HomeMy WebLinkAbout5412-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate C~ Occupancy
Date JUne 2q 19~
THIS CERTIFIES that the building ................................................
Location of ProDerty 2405 Private Road #7 (Diedrick Rd.) Orient
- h3&~ hid ....................... 's'~i ....................... hJ;.i.i
County Tax Map No. 1000 Section ....1.8 ....... Block . .3. ............ Lot..2.7. .............
Subdivision X .Filed Map No. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore filed in this office dated
* see below # *
..................... ,19... pursuant to which Building Permit No ..................... ..
dated * 19 ., was issued, and conforms to an of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
...... .a..o.n.e..-.La.m.;; y..a.-. ? 3.~.~.~..g.. ................................................
The certificate is issued to DON & RUTHANNE GULLAKSON
(owner,4e~ee er-tenee~).
of the aforesaid building.
Suffolk County Department of Health Approval ..... .S.-. 9., .6/.2./. ? .2 .........................
UNDERWRITERS CERTIFICATE NO ............. .ff..3. ~ .8.2.3. ,..8./.2./.7.2 ...................
*B.P. 5412Z - C.O. Z4833, new dwelling
B.P. 5793Z - C.0.'Z7471, addition
B.F. 8046Z - Fence, ok on C.O. Z7471
Access approval, BA 1292 and BA 1302
Affidavit by Don Gullakson, 5/20/83
Building Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold,' N. Y.
Certificate Of Occupancy
t,up e o2 d nf ooz
No.Z.~.833 ....... Date .............. S~t. .... 2y.., 19 .~.
THIS CERTIFIES that the building located at ~ ~1~. II/~. ~ta~. ~ ..... Street
Map No.~eid~ek. l~]~lock No ........... Lot No..~1~..~'~1~.. ~e~, ............
conforms substantially to the ApplicatiOn for Building Permit heretofore filed in this office
dated .......... J.111y..19.., 19.~. pursuant to which Building Permit No..
dated ............. JuLy:.. 1.9., 1W. 1.., was issued, and conforms to all of the requ/re-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .Pr~,lmte. 4me. £a,ail~r..dwe.l.l. in8 ......................................
The certificate is issued to. l~eitb .14ear~s ....... 0~na~ ...........................
(owner, lessee or tenant)
of the aforesaid building.
S~olk County Department of Health Approval ...Jlme. 2. · 19~r~.. b7 .Re..~$~a...
UNDERWRITERS CERTIFICATE No .... Il..~3281 ......................................
HOUSE NUMBER, .~ ~5 ...... Street. ~i~ .Hoed .l~. ~...(De~,ok ~[~) ...........
Building InsPector
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? 5~12 Z
Permission is hereby granted to: KeJ~,~ ]JI~I~IB~
............... ~....~..3~...~t ..................................
to ..... ~.~..~..~...t~..~ ...............................................................................
at promises I~ated at ......... ~..~g~..~..~..~.~ ..............................
............................................. ~ ....... ~.X.~ ...................................................................................
pursua:n~ to application dated .......................... ~ ......... .].~. ......... , 19~...., and approv~ by the
Building Inspector.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. 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 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 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusua~ natural or
tOlx)graph 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 $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5,00
Da,e ..... ......
New Building ............. Old or Pre-existing Building ×× Vacant Land
Private Road #7 Orient
Location of Property ...................................................................
House No. Street Ham/er
Owneror Owners of Pr(~perty . Don and Ruthanne Gullakson
County Tax Map No. 1000 Section .... 0,~..8 ........ Block ........ 0.3. ..... Lot ........ O;~.7 .....
Subdivision .. ............................... Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate... ~ ................. Final Certificate .......................
Fee Submitted$ ~15~00 ) ' ' ' ' -
....... ..... ~; ........ '.:..~..'
Construction on above described building and permit meets all applicable codes and regulations.
Re~. 10-10-78
Applicant ....................................................
William H. Price, Jr., Attorney/Agent for
Don and Ruthanne Gullak~on ~
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. 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 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.
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.
C. 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
Date..~'"/. ,, .~'.~..../~. ~. ,~, . .
New Building . .~{~.~ ..... Old o,r Pre-existing Buildin~Q . .~ ......... Vacant Land .............
