HomeMy WebLinkAbout3208-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26776
Date: 11/10/99
THIS CERTIFIES that the building DWELLING
Location of Property: 2100 LEETON DR SOUTHOLD
(HOUSE NO.) (STREET) (F~%PILET)
County Tax Map No. 473889 Section 58 Block 2 Lot 20.1
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 1, 1966 pursuant to which
Building Permit No. 3208-Z dated SEPTEMBER 6, 1966
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 ONE FAMILY DWELLING WITH GARAGE UNDER & ATTACHED DECK AS PER
ENGINEERS REPORT OF LAWRENCE M. TUTHILL DATED NOV. 5, 1999.
The certificate is issued to CARL J GRASECK
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R. VILLA
ELECTRICAL CERTIFICATE NO. N-834324
PLUMBERS CERTIFICATION DATED N/A
06/18/68
10/08/70
' /~ild~g Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BERTIFIBATE OF EIEIEiUPANEIY
No. ~; 3135 Date ......... ~rll~y .l ...... , 19 68
THIS CERTIFIES that the building located at ]~/~ [~e~;e= D~':['~'e ...... Street
Map No. ~ Block No. :K~ Lot No. :K~ t~tthold~' t~ ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ..8e~.~ , 196({ pursuant to which Building Permit No. 3208 Z
'dated ..... [}cpi; 6 "', 19 66, 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 ...Pl'iYa~ ozle. f~m~t~..~e.i.]: .~lg ................................
The certificate is issued to ~a:r].- & ~a~o}~e- Gl'&se~k ....... 01~rilel, s- ...........
(owner, lessee or f~nant)
of the aforesaid building.
Suffolk County Department of Health Approval ~Ttlne l~, ~968 .by. 1~,
.. .......
Building Inspector
Upon cc~21etion of all structural work~ notify this office so
a perminont eertifieat can be issued,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY N834324
PP
~--- 85 JOHN STREET, NEW YORK. NEW YORK 10038
October 8, 1970 .~.p,~c.,,o.,,o.,.s.,e4:z8572N 83437,4
Date
THIS CERTIFIES
that the electrical eflt~p~nent as described helotv and introdu( ed by the applicant nanted on the abore applicatgon number ir~ the pre.dse~ of
C. J. Graseck Leeton Dr., Southold, L.I.
m,hefollowmSIocat,on: ~ Basement [] ~,t r~ [] ~.d r/ outside soc,~o. ~o~ Lot
,~..~.,.~..do. October 2, 1970 andfoundtobein~omplianceu,ththerequlrement, ofth,sBo.rd.
RECEPTACLES I FIXTURES RANGES ICOOKING DECKS I OVENS IDISH WASHERS EXHAUST FANS
FIXTURE SWITCHES INCANDESCENTFLUORESCENT MERCU~R¥ X W Ij AMT K W [ AMT KWI AM.T K W A,V*T H P
OUTLETS v*.o. ~T
DRYERS FURNACE MOTORS I FUTURE AP~UANCE FEEDERS 'SPECIALREC'PTl TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
I SYSTEMS
AMT K W OIL H P GAS H P AMT NO A W G j A/AT A~P A,~T AMPS TRANS AMT H ~ NO OF FEET AMT WATTS
SERVICE DISCONNECT NO OF I S E R V I C E
METER A W G ^ W G
A,~T AMP TYPE r:QUJP 1~'2w 1,~'3w 3~r3w 3~'4w NO OF CC COND A W O NO Of: HILEG NO OFNEUTRAL5
PER ~' OF CC COND OF HI [FO OF NEUTRAL
1 100 CB x I 2 I h
OTHER APPARATUS
Water heater 1-~.5kw
Motors 1-1/2hp
Leeton Dr.
