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Home My WebLink About5800-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. gl4.?. .~ ..... Date ............ A~agl;tlit' · '3 .... , 19. ~ THIS CERTIFIES that the building located at ll~W' 8~f£011[ 'AVis' '& 'BlO~s~tr~j~ll4 Map Nol~a~tit~/C]g.Et~ock No ........... Lot No. 31;... Matti.c~Ac~R.. Nd]I, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... At~r'~l' ? '" 19.72 pursuant to which Building Permit No.~800 .... dated .......... Apr'Iii[' ' ' '~'" 19~.., 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 . ~i,a~e '~e' ' 'railWay' ~'~Oiiin~ ..................................... The certificate is issued to .. zfatbr' ;qn'~'aaa .....i~v~&r,~e~e~' &~ 't~'t') ......... of the aforesaid building. Suffolk County Department of Health Approval ' ' Jb~2' ' ' 2~4' ' 1V,e~-. ]~t' B',' Villa' UNDERWRITERS CERTIFICATE No. I '3t~7~ ........................................ HOUSE NUMBER. '~0~ ....... Street ......New S~tlffo]J~: :AVe .......................... .................. ?~ ................. Blos s'o~ 'Bend ............................ j~,z'l.--- '( .......... Building Inspector TG~N OF $OUT~LD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5800 Z Permission is hereby granted to: gd~o Ab~tz A/~ ?letor Wlllia~ ~' ........... ~attXtuek ~o .....l~l~l~ .~.. ~.~...cae... ~a~l~... ~e&lJ~$ ................................................................................. a~ premises ~ocoted of ........ ~.~...._~].....~a~t:L~zck....E~.t~tea .................................................. .................................. ~.l~os~-.t~..&..lt~.. 8'~'l'~lll'""Ave ................................................... .................................................. Kat. ti.tueh ......................................................................................... pursuant to application dated .......................~t,i~IL~.. ....... ~/. .......... , 19..~.., and approved by the Building Inspector. Fee $~,~.00 ............ Building Inspector~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTH JUL ~ 4 197~ P e rmi ~ No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located - (Give deed location)/' J .~ have been inspected by this department and found to be satisfactory. Chief of Genera]. Engineering Services JUL 2 4 1972 FOBM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 features. 2. Final approval of Health Dept. of water supply and sewerage dispcsal--(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. 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-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building .................... C~)ld or Pre-existing Building ..~ ......................... ¥ocant/and ........ ~ ......... ~ner Or ~ners Of Pcope~ ..... ~'~ ........ ~%.~ ........................................... Su~ivision ~~'..~ ............................ Lot No. 4~ ...... Block No ..... ~.. House No.~.P.~.*: "7 ..................... [o or ...... ................................ ...... ............... ....... ............................... Underwriters Approvol .... ~ ......................................... Plenning B~rd ~provel ........................................ Request For Temporary Certificate ........................................ Pinal Certificate Fee Submitted $ ~' ~ Construction on above described building ' ~-~ ~,// .--~/' ~-~//and permj,?.-~neets all applicable ~codes and regulations. Sworn to before me this ~ ~ //~ ................ day of ............................................ (stamp or seol)~4'?3 Notary Public .................................... County ~ ~' - ~/~'// REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERNE^D, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: VICTOR E WILLIAMS 8, JEAN E. WILLIAMS LOT NO. 31," MATTITUCK ESTATES,INC." GUARANTEED TO: AT M ATTI TU C K SOUTHOLD SAVINGS BANK THE TITLE GUARANTEE CO TOWN OF SOUTHOLD -_ SUFFOLK CO., N.Y. BY ~/2~,~t' ,~ ~ J DATE: J NO, V ~' SCALE: I" = 40' MAYI7, 1972 72--229 NO~, · .. - ~'"""' ~ -'MONUMENT ~-"~ ~.-.*.*.~SIJBOIVI$10N MAP FILEO IN THE OFF/CE OF PRE CLERK OFSUFFOLK COUNTY ON SKP ~ O, 1965 A S FIL E NO. 4455. DIETZGEH 135 11846 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~UTH~D, N.Y. ' Approved t~ ,- ~, ........................................ , 19 ........ Pemit No ........ ..... ........... Disepproved a/c ....... ~ ...................... ~ ................ FOR BUILDINT PERMIT .~ q., Date .......................... ,. ............... .....~ iNSTRUCTIONS wlh a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, ,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, anl~. giving a detailed description of layout of property must .he drawn on diagram which is pert of this application. c. The work covered by this application may not he commenced before issuance of Building Permit. d. Upon al~oval of this application, the Building Inspector will isaue a Building Permit to the applicant. Such permit shall he kept/~n 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 Occupency shall have been granted by the Buildir~g Inspector. APPLICATION I~S HEREBY MADE to the Building Depertment for the issuance of a Building Permit pursuant to the Building Zone Ordinance eft'ne T~wn of Southold, Suffoik County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, addft'~,or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws. ordinances, bu~. ~l:le, housing code and regulations and to admit authorized inspectors on premises and in buildings for necessary inspections. Edward Abits Builder Inc (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................... C,o~t~ac~r .................................................................................................................. Name of owner of premises ...... .V.;;J,e,t,e~...W.