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Home My WebLink About5341-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~RTIFI~TH OF ~CUPAM~ No Z-23082 Date JULY 6, 1994 THIS CERTIFIES that the building Location of Property. 755 HARBOR LANE House No. County Tax Map No. 1000 Section 97 Subdivision Block Filed Map No. DWELLING Street Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 9, 1971 pursuant to which Building Permit No. 5341-Z dated MAY 25, 1971 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 TWO CAR GARAGE* The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 9/20/1971- R. VILLA N/A *THIS UPDATES CO Z-4447 DATED NOVEMBER 3, 1971, ' ~Ju ~ ~ di/ng~I'I~n spect or Rev. 1/81 FELIX ALFANO N-905209 FOlt~ 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) N? 5341 Z Permission is hereby granted to: ................. ~,4L~..,~ou~bl3c. ................................... .......... ~.....~t.~..&~ ............................... ............... {.,..~l~l,l,p ............................................. to . ..~d,. IIM.. ~11 .. f&ll.1~...~e.~l~& ................................................................................ at premises located at .......&e~,ekL~..I,C.~..~/~....~13~..,~,l~ ................................................... pursuant to application dated ........................ F~. ....... ~.~ ................ , 19.~.~..., and approved by the Building Inspector. Building Inspector/ Ae · ..'- ·Form No.'6 .. '. TOWN OF soUTHoLD BUILDINO DEPART~ENT . .TO~NHALL · 765-~802 . "' ': APPLICATION'FOR' CE~TZ~fCATE OF OCCUPANCY This application must be filled in. b~'"'t~pewriter OR ink and s~bmitted to the building Inspector with the following: for new bu/l~in.8 or new'user 1. Final survey of property with.aacuret~ location of all buildings~ property lines~' "streets, and unusual natural or toposraphic featu'res. 2.. Final A~proval from Health Dept. of water supply and sewerage-disposal(S-9 3. Approval of-electrical installation from'Board of Fire Unaerwrtcers. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2}10 of 1~ lead.' · ' ' $. Commercial building, /ndustrial build'nS; multiple residences and similar bulldin.gs and installations~ a certificate of Code Compliance from architect or e~Sineer' responsible for the building. , . , , '6. Submit Planning Bo&rd App~o~al.@f'comPle~ed site plan r~qu~rements. ¥or sxisting buildings (prior to' April 9,. 1957) non£'~onforming uses, or bu//dlm~s and ~'pre-existing- land uses= "?!!i:!?ii:: :: ::::::: :: ::ri :::i ' o pro P Y mpleted application and a con,eh= 'to 'inspect's~gned by ~he applican~ If a Certificate of Occupancy 'ia' denied, ~he B~ll~ing Inspector shall state the reasons therefor in writing to ~hs ~ppltcenti'' C. Fees '- '. 1. Certificate of Occupancy - New dwelling' $~.00, Add~llons to dwelling $25.00, " Alterations =o dwelling $25.00, S~/mming pool $25.00, Accessory buildin~ $25.00, Additions to accessory build~ug $25.00.. Businesses $~0.00, 2. Certificats'of Occupancy on Pre-extstin§ Bu~ldin$ - $~00.00 ~ Copy of Certificate of Occupancy -.$5.00 over 5 yea:s~ ~ $10.00 , ~ Updated Certificate of Occupancy - $50.0~ " . ~. Temporary Certificate of O - ' . '. . ccupancy ~e~iden:!al. SF'00,/C°m~ercial $~-00 ' .' .. . . . tt. ..... ao~.. ~o.' ' , i[;;.'Cv' ............................... Haan-et ;ubdivision .................................... F,i,,/~,d Hap ............ Lot ...... ' ................ ial~h Dept Approval ' e , ' .... ''''~ ................ Unde~rtters Approval ......................... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy ............ · ~ Date ......... THIS CERTIFIES that the building located at~.ll.,../4.~.~. ~/. ~.[~.[~0~.,.~.,~.'... Street Map No....~..~1, .... BlockNo...X.* .... LotNo. X.~ .~.b.~~ ..... conforms subst~tially to the Application for Buil~g Permit heretofore filed in this office dated .....~ A J..~ .... , 19~. p~su~t to which Build~g Permit No. ~.~ dated ....... ~.~..~ ..... , 19~.(, was issued, ~d conforms to all of the requ~e- ments of ~e appH~ble pro~sions of the law. The occup~cy for which ~ ce~fficate ~ issued ~ ~/~.I.V. A~..~.~.~4.1~.~.~l .... ~.~4~ ~ ............. The certfficate is ~sued to ~../~~ ~ (owner, 1~) of ~e ~oresad b~ding. S~olk CoWry bepa~ment of Health Approv~ ~. ~. ~..~ ~. 7/... ~.. ~-~ /~.~- ~ 7~'"~'" Building Inspector / SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date SEP 20 197~ Bldg. Permit No. TO WHOM IT MAY CONCERN: at ~ The sewase disposal facilities for (Oive deed location) a structure located have been inspected by this department aud found to be satisf~t~y.~: District SEP, 2 0 197! SUFFOLK COUNTY DEPARTMENT OF HEALTH EASTERN DISTRICT, RIVERHEAD,N.y. APPLICATION FOE APPRf~¢AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,pertinent data herewith: Date 1-Applicant A~,Scg ~ X/o u~-/< Phon/Z"/~J-~ 6-Sub div - Address ~ ¢~,~/~z/~' ~4~/'~ ~-~/~'z./,/_~ 4/F' //2~ 7-Section,- 2-Detailed property'location~/~/~^,~b,~'~.~, z~j, '~/~ ,~,~,,, ,f,~ 8-Lot No. - Hamlet r.."u~-c/-,a~- e~-Ueg. Town $<.,c~'-~ ~,.~ 9-Private well? 3-Public w~ter supply name ~ Distance to nearest main 4-Lot Size: Width~ ft. Length4'$~ ft. (also enter on center plot plan below:) 5-Dwelling: ~e~ingle Family ~ Two Family? I-/Cellar? l%'~l,Slab? l~lCrawl Space? lO-Proposed system: Septic tank ~ lPrecast l~'/Cesspools ~ YShallow pools · yOther 11-Septic tank inside dimensions: Volume Gals. Length ft. Width ft. Liquid depth 12-Precast sections: ~2lNumber/ /SqUare Ft. Cesspools: Block sizeL incs~ ins. H Total blocks below inlet: ~1_~_~2 (f~ $3 PLOT PLAN .Grade The Undersigned CERTIFIES: H.D. Reference No~--~2~~ . / ins. / Indi~ ,ate No 'th "Construction of authorized installations will be in Data ~eet 0 2 4 6 8 10 12 76 accordance with the Suffolk County Health Departments' current Stand=rds Bulletins e ,ents thereto, oovering Pri ate Se g Disposal 7 FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date (10/65 Revis. ) Signed TOWN OF souTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE m,ned ...... 1,2(... Approved ........................................ , 19..'..~.... Permit No... ~.....~......L~......(.....,,.~,,._~ Disapproved a/c ....................................................... __ (Building Insp~tor) APPLICATION FOR BUILDING PERMII' ~ ......... ............. ............... ,19.Z./ ...... Date INSTRUCTIONS This application must be completely filled in by typewriter or in ink und submitted in d~plicato to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to edjainlng premlees or laublic streets or areas, and giving a detailed description of layout of pmparty must be drawn on th~ diagram wh]ch Il part of ~hle 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 Clrtlflcate of O~upancy~) shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Degartment for the issuance of a Bulldlna Permit Dumuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or ~R.egulations, for the construction of buildings, additions or alterations, or for removal ar demo t on, Il hem n described .ne applicant agrees to comply with all applicable laws, ordinanc~atlons ............. ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............ ..~..~......~.f?...~../~.. ...... ~ ................................. If applicant Is a corporate, signature of duly authorized officer. ~4~ (Name and tltle'of corporate officer) ~ )~/ 1. ~ation of land on which proposed ~rk will ~ done. Map No ~ ............ ~No.' ................ ~ _ ~&~ ~/Oe o~ / ~o~ A~ I ~ C~ ........ ~ 2. e I 9 o. ~i~ting u~ ~ ~uBon~ ..................................... ~ ...................................................................................... b. Intend~ use ond ~cupan? ~e~ R~/~ ~ ~C ~ , Nature of (check which applicable).~,~w BuildingS,Lcd..... ......... Addition ................. Alteration ............. Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost .... ..~....~...4~..~...~. ........................... Fee ....................................................................................... o,~e F'.4~,x.¥ tto~.~. (to be paid on fi".ing this application) 5. If dwelling, number of dwelling units ~.~R.o'~,.~...~...~..~umber 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. Dimensions of existing structures, if any:,rm.m~' .....~'..o..../?....~.. ......... 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 ....... .~.....°....~. ........... Depth .....~..?...~ .......... Height ...[~..~. ......... Number of Stories ......o.../?....e:... ...................................................................................................... 9. Size of lot: Front .......x~..~..( ......... Rear ............. ~../. ........ Depth ...~k~/~/~.~.~.........'~......'~ 10. Date of Purchase ....(~...¢...~...../../....../..~....~..~. ............... Nome of Former Owner ..~'.~/..~..Z:../..~../~'........~../T:~..../~..Z.../.../~....~'....- ! 1. Zone or use district in which premises are situated .....~.~..~/..~..?..~.-/:../...~..~-~ ...................................... ~ ...................... 12. Does proposed construction viol~,te any zoning law, ordinance or regulation.;) ..... .4/..~.. ............................................... 13. Name of Owner of premises .~...~...¥.~......./~..°....~....~...E:...¥..~'...Address ..'te..5(....E.//~.E'J~J'./..~...~...~...~.. Phone N o.~'..~. Z../..~.../...~..~'". ~ Name of Architect ..~.../..~..../~.,5.. o~' ~' /~'~;./j~ Address ~'~/d'~' /J'/-/,? Phone No. Name of Contractor ..~'.~.....~.~...~...~.~..f../../f~....~....u'..c. Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate 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 comer Jot. ~l~eev- STATE OF NEW'YORK, ,. COUNTY OF ..~ ...... ,f"*~' ......... ./~...~.~..E.~..~../'~..~.'..-../~'..E-~.....~...~...../~... ............................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....... ..~...~..~...~...~..../~....~. ........ ~.~...~...'~'....~'...~.....c....7T'..°..../~... ....................... : ......................................................... (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; teat all statements contained in this application 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. Swam to before me this ........... ........... ............. ~1~1.'~ .......................... Counh, (S~ature of applicant)