Southold, L.I. 11971
may be ~dent,t.ed ~y fhmr creden a s
Th~s cerflf,cate must not be altered in any manner, return to the off,ce of the Board .f .ncorrect Inspectors I
Form San. RS-2
$CDH
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
DIVISION OF PUBLIC HEALTH
HAUPPAUGE, NEW YORK
BUREAU OF ENVIRONMENTAL HEALTH SERVICES
TO:
CERTIFICATION OF APPROVAL OF REALTY SUBDIVISION PLANS
Charles L. Rand
Maple Lane
Southold, New Yo~k 11971
This certificate is issued under the provisions of the Suffolk County Sanitary Code in connection
with the approval of plans on . .A..6~2 .~.~. 2./.4~.,./. 9.7.8. .......for your realty subdivision known as
BRI ONNGLOID-BY-THE-SEA
The following data was furnished in connection with the submission of the plans.
Location ... E..~..~ .M..a~..'o.n..4n..~. 0e..T.o.t.~..°. 4 .S..o..t~. h. o..~. ..................................
Acres (approx.) 18.2 No. of Lots 7 Size (approx.) TWO Acres
Owner intends to .... S..e~....~..~..q .fcC. fi: ...............................................
To p ogra ph y ........ ~.e..~..g.. 3. L.o.p.g... .................................................
Depth to Ground Water- Max: . .~.~. ~.., Min:..0.~. .... When ...~.~.r}.t~..ff./.9.7.8. .............
soil 2, -o,,
'~6
Drainage .......... .~..a.p..p.,~.0. v.e.d., b.y..L.h..g..T.o.~.~..o. ~..S. 0..~..ho..~.: ..........................
~re .... l, On each lot, /ndividual weL~s const~ueZed in manner approved by the
~g~,~¢. ~r0 .~ex~eA~ .4 e~ ¢. d/,-6 ro0.~ ad'~ .4 y4~e~ .. ....................................
Sewage On each lot, one 900-flal~on minimum liquid capacity approved £t~.e seFtia
~in..i~m .a {. 150 .square .fee~ .e f .IcaeMn~ .~ .~eZ~w,Lke .i~geZ p.i~
~nd~,rbed medd~m-eoaase sand and/or g~avel, or ~n the eas~ 'of ~J~ual so~,'
e, xca~atian .iS .t~.~e .codified .~ .~ .de~h .~nX, AZ .o, .6.~ fo.q~ AOA~ .o. ~ .~J~.~qi.~t .ko.~g
san. d and .qravel is eneounte)te~ and the pool is p.a. qvic~.ed v~h a m~,~v/a~um 3-f0ot sand
cn~ .graueg .e~llar. for .a .0ne=~amigy .heu~ .c~ .~eSex;~ie~ .o. rt .c~ro.v.~d .~gAn~ ...........
Approval of this subdivision is granted on condition:
1. That the proposed facilities for water supply and sewage disposal are installed in conformity with
said plans.
2. That private sewage d~sposal systems shall no longer be constructed or used after public sewerage
facilities become available.
ee ~de~ick Van T, yl, P,e.
flown of So~tthold Buigdlng Depg.
Fedea~l Ho~sing AdmJ_nist~Xi0n
Dept. of State-Subd/.vided Land U~v/Z H.W. Davids, P. E.
General Engineering Uni~ Assistant Director of Public Health -
Environmental Health
S-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date June 15, 1968
Bldg. Permit No.
S0-127
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
at ~fest end of Paeton Dr, on L. I. Sound, 2100' West of Kenn~s Rd
(Give deed location)
S outhold
have been inspected by this department and found to be satisfactory.
District Engineer
District Engineer
SUFFOLK COUNTY DEP.,Xi~mLT OF HEALTH
EASTERN DiSTRiCT
County Center, Rzverheaa, New York
PA 7-4700
H.D.Ref. No.
APPLICATION FOR APPROVAL OF INSTALLED P?iVATE SEW,~CE DISPOSAL AND WATER SUPPLY SYSTk~MS
Inspection for approval is requested, pertinenn mnstallation data herewith.
