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Home My WebLink About15007-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No...Z J.4.9. q..2 ......... Date . .S.c.p.~.e.m.b.e..~..2.6., ................ 19 .8.6. Accessory Garage THIS CERTIFIES that tile building ................................................ Location of Property 825 Marratooka Lan8. Mattituck, N. Y. House No. Street Ham/et County Tax Map No. 1000 Section q q 5 ...Block 04 .Lot 32 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .g.t4r.~ .e..1.3., ............19~.6. pursuant to which Building Permit No..q ~.0.0.?..Z ............. dated June 20, 19 8..6, 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 ......... Accessory Garage The certificate is issued to Eugene Miska of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ................ N / ^ Rev, 1/81 I~OB~ NO, ~ TO~H OF $OUTHOLD I~UILDI~IG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15007 Z Dote ........ ~ ............................. , Permission is hereby granted t,p: __ .... ~.....~.../.....~ ................................................... ,o ........... " ..... ~.~ ......... Lot No...~..~ ............ County Tax Map No. 1000 Section ..... .~.~,.~ ........... Block p~r~uont ,o o~l~o,on doted .... ...~.. ,~.1.~ ...................... , ~9~.~., ond oppro~d ~ the / Building inspector, Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 lines, streets, and unusual natural or topographic featu res. 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-exist[n_g" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / / 2. Certificate of occupancy on pre-existing dwelling ~r land use $ !~-/ $5.00 3. Copy of certificate of occupancy $1.00 / Date New Building . .X.X. ......... Old or Pre-existing Building(X) ............ ~/Vacant Land Location of Property ..... 8~-5 .......... lya~y?.a. 1;..o,o.k.a....L~.n.e., .... M.a..t .t.i.t..u..c .k.,..l~ ,..~.... House No. Street Ham/et Owner or Owners of Property Eucjene 'Ho Miska_ County Tax Map No. 1000 Section 11.5, Block 4 Lot.3.,2 Subdivision ................................. Filed Map No ........... Lot No .............. p ._.., 15oo7z erm~mo ......... Date ofPermit .Applicant Inland Homes, Inc, Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval .................. ~.., Request for Temporary Certificate Final Certificat~ ~ , Fee Submitted $ ......................... Construction on above described, building and permit meets a~l~.~e~ and regulations. Applicant ~.~-- -- .......................... Rev. 10-10-Te Robert E, 'Hiltz - INLA~I~]~ HOMES, INC. $037y :SiN~OD qYNOIiI~V 'X 'N ~& NOIiVq~SNI DNIS~hq~ (pus) .g NoILVdNnO~ (~s ~ ) NOI%VdN~O~ NOI~D~$NI G q,q I ~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE ~:~/~'~/~ INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B03 Examined . .~. · .d'A'.':~z. - · .-~. .... , 19~.~- Approved-J~.~..~. 9..., 19~.~'. Permit No./...~'p.p.'7..~.. : Disapproved a/c ..................................... ................................ ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. une 13 19%6.. Date .................. , INSTRUCTIONS a. This application mnst be completely filled in by typewriter or 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 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 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 Occupalacy 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. - INLAND HOMES, INC. (Signature of applicant, or name, if a corporation) Box 117, .Mattituck,. N. X,,.:[.1.9.52 ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder ........................................ Name of owner of premises · F~ugene Hiska ................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. · Robert E. Hiltz, President (Name and title of corporate officer) Builder's License No .......................... Plumber's License No..5177.P ................ Electrician's License No. 2816 Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ~. Narr/~,t. 09.k.a..L .a.n.e ................... House Number Street Hamlet ' C~i~nty Tax Map 'No. 1000 Section .. :[.1.5. ............ Block ....4 .............. Lot .3.2. ................ Subdivision .................................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... 2 Car Free Standing b. Intended use and occupancy ............................ X× 3. Nature &~vork (check which applicable): New Building .......... Addition .......... Alteration .......... ' Demolition Other Work Repair .............. Removal .......................................... '- '- (Description) $6,000.00 4 d Co : ................................ · Estimate st ................................ Fee .......... (to be paid on filing this application) 5. If dwelling, numberofdwelh~gu~mts ............... Numbero we ngunitsonea eot ............... number of cars If garage, ...... ' ................................................................ 6. if business, commercial or mixedloccupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structures, if any: Front. ............... Rear .............. Depth ............. Number of Stories' Height ...................................................................... ~ ' ' ' Front Rear Dimensions of same structure with alterations or additions: ................................ Height Number of Stories · · Dep .................... ............................... ...... Dimensions of entire new construction: Front .2.2. Rear 22 Depth · · · Height .1.2. Number of Stories · · · .23.6 Rear .2.3.6. Depth 1~.9. 9. Size of lot: Front .................................................. 10 Date of Purchase ........... ~ .................. Name of Former Owner ....................... Zone or use ....... 11. dmtnct in which pre,raises are situated ............................................... Does proposed construction violate any zoning law, ordinance or regulation: . .n9 ............................ Will lot be regraded ...... i .... Will excess fill be removed from premises: Y. es No Name of Owner of premises '~t~¢;~'~ 'I~ ~' ' ' .. Address ~.~.l[~[t~a,.. h.a..n.~: Phone No ............... Name of Architect .......... i ................. Address ................... Phone No ................ I. d. Homes Inc. Aaar~Box ll7, Matt.i. tu.c~honeNo..~9~r.9.~90 ..... Name of Contractor.. nlan..... Locate clearly and distinctly all, buildings, property lines. Give street and block interior or corner lot. PLOT DIAGRAM whether existing or proposed, and, indicate all set-back dimensions from aumber or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF . .S.U.~.FO.L.~........ S.S Robert E. Hi~tz ........................... ~ ..................... eing duly sworn, deposes and says that he is the applicant (Name of Individual signing contract) above named. Con?racto.r ' He is the ....................................................................................... (Contractor, agent, corpbrate officer, etc.) of said owner or owners, and is ffuly authorized to perform or have performed the said work and to make and file 'this application;that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this .......... 13. ........... day,:or ......... , TII'I.E MAP o~ i~g'OPE'~'r¥ l'./l A','F TI-F'UC K.,., N "-ER'ri F. I F~,'CO, HEALTH DEPT. APPROVAL , ,' 8UFFOI~K COL.f~T,I{ HEALTH D~?.A~, TU~N~,' ' ~he ler~ai~e disposal and ~ate~f~upply -· ~'.'"'? ~'* ~.~n for this location .~ve been ln,~D~."tr'd bY this depal'tment :~d fo~d ~ DEPT. OF .~AL.TH~E"VIGI~ . POR ApPROVAl- OF COI4~TRIJCrlON ONL.Y, ' APPROVED:, i~TATEM,ENT OF INTENT THE WAlTeR ~UPPL.Y ,AND BEWAOE