HomeMy WebLinkAbout4403-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
:
Certificate Of Occupancy
Z9997
October 1~ 19..8~.
Date .................. ! ..............
THIS CERTIFIES that the building ................................................
2705 Private Road ~18.-Laurel Way, Ma~tituck
Location of Property House ............................................................... No. Street Hamlet
County Tax Map No. 1000 Section '12'1 ...Block 6 .Lot ~2.: .~
b ~]~v]sOr of. Lqe. .............. ~ Map No. 1.~. .Lot No... ~.
Su ,on .... .~.o..~..W,... . ............
conforms substantially to the Application for Building Permit heretofore ffled in this office dated
December 28 19 67 .~.0~
..................... , ... pursuant to which Building Permit No ................
dated ...D.o.~..~..b.e.r...~.8 ............. 19..~7, 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 on Lot #S With a change of the Westerly
Lot Line Approved by the Planning Board. ~he Street Line will now be
151 Feet instead of 16~ Feet. The rear line to remain 85 Feet.
*Planning Boards Approval-June ~O, 1980.
*Zoning Board of Appeals ~2725 Oranted Their Approval September 15, 1980.
The certificate is issued to ... Adeline Lee .......
.................. io¥,;&'~ ............
of the aforesaid building.
Suffolk County Department of Health Approval ...M.a~.. I. t..1.9.7...~...By..R.:..V.i.~.~.a...~.0.-.~.~../~Q ....
UNDERWRITERS CERTIFICATE NO.......lq '1.:~'~0. ....... ............................... .
...... X,/~./~..,,cC./../~.~. ....
Building Inspector
Rev 4/79
FO~/[ NO. :~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
................. a~t ..,,..~....~l~e,.~ .........
to ..... ~aS.1A ..aev...a..~azd.l~..~ ...a..Zet.. J .......................................................
at premises located at ................... .~.-~..'.~J~....~..e.O.~-.~..a.....~l~..~, .~..,-.~.Ii~.~...~L~lj .......................
.............................................. Of $..~/1~....~mmf&..~e ............ lia.tt~,tue~ ..................................
pursuant to application dated ........................ ~e~,..~ ..................... , 19.....~Tond approved by the
Building Inspector.
Fee $..~J~O(~ ..........
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of properW 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 installa-
tions, 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.
For existing buildings (prior to April 19§7), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topograph ic featu res.
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 informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $§.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00 (PI. ease ver:L£¥ change :In lot.
].lne with Plannin¢j
Date . ,6/.2,3/,8.0 ..................
New Building ............. Old or Pre-existing Building .... X ....... Vacant Land .............
Location of Property ... ~4~'le;~. ~7a¥,..:~,P~ff~-,. ~. '~¢~, ....................................
House No. Street Hamlet
Owner or Owners of Property .~, eline Lee ......
County Tax Map No. 1000 Section ...Z.2.]..,.0.0 ....... Block . .4 ............. Lot. p/o. ~2,1 .......
Subdivision ................................. Map No ............... Lot No ...............
Permit No ........... Date of Permit .......... Applicant .... .~.i.c..]~l~.. !' .li.l.c..l~1~....~..~t¢ffi~l~lJ~'~. P ,C.
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ....x ...................
Fee Submitted $.. ~i,~0 .......................
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-78
Applicant ............... 'k; ' ...................
I'/b
2723
Appeal N.o.
TOWN OF SOUTHOLD, NEW YORK
ACTION OF THE ZONY~G BOAI~D OF APPEALS
Application Dated 7/18/80
ACTION OF THE ZO~NG BOARD OF APPEALS OF THE TOWN OF SOUTHOLD
To Abigail A. Wickham, Esq.
Main Road
Mattituck, NY 11952
Appellant
at a meeting of the Zoning Board of Appeals on August 14, 1980,
was considered and the action indicated below was taken on your
( ) Request for variance due to lack of access to property
( ) Request for a special exception under the Zoning Ordinance
(X~[ Request for a variance to the Zoning Ordinance Art. III, Sec.
( )
the appeal
100-31 and 100-30
~a~ed ( ) be denied pursuant ~ Article .................... SectEn .................... Subsection .................... para~aph
.................... of the Zoning Ordinance and the deccan of the Building I~pector ( ) be reversed ( ) be
co~irmed b~ause 8:55 p.m. Application of Adeline Lee, by Abigail A.