1-Name of Owner' '~
2-Name of Builder
Address
7-Sewage System ins~ailed by. ~'
Address
Phone~
Phone
3-Subdiv.
4-Section No.
5-Lot Number
6-Bldg.Permit No.
Phone '" '
8-(a)Deed location of propertZ
(b)Hamlet or Villa~ (c)Town
9-Septic tank-Gal L__ft.W ft.Liquid Depth ft.
10-Cesspools-(a)No.pools (b)Blocks below inlet-i)__2)__3)__
(c)Block size-L in.W in.H in.(d)Precast pool (e)l .
(f)H ft. in; Diam ft. in.(g)Finished grade to cover
(h)Backfitl Material
ll-Water Supply: Public System ; Private Well
If Private, the following questions are to be answered:
12-Private WBter Supply System installed by
Address ' x' ~ ' ~'~, ~ ~* ; ~ ~, '
,2 3__
ft.
13(a)-Total Depth of Well
14-Diameter of well pip~
15-Name of Laboratory
17-Date ready for inspection
.(b)Depth to Static Water Level
in.
16-Method of Disinfection
The undersigned CERTIFIES: Above systems have been constructed and are
in compliance with ~he Suffolk County Health Department's current Standards, Bulletins
and Amendments :hereto.
18-Date ~igned
Owner - Builder
19-Insert sketch of location of Water & Sewerage Facilities with accurate dimensions.
STREET
FOR HEALTH DEPARTMENT USE ONLY ~ --~.~
Inspected by. / -' . Date
based upon thL~-Tflformation stated above,~satisfactory functioning of the
~bove systems can,be expected with proper main~~~_car~
ate 8 1§68 Approved t~,~*-~,~+ v .....
S-5e
Ao
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use:
l. Final survey of property with accurate location of all buildings, property lines
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form)
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildi
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed szte plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicar
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~ming pool $25.00, Accessory building $25.00~
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $i00.00
3. Copy of Certificate of Occupancy - .
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...~..t~X ~.~...?. L ~?~.~. ..............
New Construction ........... Old Or Pre-existing Building .................
Location of Pr~r~ ~_%oo ~oo ~e~
House No. Street Hamlet
Onwer or Owners of Property.. ~e~ ~.
County Tax Map No 1000, Section..~.c~. ..... Block. ~'~ .Lot.
Subdivision .................................... Filed Map ............ Lot .................
Permit No..%.°7~.%. ........ Date Of Permit. ~/~ .Applicant ~ -% ~¢'<
Health Dept. Approval..~.~? ..................... Underwriters Approval.~ ................
Planning Board Approval...~!? ..................
Request for: Temporary Certificate ........... Final Certicate.. ~
Fee Submitted: $ ............................. /
APPLICANT
FOI~M NO. I
T~WN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N, Y.
^pproved ........................................ , 19 ........ Permit No .............................
D~sopproved a/c .................................................................................
........................... ~"('~"~;i~,ng~lnspector) APPLICATION FOR BUILDING
iNSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duphcate to the Buildin
Inspector.
b. PLot plan showing location of lot and of buddings on premises, relationship to adloimng premises or public streets c
areas, and g~ving a detailed descnptJon of layout of property must be drawn on the diagram which is part of this applicatior
c. The work covered by this apphcation may not be commenced before issuance of Budding Permit.
d Upon approval of th~s application, the Budding Inspector will ,ssue o Budding Permit to the opphcant. Such perm
shall be kept on the premises available for inspection throughout the progress of the work.
e No building shell be occupied or used in whole or in part for any purpose whatever untd a Certificate of Occupant
shah have been granted by the Budding Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the ~ssuonce of a Budding Permit pursuant to th
Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c
Regulations, for the construchon of buddings, additions or alterahons, or for removal or demohhon, as harem descnbec
The applicant agrees to comply with all applicable laws, ordinances, building code and regulations
(Stgnatufe jif ap~phca~nt, or~name,~f a s:orp,c~iotion) .
