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HomeMy WebLinkAbout5602-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z18071 THIS CERTIFIES that the building Location of Propert~ 1505 VILLAGE LANE House No. County Tax Map No. 1000 Section 107 Subdivision Date JUNE ir 1989 ONE FAMILY DWELLING MATTITUCK Block 11 Filed Map No. Lot No. Street Hamlet Lot 04 conforms substantially to the Applzcation for Building Permit heretofore filed in this office dated NOV. 1~ 1971 pursuant to which Building Permit No. 5602Z dated NOV. 1r 1971 was issued, and conforms to all of the requmrements of the applicable provisions of the law. The occupancy for which this certificate is zssued is ONE FAMILY DWwJJ.ING WIT~ATTAC~EDGARAGE & R~ARENCLOSED PO~H.* UNDERWRITERS CEi{TTEICATENO. PLUMBING INSPECTED *EEVISED OCT. 2, 1990. The certificate is issued to KARL & JANINAA~LSON (owner, ~Lv~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL APRIL 25~ I972 R. VILLA N14093 5/31/89 Rev. 1/81 °B~i~l~ Inspector FORM NO. 4 TOV~N OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .V~,!l~£.e..I~a. ~.e .............. Street Map No. Vi~L1.. kz,no~lock No ........... Lot No...1.1 .... t.[atti.tuck~. II .~ ......... conforms Substantially to the Application for Building Permit heretofore filed in this office dated ........... I~.o¥ ......1.., 19.71... pursuant to which Building Permit No. ~h02Z.. dated ............ li~9~r.....1..., 19. ?.1., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to . .Kar& .&. J~,n±na-..,~xe&son ....... 0~.me~ .............. (owner, lessee or tenant) of the aforesaid building. ~OTE: Subject to rein~pection of ~lumbihg Suffolk County Department of Health Approval ,~,pri.q- .2~..1.972...by. P~ .Vi.~&a... UNDEI~WRITERS C£RT[FICATE No .... I~ .1.1~0.~,~ ..................................... HOUSI( NUMBER.. ~.~0~ ...... Street .... V-~-~]-age..L~.r:e. · -1.1at.b~uek .................. Building Inspector l~)E~f NO. 2 TOWN OF $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) 5602 Z Permission is hereby granted to: at premises located at .......... [J~'J"-'t'~ .......... Jj.lj, Jdl~/lt..JJat:il~l~ .......................................................... pursucr~t to application dated ...................... JJ~ ......... ~J ................... , 19....~J, and approved by the Building Inspector. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.~-0 . . . Date .. &pl~&l.. ~ , 19. ~ THIS CERTIFIES that the building located at V;Lllage l~tne ,. Street Map No. Vil~ M~O~Bl°ck No. Lot No.. 1% i~attituok~. N,Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated dated . ~O~' · .. ~. , 19 ~/1, pursuant to which Building Permit No. ~(~2~ · · . .i~o~.. ~[ , 19 ~ , was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is · Private .~ae. fam~..~ ¢lwetliug The certificate is issued to ~[aml .& ~allin& · .Ax. otsola · · 01~n~'s · (owner, lessee or tenant) of the aforesaid building, l~0'J~ S~tb]e~t t~ rsinsp.et~cm of Suffolk County Department of Health Approval &pl~[1..2~.~..]972 · .by. R, Villa. UNDERWRITERS CERTIFICATE No . ttOUSE NUMBER ~1~0~ , Street Village Lane' Hattituck ~ Building Inspcctm TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 1197l 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ or soovaoL~..,, .OLD OR PRE-EX~ST~NG BUILDING ..... NEW CONSTRUCTION ...... v 9 ~ .VACANT LAND. Location of Property. 1505 Village Lane, Mattituck, New York HOUSE NO. STREET HAMLET Owner or Owners of Property Karl and Janina Axelson County Tax Map No. 1000 Section 107 Block 11 Lot 4 ,Subdivision ....................... Filed Map ........ Lot .......... Permit No. >~?~ ..... Date of Permit .~/~/?}..Apptlcant ................... Health Dept. Approval .................. Underwriters Approval.~ ...... Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ ' Fee Submitted: $.~:~ .............. APPLICANT. rev. 10/14/88 ~~ d.o. z/2o 7/ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~ Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) ~'////k( ,~ /f,~4,' orr . have been inspected by this department and found to be satisfactory. