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Home My WebLink About6068-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~08 ...... Date ............ ][O~lllb®l'.. ~0., lg..~ THIS CERTIFIES that the building located at . .l~l~l'. I)~.~ ............ Street Map No. /~1,. [It~'el~k)ck No ........... Lot No...~0 ..... /~3~®1 ..... ][,~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... &~g...¶i~ .... , 19.72 pursuant to which Building Permit No..60~8~- . dated .......... &~lg..2~ ..... , 19. F.2, 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 .. l~l'iyate, oele. falaily, dwelling ..................................... The certificate is issued to . · AI~. MaC~abj ........ O~ne~. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... ~t. ~..¶9?2 · .by II..~'~lla .... UNDERWRITERS CERTIFICATE No... 1[. ~'.l.~.. 1}1.0~. ~ ] .11'..197~ ....................... HOUSE NUMBER...¶1~'00 ...... Street ....]~],IlMI~..l~l'],.~'~ .............................. Building Inspector ~ ~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6068 Z Permission is hereby granted to: to ~ -. ............................................................ :2 ................ :1 . /~00 'DEL ~^~ ~-~¢~v'~~ ot premises Iocoted at ............................................................................................................................ k AL~r~'~ L_ /~ .~-~' . A pumuent to opplicetion deted 19/~nd opprov~ by the Building Inspector. Fee $ ........................ PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES ~,~,/ F, EGRAC4NG LOT DRIVEWAY CONS~rRUcTION CESSPOOL CONS rRUCTION CELLAR CONSTRUCTION OTHER Building Inspector FORM NO, 6 TOWN OF SOUTHOLD Building Delm~tment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 farm or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, 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 property 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 in- formation 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 10/28/72 New Building ....... .~ .......... Old or Pre-existing Building ............................ Vacant Land ............................ 1400 Delmar Driver Lot #50x Laurel~ ~ Location Of Property ....................................................... ~. ....................................................................... Owner Or Owners Of Property ......... ..A~.....a~....M...c..C....o~....b..s. ................................................................................. Subdivision ..... ..L~...t~-e...~.....C..°..~...n:.~.z~....~.~.~.a...~..e...s......Lot No....~.Q.... Block No ............. House No...[.4...QQ.. Permit No..6...0..6...8..Z.. ....... Date Of Permit ...8../...~..5./...7..~..Applicant ...T~g~..,%~.~...~llt~e. gj...~TI.C,., ..................... Health Dept. Approval ....... ~.Q/27/.7..2. ................. Labor Dept. Approval ................................................ Underwriters Approval ....... ~,~/.9/.7..~. ...................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ................ ..Y...e..s. .................. Fee Submitted $ .............. 5...t..O..O.. ............ Construction on above described building and permit meets all applicable codes and regulations. Notary Public ....~R:~.... County Sworn to before me this .... /.Z... ..... do¥of ..... ...... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ab BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~ ""'" November lb, 1972 .4ppUcat'on~o.o,,/"~0~235 N 551 55 THIS CERTIFIES THAT only the electrical equipment: as described below and introduced by the applicant named on the above application number in the premises of McCombes, e/s Delmar Dr., n/o Joseph St.,Job 161, Laurel, L.I. int~,o/oll,,wi,,~location; [~ Basement X[~ I,t~'~. [] ~nd rt. Outside section ~lo~k rot .,.~..,nlnedon November 9, 1972 and found to be ln rompliance with tbe requirentents of this lloard. FIXTURE FIXTURES RANGES ~.OOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 16 16 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: Motor/s: 1-3/4hp *Furnace/s: Oil, E R V I C NO, OF CC, COND, A, W.G. NO, OII HI.[~G NO. OF IqEUTRAL$ A.W. G PER ~' OF CC, COND. OF NEUTRAL i 2 i 4 1-1/Shp 2-1/12bp ~! L$ Park Plac.e ...... GEN~:RALMAFiAGER ~ patchogue, ~,.±.