The URL can be used to link to this page

Home My WebLink About6288-zNO. 4 TOWN OF SOUTHOLD BUrLDING DEPARTMITNT Town CJerk's O~ice Southold, N. Y. Certificnte Of Occupancy THIS CERTIFIES that-the building located at ....~.c.v. ?! ~.. y[ ! ~ ! .~...~. \'.~.-. Street Map No. "~ Block No. ~ .Lot No. ~-- conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........~. .....~r 19.? .~pursuant to which Building Permit No.(c dated ~ I ]~ C- 197~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is is~edis. A ...~?..~- ........ r.d,.~:...~¥ ~.~..c./-.~.~.~.,.~'~ .................. The certificate is issued to ..... .'f'. !4./~. ~.'] .~. ~... ~ .1..,....Y !'~ ~ .~...O. ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval -~ ~ I 2 ~ ~ .~//~ ? lV. 9. UNDERWRITERS CERTIFICATE No. ^! / ~ 7~ 7 7 HOUSE NUMBER ....]. ~. ~ .?... Street . .~. ? ?..~/.-.~ .... .~. ~..~-...~.....A..~.c[-. ........... iX'/ tq "TC t Building Inspector FOF, M NO. ~ 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? 6288 Z Permission is hereby granted to: ~,c he~ ..~ ~l~J,3,.e......~/.c.........~....o..s......~.s...s..o.. ....... ............ .............................. .............. ~ampt~.~a~.s .......... N.~[A ................. to b.~,~4..~a~....~.e....f..a..~..~:....a.~..e. ~.~ ~.n..l~ ...................................................................................... at premises located at .........~./.;~....~ou, r~d,..]ZJ,e~...l,.v~ ..................................................................... .................................................. ~i~ I.t i.~ualc ....... ~.X~ ........................................................................ pursuant to application dated ............................. J~e~, ......... ~ ....... , 19.~.2..., and approved by the Building Inspector. Fee $. ~.~..*..,5.~. ........... Building Inspector POBM NO. 6 TOWN OF SOUTHOLD Building Depa~tment Town Clerko Office SouthoJd, N. 1'. 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 dlspcsal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences end similar buildings and installations, a certificate of Code coeopliance 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 8/28/73 New Building ..... .~.'. ............ Old or Pre-existing Building ............................ Vocont L~nd ............................ Location Of Property .~[/.~.S..~.S...~..u..~...5:..v..~i.~e.~....A.?.~.e..*..~...?~..?:.~.~.~.~.~!..~.~.~.~.!...~.%~ ...... Owner Or Owners Of Property Thome, e P,o & A. muet, t,e [&s.~o Subdivision ................................................................ Lot No ............. I~lock No ............. House No....!.?...~...~ Permit No...6..2...8..8.....Z. ..... Date Of Permit .]:..2.Z~.~.Z.T...2..Applicant .................................................................. Health Dapt. Approva~ ................ .) .......... .:~ .......... Labor Dept. Approval ................................................ 8/8/73 -~07877 ~. . Underwriters ApprovoJ .............................................. ~'tanmng Board Approval ........................................ Request For Temporor~ Certificate ........................................ Final CeJ't~ffcate .......................................... ~,00 Fee Submitted $ .................................... Construction on above described buildin9 and perm~ meets oil ol~pficable nd roguJotiom. Gene ~. 8c~v~n, ~re~den%' Sworn to before me this PAR. LIAH~_~T 110,.[.~.~, INC, .... day of ...... .... Nato ry Public .~. ~. ~)~¢~f-~ C~~ ' (stamp or seal, Nota~ Public, State of New York No. 52' 2055~10. Suffo1~ County Cornmi~sion ~xplres March 30, ~9,~5-- pOtt~ NO. ~ TOWN OF SOUTHOLD Building Department Town Cledm 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 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. 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: I. 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 $1.00 Date 8/28/73 New Building X Old or Pre-existing Building Vacant Land Location Of Property ..~./.~....~..~"u.~..~.~.~.e...~....A..?..e..~..~.....H.~.~.~.~?..c...~..L..~.~..~...~.~...~.~...u.~.b...~.~.~...~.Z~Z ...... Owner Or Owners Of Property .~.b.°.?.~.s.....R..*.....~....A.,~...~..e..~.~..e....]'..e'...s..s...°. .......................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No..../...~...~. Permit No. 6288 ?. Date Of Permit .................... Applicant Health Dept. Approval .~....0...!.~.~ ......~..~/..3...?. ........ Labor Dept. Approval ................................................ Underwriters Approval ...8.../...~'....3.....-.~.]....0..T..8...T..7. ........... Planning Board Approval ........................................ ifi Request For Temporary Certificate ........................................ Final Cert cate .......................................... $ 5.00 .. Fee Submitted .................................. n~ ~rmj~~ sj I//a~pc~ble c~ s~a J/ lations. Construction on above described buildi and al Ii nd Applicant .... ~ .... . ._. . '. .................... Sworn ,o before me this ~0~Ss~z'~d'.eo't'' (stamp or seal) of. ~. /~.~.~.. ...~.. ....... day .................... .................. ~ ....... ~ ...... County Notary Public ~ ,~ ~I~. JOYCE A. KEARNEY Notary publlc, Stole of New York No. b2-2055810-Su JoJk Cougty Commission Expires Mooch 30, J9 ~..~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM Address Q! ~,0~ ~£ ~,l!,~,g %~~6. Section 2. Property'~c~tion/f/~ ~,~.,~:~i~/~ Mf?f~- 7. Lot No. 2~ ~? ~/~P ,~.~ ~ 8. Private well Village~$~ r%! ~/~ Township~o~i ~ 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Width/(i~ feet Length o~'-----feet (Enter on center plot 10. Sewage Disposa~System: ,~ A. ~900~ gallon septic tank: Precast ~ E~uivalent Block B. '~k~ching pools: Number~}---Precasy~WO Block Special below) N Street If private well fill in blanks below: Tank capacit/~?"Gals. Pump G.P.M. Total well depth Depth to G.W.~O Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 be in accordance with ards thereto~ /~ Date/"/Z the The undersigned :ERTIFIES: "Construction of authorized installations will Suffolk County Department of Health's current stand- .~ ~,, i~ ~ - /Owner or Builder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that Disposal System can be installed on this plot. Date //2'"'/~/~ '~" Signed an adequate and satisfactory Sewage S-15 Revised 4/3/72 THE NEW,~¥ORK BOARD .OF ~ ~! ~UREAU RE UNDERWRITF RS Yasso. n/side so,.mdview Ave., Mattituck~ L.I. ~ob 661S .... · OBi ~ 1 ~ 2/0 r ~ ' ~' ' heaters: .~oe~ heaters: 1-2,0kw, 2-1.5~, 1-1.25~, 3-1.0~, 2-.75~, ~-.=~ arrabus Electric, ?o,,,~-e 112, [lox 2zl2, .mram, L.I. 11727 Unaufhorlzed a[fera~on or c~a~ff~or~ ~0 I~F~ ~ur~u:~7 A' ~ ~'<~laff~ff ~ ~eclian 7209 of the New York Stale Education L~w. ~al or embossed seal shah not be cansidered to Be a valid copy. p~rson for whom the survey i: prepared, and on his beha ~ lo he fide company, governmenta~ agency and lending inshtuh~n hste~ ~G ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM. SURVEY FOR THOMAS R. 8 ANNETTE d. AT M,4 TTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY~ N.Y. SCALE: I"'- ~0' OCT. I.S , 1972 fEB. 12, 1973 JULY 2 ,1973 YASSO REFERENCE: ~IJARANTEED TO ~ RIVERHEAD SAVINGS SANK SECURITY TITLE & GUARANTY LAND SURVEYOR N.Y.C. LIC. NO. ~87~5 RIVERNEAD; N.Y. CO. Unauthorized alteration or addition a violation of section 7209 at the New York Stale Education Law. Copies of this ~urvey ~p not bearing the land surveyor's inked se¢l or emlzo~sed s¢-cl ~hell no~ be considered to be a valid copy. ~.~ .~ ..... ~r mdica[ed hereon ~hall run only to the person :o~ where I!,e sc;~ ,~y is prepared, and on his behaff Ia the title company, governmerJol agency and lending institution listed hereon, and to the assignees of the lending institution. Guarantees jar certifications are not transferable to addilional institutions or /~bsequent owners. ELEVATIONS ARE REFERENCED TO A~ ASSUMED DATUM. SURVEY FOR ~EFERENCE , THOMA~ R. & ANNETTE d. YASSO AT MATTITUCK TOWN OF SOUTHOLD ~ eUARANTEED TO, RIVERHEAD SAVINSS DANK SUFFOLK COUNTY, N.Y.. //~~~ SECURITY TITLE · ,UARANTY CO. sC, LE, ,". I '*5 X LAND SURVEYOR N.~S. LIC.~. ~8~ HIVERHEAD~ N.Y. BUILDING DIEPARTMEN'I~-~,~__....z~ ~ -~4~'./~'~-'~'~-~',~ - TOWN CLERKS OFFICE ~ ~ ~/~. ~UTHOLD, N,Y.¢2~WB ~, ~.~ 0'% ~omined ...... ~..tl ................. , 19.2.~ '~ Applicotion No ....... ~...~.~..~ ...... ~pr~d ........................................ , 19 ........ Pemit No..,..~.......~u....~. ................... ~,~. ~ ~ ~ ~ Dl~pproved o~ ...................................................................................................... ~ ....... ~ .... ~_~ ~ ........................ .... ........... INSTRU~IONS ~ ~ ~'~ ~ ~ ~. This ~pplie~tion must ~ completely filled in by ~y~wri~er or in ink ~nd submitted in ~riplie~te to the Buildin~~ 3 se~s of pl~ns, ~eCur~te plot plan to scale. Fee ~ecording to schedule. b. PJo~ plan showing loc~tion of Io~ end of buildings on premises, rel~tJonship to ~djoining premises or public str~ or ~re~s, ~nd giving ~ detailed description of l~yout of pro~rty mus~ be dr~wn on diagram which is p~r~ of this ~ppli~fion. e. The work ~vered bv ~hJs ~pplie~tion m~y not ~ commen~d ~fore issu~n~ of Building Permit. d. Upon ~pprov~l of t~is ~pplieefion, the Building Inspector will issue ~ Building Permi~ ~o the ~pplie~nt. Such ~rmit sh~ll be ke~t on~ ~he premises ~v~il~ble for ins~cfion throughou~ ~he