Wickham, Esq., Main Road, Mattituck, New York for a Variance
to the Zoning Ordinance, Article III, Section 100-30 and
Bulk Schedule, Section 100-31, for approval of insufficient
area. Location of property: Laurel Way, Southold, New York;
bounded north by Laurel Way, west by Mulvihill, south by Sladon,
east by Schimpf; County Tax Map Item No. 1000-121-4-12.1.
(SEE REVERSE SIDE)
2. VARIANCE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) (would not) produce
hardship because
(SEE REVERSE SIDE)
practical
difficulties or unnecessary
(b) The hardship created (is) (is not) unique and (would) (would not) be shared by all properties
alike in the immediate vicinity of this property and in the same use district because
(SEE REVERSE SIDE)
(c) The variance (does)
change {he'cl~aracter ~} the district because
(SEE REVERSE SIDE)
and therefore, it was further determined that the requested variance (
that the previous decisions of the Building Inspector (
(does not) observe the spirit of the Ordinance and (would)
) be lranted (
) be confirmed ( ) be reversed.
(would not)
) be denied and
ZONING BOARD OF APPEALS
FORM ZB4
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUI'HOLD, N.Y.
NOTICE OF DISAPPROVAL
Date ................... 19 .....
File No ................................
.. ~.~.,~....~. - ................
· .- .... : .....
PLEASE TAKE NOTICE that your a~n flared .... ~,~..
Location of Property h~t~ . ' .......
County Tax Map No. 1000 Section . ./..~./. ....... 'Block . .O.. ~/. ........ Lot ..~..t.7~./..~..,....
Subdivision Filed Map No . Lot No ..................
is returned herewith and disapproved on the following g~ounds. ~'2~..~.~'.~. ~,'~..~..~...~..~. -.-~. ....
Building Inspector
RV 1/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor 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 featu res.
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 installa-
tions, 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty 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 informa-
tion required to prepare a certificate.
revised
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00 (Please verify change in lot
line with Planning Board)
Date . .6/.2.3/.8.0 ..................
New Building ............. Old or Pre-existing Building .... :(. ...... Vacant Land .............
Location of Property ... Lanre,l. Way.,. ~a~zrel.,. New. ~)rk ...................................
House No. Street Ham/et
Owner or Owners of Property ....... .A~l.e.l.i.n.e..L.e.e ..........................................
County Tax Map No. 1000 Section ...1.2.1...0.0 ....... Block . .4 ............. Lot. p/c~ &2..-] .......
Subdivision ................................. Map No ............... Lot No ...............
Permit No ........... Date of Permit .......... Applicant .... .W.ip.k.h.a~..,..w,~.cJ~h~,,~ .&. JBree,s,ler.,. ~P.C.
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ...:~ ......
Fee Submitted $.. 5
Construction on above described building and permit ~t~2 appli~c~e~/q[ regqlati~;~s.
~ / ~igail A. Wickh~ , //~)
R~. 10-10-78 ~ ~' ~ ~/~
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~t'[~ BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
..,.January l~, ~o7~ .,pp,,cat,o. No.o.f, le r,~.?ol2 ~.. N 137980
THIS CERTIFIES THAT
John I4. Lee~ Sound Ave. & Main Road, Mattftuck, L.I.
in the following location; [] Basement ~C lst FI.
w..~a.~i.edo. January 11, 1974
[~2nd FI. ou~8~de Section Block Lot
and found to be in compliance with the requirements of this Board.
FIXTURE fiXTURES RANGES COOKING DECKS -OVENS DISH WASHERS EXHAUST FANS
OUTLETS FLUORESCENT VAPOR
12 50 12
DRYERS FURNACE MOTORS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R
OTHER APPARATUS:
C
NO. OFpECRC~,COND. OF A, W.G. NO. OF HI-LEG A.W.G. NO. OF NEUTRALS A.W.G.
CC, COND~ OF HI4EG OF NEUTRAL
i
~/o i 21o
~Murnaces: Otl~-i/Shp, 2-1/15hp .
*Puture appliance feeder/s: 1-3#6, 1-2#14 '
*Special receptacles: 5~20amps., 1-30amps.
