HomeMy WebLinkAbout4813-zFORM NO. 4
TOWN OF SOUTHOLD
BUll:DiN6 DEPARTMEN~
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
Certificate CD[ Occupnncy
No..ZI0~15 ...... Date .... l~arJ~l~. :18..... ,;. ............ ,19.8.~.
THIS CERTIFIES that the bufld~g ............... I~EC.~ED. O~ .~l~. ] 7.~.. 19~
~mtion of ~op~y ...6.00 .............. ~q~ .~9~ .............. ~99 g~old
Hou~ No. ~t
~unty T~ Map No. 1000 ~ction . 0~ ....... Bio~ . 09 ............ ~t.. ~ ...........
Subdivision.. ~$d~..~gr~.~q9 ........... F~ed Map No. ~P~..,.~t No. ~ ...........
confo~s substant~lly to ~e App~cation for B~ng Pe~t he~tofore Fd~ ~ ~ offi~
.... J ~R~. J 9..' ....... ,19 7 ~. p~s~nt to w~ch B~g P~it No.. b.~ 1 ~. ~. ............
dated .... ~BD.~. 1 9 ................ 19~., ~s ~sued, ~d confo~s to ~ of~e ~ments
of the app~cable prov~iom of the law. ~e occup~cy for w~ch t~ ce~ifi~te ~ ~u~ ~ .........
.... · . .......................................
~e ce~ificate i~ issued to ...... OrR~g. A....~g~r ..................................
of the afore~d building.
Suffolk County De p~tm ent o f He~th Appw~ . P 9~. ~. g ~. ~.. ! ~ ~ ~. ~ ~..~ 9 ~ 9g.~. ~ :..~ ~ ~ ~ ~..
~ERWRITERS CERTIFICATE NO. ~.. ~..~.~ ....................................
· Thia ia an update of B.P. 4813Z iaaued June 19~ 1970 ~o John
JJ~. C,O. Z5130 ~aa ~ssued Ha7 7~ 1973.
Rm. 1~1
FO~ NO. ~:
TOWN OP $OUTHOLD
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)
N? 4813 Z
Permission is hereby granted to:
............... ~...e~tta.....~.~ ..............................
.......... ~! ....... ~..~ .................................
to ... ~.llJ~Jg..~lJ~l...tllg/i~l[r...~d]~l~...i ........ .~ ...~..~...~..~11.....l~....t~....~ .........................
at premises located at [~t 2~! ... ~,i.~.e ~el't~,~l~
pursuant to application dated ......................... ; ...... ~l')al~ ....... :1.~ ...... , 19.~.., and approved by the
Building Inspector.
Building In~
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certi[icnte Of Occupnncy
No. ~L .~¶~ .... Date ............. I~...
THIS CERTIFIES that the building located at . 8~1~1'. ~ .............. Street
Map No.~'~;L.d.e. ~.~.1'~1~ No ........... Lot No. 21 ..... 8o~lt, ho15..I~,][, .........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .......... ~1~.. '$9", 19.~0. pursuant to which Building Permit No. 1~8~1.~..
dated ........... J~ll~...19.., 194/0., 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 . .P~.~t~..O~¢. $~1~t,~,y..5.~t~L.l.t~. ~ .......................................
The certificate is issued to ~.ohn. 1~,. (h~1;$. Jl~. ....... 0~l~el*. .......................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ...Deo...2~t..
UNDERWRITERS CERTIFICATE No... p~4J.~g ~,,] -~- 07-- ~ ~
HOUSE NUMBER.. 600 ....... Street ..... ~1'. ,~ ...............................
Building Inspector
SUFFOLK COUNTY DEPARTMENT OF HEALTH
EASTERN DISTRICT, RIVERHEAD,N.Y.
APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS
Approval to construct said systems is requested,pertinent data herewith: DateF /7.
i-Applicant ~o4~ ~J. ¢~oc~2_ PhoneT.~y~l~- 6-Sub div ~ u~'~
Address ?-Section ~ ~ A~ ~J
2-Detailed property locationWs.£~..e.~ ~,~m.~?¥,~-~ 8-Lot No.
Hamlet ~4~ ,~. Town ~,,.~k ~,lJ, 9-Private well?
3-P~blic water supply, name ~. . Distance to nearest main
4-Lot Size~ Width/~ ft. Le)~gth ~.I~ft. (also enter on center plot plan below:)
5-Dwelling. Singl.e Family iVi Two Family? / /Cellar? ~ /.S19b? ; ICrawl Space? I ~
lO-Proposed system. Septic tank ~_./Precast ~.._/Cess_~.~ ~_/Shallow pools ~ IOther ~
l -Septic tank i id.e dimensions: Vol e Oals. .Z $t. Widt __ ft. Li id depth
12-Precast sections. / FNumber/ /Square Ft. Cesspools. Block si~-eL/& tncs.D ~ ins. H~ ins.