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No EASTERN DISTRICT,, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS ~ ~ ~ 2-Detailed property location ~/.J ~'~ ~ ~ ~' y ~,~' 8~-Lot No. ~ ~ ~mlet ~T~ ~ " 'T°~b~o %~ 9-Private well? 3-~bllc'~ter supply name ~ ~' Distance to nearest ~in 4-~t Size: Width ~Oft. Length ~fb. '(al~'o 'enter on center plot plan below:) ~elli~: Single Family ~ T~ Fa~ly? ~ yCellar? ~y~lab? ~ ~Crawl S~ce? lO-Proceed ~stem: Septic ~ank ~ yPrecast y ~Cesspools ~ ~Shallow pools y ~Other ii-Septic ta~ inside dimensions: Vol~e Gals.Length ft. Width ft. Liquid depth 12-Precast sections: ~umbeF/ YSq~re Ft. Cesspools: Block size~ '~ incs.D ~s.H Total blocks below inlet. ~. ~2 ~f~3. .. ~T P~N o ~ ipacity P.M.., ~- Street No~th The Undersigned CERTIFES: "Construction of authorized installations will be in accordance with the Suffolk County Health De~rtments' current Standers, Bulletins, and amendments thereto, covering Private Se~ge Disposal Systems". ~er or Builder Data 'ee~ 0 2 ' 4 8 10 12 18 FOR HEALTH DEPARTMENT USE ONLY. Based on the, information presented herewith, i~ is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date ( ~o/65 Revis S-15 Signed CONSENT TO INSPECTION Karl .Axelson and Janina A~elson, his wife , the undersigned, Owner(s) Name(s) do(es) hereby That the undersigned (~) (are) the o%vner(s) of the premises in the Tov~n of Southold located at 1505 Village Lane, Mattituck, New York · %vhich [s sho%vn and designated on the Suffolk County ~ax map as District 1000, Sec%ion 107 , Block 11 , Lot 4 That the undersigned ~ (have) filed· or caused to be filed· an tion in the Southold Town Building Inspector's Office for the folio%ring: a certificate of occu/oancy ~,~,~- ' That the unders~ned do(es) hereby ~ive consent to the Building Inspectors of the Town of Southold to enter upon ~he above described property, including any and all bu[ld[n~s located thereon, to conduct such inspections as they may deem necessar3 with respect to the aforesaid application, including inspections to determine %hat sa~d premises comply %vith ~11 o~ %he la~vs, ordinances, rules and regulations of %he To%vn of Southold. The undersigned, in consenting to such inspections, do(es) so with the kno~,led~e and understanding that any information obtained [n the conduct of such inspections may be used as evidence in subsequent prosecutions for latians of the laws, ordinances, rules or regulations of the To%vn of Southold. Dated: May 17..., 1989 Irvinq L. Price, Jr., AttQrney/A~ {print name) (s~fnature) (print name) LOT I1 Disapproved a/c ................. ~ ............. ~ ........................................ r~ ~ ~ J~d~ ~ APPLICATION FOR BUILDING FERMrT LR mt. ....... ~..O. IZ.t. ...................................... ,19..~.1. ..... Lq INSTRUCTIONS a. This ppplicatlon must be completely filled in by typewriter or in ink I~r. b. Pl~ pldn ~lng I~ation of I~ a~ of ~ildi~s ~ premiss, mloti~lp ~ ~jMnl~ pm~ ~ ~1~ It~ts or or~ .~ glvi~ a ~H~ ~Krl~l~ Of I~t M p~ must ~ dm~ ~ t~ dl~ ~h M ~ M ~k ~l~ti~. d. U~ ~al of ~is a~llcatl~, the Building Inc~ctor will I.ue ~all ~ k~t ~ the p~l.s a~llable ~r i~tion th~gho~ the p~w of t~ e. No building sh~ll be occupied or used In whole or in part for any pumoee whatever until o C~rtlflc~te of Occupmncy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, end other applicable Lawl, Oedinencse m Regulations, for the construction of bulldlngl, additions or alterations, or for rem~al or demolition, ee hel~In 41secrlbed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and reguhitl~ns, (Signature cf appllcaJ~,, or name, If a oMIxJ~tlen) ...... ............... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contreetor, eleJtrl¢lan, plumber or I~llder. .................................... ,om. of of p,mlse, .......... .............................................. If applicant is a cori~rate, signature of duly authorized officer. CName and title'of corporate officer) ~"/7//,~ ,~' fl',~iq/j'Ojj~ I. Location of land on which propo~cl work will be done. Map No.: ......