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Home My WebLink AboutZ-9306FOBM NO. 4 TOWN OF SOUTHOLr~ BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy prior Z 9306 NO ........... Date November 17, 19.7. 8 THIS CERTIFIES that the building located at .B.r.e..a.k:~.a..t.e.r..%. ?~.e.s.t.. ,'.4.i.1.1.. ~xestxRoad ~.l,...o..f....E..d.l_a_K__R ~r~Dne Marvin~ Minor Subdivision AZ'AAZ"aAA~X~Nm xWEXXXXXXXX~ NO. 149 REQUIRE}~NTS FOR A NON-CONFORMING TWO -FAMILY DWELLING built conforms substantially to the 2~al0~~lg/~AX~~~~~ to CERTIFICATE OF OCCUPANCY ~ll~lx...Ap.r..i.1..2.3, ......... , 19.57. pursuant to which~lg4~lil~:~%vR~tit No.Z...9.3.0.6.. dated ...N.o.v..e.m.b.e.r...1.7.,. ...... , 197.8.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~SUed is a Non-Conforming Two-Family D.w. elling* The certificate is issued to EDGAR MARVIN & WIFE of the aforesaid building. Suffolk County Department of Health Approval (owner, X~t~Y~) PRE--EXISTING UNDERWRITERS CERTIFICATE No. PRE-EXISTING HOUSE NUMBER 50 Street Breakwater Road, ~{attituck, ................. New York 1000-113-3-part of Lot 7 Buildin~ Inspector *This does not cover the dwelling sitting on the line of Lot No. 1 and Lot No. 2 which must be removed. FO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupancy No...Z93.Q7. .... Date ....... Novera~er. LT., ...... , 197a. THIS CERTIFIES that the building located at . .3.40. ~r.~a..k.w.a.~r' .R.o.~l .... dgar an _ lene Minor su ivision REQUIREMENTS FOR A NON-CONFORMING '~UnTIPT.~. DWELLING built prior CERTIFICATE OF OCCUPANCY xl~l~k, to. Apr±l. 2 3., ....... , 19.. 5~ pursuant to which ~~ No..Z..9.3.0.7. dated ..... ~.o.v.e..r0be.r..~.7~..., 19.. 7.~, was issued, and conforins to all of the req~ire- ments of the applicable provisions of the law. The occupancy for which this certificate is of the aforesaid building. (owner, Suffolk County Department of Health Approval . .PP, E.-.EX~.~G .................... UNDERWRITERS CERTIFICATE No. PI~-E×~$~NG Building Inspector *This does not cover the dwelling setting on the lot line of Lot No. 1 and Lot No. 2 which must be removed. ~OTE: New Owner will have to register under the Multiple Residence Law. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE 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 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, 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), Nonconforming uses, or buildings and pre-ex,shng" 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 $5.00 3. Copy of certificate of occupancy $1.00 Date September 5, 1978 New Building ................ Addition ................ Old or Pre-existing Building ...... ~ ....... Vacant Land .............. Location Of Property Cox Neek~ Breakwater & West Mill Road, Mattituck NY Subdivision ~:rLnor - da~ed 4/~o ~°-~'~'f[~"'~63'[{~ ...................... ......................... * .......... z.~x.Z.Z.V. ........ Lot No ...~ Block No Ho~,~ ~ Permit No ..................... Date Of Permit .................... Applicant Health Dept. Approval .................................................................. ............................................ Labor Dept. Approval Underwriters Approval ................................................ .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ 5.00 .......................................... Construction on above described building and pe~~ a~,~ble)~de~ regulations. Sworn to before me this ~~ ~J~ C~O~, as atto~ey "' ...... ~-~... day of Septeaber, 1~78 Nota~ Public Suffolk County ~ ~A,~~ ~OTARY PUBLIC, State cf New York No. 52-4665418, Suffolk County ~omm;ss,on Expires M~ch ~i0, 1~ FOP~I NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. 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 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, 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 ]957), Non-conforming uses, or buildings and ..... land uses: pre-exmtmg ' 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 cert ficate C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $].00 New Building ................ Addition ................ Old or Pre-existing Building X Vacant Land .............. Location Of Property .... .C...o..x..Ne~k, Breakwater & West Mill Road, Mattituck NY Owner Or Owners Of Prooertv dgar Marvin and Arle e ' r , · ......................................... n Maz~zn Subdiv s on Minor - dated 4/17/78 1 .............................................................. ............................................................ LOt NO ............. Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final CertificateX Fee Submitted $ .... .5......0...0. ...................... ' ......................................... Construction on above described building and permi~t/-rr)ee)s aJ~ al;~lic~ble codes ~d~egulations. Applicant ........~~....~ '.~~ Sworn to before me this ~~/'~ ~z~'a~':~'~; .................. ~h day of September~ 1978 Notary Public Suffolk .................................... County