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Home My WebLink About3180-zFORM NO, 4 TO~q OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z18562 Date NOVEMBER 13r 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of PropertM 4300 MAIN BAYVtEW RD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 04 Lot 03 Subdivision COREY CREEK Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 1966 pursuant to which Building Permit No. 3180Z dated AUGUST 5, 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 ATTACHED GARAGE. UPDATE OF C.O. Z2630 The certificate is issued to THOMAS & BEATRICE MAC DONALD (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED DEC. 21~ 1966 by R. VILLA Bui~ing Inspector Rev. 1/81 I~OI~M ~0. 4 ?OWN OF SOUT~IOLD ~UILDING DEPARTMENT ~'OWN CLERK'S OFFICE SOUTHOLD, I~. Y. r.I~RTIFIOAT£ OF oI]r. ui:ANI]Y No.. ~ .-,. 2630 Date .............. I~oelnber... 2.3.- 19.66 THIS CERTIFIES that the building located at {~/8' 'BaF .V~i~,..tlc&c} ........ Street Map No...Col, e~r..C~,l~lock No ..... y.~ .....Lot No. 1! .... 8au~;b. QlCl~.. J~,/t.~ ........ conforms substantially ~o the Applicati~on for Building Permit heretobore filed in this office dated ....... l~tgU~; .... .~. .... , 1966.. pu.rsuant to which Building Permit No. dated ........... A~hg~ls.~...~.., 1966., was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .occupancy ~or which tl~is certificate is issued is ... P.:r:~.v.a~;e..o~e.. $'~lll.:]..~.~r..~.w..e~.]:.:J..~.g ........................................ The certificate is issued t,o . ~O~t.~ll. {~'ol*k ')~e'~OP~owner, Ye~sseeerl~ '~ ........ or tenan~ l~d ...... of the afore.said building. .Suffolk County Department of Health Appr~oval ...D. Qg.,... · ' {" Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUtLDtNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KERT oN THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ' ,Sl;oaewoOc~ Home~ 3:n~ ~tc · ....... ~.....~ .............. ~.....:..:..~ .......... : .................... ......... · "~o~..~a~ y..~.Y.~ ................. ~ ....... to ....~..~e~r.on~..E~.~y..dwe]:~=g ....................................... ~ ........................................... et premises located at .,..~'/.~.....~8;y...tCj, e~...~a,..,.~./..,.~,...~a:,~.~.e~.,,.C,9,~G~%9~ .......... .............................................. ~u.~hot~-~ ........ t~.~-~ ......................................................... pursuant to application dated .......................... A~:9'btf~.t~ ....... ~ ........... 19..(~., and approved by the Building Inspector Fee $"[01(~) .......... APPLICATION FOR APPROVAL OF INSTALLED PRI~AT~ ~ATER~AND PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS Applications must be submitted in duplicate. The Original will be returned to .the applicant after the Installation is approved. The duplicate copy containing the Inspector's report will be retained by the Health Department. Private Sewage Systems and wells for single family dwellings must conform to the Standards approved by the Suffolk County Commissioner of Health. Compliance with the approved Standards is determined by inspection,prior to final back-filling of excavations containing the installed systems, and on receipt of the application for approval. Items numbered 1 thru 6 may be copied from the application to construct. Item #7-Means Sewage Systems Contractor. Item #8-Septic Tank: Inside ~ Volu~e I Width I Minimum liquid depth ldimension~ 600 ~a~l 13-ft. I 4 feet ~se of Garbage Grinders increase volume 50 percent Ite~n #9-For minimum distances consult "Cesspool location" on back of application to construct. Item#10-Means the open end of soil pipe discharging from Cesspool #1 into #2 and #3 pools. An 18 inch drop "~ must be attached'to the open end on the inside of pool #1, and fastened into place by a non-corrosive pin or screw. Item#II-From inside of pools and excavations containing sewage and well installations. Item#12-The leaching area of a cesspool (below the inlet pipe) shall be entirely in clean course sand and gravel. At the time of Cesspools inspection, the