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Home My WebLink About10379-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... ~{3..fi~. ........ Date ... Et!.b..l?u...~..rY... 5 .................. 19 .~0 THIS CERTIFIES that the building ................................................ Location of Property 28~ Inle% View ~aS% M~tt~i'cuek, N,Y, h$~Js~ ~d ....................... 's't~:e$i ....................... County Tax Map No. 1000 Section ...!.0.0 ...... Block .... 0.~ ......... Lot .... 0.79.'.7.. ....... Subdivision Inleg. lg~ig. E.~li.t:.e.s. ......... Filed Map No..6269...Lot No... 7 .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~:. 2 ........ ·.. 4~tJa~l,~..~ ........ , 19 ~.9. pursuant to which Building Permit No. dated .../.!-ll~ll~;. ~.0. .............. 19 ~'9., 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 ......... ................ p.e.~v~.e.e.. O.n.e..~.m:'t.~.~., .r~..e.~..~.X.n.g .............................. The certificate is issued to ........... PO~J,'i,Y~,O/t..P0~I,.~ ............................ {owner, of the aforesaid building. Suffolk County Department of Health Approval . .c).~.~O.'.7?.....'1/~.9../.8.0.....R.o..A.:..V.~.~...l.a .... UNDERWRITERS CERTIFICATE NO ............. l~.~.rl.~,~l~. ~ ............................. Rev 4/79 Building Inspector FORM 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? 10379 Z Permission is hereby granted to: ...... ......... et premises located at .-f~..~..~..~ ......... .~/~,~.~,',~...-~.~~.~.~ ........... %~.......:/ ........................ pursuant to application dated ................................. , 1 , and approved by the Building Inspector. Fee $..~..~ .................. Building Inspector 1~)~1~I NO. % TOWN OF $OUTHOLD Building Department Town C:lerks Office Southold, H. Y. ]1971 APPLIGATION FOR GERTiFICATE OF OGCUPAN¢¥ Instructions A. This application must be filled in typewriter OR ink, and submitted in tciWt~ate to the Building Inspector with the following; for new buildings or new use: 1. F~nal survey of property with accurate location of aH buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial bui}dings, 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 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. 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-exist~ng dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .~ebt;uary 1~ 3 980 New Building.........~"~'~ ...... ..... Old or Pre-existing Building ............................ Vacant Land ............................ Tr't?e~ Vi. aw ?~)st:~ Mi~tt:J ~ck~ ~J~ ............. Location Of Property ~; ................................................................. Owner Or ~ners Of Properly ~; ~ ........................................................ Subdivision ................................................................ Lot No ............. Block No ............. House Permit No ..: ........ i.TT ..... D~t~ ~r ~erm~t ..... z: ...... a...~pp~ con~ .................................................................. 1/2q/80 k h N/z Health Dept. Approval ............................................ a_or Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ......... ?.:~? .......................... Request For Temporaw Ce~ificate ......... r.~'~ ........................... Final Certificate Fee Submitted $ ~.~;29 ........................... Construction on above described building on--meWs all. applJca~c~es a~ulati~s. · . ...... f...-... . i'"::'~ ............... ~ ............. Apphcant . .~Z~~~ "Homes, Sworn to before me this ................ of F~brt~.ry 80 (Stamp or seal) !~3 t d~ ........ %..Z ............................ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY. ] 85 JOHN STREET, NEW YORK, NEW Yz. OI~,K 10038 ~THIS CERTIFIES THAT only the electrical equipfnent as described below and introduced by ttw applicant ~ed on the above application nu tuber ir~ the premises of and found to be in co~nphance wtth the require~nents of this Board, FIXTURE OUTLETS 17 DRYERS ~ECEPTACI. ES SWITCHES FIXTURES RANGES OVENS EXHAUST FANS 36 2O FLUORESCENT OTHER APPARATUS: C NO O~ HI LEG AWG OF HI LEG NO OFNE~RAL$ OF NEUTRAL 5 Th,s cert,flcate most not be altered in any~~/~]~anner, return ,o the off,ce Of the Board if ~ncoerec,. Inspectors may be identified b t;J~ crede~,a[~ ~, ~ ~ ~QT ~LT ~ IN ANY MANNER. ~o t.._~ ~"g N . I FOlt~ NO. 1 TOWN OF SOUTROLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned .................. '9Z..7... App,cation ........... ................ , ,gZ . er ,t No ..... D sopproved o/Ye .......... ~.~.~ ............................................................ { ui ding mspector~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter ot~ 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 o 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 been granted by the Building Inspector. A PLICATION IS HEREBY MADE to the Building Department for the *ssuance of o Budding Perm,t 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 oil applicable laws, ordnances, bu dng co~e, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signoture of applicont, or nome, if o corporotion) Box 117, Mattituck, NoY. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises .......... ..P..O..I..~.V..'.i,.o...S..,..P..O.~..J: .......................................................................................................... If applicant is a corporate, signature of duly authorized officer. Rober¢ E. ~[Jltz -- Pres. (Nome and title of corporate officer) Builder's License No .................. -..'. ................................ Plumber's License No. 517-P ~ 0 5' - 0/0~.7 Electrician's License No .... ~,~8...-:*.~ ........................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.:I.~.~.e...t:...~..a..s...t.....E...s.~..a.,C.,.e. Skot No. 7 ]~e~te Ma~ituck~ N.Y. Street and Number ............. ~ ............................. ~ ...................................................................................................... --~?'~,,,q~- //~-Z,~7' Z..,'~) ,~=~:~ Municipality State existing use and accuponcy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..... .V...a..c...a,..n...~. .......................................................................................................... b l.tended use ond accuponcy ..... ................................................................................................... Locate clearly and distinctly aJ property lines. Give street and bi( whether interior or corner Jot. Nature of work (check which c~pplicable): New Building' .~lJ~ ......... Addition .................. Alteration ................ Repair .................. Removal ~ DemolitJor ..................... Other Work ; ~ ,~,¢- -/' ~x~ (Description) , (to be paid on fJJJng this application) 5. If dwelling, number of dwellin~g units ......... .~. ................. Number af dwelling units on each floer~ .;.-~ ....................... if garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupdncy, specify nature and extent of each type of use ............................ Depth 7. Dimensions of existing structures, if any: Front ............................ Rear .................................................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure jwith alterations or additions: Front .................................... Rear ........................... ' Depth ................................ H~ight ............................. Number~ of Stories ................................ 8 Dimensions of entire new construction: Front ....~ ...........................Rear ....... ~ ................ Depth ....~10 ............... Height ~ Number i'of Stories ~-JJllilll~ ......................... 9. Size of lot: Front ~.~t~* ,i, . . Rear .....~J~ ........................... Depth ..... ~ .................... 10. Date of Purchase ....- .............. r,.~ ................................... Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated .................................................................................................... 12 Does proposed construction vi,~lete any zoning law, ordinance or regulation: ........................................................ 13. W~II lot be regraded . .............. , ............. Will excess fill be removed from premises: ( ) Yes ( ~ No 14. Name of Owner of premises ..,.