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Home My WebLink AboutZ-7839 FORM NO. 4 i I TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy t`, 1 No. 278.;119. . . . . . Date . . . . . . . . . . . . . . .Aug. . . . 11. . . , 19. .77 THIS CERTIFIES that the building located at !V-5. ?4'L4,in, RQ,",d• . . • • • • • . . . . Street Map No. qc?;`. . . . . . . . . . Block No. . . . xX . . . .Lot No, . .xx. . . . . . . . . . . . . . . . . . requirements for bu iness building, (bouiling Alleys) conforms substantially to the R i ,t erin}t�;kl�rgSfQr _pffjc,��;�; bkilt r: fi te , occupancy I .be--CQVe. 4r. .23 . . . . ., 19. 57. pursuant to which i}i �xe o.Z,7@30. . . dated . . . . . . ... . t4ug. . .11 . . . . ., 197.7. ., 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 . . . . . . . . . . . . . • . . . . . . . • . . . . . . • The certificate is.,issued to Inc. . . . . . . Q.xne r. . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval faro7,.qxi stingy . . . . . . . . . • . . . . . . . . . UNDERWRITERS'CERTIFICATE No.;pr-.-e xi s t trig. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER., . . . . . 9.900. . . . Street . . . .laa,in. .13.oaa . . . . . . .D.'lat:'j.tuck . . . . . . . . . .tdOTEa .Th.is. cw. tifica.te. .doe& .not. c.o Qr. .aci.c0 under. .cons-tl uc:t.10n. now. Building ins or I ' FORK NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 278�9 . . . . . Date . . . . . . . . . . ... . . .Aug. . . . 1 a. . . ., 19. .77 THIS CERTIFIES that the building located at ./.5. !Ykaln. P,qz�,d. . . . . . . . . . . . Street Map No. X?. . . . . . . . . . Block No. . . . XX . . . .Lot No, . ,x . . att.XWgl.. . . . . . . . . . . . . . . requirement s fo bu ine,�s bud ( owli�n�Alys) conforms substantiallyto the bultat ed beXQre. .Apr. 23 . . . . .. 19. 57. pursuant to which% 0.occupancy . . dated . . . . . . . . . 4W. . .1 I . . . . ., 1977. .,J. ., 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 (boWUA9. a,11eYs.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate i�jssued to .Mattituck .I3owling. .Laxne.s. Inc. . . . . . . owmer. . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval prey- existing . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. pre-axisting. . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . 9900. . . . Street . , . .Main .Bead . . . . . . .klat tituck . . . . . . . . . .NOTE: -This. ca'ttiftcate. .does. .not. jc.avor• addl-tlon. under. .eonstruct.lon. now. � . . . . . . . . . . . . . . Building Inspe or i 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 user 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 ,August .9 , 19 7 7 New Building ................ Addition ................ Old or Pre-existing Building .X............ Vacant Land ............ Location Of Property S/S.....Main Road, Mattituck, New York (#9900 Main Road) ......... ........... ...................... . ............ ,. .... .... , ........ ... .... . . Owner Or Owners Of Property Mattituck Bowling..Lanes,�„Inca......,,.. ........................... Subdivision .......... . ..................................................Lot No. ............ Block No. ............ House No........... PermitNo. .................... Date Of Permit ....................Applicant .................................................................. Health Dept. Approval .............. ..........................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ...X..................................... . Fee Submitted $ 5... �................. ... ..... r' Construction on above described building and permit meett oll .applicable Ades and regulations. Applicant . fC '„'` :. ........... .. . ... .�... . . . . . .y . . l;ark� tlro'rii ��`` �7 Sworn to before me this G l 9th....-day of .....August, 1977 9C4401z -?&3 y (stamp or seal) �� L G�" .r71" Notary Public ..........Suffolk,,,.." County r ............. .. C� AiARY LOU DUR05'KI )w& /a'(�—�. �' NaTARY pu&Lm state of Pdow York iUo. 52.1ODOM Suffolk County.1 f [l Commission Expires March 3o. 19-7 y _____ _� __ _. , r y��ycuspy ,,� Y . e h:,, t <.' ».-fir... .: y, ;s? - - `'�':,, ^�++ .",.a ',+ 4 a ";.. a-.' t ;:gs -s'' -,+ • -�+. •„�_,� - _ _ _,..�r - �'t'-:; -V` 7� i r cn x '- j t""'-`'.Via„" .fir _- t - - TL •t .^ t _..,i".,,. - n lei, x 3 .,?,=T T �__r r ;: t - - _ h _ - }• L K1 Ti 1_�S �i'Fi -iY' h"'vb.J- yry I I k - :sue ti AS-y`e : -. .:t. -� Y ;cam,; ' -� f:v"-v tCy 1� �.n fi• -.--.A.z ^. ;. - N. . s . ) - S r ``�„ r ra tip'- : . '! t �f. -."Z i Jai I `Fs df. F r - RT.y,, " rw•'..•�S.. - { _ :t _ +s/3. ,, f-ad j3.1y rh � -.r ,� .3 i' �,. tar-t� :tit' L i c. t Y✓ _r_' v sue: A C ## j �. y - - it - .. ) - - /f',. ,' 3-4 wR'7-!�V}tl4� 4� , ✓ �1 1 7 _ - - ':7. ' _ _ '� _V f 'l., - tea' '' "„°ya'a• Wit' i '""'j,a2:. L''-,Y0.,,y". H tl. t pp-- E{E t'^S " 1 iP»:.. 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