back-fill material must be in place beneath and up to the soil lines. All soil lines shall be installed and visible for inspection. Item#14-Cesspools covers and any portion of a Cesspool or Septic tank shall not be installed beneath s~dewalks~ driveway ribbons, or any portion of a driveway. Item#15-Cesspool cover must be of reinforced concrete, removable~ and with diameter not greater than 3 feet. The cover on the cesspool shall be not less than one foot nor more than two feet below finish grade, Item#16-Ninety degree 1/4 bends are not permitted on raw sewage lines. Forty-five 1/8 bends must be provided with a clean-out to grade. Item#iT-If soil line is greater than 8 feet below finish grade, cast iron pipe must be laid to and between cesspools. When soil line passes beneath the footing, it must be cast iron to point 5 feet beyond the footing. Item#18-Frecast cesspools must be of approved design, and identification markings must be clearly visible for inspection. Enter the amount of square feet in each pool. Item#19-Soil line from dwelling to the first cesspool must have a pitch of 1/4 inch per foot. Soil lines between 1st cesspool and overflow pools require 1/8 inch per foot. Soil lines joining into Gorbel or precast,domes must be mortared in. Item#20-Applicant shall enter the blocks per course for both the straight & corbel sections of the pools. The total of all blocks for each pool shall be entered also. Item#21-Enter the name of the Well Driller together with his phone number, address, license number and well number. Item#22-Well distances information~ consult "Well location dat~~ on back of application to construct. Answer "yes" if location of well meets distance standards. Item#23-Water connected complete means-Well pump and storage tank is located in an area protected against surface drainage. Drop pipe and casing is sealed against any drainage. That connection to the dwelling water system is completed and disinfected. Item#24-Method of disinfection may be obtained from the Well Driller's certificate. Item#25-Well Driller's certificate together with a copy of the Laboratory report should be attached to this application if a private well is installed on lot. Item#26-Enter the name of the Laboratory to which the Wa~,~ ~ample wa~ submitted. Item#27-Enter well pipe diameter from information~n',~e~/~'~"certificate.~ ~ WELL DRILLER'S CERTIFICATE SHOULD contain the fol~6~fJ~ informa~l~h~\ a-Date f-Dia, of wel%~t%%j%~%~ % i~q~Szze of tank · b-Well Number g-Type of well~' ~, l..~.~'~Oapacity of pump C-Well Driller~s name & address Q/~f\I.~P~ethod of disinfection h-Type of screen -Well Driller's license number d-Phone number i-Tdtal depth of well e-D~e~'flocation ~-Static water level d.-Well Driller's Signature SUFFOLK COUNTY DEPARTMENT. OF PLEALTH EASTERN DI~TRICT,RI~D,N.Yo H.D.Reference No. 80-102 APPi~ICATION FOR APPROVAL OF INST~T.T.ED PRIVATE WATER~AND PRIVATE SEWAGE DISPOSAL SYSTEMS. Inspection for approval is requested,pertinent installation data herewith. A~dress ' Phone ...... ~-Section No 2-N~me of ~ml~n B~¥s, N..Y., .. Phone~u~°'~° 5-Lot Number Address ~;ono~,ood~ Homes, ~nc. ~o-u~o~ 6-Blg permit No_~ Ams~er ap~kic~b143~l;ge~'~o $~fS~s~l~t~n refers: ~ ~0- SEWERAGE 7-Sgwage system installed by ~ A~dress I.lYl,~ ~, ~ ,,~ ~ [~ l U ~ F~ Phone 8-S~ptic tank:vol" -Gal. L ft.W ft.Liquid D ft. 9-M~imum distances held to Health Dep't Standards?~~ 10-ESghteen inch Drop"T" installed & fastened in Pools?_~ ll-A~l excavations & pools free from accumulated debris?_~ 12-B%ckfill:Material ~fO Clean? ~f~Obtained on Job? ! ~ 13-S6il lines and pools ope-~ for inspection:Yes :~-C, 15-P~ 16-S~ 17-C~ 18-P: 19-S~ ~'~O-C, '~. 1-P ASdress License No Well No 22-W911 insta~lo~r/%~ A~c%~mH%~h Dep't distance standards? , 23-P~ivate water connected to dwelling? .... ~ 24-well Driller's Certification? '~-~ra%~ry report attached? ~ 26-Name ~f Laboratory? ~27-M~tbod of Disinfection ...... ~ 28-Diameter of well pipe ins. '. The undersigned CERTIFIE~ Above Systems were constructed and ins%ailed in compliance with the Suffolk County Health Department,s/current Standards,Bulletins and Ammo ~dments thereto. ~ /~ Owner Builder Date ready for inspection /.