work. e. No building sh~ll ~ occupied or u~d in whole or in p~rt for ~nv purpose wh~ever until ~ ~rtifie~te of Occupancy shah h~ve been gren~ bv ~he Building Ins~e~or. APPLICATION IS HEREBY ~ADE to ~he Building Deponent for t~ issu~n~ of ~ Building Permi~ pursuant to the Building Zone~ Ordinance of the Town of ~uthold, Suffolh Count, New York, ~nd o~her ~pplieeble L~ws, Ordin~n~s or ~egul~tions, for ~he ~nstruetion of buildings, eddifions or ~lter~tions, or for remov~l or demolition, es her~n described. The ~pplie~nt ~grees to eompl? with ~I~ ~ppli~ble ordinances, building code, housing code, ~nd regul~fions, ~nd ~o ~dmit ~uthorized inspe~ors on premises end in buildings for ne~ ins~efions. (Signature of applicant, or name, if a corporation) I k s (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ ............................................. ............ . ............................................................................ i .................................. - Name of owner of premises ....I..~..C),.~....~.~.....~.......y...~..~..~.~. ...................................................................................... If applicant is a corporate, signatuze of duly authorized officerJ' ~' ['~ (Name and title oT corporate officerl 1. Location of land on w~jiFh proposed work will be done. Map No.: .................... Lot No ............................................. .~.~J ~ Street and Number .~l.~.......~...G..u...~.....~..J..~...~/.-...~/~ ....... ..~/, A.T..~.IT.~..(,~...'..~.~..P.....q.~......~.l~T~..O...~...~.. .............. . [ / D ~'_,~ Municipality 2. State existing use and occupancy of premises and intended use and occul~ancy of proposed construction: a. Existing use and occupancy ..... L .~..~ ~J .=.. 1..'( .~...~..; .............................................................................................. b. Intended use and occupancy ~ S-.~.~..~'~ ~ ~ .. l ... ..ff. .,.. ........ ................................................................................................... N'atOre of work (check which applicable): New Building ..... Z ........ Addition ..................... Alteration.:l....;.~. Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ..~2 ..0...O...~. ..................... 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 ........................... Depth ............................ Height ....... L.~.. .......... ; ........................ Number of Stories .............. J~ ......................................................................... 9.' Size of lot: Front ...iI.0..~...~ ..................... Rear .....L.~..~.;../.4. .................... Depth .......~..../'~..~.. ................................ Height Number of Stories ..................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ · . /=, RE. 11. Zone or use district in which premises are s~tuated ...... /........'.~E,~. ......... ~..~. ................................................................ 12. Does proposed construction vie)ate any zoning law, ordinance or regulation: ....... ..)~....0. .............................................. 13. Will lot be recjraded -.--~....~.~. ................. Will excess fill be ~[ng~d_f,,rqEnprem_ise_s: [ ] Yes. 14. Name of Owner of premises ..,L/.~LU.I;I./~I.J ...... ...... Jn/.I Id, ~ $. ~(. ,~°~ll~.~. '~..' .......... I.. ¢...~.~ .'~.-,,'. · 4. ........... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) " {Address~ ...... (Phone No.) .......... PLOT DIAGRAM Locate clparl9 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 individttal signing contract ) 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 beli~f~sn~ II~tRtb~work will be performed in the manner set forth in the application filed therewith. INerer~ ?~b|i¢. ~tete el New York N~ 52-2055810-suffolk Co~h~ (Signature of applicant) t L-,II o, 1 I !1 - - t f GENERAL NOTES 'Contractor to verify al~ conditions prior to commencement of work. 2. All footings to ~est on undisturbed soil with a minimum capacity of twa tons. 3. Do~ble all floor joists ~nder partitiQns. 4. Ail ~lumbing work~o be. in strict accqrdance with applicable' ~odes. 5J All structural lumbe~ to'be Hemlock or Doug- las fir with a minimum fs~1200 psi.. ~. Ali electrical work to be Fire Underwriters approved. Headers an~ ~rimmers to be doubled. 10. Ail glass in shower doors' tO be tempered. Ail windows ~o be.A~...~e, rsen.permashield with t~mpered glas~ an~ screens. Size and loca- tion as indicated on drawings. Ail ne~ qonditions and details, e.g. trim, soffits, fascias and f~nish materia~,.~ar~e~D~ ~WC~?,~ ~,~[~ match existin~ conditions. , ~Q~ ~a~ ~,~ Ptu~er to s~mi't ~o~vecto~ layout/prior ~,~¢~ "~ ~ i · .L ,.% % , APPROVED AS NOTED iI x,