~±~lz i ~ ~ Per ~' ~ ~This cedi~ico~ m~st not bo ~lt~r~d in any monner; r~t~rn to th~ offie~ o~ ~h~ Board i~ Mco~reet. Inspectors m~y b~ identified by 'lheir credentials SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No~-///~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date 7/L~/72 Approval to const.r~ct said systems is requested,pertinent data herewith: l_ApplicantAlan Mc Com~ Phone 6-Sub div La~ Cottutr~F~tat~ Address 240 P~a AWls. F~:I~ 7-Section 2-Detailed property locatio~E/$ D~lmar Hamlet T~ Town So%ttB~d .9-Private well? X 3-Public water supply name Distance to nearest main 4-Lot Size: Widthl40 ft. Length~5~ ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~ ~ Two Family? lO-Proposed system: Septic tank ~ ./Precast~_/Cesspools ~_/Shallow pools / /Other / / Vo lume ~Gals.Length ft. Width ft. Liquid depth ft. ii-Septic tank inside dimensions: 12-Precast sections: /...~mber/ /Square Ft. Cesspools: Block sizeL-~- incs.D8 ins. H8 ins. Total blocks below inlet. ~LI~O~O PLOT PLAN , Grade G ,W.L. Street N Capacity ~C,a 1 s. G.P.M. ~ -J ;ate ~th Data ?ee~ 0 2 4 6 8 10 12 14 ~6 18 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". Date 7/~/7~ Signed INL~t~D tIOME~, INC./Do10~$~ Schombm, $®~retat-y Owner or Build~r~ ,, , .( /' FOR ~ALTH DEPA~T~NT USE ONLY. Based on the info~ation presented here~th, it is the opinion of the Health De~ment, that an adequate and satisfacto~ Se~Ee Dts~sal System can be installed on this Plot. ~ Date ~~ Si~n~ (10/65 Revis.) S-15 APPLICATION FOR APPROVAL TO CONSTRNCT PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate i-Means Owner or Builder. Address to w~ich mail should be directed. 2-Means detailed description of property location, together with street name and distance to nearest intersection of main thorofare, also Hamlet/Village & Township 3-Enter name of Public Water Supply District, together with the distance to their main. 4-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 '~" items applicable to the proposed new dwelling. 6-Name of sub-di~r~sion ?-Section Number ~' 8~Lot ~Number 9-Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. PROPOSED SYSTEMS: Answers to Items number 10, ll, & 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 " " ~ " " " Septic Tanks Part IV " " " " " " UnUsual soil conditions Part V " " " " " " Shallow Leaching Pools PI~)T PLAN: The following information is required concerning the Applicant's Lot: Lot size-Length and Width in feet to be i~dicated at the LOt lines of the heavy lined square in the center of Plot Plan~ shown on face 9f th~s a~plication. Surface 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. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. Where no Buildings exist on adjacen~ lots, state "Vacant" on the plot plan. Streets adjoining applicant'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-10 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-4 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 mini..m.,u~,~..d~n~ from nearest well Septic tank exterior must be 75 feet f~ ~~l~ Cesspool Center must be 12 feet m~ ~s~ance from nearest water line Cesspool "Center# must be 15 feet from house foundation Cesspool exterior m~t~ be ~ ~ II n~ v~ feet ~ni~m,~s~c~' o~urface Waters, Streams, Lakes & Bays, etc. ~. Cesspools must be 20 feet' ~ainimU~diStance from large trees Cesspool center to Cesspool cent~ m~st~.~~t~st~ ~6 feet Cesspool cover top to grade must be he J ki i%f 1 food to ximum of feet Bottom of Cesspool to ground water must be held to minimum of 1 foot NOTE: · =' MONUMENT TNEOFFICE ~ Ot 5~ SUBDIVISION MAP FILED IN OF THE CL-ml~/~ OF SUFFOLK COUNTY ON dUNE R~Ig?O AS RLENO. 5~BS, \ R~V,S,ON$ YOUNG & YOUNG 400 OSTRANDER AVENUE, RiVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES,INC. LOT ,50" LAUREL COUNTRY ESTATES" AT GUARANTEED TO: LAUREL TOWN OF SOUTHOLD SUFFOLK CO., N,Y. "Y SCALE: 1~, 0 ~ DATE: I NO. = 4 MAR. 27, 1972 72-221 SUFFOLK COUNTY 5BALT]{ D~PART~%' m"'~~ ~i '&gTZ ~.D. ~. DATE ~u' -- ' -- The se~ge disposal=and water sup~l~ faclli%lss for th~ ~t~cture located aZ Cot ~9 NOTE: SUBDIVISION MA~ F/LED IN OF Fff~ CL~NK OF $&cFFOLK ~OUN KY ON dUNF RR,;gFO A$/qL~A~. Lot .51 ~ a~V,S,ONS YOUNG & YOUNG MAR. 29,19T2 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SEPT. Il, 1972 ALDEN W, YOUNG HOWARD W. YOUNG OCT, 5~ J972 PROFESSIONAL ENGINEER AND LAND SURVEYOR SURVEY FO[?: INLAND ,H, OM ES,INC. ~ LOT 50 LAUREL COUNTRY E,~,~o~,~...~, :. ;.o~,~ A~ LAUREL ~ ~l ~ ~ ~.~ ~. :o. TOW~O, SOUTHOLD ~5~:~,,~ / SUFFOLK CO., N.Y. s~ ~~ Disapproved a/c ................ ~,, ......................................................................... (~o (~' (Building Inspector) APPLICATION FOR BUILDING PERMIT No. TOWN OF SOUTHOLD "UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19....':.. Appli N ............ ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate t~ the Building Inspector,;~ith~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ~ / b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas,~ndl giving a detailed description of layout of property must be drawn on diagram which is part 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 kep~on~ the premises available for inspection throughout 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 b~'~n granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zbne 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, and to admit authorized inspectors on premises and in buildings for necessary inspections. . (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................................................................................................ If applicant is a corporate, signature of duly authorized officer. ..................... :.: :.: :_. :._.::.:. ................. 1. Location of land on which prop(~sed work will be done. Map No.: ...~ ......... t Lo No .............................................. Street and Number 1/111 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy .................................................................................................................................... Intended use and occupancy ................................................................................................................................ ~.,~ Nature of work (check which applicable): New Building ........ ~, ............ Addition ..................... Alteration ............... Repair ............ - ............ Remo I ......................... De olrtion ........................ Other Work (Description) 4. Estimated Cost .......~..e~ ..~.. ......................... Fee ................................................................................................. (to be paid on filing 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, 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 Stories ........................................ 8. Dimensions of entire new construction: Front ......~..~..~.. ........... Rear ..... ..~...I...~.. ............. Depth ....... ..~... ..................... Height ................ ~. ............................. Number of Stories ................. ~. ..................................................................... 9. Size of lot: Front ........ ~ ........................ Rear .............. ~ ...................... Depth .............. ~ .............................. Height .................................................... Number of Stories ...................................................................................... 10, Date of Purchase ............... ~ ..................... Name of Former Owner ..~.~ .......................................... 11. Zone or use district in Which premises are situated ..................................................................................................... 12. Does proposed constrbction violate any zoning law, ordinance or regulation: ................. ~ll ...................................... 13. Will lot be regraded ................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ~ ~ ~ ~ ..... ~ ~ ll~l.~Jl ~ll ~.~ (Address) (Phone No.) f r hltect ~1~ ~ll~e :lll~e ~11 4~ ~ ~ ~1~ ~ ~ Name o A c ' . ................................................................................................................................................... (Address) (Phone No.) Name of Contractor (Address) (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 wheth- er interior or corner lot. /~- · STATE OF NEW YORK, ) ,SS' COUNTY OF ......................................................) .............................. · ~. ........ .,[~,,~., .............. ~.¢~7,,.....~.. ......................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) (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 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. ...................................... day of .................................................. 19 ............. (Signature of applicant) I I f "o -1 ;I J