The URL can be used to link to this page

Home My WebLink About6267-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~08~ ..... Date ............ Apt'SI, ....13 .... , 19. THIS CERTIFIES that the building located at ...De~mm~, '~l':[ve ........... Street Map No. la,ravel- C-t~I~,~i No ........... Lot No.. ~,.. la~ll'el ..... li.,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ liovembel~ ·. 211 19 'Ta' pursuant to which Building Permit No.. dated ........ 1~o~.. · 58 ..... , 19~2.., 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 .. Pr-:i,-va'c~..one- -f.a~t..ly 'dYe'DtSng ...................................... The certificate is issued to Laure.l, .Cour~try. Estates.-to. J~ph .Q~I,I~J~ .... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .~,pl'i.1. 1~,..~t)~.. by. R.o..V~,i.I~... UNDERWRITERS CERTIFICATE No..Il'. 80270.. ~r-. ~7" 973 ...................... [lOUSE NUMBER.. '1000 ...... Street .....D' e'l~ar. D-~vO .............................. .... Building Inspector FOR~[ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6267 Z Dote ....................... Iq ~.~h~b~.i¥ .~ B. ...... , 19.~2.. Permission is hereby granted to: Znl~n~...~.9~l~..;[~...~/.C..:Lau~l.,.Coa~t~.~..i~state ~ · ...~32....~l~ld~e..~tat~...~ea~ .................. ........... ~e~Laa ...... .~,L ........ 1..1.~.81,. .................. to .~l-~d..~e~..o~a..£a~&~,~~. .<l~e,3&.~-3g~ .................................................................................... at premises located at ..... .L...o..t;....~.,~. ....... ~l,~t~.~-...~.~.l~L~,:~y...!~.~;~a.~e.s ............................................ ............................. ~.e....~....a..r....~.v..e. .......... ~t~r.e.L...~:..~.. ................................................................ pursuant to application dated ...................... ~0~ ....... ~ .............. , 19.~.., and approved by the Building Inspector. Fee $..~..1..~.~.Q. ........... Building Inspector / TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, H. 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 dispcsal--(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. §. 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 aT 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 $I.00 Date 5 April 1973 New Building ...~ ......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property Delm&r Dr~.ve Owner Or Owners Of Property ..... J.o~i~h..~,,..Q~ ........................................................................ Laurel Country ~st&tes Subdivision ................................................................ Lot No ......5..3..... Block No ............. House No ............. Permit No...6...3..6...7.....Z..... Date Of Permit ..3:...]...-..3...8..-..?..3. Applicant .~...~.....Z~...C..,. ...................... Health Dept. Approval ....S....O:T....8..5...?......4...-..4..-.7...3. ....... Labor Dept. Approval ................................................ Underwriters Approval ..... .~...8..O...~..~..O........3..-...~.~..T.?..3......Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......~ ............................ Fee Submitted $ 5.00 Construction on above described building and permit meets all applicable codes and regulations. Applicant Sworn to before me this ~ ................ day of ............................................ Notary Public .................................... County (stamp or seal) · ~" ~ ~ SUFFOLK COb~TY DEPARTMENT OF HEALTH H.D.Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPR~¢AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,pert~nent data herewith: 1-Applicant~lA~3~ f~,~,~ ~f~ C~ Phoneq~ 2~'~77 6-Sub div~L~/ Address ~ ~. '7~/~-, ~ n",~T ~,.~ %~.~,~ ,, m '~ ~'--~ -f- ?-Section 2-Detailed property location ~S-'-A/~%/¢~ ~ ~( u~[-_- 8-Lot No. Hamlet A.,.~ ~ L. Town ~oz'~ ,~ ~ ~J 9-Private well? 3.Public' w~ter supply name ~- Distance to nearest main ' 4-Lot Size: Width ~L~ ft. Length i~-3 ft. (als~ enter on center plot plan below:) 5-Dwelling: Single Family ~g/~ Two Family? /~zYCellar? ~ /.Slain2 ~_.~Crawl Space? 10-Proposed system: Septic tank ~ /Precast ,~_~_/Cesspools ~k~Shallow pools / /Other / / Il-Septic tank inside dimensions: Volume G~ls.Length ft. Width ft. Liquid depth ft. 12-Precast sections: / /Number/ /sqUare'-~. Cesspools: Block sizeL~.aincs.D ~-fns. H ~' ins. Total blocks below inlet: PLOT PLAN Capacity ~-Oals. G.P.M. -3/ Indt Nc Street The Undersigned CER~ IFPS. Data ~eet 0 2 4 6 8 10 12 "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 Builder FOR HEALTH DEPARTMENT USE O~LY. Based on the information presented herewith, it is the opiDion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date ~//~/~. Signed (10/65 Revis.) s-t5 jO$ sewage disposal and water supply ~,,faeilities for %his location have been ~ected by this department and found be satisfacto ~ ' ' Chief of General Engineering Services LOt NOTE: dAK$, YOUNG & YOUNG 400 OSTRANDER AVENUE, RiVERHEAD, NEW YORK AL. DIrN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES, INC. ~ LOT 55 "LAUREL COUNTRY ESTA' ~,,~X~tb~O+~m~X'~' LAUREL 5ECURIT~ ~t~i~ TY/G~)# I SUFFOLK CO., N.Y. I~/~. ~L~'~ LOt 5~ :¢ .