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Home My WebLink AboutZ-9982 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . . . . . . . . . . . . . . . . . Date . . . . June. 7 ... . . . . . . . . . . . . . . . .. 19 80 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property .1055 Sigsbee Road., Mattituck(Fast side Sigsb( House No. Street Ham%i County Tax Map No. 1000 Section . . . .14.4... . . .Block . 2 . . . . . . . . . .Lot . . .3 . . . . . . . . . . . . . s Subdivision . KR*tt. fax' . P):Qp.. . . . . . . . . .Filed Map No. . .801 . . .Lot No. . .8.. . . . . . . . . requirements for a one-family d 11�n bu' t or to conforms substantially to the �4g}�liEatic .for Bildi -1'eruiit-1uretoor��fed-in. is-office.da _ Certificate of Occupancy April 23. . . . , 19 57 pursuant to w-Md- RTUdi"ng`P"e'rn-lit No- . . . dated . . . June 17 . . . ... . . . . . . 19 .$01 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 . Private ,One-Family Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . , Esther Madsen (owner,lessee or�tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . .N/R . UNDERWRITERS CERTIFICATE NO. . . . . . . . . ... . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . ✓�� . . 1. . . . . . . . . . Building Spector Rev 4na J J Z 't• ly F - .) t BUI D r :DEP IEN L I1�G ARTi� T MN OF SOUTHOLD, N. ,X. HOUSING CODE INSPECTION REPORT ' Road, Matt1055Sigsbeexocation tuck Ifunici alit _ number & street D Y " Matt Park Pnop. Map No.:. 801 L'Dt(s) -8'3 ..,., Subdivision - ESTHER MADSEIV E Name of Oimer_(s) - Occupancy R-1 .type ozmer—tenant Admitted by: - Self Accompanied by:' Self Key available William`J:'ClarkSuffolk Co. Tax No 144-2-3 - Source of request :Will-jam* J. Clark Date June 11, 1980 DULLING:' Type of construction Waod Framed stories One Foundation Cement Block ' Cellar PartialCrat-11 space .. Total,rooms,: lst. Fl 6: 2nd.. Fl. 3rd. Fl Bathrooms) One .Toilet room(s) Porch, type . .beck., type Patio, type . . Utility room Breezewaay Garage ty . Type Heat C enteral,Gas '"Warm Air X Ho-tc��ater T'ireplace(s) No. Exits` Two Airconditioxiing Domestic hotwater .v Type heaters Other ACCESSORY STRUCTURES: NONE Garage, type const. Storage, type cons - Shimming pool Guest, type const. Other - VIOL4TIONS: Housing Code, Chapter 52 - Locution = Descri tion 't• Sec. Kitchen- No Shut -off- Gels Stove52-52=E 6 Remarks: Inspected by: Date of Insp.June 17, 1980 Curtis Horton dime start 15^end 10: 30 , 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), 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 $5.00 3. Copy of certificate of occupancy $1.00 Date June.A!.7...1.980................ New Building ................ Addition ................ Old or Pre-existing Building .....X........ Vacant Land .............. Location Of Property ...1055 Sigsbee Road, Mattituck (East side Sigsbee) Owner Or Owners Of Property ...Est,ate. of„Esther„Madsen.,,,.Deceased .... Subdivision ................................................................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 Certificate .............. .......................... Fee Submitted $ ...........5.t00................ onstructio on above described building .and permit meets all applicable codes and regulations. 15(X1� Applicant ......William J. Clark Atborney for the Es to of Esther Madsen, worn to before me this Deceased 11th June 1980 ) ..... ..... ... day of ........... ..... ................... (stamp or seal � � v q .. . I�� Notary Publi ..........................:.... County � � V 11 i7 ROBERT J.B. SHAW � C/ NOTARY PUBLIC, State of New York No. 52-8949000 Qualified in Suffolk County YV STATE OF NEW YOB 8S. : COUNTY OF SUFFOLK WILLIAM J. CLARK, being duly sworn, deposes and sayb: That I am the attorney for the Estate of Esther Hadseno Deceased the owner of record of the premises .known. as 1055 Sigsbee �,oadj Matt tuck. Upon information and believe the said premises have been used and occupied as a one-family dwelling for the past 25 yeabs. That the building erected on the said premises is and has been in good condition and su�table for occupancy as a one-family dwelling. . Sworn to before me this- 11 th day of June 1980'. ROBERT J.B. SHAW NOTARY PUBLIC, State of New York No, 52-8949000 Qualified in Suffolk County Commission Expires March 30, 19 77 � kr rr {' 'i:! - ,,r .. � \ .. �k a. •, 'VL�./r�Y�_��G�� s"C.iI� � 7 yd''r[ , .! ��•'� r1 ..`�Y <y Y S`^: - - �( �{ -yam /y •. X ..'W 4 . r c � f - Grp/�rQ��.®�-d' •-C rr�r`�,.�- -�/'J.`.Lt.`-^1t'"� //��,;.•d....e'/��'.�', ""y�' C-2),h� Gdh".,: ref f0 TG �� l�t•//C?e� f? �L^ " /^� C TES � . f ,' /e' c ' tit ' C? :,� • col ,, a FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . Z998`-'. . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . 19 8Q THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 1055 Sigs bee Road, Ma.tti_tuck(��-:.st side Sigsbec House Alo. Sheet Hamlet County Tax Map No. 1000 Section . . . .14L . . . .Block . ?. . . . . . . . . . . . .Lot . . . . . . . . . . . . . . . . Subdivision . ,:'I@tt. j arl�- k r.Q-n. . . . . . . . . . .Filed Map No. . 801 . . .Lot No. . .37. . . . . . . . . requirements for a one-family dwell n ,bu'tt ptri or to conforms substantially to the Application-for--Building-P-ermit-hereto ore-file in.this-.oike_da ed_ Certificate of Occupancy A:nril 23 . . . . . . . . 19 57 pursuant to which-Building Permit No. . . . . . . . . . . . . . . . . . . . . . dated . . . . . Junk lr/ . . . . . . . . . . . . . . 19 . 30,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 . Pri.v. to One-Family..Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . , Esther Madsen . . . . . . . . . . . . . . . . . . . . (owner,lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . .NIR . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . .N�i� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Spector Rev 4/79 STATE OF NEW YORK ) ` SS. . COUNTY OF SUFFOLK ); WILLIAM J.' CLARk:, being duly sworn,' deposes and says: That I am the attorney for the Estate of Esther Madsen, Deceased,. the owner of record of the premises known as 1055 S gsbee Road, Mattituck® Upon information and believe the said.-premises have been used and occupied as a one-family dwelling for the past 25 years. That ..the building erected• on the said premises is and ha's been in good condition and suitable for occupancy as a one-family dwelling.. Sworn to before me this 11 th day of June '19 ROBER! J.B. SHAD° NOTARY PUBLIC, State of Nett YoM No. 52-8949000 Qualified in Suffoll� County Cnmmission Expires March 30, 1i3,_