~/~, ~ canB~eed upon the information stated above,satisfactory functioning of the above systems Date D [C 2119~ Approved /~ ~ -~'6~'~/~ ..................................... ~ ................... J~-Ls~_r_~_o_~_ _E~i n ~ ~ _ ~ J ~ _ _ _ ~ ....... ,sspool exteriors clear of driveways and Sidewalks?-~ .ol covers reinforced and at proper depth of grade?~ ~il pipe bends & clean-outs as per H.D.Standards?__~ .st iron soil lines installed to H.D.Standards? f'~ ]esspoql blocks ~er course Course Straight Corbell number 1 2 ~ 1 2 13 ' 1 2 3 6 7 8 10 11 'ecast approved sections,square feet #1 #2~- 37~ ,il Lines pitched correctl~ & mortared to cor~ell? -~ ,sspool block size H ~[L /~, W ~.Tapered cell and ,stalled correctl,v.?___~Total blocks below pipe ...... ivate Water Suppl~ Sygtem installed by Ambassador Well Dri~s Item Yes No Item Yes No. Ite~ Yes No Item Yes No Item Yes No. Item Yes No Item Yes No Item YesNo. 1 6 II 16 21 26 31 36 18 23 28 33 38 ~ ~ 1~ 19 2~ 29 3~ 39 ~ lO l~ 2o 2~ ~o ~ ~o ~nspecto ~s reamrks:. TOWN OF SOUTHOLD BUILDING DEPARTNENT TOWN HALL SOUTHOLD. NE~ YORK 765 -- 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE..! ........ NEW CONSTRUCTION ..... ,'O~-~R PRE-EXISTING BUILDING..M. VACANT LAND... HOUSE NO. STREET HAMLET Owuer or Owners of Property Cdynty Tax Map No. I000 Section .-~.Z. Block ....... Lot'. ........ Permit No 7 f rm Health Dept. Approval .................. Underwriters Approva~ .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ ~-~ dC) rev. 10/14/88 FORM NO. TO~ OF SOUTUOLD 765 - 1802 I APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must be filed in typewriter OR ink and submitted to the Building Insp, tctor with the following; for new buildings or new use: ]. F~oal survey of property with accurate location of all buildings, property lines, s~reets, and unusual natural or topographic features. inal approval of Health Dept. of water supply and sewerage-disposal(S-9 form) 3. A prnval of electrical installation from Board of Fire Underwriters. 4. S ora statement from pltunber certifying that solder used in system contains less' tl an 2/I0 of Il lead. 5. C~mmercial buildings, industrial buildings, multiple residences and similar. blildings and installations, a certificate of code compliance from the Architect o' Engineer responsible for the buil'ding. 6.S~bmit Planning Board Approval of completed site plan requirements. ~xistlng buildings {Prior to April 9, ~957~ non-conforming uses, or buildings Pot ~pre-existing" land uses: and 1. A~curate survey of property showing all property lines, streets, buildings and u~usual natural or topographic features. 2. A[properly completed application, a consent to inspect signed by the applicant a~d a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, ]957. · I~ a Certificate of Occupancy is denied, the Building Inspector shall state the r~asons therefor in writing to the applicant. 3. D~te of any housing code or safety inspection of buildings or premises, or other p~rtineut information required to prepare a certificate. For ~acant Land Certificate of Occupancy: ]. ~ application for vacant land Certificate of Occupancy shall be submitted, ~hd a certified abstract of title issued by a title company showing single and sleparate ownership of the entire lot prior to April 9, I957 shall also accompany tihe application. If a Certificate of Occupancy is denied, the Building Inspector ~hall state the reasons therefor in writing to the applicant. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. Certificate of Occupancy om pre-existing dwelling - $100.00. Copy of Certificate of Occupancy - $5.00 - over 5 years - $~0.00 4. Vacant Land Certificate of Occupancy - $20.00 Updated C~rtificate of Occupancy - $50.00 Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial er. 10/ 4/88 _) 'I~OWN OF SOUTHOLD ~UILDI~G DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No...~...?...~ ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. · ..................... (Signature of applicant, or name, if a corporation) .............. (Address m' applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ...... ....... .......................................................................................................... Name of owner of premises .5~i..~'..~-..~.. ....... ...~..~...~....~.. ...... ...~..~....~ ....... -~--./..~...~...f ........................................................... If a lic nt is a carp rate, s gnatur of duly authorized officer· PP, , ~ ' , ..... ...... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number .d~..~.~/~......~...~.'~..~.~.../..~.....g~.......~..~....j ....... ~..,~-~..~..~.~..~.~/--' .~... ................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... i~ ...................................................................................................................... b. Intended use and occupancy ../~...~.....~.?..f~.....~..~.~../~..~ .................................................................................. property li'nes. Give street and block number or description according to deed, on~ ' of work which New 3. Nature~ (check applicable): Building ....... Addition .................. Alteration ............... Repqir .................. Removal .................. Demolition....; ............. Other Work (Describe) ..................................... .. :.. ~ 4. Estimated Cost ,~'.'.~ ................................................. Fee ....................................................................................... [ ! (to be paid on filing this application) 5. If d~elling, number of dwelling units .......... ./... ............. Number of dwelling units on each floor / / If g?age, number of cars .................................................................................. ' 6. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories .............................................................................................................. Dimbnsions of same structure with alterations or additions: Front ....................................Rear ......................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimlensions' of entire new construction: Front ........... ,,~,~,~,~,~,~,~,~,~-....~. .............. Rear ..... .~....~... ............ Depth .~2,_~. ........ Height ...z(..~, ............ Number of Stories ..... ~ .......................................................................................................... 9. Size[of lot: Front ............................ Rear .................................... Depth ................................ 10. Dat~ of Purchase ........................................................ Name of Former Owner .................................................... 11. Zonb or use district in which premises are situated 12. Doei proposed construction violate any ~oning law, ordinance 13. Nar~e' of Owner of premises ~...:...~.~.,9,.~..../'~..¢~.". .......... Address ..~4'../~.~.~....~T~../.~..J~...'ft-~.~.... Phone Naq~el of Architect ...................................................... Address Nomej of Contractor ~...~...A(~..../~....~.?..~.......~..°..~.~'.~....~..?.~ddress ")~"~:"~'""~J'Y ...... ~" ........... Phone No. ..... /r--C..~t~C.~.Z'..~..~...../~..~..,~.... Phone No. PLOT DIAGRAM L.ocot~ clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions fr show street names and whether in 'erior or corner lot. STATE 01~ NE~f'"~OI~, ~,/~', t~ S COUNTYJOF, ~~...'F~......,f'~'' !(Nome of individual signing applicon) abow,' nerved. He is the .......................... .~..~~....~:~-~ ............ : (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make and this opplk~ation; that all statements contained in this application are true to the best of his knowledge and belief; that the wk)rk will be performed in the manner set forth in the filed therewith. Sworn to ~efore me this' ~ 19~.~. ............... of ..... ¢~ ,' Notary PLbli~.~.~.....~:.....~.~County (Signature of applicant) ~0TARY PUBLIC, Sta~o :~ :e'¢l YOr~ ~0. 52-3233~20 SuUoh{ and says that he is the applic