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Home My WebLink AboutZ-7950 fOla[ N0. 1 TOWN OF SOUTHOLD BUII.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Cif Occupancy No.Z7.4~~....... Date Oct....12....., 197.7.. THIS CERTIFIES that the building located at P.R>'1~. AqQ . &..13~pg.~],4!?. L~6treet Map No.. x7C Block No. ..7qC .....Lot No....XX....Maxtittl~k N.•.1Gr.... . requirements for one family dwell'. g & Housing code conforms substantially to the buidl.t c c t o oec~p~ y ated .before. Apr...23.... , 19.57• pursuant to which Z 9 dated ...........pct.. ,12.. , 1977.., 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 . Private..one..family .dwell.ing...with .garage ano. accessory. huilding The certificate is issued to .~1~'@8A. FQT8at81....~eF . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,Pre- .existin& UNDERWRITERS CERTIFICATE No.. Pre-existing, , , , , , , , , , , , , , , , , , , , , , , , , HOUSE NUMBER 2.1.Q5. • • Street Park . Ava riat:tituck . .................................................n............................... fv, ~ _ ~pf ~J" Building Inspector y ` 1°OB1H NO. e TOWN OF SOUTHOLD Building Dsportmerrt Town Clarke Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructbne A. 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 I«ation of all buildings, property lines, 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 installations, o 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 os to use, «cuponcy and condition of buildings. 3. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o 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 ......Qctober„4,,,,,1977,,,,,, New Building Old or Pre-existing Building ..X....................... Vocont Lond L«otion Of Pr art S/ESC Park Avenue & Bungalow Lane, Mattituck, Town of y S o u t:'[i ii'Td"""""""' Owner Or Owners Of Property ......Maureen„Forrestal Subdivision ................................................................Lot No............. BI«k No............. House No............. Permit No Date Of Permit ....................Applicont Health Dept. Approval ............................................Labor Dept. Approval Underwriters Approval ..............................................Planning Board Approval Request For Temporary Certificate Final Certificate Fee Submitted $ .5„QO Construction on above described building and permit me is all licable codes and regulations. Applicant ANT HO B . TOHILL ? /U//a/ Swor1n tp before me this -y day of .........QC.X4)?!*.~:,...>r9.7~.... (stamp Or seal) ~z.ZQs~ Notary( Public ......Suffolk County ~ 3 S q~ C T JUTTA E. FfTZ ! Y ~ T' ~TARY PUBLIC, Stare of New Ymk T Na .`21236770 Quofi Fleu In ~uPfclk County ~Commissicn E. ^La:ch 30, 1974 STATE OF NEW YORK ) SS,. COUNTY OF SUFFOLK ) ANTHONY B, TOHILL, being duly sworn, deposes and says: 1. That he is an attorney with offices at 108 East Main Street, Riverhead, New York, and he makes this application to the Town of Southold Building Department for a Certificate of Pre-existing Use, concerning the land depicted on the annexed survey. 2. That your deponent represents Jane Stubelek and asks that a Certificate of Pre-existing Use concerning the lands and improvements depicted on the annexed survey be issued in the name of Jane Stubelek. 3. That upon information and belief, the Forrestal house depicted on the annexed survey has been located at its present state of improvement since prior to April, 1957, 4. That the reason this application is made by your deponent and not by the current owner, to wit, Maureen Forrestal, by inheritance from Elizabeth A. Forrestal, deceased, is that your deponent has not yet been able to obtain this information from Maureen Forrestal and we are trying to set up a closing date for the transfer of this property from Maureen Forrestal to Jane Stubelek, .~Q ANTHONY B. TOHILL Sworn to before me this ~ day of October, 1977. Notary Public JUTTA E. FITZ NOTARY PUBLIC, Stete of New York No. 52-1236770 Qualified in Sufk,!k County CAmmission Expiros March 30, 1974 now or formerly W. P. Schol% Jn moq. found N.B6°571E. ~ - 70. BO ~ ~ ipoiJ-sef o w ~ ° w o ~ f¢ .~µEO m ~ O 1 °a~ ~ ~2~ ~Q` ____`f /o.3 ~~c 4Pa~y o m 3~6` n ___51.2____ ZL° ~ A 9('• I y2.~ I ~ 1 I p sTOR N Q II ,o° 29AIG KL C.i ~.//L1t~ Q i .p Ne4 a~~¢~EaN~g Se opike I 1O~ e. ~ 1 ,./B~ co 205 g5 O I `N ~ 05~11~ O ; \ mom. ~j-tf `'Z ~ E A s VE U - mon.fouad ' PARK = ' _ REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG PROFES910NAL ENGINEER AND LAND SURVEYOR LAND SURVEYOR. N.Y.S. LIC. NO, 12845 N.Y.S. LIC. NO. 43893 SURVEY FOR: UNAUTHORIZED ALTERATION OR 40DITION TO ,/q NE STUBELEK TNIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAw ~,~ptE OF Nfk, } COPIES OF THIS SURVEY MAP NOT BEARING ~r~D NI ~ O-`"I THE L4ND SURVEYOR 5 INK£0 SEAL OR F` -I EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY AT GUARA O' MArrirucK sourH D AV/ ~ GUARANTEES INDICATED HEREON SHALL RUN ONLY Po TH£ PERSON FOR WHOM THE TOWN of SDUTf/~L~ CH/CA T LE/ CE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL 4GENCY 4N0 LENDING INSTITUTION LISTED 9Y HEREON, AND TO THE ASSIGNEES OF THE SUFFOLK CO., N. Y. LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL SCALE: , DATE: p INSTITUTIONS OR SUBSEQUENT OWNERS. / = 50 SEPT. 23, /977 K Br E 17 5153 9-74 40913