HomeMy WebLinkAbout5947-zFO~W~ NO. 4
TOWN OF SOUTHOLD
BUll,DING DEPARTME, NT
Town Clerk's Office
$outhold, N. Y.
Certificnte Of Occupancy
No. ~2~..h.[~2 .... Date ................~'ala..~0 .... , 19. F.~.
THIS CERTIFIES that the building located at . Stars..gea~l ............... Street
Map No. ao~o~d~l,e~t Block No ...........Lot No. 1.~ .... Mat. ~lo~,..]~,~., ......
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ............ J.v, lae...1,~., 19..72 pursuant to which Building Permit No..
dated ..........J.~r~...l~..., 19 .?~., was issued, and confoms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ... Pr£vat~..one. £a~ly. ~w~lling .....................................
The certificate is issued to .... F~:~th. ~tadelram_~ ...... 0~er ....................
of the aforesaid building.
Suffolk County Department of Health Approval
(owner, lessee or tenant)
... Ce.t,.. 20... 1975.. .a..
UNDERWRITERS CERTIFICATE No...l~2~0.%1~1 .... Oat...1~..-t97~ ..............
HOUSE NUMBER .... $~80 ......Street... $.tal,$. lloa~ ....... ~a~ l~al.~.o~a ......
ing Inspecto7
FORM 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? 5947 Z
Permission is hereby granted to:
,.!..~.~..~.~...~. ........................................
....~....~..~ ...............................................
...... C. ellala~ ....... 1[.~.....1.1.72~ ..................
~o ...... ~M~..l~v..~a~..g, ljt,~..d~ett~_~,~ ................................................................................
at premises lecoted at ........~J~.~....'J...~. ....... .~..~..~.l~....~..~.....l~...~J~ .....................................................
................................................... ~t,~a..li4~ ................ F~s$..lla~,.~.... # ,~.. ...........................
pursuant to application doted ..................... eTIII~J.....~.~, ............... , 19..~L1~.., and approved by the
Building Inspector.
Fee ~.~ ~.. ............
pERM, IT INCLUDES APPROVAL
TO ~,EMOVE EXCESS FILL
FROM ABOVE PREMISES
i~GR~,DING LOT
D~,V~WAY CONSTRUCTION
CESSPOOL CONS I RUCTION
CELLAR CONS~ RUCTtON
OTHER
Building Inspector
FOR~ NO. 8
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. Swam statement of owner or previous owner as to use, occupancy and coalition 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:
i. 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
I-I -'7
Date .................................. Z .........
New B~ilding .....~ ......... Addition ................ Old or Pre-existing Building ................ Vacant Land ..............
Location Of Property ...Jt..~...~.....~. ......... .~.~.....~.~...~....i~.......~.....~....~...../...&'.....J~... .............. ..~....../~.. ..................
Owner Or Owners Of Property ~..~x~....~..~:~.C.~.~/..~..~./~ ....... r~ .....................................................
Subdivision ~....~.~...~/...~..~,~.~.~.~.~.L.~. ........ Lot No ....../...~... Block No ............. House No .............
Permit No..,~..~...~..~..~. Date Of Permit ~/./.~/~,,.~-....Applicant .........~..~..../~.~..~.,.., ...................................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Fincd Certificate
Fee Submitted $ ..~./....~..C~ ...................
Construction off above described building ~Id~,permit meets,/~ applic,ablecodes and regulations.
^pp,,cont ..... ..................
