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Home My WebLink About11586-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.~. 1..19.0. ......... Date ... ~.e.p.t;.e~l~Or..1.6 ............... 1982. THIS CERTIFIES that the building ................................................ earl Pro crt 4'145 Cardinal Drive Mat~ituck Lo on of p y .. .............................................................. .ouse No. Street Hamlet County Tax Map No. 1000 Section . . 1 ~ 5 ....... Block . .O6 ........... Lot . .O 18 ............ Subdivision...Igs.t;.t;J,t;~¢k .l~0.i;a,t~0s ........ Filed Map No. A453...Lot No...1.7. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·, .M.a?.c. ~..4 ........... , 19.8.2. pursuant to which Building Permit No, , ! .~ ~,8,6,. ,2: ............ dated March 22 19 82 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 ......... ...a.n..a..d.d33. X. 9.n. 3. o...a.n.,.:e..x.L~.~.~..nS. ?.-..e.LX.X.n. &. ................................... The certificate is issued to ........... .~.h.a.~ .1.eg..~ :..&..1~..ary' ,~ .n.h. ?.9 .:L.l.a.n.d. ............. (owner, levee .~.te~A of the aforesaid building. Suffolk County Department of Health Approval ...n./..a .................................... UNDERWRITERS CERTIFICATE NO ........... 1~. ~.6.8.Q~ ~ .............................. Rev. 1/81 Building Inspector Rev.;6~30 80 (THIS PERMIT MUST BE KEPT ON TH,~ PREMIsi~s uNTIL FbLL WORK AUTHORIZED) ' cOMPLETION OF THE N°. 11586Z Do~o ...... ,... ............. ,..,..~ ......................... , Pen ~iss on is hereby granted to: x ~' · ~'.~ ~ f ~. , ot ~e~,~e~ ~o~ot,d et ../../.. ................. ~~,:2.,.~...,..,.~d ...... ~....{,. ............ , .......................... C.& ..... ~ ....... ~....,!~....,., ....... ~.~ ........ /... pursOont to oppli¢otion doted ........ ./;.;..{h..~}...., 1: °nd ~pprovod by the Building Inspector' ! Fee: ........................ { ' FORM NO. 6 TOWN OF SOUTHOLD Buildin9 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- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property ~ines, 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 comp)eted 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 topogrgph ic 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: 1. Cerzificate 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 New Bui!ding ......... Old or Pre-existing Building(X) ......... ~ ~Vacant Land ............ Loc t on of roperty. .............. ...... Hou~ No. Street Ham/et County Tax MapNo, 1000 Section ..//~ Block ~ Lot ~ea~th ~e~t. A~prov~l ........................ Labor DeOt. Approval ...................... ,.. Unde~Hters ~9roval ~ .~lannin~ Board Ap~roual .............. Bequest for Tempora~ Certificate ..................... Final Certificate ../~.'..- ......... FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .. ?.c?.. .... ./..~...¥...~.-~:. ....... PLEASE TAKE NOTICE that your application dated... ~~ · · .~ ..... 1 ~. · ~,~ ~ ~ /~ at for pem~t to construct ................. LOCa[10~ OI trope y ~s~ ~o ................................................ ~ Street ~ famlet County Tax Map ~1000 Sectio~AK¢. ....... Block .. ~. ~ ........ Lot .. ~ Z.~ ...... S~bdX~,~io~/~ ~2- 5%~ "~ ~o ................. ~ot ~o../Z ........... is returned herewith and disapproved on the following grounds ~.~, .~. ~.. ~ilding In~ecmr~' FI~D INSPECTIO~ FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: THE LODATION OF WELLS AND CESSPOOLS SHOWN HEREOI OBSERVATIONS ANO/OR FROM DATA OBTAINED FEOM THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FI CONFORM TO THE STANDARDS OF TH([ SUFFOLK COUNTY SERVICES APPLICANT ADDRESS -- - TEL - S. 42°55'00"E. 150.00' ,l =25 7 el=gl5 .,... 25,6',,/x ~ 42°55 O0 k~ 130.00' CAt,DINA I e/ =3os DtqlVE e/=lg.e Y (residence) & YOUNG l~Olt~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTME~4T TOWN CLERK'S OFFICE SOUTHOLD, N, ¥. ^pp,ico,on ........... o. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the BuiJdin Inspector, with 3 set~ 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 str~4's c areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applic,~W~r 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 per:n~ shah 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 o Certificate of Occup¢~'~c shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant lo th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein describec The applicant agrees to comply with all applicaNe laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary )n~ections. (Signature of applicant, or nam?, if a corporation) (Address of applicant) ~, (.