~.l.~.alas ...................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ~..~$..~$~ Lot No ........ 3.1 .................................. Street and Number ................ .N..e.~.w.~..S~..u~..~.f..9~].~]~..A.~v..e.~.&.~.B~]~`Q.s~QELa~.~1p`1~. ........ ~,a.~:l;d,:l,;~..k. ................................. ~ ~._.,~ .~. ~ Municipality · 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ,..~a~z~t,...~)~. ........................ ~ ................................................................................ b, Intended use and occupancy ........................ ~p.J$...;~Am;Llg...dwal ] tug, ............................................................ ~, ,~ 4 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ...... ~ ....... Add,t~on ..................... Altera{,on ............. Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) Estimated Cost ..... ~2.~QO...+. ...................... Fee ~ (to be paid on filing this application) If dwelling, number of dwelling units ...(:}A.e. ....... Number of dwelling units on each floor ...... , .................................. If garage, number of cars .......... two .......... ~ .............. ~ ................................................. , ............................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... Dimensions of existing structures, if any: Front ..................... Rear ........................... Depth ................................... Height ........................................................ ,. Number of Stories ............................................... , ...................... Dimensions of same structure w'th alteret'ons or eddltions: Front .......................... Rear ......................... , ............... Depth ............................................. Height ................................ ~ ........ Number of Stories ........................................ Dimensions of entire new construction: Front ...~ ................ Rear ....... /:~ ................ Depth ....tf~..~...~2, ............. Height., .............................................. Number of Stories ....~.?l.q .............................................................................. Size of'lot: FrOnt ' ..................................... Rear .......................................... Depth .................................................. Height ....... ~ ............................................ NUmber of Stories ...................................................................................... Date of Purchase ....................... ' .............. Name of Former Owner ............................................................................ Zone or use district in which premises are situated "~ ............. ~....~%ts.t ...................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ......... No .............................................. Will lot be regraded ----.Sr~.~. .................... ,. Will excess fill be removed from premises. [ ] Yes Ix] No Name of Owner of premises ....~.~c.t, oA'...l~;&~l,~.az~s ....... ~ ........................................................................................ (Address) (Phone No.) Name of Architect ............................. (Address) (Phone No.) Name of Contractor ........ ..~..~..w...~.~ .................................... .M..?..t.!,i.t...U...l~.' ............................................................ (Address) (Phone No.} PLOT DIAGRAM LocatecleerlY and distinctl~ all buildings, whether existing or proposed, and indicate all set~oack dimensions from property lines. Give street and block number or description according to deed, and show ~;~eet names and indicate wheth- er interior or corner, lot. STATE OF NEW YORK, ) COUNTY OF ................... ............................................ ~.,.~..W...~,,~..~.~,~. ..................................... being duly sworn, deposes and says that ho is the eplHicant above named. (Name of indivin~,~! signing contract) He is the ....................................................... Co~t=.&c.to=. .................................................. i ................................................................ '. .......... (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make and file this application; that ell statements contained in this application are true.li~)t1~ ~llR~flis knowledge and belief; and that the work will be performed in the manner sct forth in the application filed tberewithl.~k~ INbl~ i~p~e o{: New Yog~ N~, ~2.0,M4~ Suffolk Coun~ o' (~nature of appllc~t) 32' · . I