Sworn to before me~is
............ of ..................... .Z .......... (s,.c. or
T,HE NEW,,YORK BOARD OF FIRE UNDERWRITERS ~ ,I ~ ,~ ~,,
=Ir , ~ ~! ii! ' I t: ': BUREAU OF ELECTRCTY ' i i : I =II =l iii I i
Date, OCte}b~ :'IR,, :~.CJ?~ ;~i ~i ~!/lppli¢~toe~No, onfile 72~68~_ ~ ~l i ,i i ~M, ~q! II
o~y ~he ~l~tr~col ~jp~t ~ ~¢.~ ~w ~d ~n~r~ed by t~ ap~hca~ ~med ~n the a~ application ~umber I~ Ihe premises
~ ~ ,,~dl,~ado~agO,:~g80 Stav~ Rgad, East M~,~gn, ~,~..~ ,,, ,, ~ r~ ~, ~,
~XTU~E ~XTURE$ DISH WASHERS
31
DRYERS
OTHER APPARATUS:
*Furnaces: Oil 1-1/Shp, 2-1/12bp
Motor/s: 1-1hp
l- 4.5kw Hot water heater
Fred Stadelmann,
502 Madison Ave,,
Greenport, L.I. 1194~
This certificate must not be aiteree in ony manner; return Io the office of the E~oard if incorrect
Per~
nsoectors may be identified By their credentials
tV.'t'9~4Z'40"E. I~.1.17'
,09 ,~
79'421 '..'iO'%V. - /gZ.l..~
Lo"7- I~
,5~= ta' : 40'= I"
SUFFOLK COUNTY DEPARTMENT OF HEALTH
H.D.Reference N c~3 ~ ~///.~~
APPLICATI8N FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS
Approval to construct said systems is requested,pertinent data herewith:
1-Applicant Fred Stadelmann Phone8~2-15286-Sub div Stars Manor
Address 370 East Drive, Copiague, NY 11726 F-Section
2-Detailed property location Stars Rd. l~4~ft Main RdB-Lot No. 1 4
Hamlet East Marion Town Southold 9-Private well? Yes
3-Public water supply name Distance to nearest main
4-Lot Size: Width 106 ft. Length 1 Q2 ft. (also enter on center plot plan below:)
5-Dwelling: Single Family ~V~ Two Family? ~ /Cellar? ~_~Slab? ~ /Crawl Space? / /
10-Proposed system: Septic tank .f fPrecast~Cesspools / /Shallow pools J /Other /
11-Septic tank inside dimensions. Volume q G~als.Length ft. Width ft. Liquid depth
12-Precast sections: ~ /Number~ /Square-~. Cesspools: Block sizeL incs. D ins. H
Total blocks below inlet: ~1 !~ ~2_~3
PLOT PLAN
/
ins.
Date May 11, 1972
Capacity 82Gals.
Vacant Vacant Vacant G.P.M. I 1
. ~~ ,W.L.
Vac ant ~ Vac ant
80
:at
'th
Street Stars Road
Data ~eet
0
2
soil 4
6
8
l0
12
sand
16
18
bOl
will be in
Vacant Vacant Vacant N ~
Ind5
Nc
The Undersigned CERTIFIES: "Construction of authorized installation:
accordance with the Suffolk County Health Departments' current Standards, Bulletins,
and amendments thereto, covering Private Sewag~e Disposal Systems".
Date Ma~ 11 ~ 1972 Signed ~Z ~~2-~-'-~,-~~
Owner 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 this Plot. -
Date ~-~-/~--~ Signed i~
(10/65 Revis.)
S-15
$~PLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS
INSTRUCTIONS: Applications must be submitted in triplicate
1-Means Owner or Builder. Address to ~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 H~mlet/Village & Township
3-Enter name of Public Water Supply District, together with the distance to their main.
~-~ter 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 "V" items applicable to the proposed new dwelling.
6-Name of sub-division
?-Section Nl,mber
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 ~eaching Pools
PLOT 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 linem of the
heavy lined square in the center of Plot Pla~ 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 ~o 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.
WE~L 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 following 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 100 feet minimum distance from nearest well
Septic tank exterior must be 75 feet from nearest well
Cesspool "Center" must be 12 feet minimum distance from nearest water line
Cesspool "Center~ must be 15 feet from house foundation
Cesspool exterior must be 50 feet minimum distance from surface Waters, Streams~
Lakes & Bays~ etc. :
trees ' -
Cesspools must be 20 feet minimum distance from large
Cesspool center to Cesspool center must be a~lM~l l~ if~et ~ ~
Cesspool cover top to grade must be held to min~ o~ ~1 ~ood ~ maximum of 2 feet
Bottom of Cesspool to ground water must be held to minimum of 1 foot
.5.79°4Z
191.17
Low /,4
inspec! ~d b~' "' ' ~ '~'
to be s ati~iactory.~--~
Chief of Oenere, 1
Services
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. 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, and
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 sh~ll have been
granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance, ofa Building Permit pursuant to the Building Zone~
Ordinance' of ~the Town of ~outhold, Suffotk County, New York, and other applicable Laws, Ordinances or RegulatiOns, f~r'the~onl~ruction
buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all agglicable
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, Jesses, agent, architect, engineer, general contractor, electrician, plumber or builder.
General contractor
Name of owner of premises ..... Ed. ith St.a..d.e_l~a..n~.... . ......................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
I. Location of land on which proposed work will be done. Map No: .~.~.1..~. ..... Lot No .......... .1...4. ................................
., -- Stars Road East Marion. NY
Street and muml:~er .......................... i~.~;~. ............................................................................. '""'l~i~i~;"if~ ..........
2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: ,;,-~: '
a, Existing use and occupancy ....................................................................................................................................
Dwelling (residential)
b. Intended use and occupancy ............................................................................................................... ~-~.-~.~.'"%~,.
3. Nature of work (check which applicable): New Buildin~ .......~...e...w. ......... Addition '
..................... Alterat,on .............
Repair ......................... Removal ......................... Demolition ........................ Other Work ....................................
(Description)
....... $20,000.00
4. ,samamo ~o, ..................... ; ......................... Fee ......~...~;..~..'~.. ........................ . ..................................................
· ' (to be paid on filing this application)
If d,Welling'~ number of dwelling Units .......~ ........ Number of dwelhngunlts on ee~h~floor ..].~$,1L..~..r~t,~.tl~l...2...r~.
If garage, number of cars ........... ?..n.e · ·
If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................................
7. Dimensions of existing structures, if any: Front .....................Rea-~ ........................... 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 41 t_6" Rear ....... .~.1...'..T..6..". ....... Depth ......~.(;....r.~. ...............
Height 23 ft Number of Stories two
g. Size of lot: Front .....1...0...6..'..-...0.~ ................. Rear..........................................1 06'-0" Depth ........ .1. ,9. .2. .. .f. . .t. ............................
Height .................................................... Number of Stories ......................................................................................
Date of Purchase June 8, 1971 Nameof~ ..... n ..... ' W. Schreoder
Zone or use district in which premises are situated ................... ~.A.'. ..........................................................................
Does proposed construction violate any zoning law, ordinance or regulation: ............... .N...o. ...................... ~ .................
Will lot be regraded .......... .Y..e.?.. ................... Will excess fill be removed from premises: [x] Yes [ ] No
Edith Stadelmann 370 East Drive, Copiague, NY842-1 28
Name of Owner of premises ..m .......................................................................................................................... ~...
(Address) ' (Phone No.)
Name of ~,,k~.,,. H.H. York & R.E. Schenke
(Address} (Phone No.)
Neme of Contr, tor ...............
(Address) (Phone No.)
10.
12.
13.
14.
PLOT DIAG RAM
Locate clearly and distinctly all buil~dings, whether existing or proposed, and indicate all s~-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 Iot.~
STATE OF NEW YORK. Suffolk )
COUNTY OF ...................................................... )
...................... ~.~.~....~.,,~...~.~e,....]:~... ,~.,... ...................................... being duly sworn, deposes and .y, that he is the a~li~nt abo. named.
fNa~ of ~i~ sing ~n~act)
He is the O ontrac t or
~n~tor, ~, co~mte o~,
of said owner or o~ers, and is duly authorized to ~orm or have ~or~d the ~id work and to make and file this appli~tion; ~at all
s~n~ con~in~ in this application are true to t~ ~st of his knowle~ and ~lief; and that the work will ~ ~r~ in ~e ~nner
~t fo~h in the ap~ication fil~ t~mwith. ~EOR~ C. S~H ' r
~0~ P~C, State ~ew
...~ 1 3t~ ~.. ~ J~e ~o.
· .................
· ~nt~ ~z~hlir~ ~d New Y~nfies - ~ .,.
........................................................... =~.~ ~. ~t~ .............................................................
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12'- ~" 6'- 0" ~ 23L0''
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8;0"
3x B J,~I~S
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.... ~ TRIPPLE
7Lo''
7L I0'
3L6"
PITCH
5 ' CONC. FLO0 R
A
,]
FULL BASEMENT
:EXCAVATE POe
4 CONC, FLOOR
~5"o.c, --
13~0"
5x8 J ST3
16 o,c,
t5'~ 8" POURED
CONC. FTNC~.
(T YPICA L)
TOP COURSE
I2"CONC, BLOCK
FOR
DECK/~,EA RING
/
FOUNDATION PLAN SCALE. ~=t-0
A
9C6"
5"GARAGE FLOOR
CONC. BASEMENT FLOOR
SECT/ON
SCALE ~'L_ /'-0"
ETN5. FOR ';,
~ARA~ FOU~ZZ
CONC, FTNG
32L0~
i
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13~6"
BEDROOM
UPPER f3qRT
L/V/NC ROOM
UP?£R
fO'-2'
RT
Pr~ E FA B
13 -4
FLOOR.
504
6Lo"
12c G "
W~ GIRDERS '.
2xE JOISTS
BEDROOM
-- W)£' RAIL
GA RAOE
UTILITY
21L 8"
2-2v,8
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FIRST'FLOOR
SCALE~"=i'-O"
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4;0"