The URL can be used to link to this page

Home My WebLink About9767-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z9256 Date October 17 19. 78 90 Deer Drive r ' THIS CERTIFIES that the building located at .2~.50..~!e..~.~p.t~a. ~..~.a..R.O.a.d.... ~ Map No .... 32. Q~ .....Block No ........... Lot No .......... ~.9 ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated Juue 1 19..7~. pursuant to which Building Permit No. 9767Z dated Juue 7 1978 ....................... , .... , 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 Fardily Dwelling The certificate is issued to ...... ~!'~..1.ff. qV .d' .K.r.~g.e?. ................................. (owner, of the aforesaid building. Suffolk County Department of Health Approval ....S.e.p..~.e.m.b.e..~...7.,.. ?.9.7.8....8.-.S..0.-.~.6. UNDERWRITERS CERTIFICATE No. N40t~337 90 Deer Drive HOUSE NUMBER 2850 ......... Street ..... Wes.l~phal£a .Road ................... Mattituc.k? New York: Building Inspector County Tax Map Number 1000-114-10-1 FORt~ 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? 9767 Z Permission is hereby granted to: ..... ~.c_ ...... ~/. z .~,.. L .~;~.a./.~. ....... .~;. l:.'..~., d/.: .,k .......... at premises located at .................. q..~...'~. ....... ................................................................................. ~.~:.~.~.Z.~-.~ .................................................. pursuant to application dated .............................. .~.~..~.....J......, i~,...., and approved by the Building Inspector. Fee $ ...... L.[4 ............ /ooo~//,/-/t~- / Building Inspector TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application n~ust be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. Final survey of property with accurate location of oll 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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 October 16~ 1978 New Bq Idmg,.~;~I ......... Adrift[on ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Proner2~50 Westphalia Road and/or 90 Deer Drive~ Ma'ctituck, N,Y0 Owner Or Owners Of Property ~ilford Kryger .................................................. ~' ................... ................................................ Deer Park Map ¥~3~ Subdivision ................................................................ Lot No.....~.?,...o Block No ............. House No...,2..,8_5..,O. Permit No...,g.,7.6..7.._~.... Date Of Permit .tT.~..~..~. 7.../..~.Rpplicant ~nland ~omes, InCa Health Dept. Approval 8,.-,.,S..g.r..],.6.....-:....S,~.~...Z./,~,8. Labor Dept. Approval ....~./_r., .................................... Underwriters Approval N40437~7 - ~0/2/78 Planning Board Approval yes ........................................ yes Request For Temporary Certificate no Fined Certificate .......................................... Fee Submitted $ ...5..,..0...0. .......................... Applicant .................... ~ -~-~~ ~-~,~--~' I~,,_ : .................... ~~"~'~%~-~'" ....... ~ ................... Robert E. Hil~cz - Inland ~Q~es .~nc. Sworn to before me this 16 day of Oc%ober Notary Public _~.q,].~ ............... County TEl-. TOWN OF SOUTHOLO OFFICE OF' BUILDING INSPECTOR TOWN OLERK'E~' OFFIOE 50UTHOLD, ~'L Y. 119'71 FORM NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam ned ............. ~ 7 , 19 '70(~ Application No. ~ .~....7...~. 7 . Approved ]~.'.'~ ....... ~', 19'~Permit No ~7~/ 7'7 .............................. 'sapproved o/c ./~Z.. ........................... ~"~"~ ......... i_' ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... J'~m~... ~t ............................ , 19.....;Z&.. 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 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 port 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 b~en granted by the Building Inspector. APPLICATION IS HEREBY MADE to tine Building Department for the ssuance 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 inspections. INLAND HCi~IE$, INC. ..... ........ Box 117~ Ma~ituck, N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................... ~en e r.& 3....~n.~zr ~,~ .t.(~ ............................................. Name of owner of premises Wilford Kryger If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .............................. -. ...................... 