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Home My WebLink About6280-zFORM NO. & TOWN OF SOUTHOLD BUILI)ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No. Z69;~ ...... . Date ............. .F~r... ~ ....... , 19.76. THIS CERTIFIES that the building located at .Fasbender..&. 8nuzui~.ew. A~treet Map No~a:l,ley. Pk.. Block No ...........Lot No, .6,7.l.[Jt.. P. ecoll,t,~., l~.o.~: ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............D.ec.. $.., 1972. pursuant to which Building Permit No.. dated ...........Dee ....1 .... , 19.72., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr.i,V&.~.~ .01~../~1~1,~. il¥.el:~l,~ ........................................ The certificate is issued to .. Carl. Iloselmtte ..... .°~e~ .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . liar.. ~.. 19.~1*.. by. R,. UNDERWRITERS CERTIFICATE No.. 1t~968... April..~.. 1.~7.~ ............... HOUSE NUMBER ... t+0~; ....... Street..P.a..s.b.e.n.d..e,..A.v..e ....... .P.e..e.o.n.i.q ......... ... ............ Building InspectOr TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificate Of Occupancy No. Z58~ ...... Date ............. l%r.¢h... 27...., 19..7.~ THIS CERTIFIES that the building located at . .Farben(tot. ~..$omud..Vie~S~t Map No..Bs,:~le~: .l~k. Block No ........... Lot No..6.~?.~.8. ..... P.e. 99.n.i.e' .... ~ :.Y... .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... I)e¢ ....~...., 19..7~ pursuant to which Building Permit No.. dated ........... Dee .-..1 .... , 19. -72, 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 . ~.z, iva.te · one · family, dwe 13.in{$ ...................................... The certificate is issued to . Ca.=l. b.osehe.tte...ow~.or. ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · ~:- · 25. ~ .9-7)+- - b~..ff.,..~/il.~ .... UNDERWRITERS CERTIFICATE No .... pencl.tal~ ................................. HOUSE NUMBER ... t,~)5 ....... Street...Fasbendez:. Ava ....................... uilding Inspecto~ ' FO~M NO. 2 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 ^UTHORIZED) 6280 Z Permission is hereby granted to: m~rz,, ~..o.~..]..e...~..o.~.,.. ................... ~...~.,...~..~t~ h~es ........... !~q~......~.o...~.......~....a.~. .................. ......................... ...M...v..~ .r.,,h.~a~ ................................. to....~.d.....(.....e.~.e.~.~)....~...~..e...~..~.~....SM. ............................................................. at premises located at .................. t ......... · ........................................................................................ ........................ ,EMI~.~t~x'...,~...~:~...'F;% ~,.,:.. &~....~o.~ozd,~......l{.tX, ..................................... pursuant to application dated ......................... ~IEG .......... ~ ........... , 19.~.~.., and approved by the Building Inspector. Fee $...~...~..e....O~.. .......... TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Iflstructions 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), 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 $5.00 3. Copy of certificate of occupancy $1.00 Date .....~...a:..~. ~..~. ....... ..2.~... ....... .1.~.Z.~.... New Building .~ ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .... .~.~.8:~.~...e..~...C]:.e...~....~.....~...~...~...~....~..~...e..~.....~..?..e. .................... .~..e...~..o...~..~..~.. ............................. Owner Or Owners Of Property .....~..,...D&~'~S.....~.G....~,~'~...~,S.~et.t~.~...]~'.~.~.~t~,...~. .............. Subdivision ....... .~.'1].~...~.1c .................................. Lot No.6e.2. s~. Block No ............. House No....LJ:.(~,~... Permit No..~-~0~ ....... Date Of Permit ....~2~..l~/.~.~,Applicont ..... .~.~.~....~..~.~.~..~..~....~...o..~..e..~.....~.~g ........ Health Dept. Approval ..,[~.....2~......~.~.~.~ .......... Labor Dept. Approval ........... ..~..*...~.*. ........................... Underwriters Approval ..Rez~].J.~.~ ........................... Planning Board Approval ...,~.e~.e ........................... Request For Temporary Certificate ...... ~ ........................... Final Certificate .......................................... Fee Submitted $ ,~.t..0...0. .......................... fasbe- nder A Construction on above described building a~,~ermit mee~ and regulations. Applicant ...... C.