........ ~ddr~s~ of 'applica~t .... '~'" '
State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buddei
.......... ./- .....................................................................................
Name of owner of premises ......~...~...C~......~.......~.....~.~...~...!.(..W'.' '...~..'...~......'J...J .~. ~"~'
If apphcant ~s a corporate, signature of duly authorized officer
................................................................................................
(Name and htle of corporate officer) 't/~/I o~ ~lt&t ~I~U~&JC(C, ~,
Location of land on which proposed work will,be done .Map No ~...~ .~..~..~.~..,.~.'~$/. °~. Lot.No. ~.
Street and Number ...~...~..~...~.i~.~l......~.~../...~..~... (.J....~..~...~..../~..~.~.~...~...iJ .~..). ..... .~I~...~..)~..i).~..j~.~.~..~i.~.L~.'
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction'
a Existing use and occupancy .... ..~.(k.~.i~..',~.~.. ......
b Intended use and occupancy ..... .0..'~....~....~.~A~%. ;l. L¥'~... ~..f,~ ~...(. t. L ),,~..~ ....................................................
3 Nature of work (check which applicable) New Building .................. Addition .................. Alteration ............. :.
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ............................ ~ ..........
4. Estimated Cost ...'.'...~..~.~..~. ......................................... Fee
(to be paid on fding this apphcot~on)
5. If dwelling, number of dwelling umts ...... .Q...~....~. ............ Number of dwelling units on each floor ....~..~..~. ................
If garage, number of cars .............................................................................................................................................
6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ...........................
7 D~mens~ons of ex~stmg structures, if any' Front ........................... Rear ................................ Depth ....................
Height ........................ Number of Stones ............................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height .....................Number of Stones ........................
8. Dimensions of entire new construction' Front .................................... Rear ........................... Depth .....................
Height .... /....~...~ ...... Number of Stories ...... ..Q~...~. ........................................................
11 Zone or use d~strict in which premises are s~tuated . . z~t .................................~, ..............................................
2 Does proposed construction vio ate any zon ng law, ord nonce or regu at on~ ;./~...~
1
Name of Architect ............................................... Address ......................................... Phone No ..................
Name of Contractor ....................................... Address ....................................... Phone No ..................
PLOT DIAGRAM
Locate clearly and d~stlnctly all buddings, whether ex~sting or proposed, and indicate ail set-back dimensions fron
property hnes. Give street and block number or descnpt~on according to deed, and show street names and ind~cat~
whether interior or corner lot. ~, ~, ~ ~ tJ ~, 4
STATE OF NEW, yORK, ~ ¢ c
COUNTY OF ..~.: .~.,fo.o. ~' ~'~-'//-~ ~/"/re
............................................. being duly sworn, deposes and says that he ~s the apphcar
(Name of ind~vidual signing apphcat.on)
above named He is the ....... .~f,~..~.~:.J~.. ...................................................................................................................
(Contractor, agent, corporate officer, etc)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fH
this application, that all statements contained m th~s apphcation are true to the best of h~s knowledge and behef; an
that the work wdl be performed in the manner set forth in the application filed therewith.
Sworn to before me this 0 ,
........ ...... o, .... cc
" ..........................,c,~-~.,.~.~,e..;:'; ....... 7...,~...~ .... ~..~g..;.~.:."7... ............................. ;.
Notary Public,. .......................................................... ~<~:.&yv-'~c.~' .~ ~'~ature of applicant)
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT. N.Y. 11944
(516) 477-1652
November 5, 1999
To whom it may concern:
On October 26, 1999 I inspected the one family
residence on the premises of SCTM No. 1000-058-002-020.1
with reference to the temporary certificate
of occupancy No. ~' 313~ dated July 1, 1968 and
have found all the ~=~,-=u~! work completed a~::~,per
code.
It is noted that there are several vertical cracks
in the cement block foundation, but none effect the
structural integrity the wood frame there on.
Sincerely, ~
rence M. Tuthill, P.E.