~?...~.~..~..~. ................ Address ................................ Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No ....................... Name of Controcto~,~...~ ................... Addres ,~.... ......................... ~ e No ....................... PLOT DIAGRAM I buildings, whether existing or proposed, and indicate all set-bock dimensions from ,ck number or description according to deed, and show street names and indicate STATE OF NEW~Y-~,J~,~. COUNTY OF ..... .......................... ................................. ~...~..~,.L,,J~.~...~.~ ........................... being duly sworn, deposes and soys that he is the applicom (Name of individual sijgning contract) ' · above named. 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 m~ke and file this appi. ication; that oil statements contained in this appJ~caHon ore true to the'best of his knowledge and belief; and fh~ the ~ork will be performed i~ the manner set fo~h in the application filed therewith. Swim, before me this ........................ ........................ ....... Nota~ Pubhc, . ................................................... Coun~ ...~~.,~ ......... :~...~ .................................... ~ ' ' ~'_ ~_ '~ure of a~ant) HARBoRVIEW Lot ~ S 89~24 '/0 "~ AvENdE Lot $~Z 56 ' Lo! ? Areo= 42, Z48sq H. Lot 8 Lot $ The sewage disposal a~d wato~ ~,uppl~ inspected by this d.~part~en% ~d found ~ be sattsfacto~~ ~ ~hief of General Engi~eri~ HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSFRUCT t( NEAREST WATER dlAIN--MI -+ R SOURCE OF WATER PRIVATE _~_~PUDLIC R SUFF CO TAX MAP DlST/OOo SEC TlON/pO BLOCK ~ LOT /0, ? HTH£RE ARE i~ DWELLINGS WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON .? ADDRESS TEL NOTE ~ -' IWONL/MFNT SUBDIVISION MAP FIL£D IN THE OFF/CE OF THE OF SUFFO£K COUNTY' ON MAY I, 1975 AS FI£ENO 6249 ~ TN~ LO~ATION OP WELL(W)~SERT~C TANK($T~ EE$SPOOL$~CP) SHOWN HENEO~ ARE PNOM F~ELO OBSERVATIONS ARD OR OKTA OBTA~RED F~OM OTHER $ SURVEY FOR POLlY/OS POLl 8 CLEANTHY POLl LOT ~0, 7, . ~NLET EAST ESTATES AT i MATTITUCi¢ TOWN OF SOUTHOLD SUFFOLK COUNTY~ NEW YORK MENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, Al~O TO THE ASSIGNEES OF THE LENDING IRSTITiJTICN~ GUARANTEE~ ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT " NOV. 19 , 19F9 DATE AUG. I, 1979 SCALE /" = .~O NO ;'9 - 425 YOUNG a YOUNG ALiJEN W YOUNGi PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.8 UCENSE NO 12845 HOWARD W YOUNG, LAND SURVEYOR NY$ LICENSE NO 45893 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK r- _,.._, --, Pr••',.-_+ti-^' _" = - - - - .: - - _ •�„ •} "ice Zv y- - _ { tea;•'+' :e-'r 3- - _ _ - - - ,`,.1_p+f-`.• .. �r]" -- _1 1 �- ��-�, _ .YI - -<1 - _- <� {30 rj _ '-EGET+ -f.`•>. d+. +•-` } _ rte,, a.-• r - - x-f. ==1<" •••yam. r_ - - yr•- _ _ "'�a'(" ••-b,- ,..k - cL� - )_ '�. '',�' _ mat---�. ",r: _ � s _:i'r-= J� - TL+` 4"'S:-'• "x:jy'•Ii _« S;F yrs Sti.'_ -.� ._ nom - •'4� e t..�� - - ,+-_„•,-»:�=,yf.,..- t_ .'s - _ .r ['�y'�•...z p _ f � _ y\�- __ _ - O R• �Y;� ori..`•'v auk 4'-'•- fa�� - :� �` -ems_ _ = _ _sem J -� R - _ y.� - ✓*--2- _ 7_{,e _ (�..'-� e•'- - ..�`,t.�.� .:r,$' - �\ - -. ^`S' r/'� �ry'._'_i.i.•_. 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'F'�:.�."C Z�4 4 .O.C. + +I� , { - _ u cyAT USA Olt- GR IS W '�RCOF --�- _ OUT ct cUPASYo -T 1 ri l , - -- .. o` c ' Uf� r1orJ C9 E LUMg�. ._.. ._.___-._._..___ .- . _.... ._----..---...._._..__---__.._.__ .__ _. ._. ... ... _ .. ._ .- Tr ._.- 2 AP R!O`'ED AS NOTED -- - • DATE: � ,'� BP 1 - + FEE: f Z �' BY. # NOTIFY BUILDING DEPARTMENT AT I 765-1802 9 AM TO 4 PM FOR THE L11FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED RE RE •�-+-- FOR POURED CONCRETE T --,�--- 2. ROUGH - FRAMING & PLUMBING 3. INSULATION I 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMLNTS OF THE N. Y. STATE CONSTRUCTION & ENERGY CODES. NOT I"ESPONSIBLE FOR DESIGN OR CON5TRUCTION ERRORS. �. (NUR —41 "4" 4'0. 440e�6 fR ��` FES.-IONA' ' 1 LRE. NO.N HY 41 A j VA T�S17Z I or ICHE-K[O BY l DAT; �� 3 C5 t -10 1�P I0 R¢AOE Z--2�x - _ -01 E DI I 17 14 - 0 2 �v 01 i x 6 �� 1 OX FFiil!l t {. 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