0~,~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Occupancy No. Z956~ Date December 28 19 78 THIS CERTIFIES that the building located at ...q.l/~5.. C~dinal. Dr. ive.. $ Map No .... /d~,~5 .... Block No ........... Lot No ............ q.? .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.u. gt~..~.~...~.9 ...... , 19..7.8. pursuant to which Building Permit No....9.9.0..7.Z dated .... .A.u. gt~.$.t...2.? ....... , 19..7.8, 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 is Private One Family rr~elling C. Heiland Jr. The certificate is issued to ........................................................ (owner, of the aforesaid building. Suffolk County Department of Health Approval ...D. 9.~.em.b. 9~..2.7. ~..1.97.8 .... UNDERWRITERS CERTIFICATE No. N~1~927 Robert A. Villa HOUSE NUMBER 11 ~5 Street Cardinal Drive Mattituck, N.Y. County Tax Number 1000-115-6-18 Building Inspector FOF,3~ NO. 2 TOWN OF, SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISEs uNTIL FULL COMPLETION OF THE WORK AUTHoRiZED) 9907 Z Permission is hereby granted to: 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 Wpewriter OR ink, and submitted in duplicate 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, propertv 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 installa- 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 all property lines, streets, buildings and unusual natural or topographic 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date New Building .... /~..~, .~.... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ,~'/~..~ .... ~ .~.f~..~../.~..~..~....~ ~.~.~'~- ............... Hob~ No. , Street Hamlet Owner or Owners of Property . ~..(~ ~ ~N~,'~ ......... County Tax Map No. 1000 Section ............... Block ............... Lot .... ~ '~ .......... ~ ~r / Tuc~ - 5'~ r~J' . ......... Subdivision .~ ............... ~ ............ Map No ............... Lot No. .~. Permit No..~q.~. ~ Date of Permit ~ '~..Applicant ,. Health Dept. Approval ~¢~ ?/~ ........ Labor Dept. Approval ........................ Unde~riters Approval ..... /.. ~ ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ~. ~ ~ ............. Construction on above described building and permit meets all applicable codes and regulations. Applicant..~~..'~..~"'~. · · · · .~..'. · .1~. ~~"~ '"~ ~ ......... THE NEW YORK BOARD OF FIRE UNDERWRITERS iDS BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT onJy the eleetr/ce~ equipment as described ~ a~d introduced by the ~ppllcant named on the abo~e ~p~ic~tio~ number t~ the premises Charleu Heilands Jr., e/n Cardinal Dr., ~000' E/o Rt. 25,Mattltuek,L.I in the followlng loc~tlon; [] Basement ~ tst FI. [] ~nd Fl. S~ctton Block Lot ~.~..~.~do. Deeembez' 1~ ~9~8 a~fou~tobeincomptlance~iththerequlrementsofth~B~rd. ~XTUnE ~A-,~I IT i RXTUR~ ~ ~NO~KS OV~S Ol~W~ ~HAUST FANS I . I I [ am N T F ~n ] · [ S E n v ~ c ~:'-'"~=~'''2WI'3W3'3W3~4W~'~C~CONO'OF%Cy~'~'OFHI'~G~'~'~NEU'~ALIO0 ob x 1 ~ 1 OTHER A~A~AT~: ~-~moke D~teeto~ JOseph D. Mazzoni 227 Waverly Ave. Medford, L.I. 11767 L.e. ~2 E p,,_ 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ~OJ~ Folff~W~ THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MA~NNER. __ __ ' TEIWN ElF -~[]LITH[]LD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOL)N'HOLD, N, Y. 11'~'71 T~EL. 765-266C leOll~l[ ~0, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE . SOUTHOLD, N. Y. E~amined ............... .~.Z...:.~.., l .~.....~ '~praved ............ ~. -~ ,~.7~-~o. ~°Z~ ....................... ............ : ............................... ............................................................... . ......... ............................ 1~'TP'['-~-'-ector~"'''~(Buildin~ nsp ) ....... ~ ........... Application No. ,..~,.:..~.,.i: ................. APPLICATION FOR BUILDING PERMIT Date ........... ~././...'t. ....................... ~.?..~... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 iot 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, bui!ding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .... z.. ...... Z..z..:.c:.. (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 builder. ...................................................... .,..r.. ................. , ..................................................................................... Name of owner of premises ....... C,/~.~].../~.....~...~..~.~t .7~..~,.L..~...~..../~.....~. .......... .~...I..~].... .......................................... If app~cgnt is a corporate, sign~ur, e of duly authorized officer. .... ................ (Nome and title of corpora!~officer) Builders License No ...................... .l..~... ..................... Plumber's License No. Electrician's License No ......... ~..~.....~.:..~...~....~../. ....... Other Trode's License No ............................................... ~ - . ¢;[.. 1 Location of land on which proposed work will be done. Map No.: ~./~7'~'J! ~C/<~ ~::~7'~ ~o~t'rxl^ / 7 Street and Number .............................................................................................................................. ...................... 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 .................................. ....:y ........... ~ .......................................................... 3. Nature of work (check which applicable): New Building~ ......~...--..... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ................................................ (Description) 4. Estimated Cost ................... .3.....~...,....~....~.....~. .............. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ...~......~.....~...-:.....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, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ of entire new construction: Front ............~'.. ,.~... ............. Rear ............................ Depth ....~.~ ............ 8. Dimensions Height ....... .~../~~'~ ....... Number of Stories ....... .~.. .................................................................. i ....................................... 9. Size of lot: Front .......... ./..~.~.. ............................. Rear .......................................... Depth .....~......'~..~.. ............... 10. Date of Purchase .................... ~...~. ............................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............ ~. ..................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... 4~...~ .................................... 13. Will lot be regraded . ......~..~ ............. Will excess fill be removed from premises: ( ) Yes (~o · ,'Il r . 14. Name of Owner of prem,ses ....~....~.. ............~. ................. .~.. Add ess ........ ~.. ....... Phone No ....................... Name of Architect ......................................... ~, .................. Address ................................ Phone No ....................... Name of Contractor ......... ~ :..~....~r. ................................ /~' ~...'~....~....~...../~..~Address ......,ff~......~...~...'..~..... 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 YORK, ~ ~ c COUNTY OF ................................ ' ........ ~...~.....~..~.~.~.......~..:... ,~...~..C../...~....~..?... .............. being duly sworn, deposes and says that he is the applicam (Name of individual signing contra(f) above named. , He is the ............................................... ~.('Y /...~ ./~ .'~....'~' .......................................................................................... (Contractor, agent, corporate officer, etc.) ' of said owner or owners, and~ is du y author zed to perform or have performed the said work and to make and file th s app ication;-that all statements contained'in this application are true to the best of his knowledge and belief; and that the work will b~ performed in ~he manner set forth in the application fi ed therew th. Sworn~ )'o before me this x~ ,--., ...... · /..7. ......... dayof ........ ...... , Notary Public, · .................................... County . ~ ..~...../..~...,t .¢..-J...'-J.......'r-~/....: .. ,/~....~~ .......... " .... / ' (Signature et applicant) Appp. O.~,~D ~ NOTED ¸ LL