-~..~'.~...q. .................. I, mt No.:........................ Street and Number ...~..i./l.~.ff---~........~../~./~. ................................. ~(i~.~...~.....~.'..~...~.~. .......................... / 5 0 _~ MUnicipality State existing use a.nd occupancy of premises and intenc~d use and occupancy of praised r~xisting use and occupancy ................................................................................................................................... ,nt,nded use and occupant, ....../......~..i~'./g/~../:/..)L- ........ ~......(~...~.~..,//..J./~..~,, ............................................... Nature of walk (check which applicable): New Building ,.~. ........... Addition .................. Alteration .............. Repair .................. Removal ..................Demolition .................. Other Work (Describe) ...................................... t~..~° . Estimated Cost .......... .~ ............................................. tee .......................................................................................... (to be paid on fi~ing this application) If dwelllng, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. If business, commercial or mixed OCcupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .............. Height ........................ Number of Stories ....................................................................................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ : ~)epth ................................ Height ............................ Number of Sfories ................................ Dimensions of entire new construction: Front ...~....'~.....~. ................ Rear .....'~...~..-~....J...~'...*.... Depth .~......~..?....-~.....~..... Height ...... /~.. ....... Number of Stories ...................................................................................................................... 9. 'Size of lot:Front ........................... / o ~ Rear ........ /...~..~. ............... Depth ........ ./..~.~ ............. ~0. Dote of Purchase ..~C.E.~ ........ /.~...;M.. .............. Nome of Former O~ner ....~'[~-4~.. ............................. 1 1.. Zone or use district in which premises are situated ..................................................................................................... 12.' Does proposed construction violate any zoning law, ordinance '. ..................................... ~ ...................... o, .er o,,r.m,. ,o ..................... Name of Architect "tl"'~ .......................... ~'~ .................. Address ....................................... ;;... Phone No ..................... , Name of Contractor (.~..ffff.~l..'-.......[~..l~J......Address ..W..x~.~..~..../~..~./4d~'~ne No..'~D~..~. ..... Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate all set4~ack dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. COUrt__OF .............................[ ,~ .... ~~.~~~~.~ ......................... being duly sworn, d~es and says t~t he is the applicant (Na~ of individual signing a~[ic~tipn) 0~o~. ,.med... ~, ~...E.e..~~~..~ ................................................. :, ....................................................... (Contractor, ag~t, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfo~ed the ~id work and to ~ke and file this application; that all statements contained in this a~lication are tree to the best of his knowledge and belief; and that the work will ~ performed in the,mann~ set fo~h in the appliCati~ fil~ therein. Swam to ~fore ~ ~is ~ J_ ~ ~~ ~..~~.~....~ ....... No~*e/~ubll ... . .....· ........... C~ {$i~nomr~ o{ opplicanfl ~ .......... ,,'n©.l~A n T B UI L DER,~ oNT- E/_Ek'/T/OM SCALE. V.~"-- t~-0" ~E/l~ EL£-P~T/o/V /?/C~/:/? .S/DE EL E~4 T/O/V R 0 t~,~lA R T B UI L D£/~'~ .SECT/ON ',! B uI L D£/2_.-,e ROM4R7'- ££oor ,SCALE PLA N U IYEX C,~ V~q T~ ~ t90 M ,4 ,n 7- B UI/DE,eS F-OUIYDATION PLAN · ~CAL E- y4'S I~-O"