Total blocks below inlet: ~1.____~2 ~3 1~ ~c~ ~ ~o,c. ~ ~ ~e~')
PLOT PLAN
'- Capacity Gals.
~ ~.P.M.
· t~. ,W.L.
Street J~-~-.~ l ~.
The Undersigned CERTIFIES: "Construction of authorized installations will be in
accordance with the Suffolk County Health Departments' current Standards, Bulletins,
and amendments thereto, covering Private Sewage. Disposal Systems".
FOR HEALTH DEPARTMENT USE ONLY. e~ the
Bas information presented herewith, it is the
opinion of the Health Department, tha~an adequate and satisfactory Sewage Disposal System
canDate ~7~~be installed on this Plot. Sign~~. /~/Z_
(~o/6~ ~evis.)
s-~
APPLICATION FOR APPROVAL TO CONSTRUCT PRi-~AT~ SEWAGE DISPOSAL SYSTEMS
INSTRUCTIONS.' Applications mast be submitted in triplicate
1-Means Owner or Builder. Address to ~kich mail should be directed.
2-Means detailed description of property location, together with street name and
distance to nearest intersection of ~ain thorofare, also ~amiet/Village & Township
3-Enter name of Public Water Supply District, together with the distance to their main.
~Enter Length and Width of Lot under appropriate heading, also enter these dimensions
on center plot plan shown on the face of this application.
5-Dwellings: Check-mark "V' items applicable to the proposed new dwelling.
6-Name of sub-division
F-Section NumBer
8-Lot Number
9-Private well: Enter 'Non if Publie water supply is available. Enter "Yesn otherwise.
PROPOSED SYSTEMS: Answers to Items nnmber 10, 11, & 12 please consult the Suffolk County
Health Department's Standards, Bulletins and Amendments for Sewage & Waste Disposal
Facilities. i.e.,
Part II-Residential Sub-surface Disposal Systems covering Cesspools
Part III ~- " n # " " " Septic Tanks
P~rt ~IV " " " " " " Unusual soil conditions
Part V~ # ,, . n " " Shallow Leaching Pools
PLOT P~AN:__The following information is required concerning the Applicant's Lot:
bt Size-Length and Width in feet to be indicated at the L~t lines of the
heavy lined square in the center of Plot Plan shown on face of this application.
S.u_~face waters-Streams, Lakes, & Bays, etc., located within a distance of 50
feet Of Applicant's Lot lines, must be shown on the plot plan also.
W&lls and Cesspools now on adjacent lots mast be shown on the Plot Plan
together with the distance to the Applicants proposed Sewage Disposal Systems and
Well.
Where no Buildings exist on adjacent lots, state "Vacant" on the plot plan.
Streets adjoining ~pplicant's lot to the right, left or rear, enter street name.
WELL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the
following Standards must be observed:
Well-100 feet minimum distance from the nearest cesspools
Well-25 feet minimum distance from rear, and rear sides of property lines
Well-lO feet minimum distance from front, and front sides of property lines
Well-50 feet minimum below grade for well point
Well-40 feet minimum into ground water for well point
Well-$ feet 6 ins. minimum below grade to well head and lateral water pipe
CESSPOOLS LOCATION: Upon determination of the Sewage & Waste disposal "type of
systems" required, the following Standards must be observed for the location
of same:
Cesspool-10 feet minimum distance from lot lines to center of cesspool
Cesspools exterior must be 100 feet minimum distance from nearest well
Septic tank exterior must be 75 feet from nearest well
Cesspool "Center" mast be 12 feet minimum distance from nearest water line
Cesspool "Center# mast be 15 feet from house foundation
Cesspool exterior must be 50 feet minimum distance from surface Waters, Stream~
Lakes & Bays, etc.
Cesspools must be 20 feet minimum distance from large trees
Cesspool center to Cesspool center must bc at least 16 feet
Cesspool cover top to grade must be held to minimum of 1 food to maxi,am of 2 feet
Bottom of Cesspool to ground water must be held to minimum of 1 foot
34.3
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This applicat on .must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
·tor with the fol[bWing; 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 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 wbere applicable·
B. 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.
Fees:
I. 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.O0
February 24, 1982
Date ..........................
New Building ............. Old or Pre-eXisting Building XX Vacant Land .............
600 Summer Lane Southold
Location of Property ...................................................... Hamler
House No. Street
Craig A. Richter
Owner or Owners of Property ..................................................... '~"~" -
County Tax Map No. 1000 Section 078 Block 09 Lot 020
21
Subdivision...]~a¥~.i.c~e. T~.~'.a??. ............ Filed Map No. 2034 .Lot No ...... ~', :~' ,'
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ P arming Board Approval .....................
XX
Request for Temporary Certificate ..................... Final Certificale ......................
