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Home My WebLink About6080-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. z~126 ...... Date ............. Ma~' .....:~ ....., 19. THIS CERTIFIES that the building located at l~ew. Sttt. f.. Ave. &. Meado~ L itreet Map No~4a.t.~.a..g~.~.~. Block No ........... Lot No...~.~... l~ttt:tl:u~=k., ll o¥.o ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Aug..-aS.. , 19.?a. pursuant to which Building Permit No .... 6080~. dated ........... A'ag-..28 .... , 19. ?3., 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 ?r~vat~..one. Saintly..dwe&l~ng ........................................ The certificate is issued to .. F~.ttituck. Estates .Inc ...... ~,rne~ ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...E~....~...~.973 .... bY..R :..V~i..a... UNDERWRITERS CERTIFICATE No....lq' .~49~,9.. Ap~.. - ~JS..1973 .................... HOUSE NUMBER...~60.~. ..... Street... ]JEW. 8llf, f-olk'. Ave ............................ .................. ............. 4.egao ...r n..e ................................ Building Inspector FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL CO~MPLETION OF THE WORK AUTHORIZED) No. 6080 Z Permission is hereby granted to: .... ~,....*..ks.~.....~ .~.....~..~..s.~k..~....~.~ z~, to B*dJ.Xd. nov e~e gmM.~ aWelliz~ at premises located at ....... ~i1~....~.~..~.~1~1;..~.11~.~ ................................................................. .......................................... .~...~..e.~..~..~.~....~...~ .......... ~.s.~ ................ pursuant to application dated ..................... ..~....~. ....... .~..~.. .............. , 19....~..., and approved by the Building Inspector. Fee $.bJ~.6.~ ........... Building FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 duplicate 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 form 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), No~-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 $5.00 / 3. Copy of certificate of occupancy $1.00 blew Building .................... Old or Pre-existing Buildlng ............................ ¥ocont Land ............................ L n P O ner Or O ners Property Subdivision ..~...~~...~....Lot No...~..~'ock No ...... ...~.... House No.?..~...°....~.'. Permit No..~..O..~.....~.....'~e_ Of Permit .~...~.¢~../,/~p'pplicant .... ..~...?...~.......~..l~"~ ......................... Health Dept. Approval ...../..~...~.~...~'"'--' ....... '--'~.[.~...L~.......Labor Dept. Approval ........ '-~-~.~....[..~...~' '~-~ .......................... Underwriters Approval ...... ~. .......... ~......~. ................ Planning Board Approval ..~... ................................. Request For Temporary Certificate ........................................ Final Certificate ......~ .................... Fee Submitted $ ......~/. ............................ Construction on above described building and peri, tjx'roe, ets all applicable ¢,es:les and regulations. Sworn to before me this .......... ~doyo ..... ~. .......... ~....~... (stamp or seal) Nota~ Public ..................... Z ............. Coun~ Examined ..~.......~......~.. ............ Approved ........................................ , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 .?....'~. 19.:.!.... Pemit No...~...g.....~.....~..~ .... Disapproved a/c ............................................................................................ ............. ................................. * APPLICATION FOR BUILDING PERMIT k~ ~ ,~ . August 28 .. 7~\ ~' L~Ote ................................................ · lY ......... ~ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspecto i~ 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 area.~ giving a detailed description of layout of property must be drawn on diagram which is part of this applicatiom ~ 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 k e the premises available for inspection throughout the work. I e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buildin Zone Ordinance of the Town of Southold, Suffo[k 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. X (Signature of applicant, or name, if a corporation) Mattituck N.Y. State whether applicant is owner, lessee, agent, architect, engineer,~ general contractor, electrician, plumber or builder~ ............................................... ,~£.'t c~a: ................................................................................................................................ Name of owner of premises ..E~¥ei.~e~...~s~a'bes...~r:c ......................... : .................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: .l~.t,.~.~.t, Lot No ...... ~. ...................................... Street and Number New Suffolk ~ve & 1,1eado~,,~ Lane 1,:attitu~k Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....vAc~a°.;t...-~c~t ......................................................................................................... b. Intended use and occupancy ....ar~e...£amd,~;.~lw~.l.:t.i.~ ................................... ~~ .......... ~ 3. Nature of work (check which applicable): New Building ..~ ........... Addition ..................... Alteration .......... Repair Removal ......................... Demolition ........................ Other Work (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ...(~e ....... Number of dwelling units on each floor ......................................... If garage, number of cars ..... ..2......~D.~.~' .................................................................................................................... 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 ............ .~J~. ....... Rear ................ ~8 ....... Depth ....... ~,5'.~'. ............. Height ......................................... ~ ....... Number of Stories ...... .o..~.e. ............................................................................ 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 ..................................... .~......~.3.~.[ ............................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... ~Q ............................................. 13. Will lot beregraded-....~.~. ....................... Will excess fill be removed from premiSes: [ ] Yes [ ~No 14. Name of Owner of premises ..... .~.{...?c.[ ~ ~ .c..~.....~..s..~..~..~...e..s....~ .~..c. ................ ~.~ .t,..~ ~..~..~. c...~. .......................................... (Address) (Phone No.) Name of Architect ................................................................................. ....... . . .... . .~ ............................................. . .. .... (Address) (Phone No.) (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, COUNTY OF .............. ~ '~t,~,, ~'43 ,.~,,_~ .................... ~.~W' o ~3. t;~. being duly sworn, deposes and says that he is the applicant above named. (Name o£ individual signing contract) He is the ............................................................. ~-~.j:..3.~.~.~ ................................................................................................................................. (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 a~p, lical~.~.lTa~e?tr~l~Nthe best of his knowledge and belief; and that the work w II be performed in the manner set forth m the apphcat~on filed t~er~l~h e of New '-u,~4~F~3 Suffolk County ~_ ......................... ................ SUFFOLK COUNTY DEPARTHENT OF HEALTH HoDoReference No,~/~-//~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,pertinent data herewith: 1-Applicant .~- ~ ~._4 ~ v ;_ Address · ..... ~ ~ --~.~._~ . ~. ~ ,- 2-Detailed ~'roPerty' 10cat~0n Hamlet Town 3-Public water supply name ~1 ,,, ' ' 7-Section' ' 8-Lot No. 9-Private well? V~, Distance to nearest main 4-Lot Size: Width_~ft. Length ~.2~z_ft. (also enter on center plot plan below:) 5-Dwelling: . Single Family ~M~ Two Family? ~_~Cellar? ~.Slab? ~ ~Crawl Space? ~ ~ 10-Proposed system: Septic tank ~ ~Precast ~CesspoOls ~ yShallow pools ~ yOther ~ il-Septic tank inside dimensions: Volume~gGals.Length ft. Width ft. Liquid depth 12-Precast sections: ~ z~Number ,~. Square Ft. Cesspools: Block sizeL incs. D ins. H Total blocks below inlet: PLOT PLAN ! ins. Capacity Gals. G.P.M. Street The Undersigned CERTIFIES: IndJ N( ~e ~th Data ~eet 0 2 , ~] ~ .~'¢~ 6 ,A'. ""8 ~' ,~¢ 10 18 "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". / ' Owner or Build~r FOR HEALTH DEPART~NT USE ONLY. Based 9n the information presented herewith, it' is the opinion of the Health Department, that an adeq~dat~ and satisfactor~ewage Disposal System can be installed on this Plot. APPLICATION FOR APPRUYAL TO CONSTRUCT PP~IVATE sEWAGE DISPOSAL ~/STEM~ INSTRUCTIONS: Applications must be submitted in triplicate i-Means Owner or Bntlder. 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 Bamlet/Village & Township 3-Enter name of Public Water Supply District, together with the distance to their main. 4-E~ter Length and Width of Lot under appropriate heading, also enter these dimensions on center plot plan shown on the face of this application. ~-Dwellings: Check-mark "V" items applicable to the proposed new dwelling. 6-Name of sub-division ?-Section Number 8-Lot Number 9-Private well: Enter "No# if Public water supply is available. Enter "Yes" otherwise. PROPOSED SYSTEMS: Answers to Items ~,,m~er 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 Part IV " " " " " " Unusual soil conditions Part V " " . " " " Shallow Leaching Pools PLOT PLAN: The following information is required concerning the Applicant's Lot: Lot size-Length and Width in feet to be indicated at the Lot lines of the heavy lined square in the center of Plot Plan shown on face of this appliCation. 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 aTso. 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 adjacent 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-lO0 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 followin~ Standards must be observed for the location of same: Cesspool-lO feet minimum distance from lot lines to center of cesspool Cesspools exterior must be I00 feet m~.,n..i~a~e from nearest well Septic tank exterior must be 75 fe?,~.~e~'~ Cesspool "Center" must be 12 feet ~~$~g 'i~r~ nearest water line Cesspool "Center" must be 15 feet from house foundation Cesspool exterior must be 50 fee~d~u~i~.t~nc~r~surface Waters, Stream% Lakes & Bays, etc. ns.II nv ,,' -- . Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center mua~.~e, af.l~ 16 feet ' Cesspool cover top to grade must be h~~ of ~ food to muxi~ma of 2 feet Bottom of Cesspool to ground water must be held to minimum of 1 foot A/EH '/ Lot 44 SUFFOz K /VO T£: REVISIONS ,IUNE 7, ~972 NOV. 1~.~1972 · = MONUI~EN T SUBDIVISION h~AP F OF THE CLERK OF S, SEPT. 8, 19~5 AS t4~ SURVEY FOR EDWARD LOT 45 -r O~r ? Lo! 44 N86°~ SUFFoL The sewage disposal and wa~er supply facilities for this location have been inspected by this department and found Chief of General Engineering Services m: ,~ONUI~EN T SUBDIVISION ktAP FILED IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON SEPT. 8, 1965 AS MAP NO, 445~$. REV'S,ONS YOUNG & YOUNG JUNE ?~1972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK NOV, 14,1972 ALDEN W, YOUNG HOWARD W, YOUNG SURVEY FOR: EDWARD G. ABITZ.../~"-~..o , ,"~ MATTITUCK ~ow. o~ SOUTHOLD