£V.S.ONS YOUNG & YOUNG 400 0STRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SUEVEY FOE: INLAND HOMES, INC. LOT 53 "LAUREL COUNTRY ESTATES AT GUARANTEED TO: LAUREL SECURITY TITLE & eUARANTY CO. TOWN OF SOUTHOLD SUFFOLK CO., N.Y. SCALE: 1"=40' IDATE:dUNE 10.19'71 Joseph .~uinlan, n/s Delmar Lane~ Laurel, L.I. Job #172, Lot: #53 ,-, - F ~ outside ~'~-' "'~h 23~ 1973 , ~ 1 2/0 ~<nl OB ' X , I , 2/0 , *?ur:qaces: Oi!.!-l/Shp, 3-1/!2hp ~Future a~plianee feeder/s' 2~3~8 1-2#12 D / ................... · 4..~ .......... ~_~ ....... :~ ........................ /.!.+.. '-/ (Building Inspector)~ ~ o ~, APPLICATION FOR BUILDING PERMIT 22 Noveatbe~' ..--'~'.72 ...... C, Dote INSTRUCTIONS e.- This application must be completely filled in by typewriter or in ink and submitted in triplicate tO the Building Inspector, with 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, an¢ 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 shell be kept 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 been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Ordinance of the' Town of Southold, Suffolk County, New York; and other applicable Laws, Ordinances or Regulations, for the construction 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) ~-- Z~ ~ ~ ...... S.e.~.~.e~s...~...~..q..~...~.~ ~,.8~... ..................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~.uilde~ Name of owner of premises ................................ .L...a...u~....e.~...~..t...~....,.~E~....t..a...t..e..s.. ........................................................... · . ~ ~"~/.,-.~'-- ~ -'r// _ ~ If applicant is a corporate, signature of duly aUthorizea o~ricer. ,~ ................ ~..m....e...~....~ :...~,.~, ,uz...~....z.(. ............... . ....................... ~ (Name and title of corporate officer) L~u~e]. Coual:~-y E, st&tes 1. Location of land on which proposed work will be done. Map No.: ..... ..5..4...8..6. ..... Lot No .......... _5_3. ............................... Street and Number ................................... ~..~.....a~.......D~...~.v..e.. ................................ ~ ..................... ~ ................................. / d 0 0 Municipality 2. State existing use and occupancy of premises and intended use and o~cupancy of proposed construction: a. Existing use and occupancy .............................................................. b. Intended use and occupancy 1 Ya~.l¥ D~ell~ag 3.' NaCre of work (check which applicable): X · , . , New Bu Id ng ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work ........ ~..~..~...?. ................ ~ (Description) 4. Estimated Cost ...~.2,,2..,~.~.....,0~. ..................... 'Fee (to be paid on filing this application) I 6 5. If dwelling, number of dwelling units ...... ~ ........ Number of dwelling units on each f oor ......................................... If garage, number of cars ............................................................................................................................................ 6. If businesq, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, !f 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 ......... ~[7.!.~.f.~..... Rear ..... ~7...~.~!! ........... Depth ........ .2..6. .................... Height ........... .3:.8.. ........................ ~ ........ Number of Stories ............ ~, ........................................................................... 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 construction violate any zoning law, ordinance or regulation: ...........n...o. ............................................ 13. Will lot he regraded ...........ff..e..s.. ............. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises .......... ~,l~T.~,..~l~l~t,,%-~r..~,AJ;a,1;e~. ................................................ , ....................... (Address) (Phone No.) Name of Architect., ................. ..~.a~...d....T'~t~.~.&...]ClIC,~ .......... ~,,1,~ .........~ ................. .7....3..2..-...2../.?..?. ............ (Address) (Phone No.) Inland Homes Inc. Selden 732-2177 Name of Contractor ............................................... ~ .............................................. ~ ................................................ (Address) (Phone No.) PLOT DIAG RAM Locate clearly and . distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines, Gi~ ~tree( and block nbmbe~ or description according to deed, and show street names and indicate wheth- er interiOr or corner lOt. (Na~ of i~v~ si~ing con~t) Ha is tbs ................ ~ ..................................................................................................................................................................... ( Con~ctor, a~t, coyote o~tcer, etc.} of said owner or owOsrs, and is duly authOHZSd to ~rform or ha~a ~rfor~d ~hs said ~rk an~ ~o make a~d fils this a~li~fion~ thet all ~tsmsn~ ~n~ain~ in ~his a~gli~fion ars true to t~ ~s~ of his knowls~ and ~lisf; and that tbs ~tk will ~ ~t forth in the ap~i~tion filed t~mwith. : '., DOLORES ' · ~ ~ · ' : ' ~ N~ARY PU~IC. State ~ New Y~ (~m~ of ~t~t)