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Home My WebLink About12051-z FORM NO. 4 TOWN OF 50UTHOLD BUILDING ]DEPARTMENT Office of the Building Inspector Town Hall 5outhdld, N.Y. Certi{icate O{ Occupancy No..Zl 1'.5.7.4 ......... Date - March 28 19 .~.~. THIS CERTIFIES that the building .... .Ag.c.e. @ .s.~.~.~. ................................. Location of Property . q. 5.9.QQ...1~.~. $~..R.d., ...................... ~...~).~.J:.~..~9.k. ........... House No. Street Hamlet County Tax Map No. 1000 Section ..... q.!~ .... Block .... .'1.'1. ........ Lot ... 002 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 'I 5 82 'ch ................... ..................... ,19... pursuant to whi Building Permit No: . d 205d Z . December 2 82 dated ............................ 19 .... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Aocessary Doll House The certificate is issued to Mattituck Free L~D~rary (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO, N/A Building Inspector Rev. 1/81 TOWN Or Sou'm0~. ~ BUILDING DEPARTMENT TOWN .HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON iHE PREK~IS~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) ~ev. :e/3o4~0 permission is hereby granted to:/ / .............................. ../. ;. ~ , ..i~ ,0 ........................................................................ 7'";'" ....... :"7'"~' ................................................ //,-/ County Tax Map No. 1000 Section ........................ Block .~....,~ ............... ~Lot No. ~..: .................... pursbant to application dated .~~C......~.i~...., 19....~-.~., and approved by the Building Ir~$pector. Su.d~no ~';; ......................... FORM NO. 6 TOWN OF SOUTHOLD Buiiding Department Town Halt Southold, N.Y. 11,971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of prop.erty with accurate location of all buildings, property lines, streets, and unusual natural o, topog, aoh~ featu.e~. 2. Final approval of Health Dept. of ~vater 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 building~ and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Beard approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings ahd "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topograph 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. 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(X) ~ ' /Vacant Land Location of Property .............. ~ ..... Hou~ NO, ' ~;~e;; ............... "'" .... Z ' l, · Owner or Owners of Property ~' o ~ ~ County Tax Map No..1000 Section J~ ~ Block J.~.,/. Lot .... ~.~ Subdivision ................................ Filed Map'No...; ....... Lot No. ' Permit No. Date of Perm,t ......... ~-..~--. ~~ Health Dept Approval Labor Dep~ Approval Unde~ri[ers Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificat~ ....... - Fee~ubmittedS ~O°° ~ , <b' ~0- ~1~ t~ ~ (] ~ , Construction on a~ove described building and pej~'i~meets all apP~cabl~odes and r~gulations. AppHcant ,~~~., ............................ -- " FLELD ~NSP~CTIO~ FOUNDATION (1st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: HENRY E. RAYNOR, Jr., Chairman JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RiTCHIE LATHAM, Jr. WILLIAM F. MULLEN, Jr. Southold, N.Y. 11971 TELEPHONE 765-1938 November 11, 1982 Mr. Victor Lessard Building Administrator Southold Town Hall Southold, New York 11971 Re: Mattituck Free Library Dear Mr. Lessard: The following resolution was passed by the Southold Town Planning Board, Monday, November 8, 1982. RESOLVED that the Southold Town Planning Board approve the amended site plan of Mattituck ~.r~e~ for the addition of a "doll house" on the property. A copy of the site has been attached for your records. Very truly yours, HENRY E. RAYNOR, JR. , CHAIRMAN SOUTHOLD TOWN PLANNING BOARD ~c: Peter E. Hanlon, Trustee FORM NO. 1 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examine,~ t~.~:.~.....Z ...... , 19..~..~" Disapproved a/c .. i..--Z--. ............... /5../. ......../ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application NO..~..~.O..~..2/'. ....... Date ...If~../..~.~... ...... 19 .~.&. a. This application must be completely filled in by typewriter or in ink and submitted 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 of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th/s application, the Building inspector will issued 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 o~ 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 building for necessary inspections. (Signature of applicant, or name, if a corporation) State whether applicant is(~)lessee, agent, architect, (Mailing address of applicant) engineer, general contractor, electrician, plumber or builder. Name of owner of premises /4~i~'11~1~l°¢[~-- ~ ....... ~: ......................................[7. (as on the tax roll or lates{ deed) If applicant is a corporation, signature of duly authorized officer. ...... · (~~e.~~il~:~r3 · · · C..~-A~--~) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done....g~.~, r~.'(..../~. ..... .~..~.6 ................./ac/( ...... House Number Street Hamlet County Tax Map No. 1000 Section ..... [.t..~.. ....... Block.../.[.. ............ Lot .... .~. 9..~. ........ Subdivision ..... .~. .............................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. xisting use and occupancy b. antended use and occupancy ..~t~..~~.,.~~....'-..~..Q(.L../'/~.(J~TJL.,.-- 3. Nature of work (check which applicable): New Building .... l? .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... , .~ /(~ ~o ~/ (Description) 4. Estimated Cost ......... ~..~..O ....................... Fee ..................................... (to be paid on ~ing this application) 5. If dwelling, number of dwelling hnits ............... 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 ................ Rear .......... Depth -J . ~ ..... Height ............... Number of Stories .... ._/../~? ........................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... !.. Height ........... , ........... Number of StDries ............. t ........ 8. Dimensions of entire new constrUction: Front ..... .,fL'~ .......Rear ...,(~(-....~. ..... Depth ./.~. .......... Height ............... NuN!bet 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: ....................... .,,._~ 13. Will lot be regraded ......... ................... Will excess fill be removed from premises: 14. Name of Owner of premises ...i ................. Address ................... Phone No ................ Name of Architect .......... i ................. Address .,:...:. . Phone No ................ Name of Contractor PLOT DIAGRAM Locate clearly and distinctly all lbuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. 9ire street and block number or description according to deed, and show street names and indicate whether interior or corner lot. /--- STATE OF NEW.YO//RK:,/,//,~ ~,/_ COUNTY OF...~ S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. l' y. He is the ........ ~...~.g.. /l~ 1 ............................. (C~tract~, a~nt, corporate officer, etc.) of said owner or ownem, md is duly authorized to perfom or have perfomed the said work and to m~e and file this application;that all statements contained ~ this application are tree to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ...... .... ............ Say ..... JUDITH T. TERRY ~'{otary Public, State of New Yo~ 62.0344963 Suffolk: County(~,.5' eamrnisslon Exoires March 30, (Signature of applicant)