~...~ ................................................................................ Sworn to before me this ¢~-L~ ......... .a2.. day of ..... ............ (stamp or seal) ~//C~,~- Notary Public .................................... County ~ FORM NO. ~ .... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ...... :~ ....... ~ ................ ' Other Applicable Laws, Ordinances or Regulations ......... . .................................. at premises hereinafter described in that ~.~.~/Z.!.L..D..!~.~.~..~.?..E.~.~.~....t~.`~..~.~.~.~.~.~.Z..~.~..~.~.~.~.E.~!~ (state character of violation) ..,~,N.~;,,..N~.:..;.~.~.~.~..I~ ....... ~.~.~.c~...~.c~..~ ....... .0.~......0.~..u..~.R..~..T.:.....~!.~.,~..: .............. ..1~; ~..,....!.SSuJE,:~.~ .................... : ...................................................................................................... in violation of ....:~..,;......)~J~...T....~:[~...;...!:~;.'..!..L:I...~..~ ...... .~.,..(~.O.:.'..!.~!........H.. ................................ (State section or paragraph of applicable Iow, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law end to remedy the conditions above mentioned forthwith on or before the .......................................................... ~ ........ .:..: ........... : ............... ...... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ..~.l~..~A.~:~.~..~.~lE.[r~...,,&l~J~ ....... .'.~.~....°~...~....County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. uHd~ng Inspector SUFFOLK COUNTY DEPARTHENT OF HEALTH APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEH Address A~ ~o/ ~.~3 ~ #t~,~,,¥~,./ 6. section 2. Prope~rty location~/K ~'~-~/t t ~~¢ ~ 7. Lot No. goF ~,~, *O ~Oo~ ~/e~ ~ 8. Private well ~ Village. ~ ~ Township ~P~/ 9. Public water 3. Public Water Company name ~ Distance to main 4. Lot size: Width /~ feet Length/~ feet (Enter on center plot below) 10. Sewage Disposal System: A. 900 gallon septic tank: Precasti/ Equivalent Block B. Leaching,.pools: Number I Precast Bl~ck Special r-TI 0 ,~ II The undersigned If private well fill in blanks below: Tank capacity~O Gals. Pump G.P.H. Total well depth~/~ Depth to G.W. g Amount of water in well ~ Test Hole Data Feet 0 2 4 be in accordance with the aras thereto." Date //-,~0 ' 10 12 14 16 18 IERTIFIES: "Construction of authorized installations will Suffolk County Department of Health's current stand- Signed ~ ~-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 S-15 Revised ~/]/72 EXC/ TIGN ]HSPECTION this plot~ Signed RtmRED APPLTCATION FOR APPROVAL TO CONSTRUCT PRIVATE S~AGE DISPOSAL STSTEF~ INSTRUCTIONS: Applications must be submitted in triplicate 1-Means Owner or Builder. Address to which mail should be directed. 2-Means detailed description of property location, together with street name and distance to nearest intersection of main thoroughfare, 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-Name of subdivision. 6-Section number. 7-Lot number. 8-Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. 9-Public water: Enter "Yes" if Public water supply is available. Enter '~o" otherwise. 2~OPOSED SYSTEMS: Answer to Item number 10, consult the Suffolk County Health Department's Standards for Sewage And Waste Disposal Systems Design of Residential Subsurface Sewage Disposal Facilities. Part I-Residential Subsurface Disposal Systems covering cesspools. PIA)T PLAN: The following information is required concerning the Applicant's 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 shm~n on face of this application. 2. Surface waters-Streams, Lakes, & Bays, etc., located within a distance of 1OO feet of Applicant's lot lines, must be shown on the plot plan also. 3. Wells and cesspools now on adjacent lots must be shown on the plot plan, together with the distance to the Applicant's proposed Sewage Disposal Systems and well. 4. Where no buildings exist on adjacent lots, state "Vacant" on the plot plan. 5. 