//
Location of Property... ~.~.~.~....~.'.~.~ .~.~...~...~.. ......................... .~.~.~..~'t..'~--
House No, Street Hamlet
Owner or Owners of Property .~.~.~t~/ ~....~..~I~.*/.. ~.~.~.~.~....~..~...~..~. ........
County Tax Map No. 1000 Section ...~..~.~. f .~..~... Block .. ~..~'..~..~ .... Lot. ~)~.~.:..~..~:~..~..
Subdivision ................................. Map No ............... Lot No ...............
Permit No..~'-..~../.~...~. Dateof Permit ~..~.~/~./...Applicant..~..~... ~.~./~..~':...~ .~....
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $.. ~.,...~.~. ....................
and permit meets all '
Construction on above described building ~latlons . [~:~ ~ .~. ,~.~,
Applicant .............
Rev. 10-10-78
SUFFOLK COUNTY DEPARTMENT OF HEALTH
EASTERN DISTRICT, RIVERHEAD, N. Y.
!
APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Dat~/~ 9'/7
/
Approval tn construct said systems is requested,pertinent data herewith:
1-Applicant /<~, 7(~ /./';?' ~ , , ~J~e, 6-Su~iv
2~Detai~d property locatxon ~ ~ ~ ~ ~ ~o ~- 8-Lot No.
Hamlet , ~A~9~ ~ ~A Town~.¢ ~/~;~ 9-Private well? ~
3-~b~ter supp~p~ ~'~'; '/1~ ''~' - ' Distance to nearest ~in' --
4-~t Size: Widt~t. Le~3~ ft. (also enter on center plot plan below:)
5-~elling: Singl~ Family ~/~ T~ Family7 ~ /Cellar7 ~ /~1~7 ; ~Crawl Since? / ~
lO-Pro~s~ syst~. Septic tank ~ /Precast y /Cesspools ~Shallow ~ols / /Other / /
ii-Septic ta~ inside dimensions: Vol~e Gals.Length ft. Width ft. Liquid depth ft.
eoUon : Ft. , zeL
Total blocks below inlet: $1 ~ ~2 ~ ~3
T PB~N
Street
Capacity ~ Gals.
G.P.M. ~
Indi
No
Data ~eet
0
2
8
10
12
~6
i8
The Undersign~ CERTIFIES: "Construction of authorized installations will be in~
accordance with the ouffolk County Health Departments' current Standards, Bu~l.l_~ins, /
and amendments thereto, covering Private Sewage ]~i~posal Syste~m~'.
· Owner or Builder
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 '~., . ~ Signed
S-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date J{J~ 2 1972
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
(O~ve deed ~/o/c~ion)
have been inspected by this department and found to be satisfactory.
Chief of General EngineerinM Services
JUN 2 1972
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiees or _public streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which Is I~rt of thi~ 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 Jn whole or in port 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 purduant to the*-
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, Grid other applicable ~ Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al heroin described. -.
The applicant agrees to comply with oil applicable laws, ordinances, building code, hOusing code, and regulations. :
Ke~th l~earns
(Signature cf applicant, or name, if a carl)oration)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulld~r.~
................................................... .0~,¢~3~ .................................................................................................................................. ~
Name of owner of premises ....~.~..~I,~3~G ...................................................................................................................
If applicant Is a corporate, s~gnature of duly authorized officer. ~
(Name and title'of corporate officer) ~
J. Location of land on which proposed work will be done. Map No.: ....~ ............................. lot No.: ..~ ...............
Street and Number .... .(.~.~..~,g~.l~il..~.Q~.~..~'L'...]~.~..~la~l~.~a.d,~,:..~t~....M,~, ....................
/ ~ ~ ~ ~gl Z)~> ~C I~' ~ D ~:~V'~ Munm~pall~
2. State existing use a~d occupancy of premises and intended use and occupbncy of proposed constru~lon:
a. Existing use and occupancy ..Y.&g.&~..~LG4I ......................................................................................................
Intended use and occupanc',. ...... ~..~L:l,~.¥...d~e.l.~..~K ............................................................................
3, Nature of wo~k (check which applicable): New Building ~r~'~ Addition Alteration
Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) .....................................
4. Estimated Cost .... .................................... Fee ....1...0..,...0..0. .......................................................................