Fee Submitted $. ?...q0. .... .J. .................
Construction on above described building and per~
Applicant ¥~.¥ ii~~'~'6 ~ ....
n~.~0-10-7a Craig A. Richter
S-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Bldg. Permit No.
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
(Gi6e deed loca~ion) 0
have been inspected by this department and found to be satisfactory.
BUILDINGDEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 600 Summer Lane Southold
(number & street) (Municipality)
Subdivision Bayside Terrace Map No. 2034 Lot(s) 21
Name of Owner(s) Crai~ A. Richter
Occupancy R-1
(type)
Admitted by: self
unoccupied
(owner-tenant)
Accompanied by:. self
Key available Albertson Realty Suffolk Co. Tax No. 078-09-020
Source of request William H. Frice,'Jr. Date
2/24/82
DWELLING:
Type of construction
Foundation cement
Total rooms, let.
Bathroom(s) 1
Porch, type
Breezeway
Type Heat oil fired
Fireplace(s)
Mobile home with a wood
addition
block
FI 5
#stories
Cellar partial Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Deck, type
Garage
Warm Air x
No. Exits 1
Patio, type
Utility room
Hotwaterl
Airconditioning
Domestic hotwater yes
Other This is an update of
Goetz. Jr. C.~. Z5130
$CCESSORY STRUCTURES. NONE
Garage, type const.
Swimming pool
Other
TyPe heater gas
B.P. 4813Z issued June19,
issued May 7, 1973.
Storage, type const.
Guest, type const.
1970 to John
VIOLATIONS: Housing Code, Chapter 5~
..Location Description Art. Sec.
kitchen gas stove--no shut off V 52-52-E, 6
front door storm door broken III 52-30-C
2 bvoken windows ... III 52-~0-C
Remarks:
Inspected by: ~ ~/~..~Q~; Da~te of Insp. 3/17/82
Curtis W. Horto~n Time start 3:30 end 3:48
Approved ........................................ , 19 ........ Permit No. A~/°cC~/ -~ Z---
· ow. o, Eout.o'.
BUILDING DEPARTMENT
TOwN cLERK's OFFICE
Disapproved a/c ............................................................
APPLICATION FOR BUILDING PERMIT (~.
D,te ....... ........ !.?. ........................... .....
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 premieos or public streets or
areas, and giving a detailed description of layout of pmpert~ must be drown on the diagram which Is part of thle 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 pumuant 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 lows, ordinances, building code, housing code, and regulations.
(Signature of applicant, or name, If a corparatlon)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ........~....~...;.....R:......~.......~..../:I ~ -- .............................................................................................
// --
If applicant is a corporate, signature of duly authorized officer.
(Name and title 'of corporate officer)
I. Location of land on which proposed work will be done. Map No.: -Y/ o~ ..O....~....~. .......... Lot No.: ...~.~/ ................. ~'
Municipality
2.State existing use and occupancy of premises and Intended use and occupancy of proposed comtructlon:
a. Existing use and p y ............................
b. Intended use and occupancy' ' ...............................
3. Nature of wmk (check which applicable): New Building .................. Addition ~ Alteration .
Repair .................. Re~oval .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ................ ~go , Fee .............................................................................
(to be paid on fi!ina this application) .......
5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................
If garage, number of cars .....................................
6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front. .......~..O. .............. Rear ........... ~...~. ............... Depth ......./....'~.. .......
Height .~..~ ....... ~ ....... Number of S!ories .......... ./. ...........................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
,/ "
8. Dimensions of entire new construction: Front ............. .~. .................... Rear ......... ./..~. ...... Depth
- Height ...~...?.....~..i~'.P..~- Number of Stories ........................ J... . ..........
Size of lot: Front ....... ,/..6...~. .............. Rear .......... /.....o:~.. ................... Depth ....... ./...~..?.:.Z.O. ...........
Date of Purchase ...... .~-..fi..~. !.q..,../.~.~[/? ..................... Name of Former Owner .~./,,~.,~,..~..~,..~..~....r.Z q.o..vI ...........
Zone or use district in which, premises are situated ...................................
Does proposed construction violate any zoning law, ordinance or regulationP
Name of Owner of premises ........................................ Address ............................................ Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .................................................... Address ............................................ Phone No .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicute all 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 Jot.
10.
11.
12.
13.
STATE OF
obove homed. He i~ th* ..................~ ................................................ ........... ; ......
of ~aid ownor or ownors, ~nd is du¥ ~uthori~ed to perform or h~v~ per{ormed th~ s~id ~ork ~nd to ink* ~nd ill*
thi~ opplic~ti~n; that ~11 ~totem~nts contoined in thi~ opp~ic~tion ~r~ tru~ to th~ best o{ hi~ ~owled~* ond b*li~{; ond
tho~ th~ work ~ill be performed in the monner set fo~h in the ~pplicoti~ filed therewith.