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-lOO feet minimum distance from the nearest cesspools. Well- 25 feet distance from rear and rear sides of property lines when possible. ~Well- 10 feet distance from front, and front sides of property lines when possible. Well- 50 feet minimum below grade for well point. Well- 40 feet minimum into ground water for well point. Well- 4 feet 6 inches minimum below grade to well head and lateral water pipe. CESSPOOL LOCATION: Upon determination of the Sewage & Waste Disposal "t~q~e of systems', re- quired, the following Standards must be observed for the location of same: 1-Cesspool- 5 feet minimum distance from lot lines to exterior of cesspool. 2-Cesspools exterior must be 1OO feet minimum distance from nearest well. 3-Septic tank exterior must be 75 feet from nearest well. 4-Cesspool exterior must be 7 feet minimum distance from nearest water line. 5-Cesspool exterior must be 10 feet from house foundati~.. 6-Cesspool exte~iSr must ~e 1OOfeet minimum distance from surface waters, streams, lakes, & Bays, etc. 7-Cesspools must be 20 feet minimum distance from large trees. 8-Cesspool exterior to cesspool exterior, must be at least 8 feet. 9-Cesspool cover top to grade must be held to minimum of 1 foot to maximum of 2 feet. lO-Bottom of cesspool to ground water must be held to minimum of 2 feet. THIS CERTIFIES THAT on/y t/w e/~ctr/~d equipment as d~cr/bed be/ow ~ int~ by t~ ~t ~ ~ t~ ~ ~ ~m~r in t~ p~m~s o~ Jame~ ~ Rlta Dav~es, s/e/co~. Fasbender ~ Sound~w Ave~. Peconlc, L.I. Bailey Park ~,~.-i~o~ April l, 1974 andfou~ncompliancewithther~uir~mentsofth~B~rd. RANGES ~. w. SERVICE DISCONNECT I NO. OF 1 COOKIN~ DECKS OVINS OISH WASHERS; V I C E EXHAUST FANS AMT. H, P. DIMMERS AMT.' WATTS 2 OF NEUTRAL Carl Boschetti, P.O,Box 523,650 FAst Main St., Riverhead, L.I. 11901 Per / ~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. inspected by this depa~taeat ~ f~ . - NOTE: · -' MON6e4ENT SUBDIVISION MAP FILED IN THE OFFIC~ OF' THE C£E~K OFSUFFOLK ~TY ON SEP~ 2~,1~ 4S FILENO. I09~ REV,SIONS YOUNG & YOUNG ~IUNE 29,1973 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: JAMES DAVIES 8, RITA DAVIES LOT NOS. 6,7 ~8 "BAILEY PA~ '- 'rowN OF SOUTHOLO SCALE: DIETZGEN 135 1~846 NOTE: · = MONUMENT SUBDIVISION MAP FI£ED IN nEWS'OHS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG PROF£g~/ION&[. ~NGIN. II~I~ AND L&ND ~IU~VI~YOR ~U~JE~ F~[~iES a RITA DAVIES LOTNOS.,,7 ~8 "BAILEY ~: F' = 40' ~*~: mv.~o,~9*2 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~'~-"-~ ~ c~.o~,.-,~ ~ .~ TOWN CLERK'S OFFICE .,~,~,~ ~:~c,~,~ ~ ~UTH~D, N.Y. ~ ~, ............ .............................. - APPLI~TIONFORBUILD,HGFERMIT ~, ...% :: ............................... , a. Thi~ ap~li~tion mu~t ~ mmpl~t~l~ fill~d in b~ W~rit~r or in ink and ~ubmi~d in tri~li~t~ to th~ Buildin~ In*~or, ~i~ ~. T~ wo~ ~overed by t~J~ ]ppl[~]tiofi m]~ ~ot ~ ~ommen~d beJore J~u]fi~ oJ Building Permit d. U~ ]ppro~]l oJ thJs ]~p[i~tJo~, th~ ~uJlding [fi~tor wi][ is~u~ ] BuJldJ~g Per~Jt to Jb~ ]pplJ~sfit, ~u~ ~[mil?b][[ ~ ke~t o~~- the premJms available for ins~ction throughout the work. e. No building shall ~ o~upied or u~d iff whole or in pa~ for any purpo~ whatever unW a ~ifi~te of O~u~ncy shall haw ~n gran~ by ~he Building Ins~or. APPLICATION IS HEREBY MADE to the Building Depa~ment for t~ issuan~ of a Building Permit pursuant to the Building Zorn Ordinan~ of the Town of ~u~hoid~ Suffotk County, New York, and other appii~ble ~ws, Ordinan~ or R~ulations, for ~he ~ns~ru~ion building, additions or alterations, or for removal or demolition, as herein de~ri~. ~e appfi~nt agrees m comply with all appfl~bie ordinan~s, building c~e, housing code, and regulations, and to admit authorized ins~ors on premiss and in buildin~ for ~a~ ins~ions. (Signature of applicant, or name, if a corporation) ~',,I'"'0 ~. ,~d~l~,~ of~./giicant) State whether applicant is owner/lessee, ~ en '~contractor, electrician, plumber or builder. ....... ........ ................................................ ' ................... ,* applicant ,:, co:p:rat:, s::n;'~"re~'~'~'~/~':~t~::ized off,"""~*'--::i: ................ ~ ..................................................................... CName and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No ........ ~..-~,,...-.Lot No. ~.;.-~...-..~. ......... Street and Number ..... ~....