~o~or./s: I- !/2hp
Arthur W. Lee~ ~ '~' ,
246 West ~th St., emiZ~
Deer Park, L,I. 11729
COPY FOR BUILDING' DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iN ANY MA~. ~
FOB~ NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exomined ...................... ! ................ , 19 ........
Approved ..~..~.J. ................ , 19..~..~.. Permit No.....~../...Z'/...~......~........Z~'
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ......... ......... ,
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 Jot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which is p~rt 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, housing code, and regulations.
/
....
(Address df applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................ .................................................................................................................................
Name of owner of premises L~ C~ /-~ A/ iA/. ~ ~ ~
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: ...... ~:.~ ...... Lot No.:
Street and Number ........ .~.~..~..~ ......... ~..~ ........................... ~.~..~.~.I~..Z..M.~.~. .................................
~/- ~ 7~ Munici~li~
2. State existing use and occupancy of premises and intended use and ~cupancy of propos~ construction:
a, Existing use and occupancy ................ ~.~..¢.~..~.[.......~.~.~ .......................................................................
b. Intended use and occupancy .......... J ......... .~.~.~].~.~......~..~.~..?..~ ..................................................................
3. Nature of work (check which cable): New Building .... .~.. .......... ion .................. Alteration ..................
Repair .................. Rem/oval .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ....... ~.....~.....O..~. ................................... Fee ............... ~'...../...O. ................................................................
(to be paid on filing this application)
............................ Number of dwelhng units on each floor ...........................
5. If dwelling, number of dwelling units O,,VE' ' o.~.~ E
If garage, number of cars ........................ O.?...~. ..........................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......~....o. .................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ....... ~ ........................ Rear ............ .~....q .......... Depth ....Z.....6. ..............
Height ...g..(2 ........... Number of Stories ............... .~. ....................................................................................................
9. Size of lot: Front ........ /..q..O.. ............ Rear .......... .~...~ ................... Depth .......... ~...~..~. ...........
10. Date of Purchase ............)Y..9..Y.....~.~...)..~.~.;Z. ............ Name of Former Owner .~...~..~wc..~...(..'~..~.......C..D..~...IZ...~..~.~..~...
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................
13. Name of Owner of premises ...~..?...fl.~....~:..~.~,.f,L ....... Address .'f.~J.r.~,..~-.~/.':..~..~.~i.~°./fJ...~Y-.~.'... PhoZne~ ZNo..F./.l...o..Z.?.e...
Name of Architect /.~-..o...~.......~._o.~./~..~..TJ~,~z. ......... Address .~..$.f....~.u..~..~.';t~.../!.Xf.~)rK...~..Y.. Phone mu ......... .z$...
Name of Contractor ......... ..~..?....*h~.......~K..:...~...~-~: ...... L_Address ..z.£!.-.x~,.//.(&..c.~J~..iF....~.~.F,.:.. Phone No...P.:~..7..~..?.~.o..
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
/ ·
STATE OF NEW YORK,~ ~-c
COUNTY OF ......... ~'..v.k..~..*r..~ ........
.................... ..'~...?..j~....,~........W..:......~...C.'~.[ ................................... being duly sworn, deposes and says that he is the applicant
(Name of individual signj~ng application)
above named. He is the ............. ~j....U../...Q.~..~.....'~.. ..................................................................................................................
(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 file
this application; that ali statements contained Jn this app!icotion are true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
..~...~ .......... day of ....0....~."¢'..: ............................ , 19..~.~. .~'~-....~'...L.~...-,...-r~ .........
· ................
Notary Public, .~~ ~ .~.w.,~r~..],a,~,~.~.,~ . , ~ (Signature of applicant)
SUFFOLKCOUN~YMEAL~N DEPART~{EN~
The sewage disposal and water Supply
facilities for this location have been
inspected by this department and found
Chief of General Engineering
Services
---
i4
, LRt~d, ..... ' .... , i-'"-' kc' '
S,.:AL AN,u SIGNATURE
L F_-',/L"~ L
NOT VAt'''~ ~'~ ""' "' '
l,.; FL') ::.: .... ,iqG
PERMIT ,;¢I I,,'.,,, ; %,~1 EOT,
SEAL AND SIGNIq LRE
LEON ROSENTHAL