(to be paid on fi',ing this application)
5. If dwelling, number of dwelling units ....... ,e~..e. .............. Number of dwelling units on each floor .......................
If garage, number of cars ....i.~...e.....(...t~...d...e.~...)' ...............................................................................................................
6. If buslne~, 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 ................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ...........................
Depth ................................ Height ........................... Number of S~'ories ................................
8. Dimensions of entire new construction: Front ............. 56.,6 .............. Rear ...... 56..-6 .......... Depth ..... ~.~..-..~. .........
1
Height ..................... Number of Stories ........ ~ ...........................................................................................................
9. Size of lot: Front ..... 2~64.¢J ........... Rear ...... 2.~6.'1'. .................... Depth .....1.Q6.,6..Z...t05.,8
10. Date of Purchase. ........................................................ Nome of Former Owner ...... .~........H..?..a.....~t....S. ............................
! I. Zone or use district in which premises are situated ...~.~[.t!...rl:[.S.t, ...............................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ............ .~.?. ...........................................
13. Name of Owner of premises ..[e.;t.t,,[3..~.{I,l~33,~ ......... Address ...~..Z:...e..I.~...]._.7~... ....................... Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No ....................
Name of Contractor ...... .~.~'.1~.ll~.~....}[..q~.e.~.....(..~..)3.e..:~,;l...)Address ...... ..~..a..~...e.~.l~..l~.7.....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 indicas'e
whether interior or~_corner~ii~ ;__-- _---_~_ .~ I~.~. ~ ~.~
STATE OF NEW' ~'_OJ~J~,.. tee
COUNTY OF ..... .~...~.....z..?....1~.... ..........
................................... ,[e.~.t~,..]~eaA~l- ............................... :be!rig, duly. sworn, deposes and says that he is the applicant
(Nome of individual signing application)
above named. He is the ....................... ~..e..~. ............................................................. · .........................................................
(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 alt statements contained in this application are true to the best of his knowledge end belief; and
tha~ the work will'be performed in the manner set forth in the application filed therewith.
Swam to before me this /
........................ <3 of ................................... ,19 ........
........
Natar'! Publi¢~~,~~.. Cou,~ ~/~ -(Slgna~Jr, e~of applicant) .
o, 52-8125850, Suffolk C01~llt,Z ·
Term Exi~ires'llll~lt 30, Zg~e~ '
I ~ow~ OF SO~TH D, ¥O/~K
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No. 1302 Dated Nove~r 3, 1969
(rehearing on &pp~al No. 1292)
ACTION OF THE ZONING BO~D OF APPE~S 0~ THE TOWN OF SOUTHOLD
~u~ 25
at a meeting of the Zoning Board of Appeals on N~ilt~r 13 ·
was considered and the action indicated below was taken on your
(X) Request for variance due to lack of access to property .
( ) Request for a special exception under the Zoning Ordinance
Request for a variance to the Zoning Ordinance
(
DATE]~ 13·196~.
Appellant
the appeal
1. SPECIAL EXCEPTION. By resolution of the Board it was detemined that a special exception ( ) be
granted ( ) be denied pursuant to Axticle .................... Section .................... Subsection .................... paragraph
.................... of the Zoning Ordinance and the decision of the Building Inspector ( ) be reversed ( ) be
corffirmed because 98 00 P.I~ (a. S. T. ), a rehearing on &ppeal No. 1292~
upo~ application o£ Harry and Evelyn laearns, Route 25. Orient· Ne~
Yo~ck, £or ~ovel o£ a.~ce~s to private road in accordance with the
State o£ New' Yo=k Town La~· Secl:lon 280Ao LocatJ.on o£ pcoperty8
l~J.vate r:Lqht-o£.-~ay o££ north s:Lde o£ Route 25· Or:lent, New York,
bounded north by land o£ applicant, east by Deidrtak, south by Hess·
west' by Brown & others.
2. VARIAiN'CE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) (would not) produce practical
hardship because
SEE REVERSE
difficulties or unnecessary
(b) The hardship created (is) (is not) unique and (would) (would not) be shared by ali properties
alike in the immediate vicinity of this property and in the same use district because
SEE REVERSE
(c) The variance (does) (does not) observe the spirit of the Ordinance and (would)
change the character of the district because
(would not)
and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and
that the previous decisions of the Building Inspector ( ) be confirmed ( ) be reversed.