~........~...~..~c~...~...~ .~(~--'~....~J,..~-.~..:..: .... v/.7/~),~ ~ J - Municipahty~ 2. State existing use and occupancy of premises and intended use and occup~lncy of proposed construction: .. -'~-.- Existing use and occupancy ....... (~ ........................................................................................ b. Intended use and occupancy .................................................................................................................................. InePreair of work (check which apl~licable):/New Building ...~ ........ ;::~.4~:~:~A .~.tj~n,. · .................... Altera,lon ..... ~...-.~. ......................... Removal .......... :~.,..~mohtlon ....................... '; Other Work .................... ,~1~..~;..).. (Description) =,~;--~+~,~ ~,,~ ~ ~' ...~ ........... Fee ................................................................................................. 4. t.a~,,,,o~,~ ,~, ........ ~ ...................... (to ~ paid on filing this appli~tion) , 5. If d~lling, numar of dwelling units ...... (.~ ...... Numar of dwelling uni~ on e~h flor ......................................... If gara~, numar of cars ........................................................................................................................................... 6. If busine~, commercial or mixed occu~n~, s~cify nature and extent of each ~pe of u~ ..................................... 7. Dimensions of exi~ing structures, if any: Front ..................... Rear ........................... Depth ................................... Height.... . .................................. . .. .... Numar of Stories ................................................... ........ .. ..... .......... · Dimensions of ~me s~ucture with alterations or additions: Front .......................... Rear ......................................... Depth... ................ .... .... .... ....... ..... Height ......................................... Numar of Stories ........................................ 8. Dimensions of entire new con,ruction: Frdnt ......................... Rear ............................ Depth ................................. Height N ~ of Stories ............................... ................................................. um r .......................................................... 9. Size of lot: Front ........./..:.~ .................. Rear ...... .~ ............................. Depth - ' 10. Date of Purcha~ ..................................... Name of Former Owner ............................................................................ 11. Zone or u~ di~rict in which premiss are situet~ ..................................................................................................... 12. D~s proposal con,ruction violate any zoning law, ordinance or m~lation: ' · .................... 13. Will lot be reCaded .................................... Willexce~fill~mmovedfrompmmi~s: [ ] Yes [ ] No 14. Name of Owner of premiss ...... .~.~ZZ~ ............ ~..../~,.~ .......... ~.~.~...,~ ......................................................... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Addre~) (Phone No.) Name of Contractor ...~,...;/. ............... ~;...-, .......... ; ........ -...; ....... Z;.....I.....J~x ....... ~. ............ 1¢.1,.~. ....... ~ . (Addre~) / ,,., , ¢,, , 5, (Phone Nmi' 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 ......................................................) .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ................................................................................................................................................................................................................. (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~ ir~ the application filed therewith. YERRI LEE ELAK ...................................... dayl~ARY..°UBLIG...g{e/e.~f.flevC.1~.k ........... 19 ............. ,~., ~ 4~/· ~ ~ ~/, / ,~ _~ ~ : ' No. 52-6Z68295 -"~'- ~ Qualified in Suff0~k co,,t //... ................... Notary Public ................... I~0mm~.Sx~re~.f~,¢tr.~;.¥r~.:.T/~f County (Signature of applicant}