517-P Plumber's License No ................................................. 2148-E Electrician's License No ................................. : ........... Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: Deer Park Lot No. 1 9 Street and Number ..... .~..r..'~..~.~.`~....~..r.~.~..~'.$.v...e....~.~.~.~.-~:.p~t9~.`~gp.~.~..~.~.~$~g~* 1~1,,¥./. ...................... Municipality State existing use and occupancy of premises end intended use and occupancy Of proposed construction: a. Exisiting use and occupancy VacanJ; b. Intended use and occupancy .............. &..~.ami.l.y. .............................................................................................. 3. Nature of work (check which applicable): New Building'..~....X. ........... Addition .................. Alteration ................ Repair .................. Removal .................. Demol[tior, .................... Other Work ................................................... _/~ (Description) Estimated Cost ....................... Fee 4. $35,000.O0 c'~ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....1. ....................... Number of dwelling units on each floor ............................ If garage, number of cars 2. ............................................................................................................. 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 .5.Q .................... Rear ...... 5.Q .................. Depth ~.~. ................... Height 26' Number of Stories 2 9. Size of lot: Front .......... t~.~k ...................................... Rear ...... :~i~. ............................ Depth ........ .1...2:..8. ................. 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: ..... .n...o. .............................................. 13. Will lot be regraded ......y..e...s. ................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ....W..i...1..f...o..r...d...K...ry.~q.e..r.. ............... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Box 117, M&tt~$,~4- 298-9696 Name of ContractorI. n.1...a...n..d.....~..°..m...~..s...M..!..n..?.: ................... Address ........................................ o ....................... PLOT DIAGRAM Locate clearly and distinctly oil 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 Iol. STATE OF NEW ¥01~1¢,, .............. ~.(,.~..-..~/.~....\ ........ be ng duly sworn, deposes and says that he is the applicant (Nome of individual sigmng contracf) above named. Contractor 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 fiJe this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wilt be performed Jn the manner set foffh in the application filed therewith. Sworn to before me this EL= O, TITLENO. IO9- S - 8 f188099/DD) AAPPL/CANTj 33,.5--~e..s1~ a~l~ eL_ _ __ -- ~,,r~ S~:P r~ 7 1978' ~tr, sewase disposal and ~,atcr supplF fn~illties foe this location bare ba~ inspected by this dopartmon% and found Servlees SUBOIWSION MAP F/£ED IN TH£ OFFICEc"~ OF THE CLERK OF SUFFOLK COUNTY ON JUL Y JS, 1960 AS FILE NO. 3204. c,~'~ NEAREST WATER MAIN = 2 MH. ES -~ .... WATER SE'NV/CE = PRIVATE WELL. , THERE ARE NO DWFLAINGS WITHIN I00 OF THIS PROPERTY OTHEH THAN THOSE SHOWN HEREON. YOUNG & YOUNG ALDEN W. YOUNG ~OFES~IONAL ENGINEER AND .AND SURVEYOR. N.y,s, LIC: NO. [284~ SURVEY FOR: WILFOHD KHYGEH ~ A/A1 KHYGEH LOT NO. 19, "DEFH PAHK" MA T TI TUCK ~o~o~ ~ SOUTHOLD ~ I "= 40" ~ JAN, IO, 1978 HOWARD W, YOUNG LAND SURVEYOR J/N4 'RAN¢E co. N. x NO -931 TITLENO. 109- S - 8 (188099/DD) THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATtONS AND ON FROM DATA OBTAINED PROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE APPLICANT: _~.>-'~'.-- ¢-~'T'~c~' .~<'c'~[ ¢.~ ,_~r~ ADDRESSJ~ ~SH-~G~-- ~ ~- TEL~O~ SUFFOLK COUNTY DEPARTMENT, OF HEALTH SERVICES / / / TEST HOLE WA ~'£ R ?. 6' SUBDIVISION MAP F/LEO IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON dULY g§~ 1960 AS FILE NO. $204. ~AT~R ~RVICE : PRIVATE W~LL. , FHERE ARE NO DWELLINGS WlFH/N I~ ~OPERTY OTHER THAN THOSE SHOWN HEREON. YOUNG & YOUNG ' 400 OSTRANDER AVENUE, RIVERHEAD, NEW ~ORK SURVEY FOR: LOT NO. 19, "DEER P~RK" ~T MA T TI TUCK GUARANTEED ~RST AMERICAN KI TLS · , IN~UffANC~ CO. OF N. ~ ~ ~ ~OUTHOLD SUFFOLK CO., N.Y. ~ 11,~, 401'1 DATE: d4N. lO, I,g78 NOTIFY BUILDING DEP~TMENT AT ED 1~SPECTIONS: I 5o -o -i ~E I t ,,tN