FORM ZB4
SEE REVERSE
ZONING BOARD OF APPEALS
Betty Neville, Secretary
Southold Town Board of Appeals
After inveltigation and inspection the Board finds that the
applicant requests permission for ap[~roval of access over private
right-of-way in accordance with the State o£ Ne~ York Texan La~.
Section 280A. Previous appeal was made and approved at the last
meeting subject to the approval of Mr. Dei~rick on whose property
the right-of-way was to be re-located. Since 'that t~/ne Mz. Deidrick
has decided that he does not wish to re-locate tho right-of-way on
his property as planned. The applicant now proposes to have a
right-o~-way 16% ft. in width and 100 ft. in length running on~
his northerly property line. This proposed right-of-way will
~/ltercept the existing right-of-way (Deidrick's) o~ both sides,
therefore the Board feels that is is not. necessary to hnprove
the right-of-way the entire 100 ft. length.
The Board f~nds that strict application of the Ordinance will
produce practical difficulties or unnecessary hardship! the hardship
created is unique end would not be shared by all ~operties alike in
the /~ed~ate vicinity of this property and in the same use d~st~ict~
and the variance will not change the character of the district and
will, observe the spirit of the Or inance.
THERE~E, ~T WAS RESOLVED HarFy & ~velyn Mearns, ROute ~'
Orient, Ne~ York, be GP~D approve1 o~f access tO'private road
'in accorde~ce, with' the S~te of, New, York Town Law, Secti°n 2BOA,L_
as applied for o~ property located o~f north s~de of Route 25,'
Orient, New York.
Vote of the Board= Ayes~- Messrs= Gillispie, Bergen, Hulse,
Doyen.
M,~P 0 F"
l~ro~bh'r~
,E, ca/¢ : I0~)'= I"
~- TO~N OF SOU OLD, R
ACTION OF THE ZONJ~NG BOARD OF APPEALS
ACTION OF ?HE ZOmNG BOARD OF APFEA~,S OF THE TOWN OF SOUTHOLD
Appel]ant
at a meeting of the Zoning Board of Appeals on ~
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
) Request for a variance fo the Zoning Ordinance
)
the appeal
1. SPECIAL EXCEPTION. By resolution of the Board it was determined that a special exception ( ) be
granted ( ) be denied pursuant to Article .................... Section .................... Subsection .................... paragraph
.................... of the Zoning Ordinance and the decision of the Building Inspeeinr ( ) be reversed ( ) be
confirmed because ~1~0 ~e~e ~e~e~e~e )a ~ ~[~[t~J~J~[ O~ ~
~ll~ Heave, Routo 25a orlm~t, lwew Yo~k, for approval 0£
to ~lvate reed ~n accordance ,~lth the 8~ of ~ ~ ~n
2. VARIANCE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) (would not) produce
hardship because
SEE
practical difficulties
(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
(c) The variance (does) (does not) observe the spirit of the Ordinance and (would)
change the character of the district because
(would not)
and therefore, it was further determined that the requested variance ( ) be granted (
that the previous deeisiorm of the Building Inspector ( ) be confirmed ( ) be reversed.
) be denied and
FORM ZB4
ZONING BOARD OF APPEALS
Betty/Nov Lib ;~ Secretary
Southold Town Board of Appeal~
After ~vost~gat:~ou and ~poctAon tho Board finds ~t ~o
~ ~ ~ ~~v~y of ~ ~o~nd ~ ~ m
~e di~% ~d ~m v~n~ ~%ll not ~nge ~o ~a~ of
of ~1~. Mt%~ of ~~ ~%~M r~~my off ~
~ ~J~ ~ ~ fol~ c~t~
1. The r~ght-o£-way %w to lm propar%¥ de~cr~bed, wubJec~ to
the approval of tho Building :LUsl~Ctor, by Otto Van Tuy%, wurvoyor.
2. A %et.er %8 to be %~e%~ fram De~dr~ck, ~hooo property
and g~ve8 h~ perm~__aeAon.
3. Tho %~ght-Of~da~ must bU Improved, ~ubJoct ~o tho ~q~oval
~Jrlqon~.