~ ~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ....~.~: ......... '. ............................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... koca' on of and on wh ch ro osed work · ~ pro~osea ~o ~ , · P .7/.-6~; ............. ~¢,... LOt No ........................ Street and Number ...~~...~ ................................................................................ ~ //~-- Municipali~ 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 ............... 9, 10. 11. 12. 13. 14. Nature of work (check which appli~ Repair .................. Removal ........ If dwelling, number of dwelling un If garage, number of cars .' .............. If business, commercial or mixed Dimensions of existing structures, if Height ........................ Nu]mber of Dimensions of same structure with Depth ............................... ~ Height Dimensions of entire new construct H,eight .................... Num/~er of St Size of lot: Front ............. ~ ............. Date of Purchase ............. i ............. Zone or use district in which premi~ proposed constructiod violate Does Name of Owner of premises J..~ Name of Architect ........................ Locate clearly and distinctly[ all buih property lines. Give street and !block whether interior or corner lot. _TATE OF NEW ~?'~RK.,.., ,! I I ¢ S (Name of individual Signing above named, i He is the .................................... (( of so~d owner or owners, and islduly eu4 th~s application; that oil statements cant thor the work will be performed i'n the mc Sworn to,before me this ........... ..~-~ r.¥_d ay~/ "~x of Notar able): New Building'. ................. Addition ... tlor~ ............... ......... Demolition ........ ...~.. ...... Other Work ................................................. ... ~ ......................... Feec¢~u~ ~ ~ (Description) (to be paid on filing this application) ./. ts .......................... Number of dwelling units on each floor occupancy, specify nature and extent of each typo of use ........................... =ny: Front ............................ Rear ................................ Depth .................... Stories ................................................................................................................. ',Iterations or additions: Front .................................... Rear ........................... ............................ Number of Stories ................................ an: Front .................................... Rear ............................ Depth ....................... ............................ Rear .......................................... Depth ............................... ............................ Name of Fc~mer Owner ....................................................... .s are situated .... ~ .................... ny zoning law, ordinance or regulation:~ .................... ...~.... ......... ~ ................ ,.. ~/Yill excess fill be removed from premises: ( ) Yes ('~/) N_o r.~,~ ............ Address ................................ Phon. No.' .................................... Address ................................ Phone Na ...................... .P.."~.~. · .~.. · .~. · ~ ................... Address ................................ Phone No. PLOT DIAGRAM Jings, whether existing or proposed, and indicate all set-back dimensions frocr ,tuber or description according to deed, and show street names and indicate o~~,~ ...beingntract~) ~''- duly sworn, deposes and soys that he is the applican~ ontractor, agent, corporate officer, etc.) horized to perform or have performed the said work and to make and ained in this application are true to the best of his knowledge and belief; an ~ner set forth in the application filed therewith. (Signature of applicant) ELIZABETH ANN NEVILLE NOTARY PUBLIC, State of New York NO, 5D812585~, Suffolk County , ''r 'T~r~ Expires tUareh 30, '1~"~ THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA 08TANNED FROM OTHERS APPLICANT ADDRESS ........... TEL ~ e~--2/5 ..,.- 120. 00' -'2t7 42°56'00"~ ~DINA L el --~o.3 Dt~I VE el -- 19. 8 NOTE: II = MONUMENT' SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK~ OF SUFF. CO. ON SEP~ 8~ 1965 AS FILE NO. 4455 NEAREST WATER MAIN- ,~.+ MILES (residence) SUFFOLK CO., N.Y. I "-- 50' DAT':MAR 30~ /976 ~URVEY ,FOR: ~UCK 6r MATTITUC ~ow~ o~ SOUTHO£ YOUNG & YOUNG 400 OSTRA~DER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG