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Home My WebLink About5773-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...l~l~..]~ ..... Date ............. 8~pt...~l~ ..... , 19. THIS CERTIFIES that the building located at . D~Xin~r. I)x'~r~ ............ Street Map No. ~,..¢~. ~ock No ........... Lot No. ~ ....... ~.. ~..~, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~a~... ~9.~. p~suant to which Building Permit No. ~.. dated .............. ~...,~.~., was issued, and conforms to all of the require- ments oE the applicable provisions oE the law. The occupancy Eot which this certificate is issued is .~a~. ~. f~y..~W~g ....................................... The certificate is issued to . ~,~,~,~~ ....... ~ ..................... (owner, lessee or tenant) oE the aforesaid building. Suffolk County Department oE Health Approval ~..~..].~...~. ~, .~.. UNDeRWRITeRS C~RTIFICATE No ..... ~ .~ .................................... ItOUSE NUMBER.~ ....... Street.. ~ .~ .................................... w~ ne~ re~peeti~ ~fore ...... ~ ~0~ e~O~e Building Inspector FO~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? 5773 Z Permission is hereby gronted to: .......... ~..~...~..:....~.~.~..,!..~.~.~../....Z..~..~ at p~emise$ ~ate~ ~ ................................................................................................................. ............................................................. L.a.~..~:..~. ..................................................................... ......... ~.~.z ....... ~.~ ......... ~~......~.....~..~ ...... ~_~_~ .................. pursuant ,o application dated ................................. .~.Y....~4.~ 19~and approv~ by the Building Inspector. Fee $.....~,./......~... ..... Building Inspector FOBM ~TO. 6 TOWN OF SOUTHOLD Building Delm~tment 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 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 dJspasal--(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 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. Date 13 S..e~.tembe~: 197'2 X New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...................... ~...D..z..~..v...e.~......[~.....t~....e.~. .............................................................. Owner Or Owners Of Property ....... ..S....~..A......~...~e..z~..~..~.s...e..s. ........................................................................... Subdivision .... ..[~.....t~....e..]......C~.~..t...z~....~...s.t..&..t..e.s. ....... Lot No...~.~. ...... Block No ............. House No.,~.~)~.. Permit No...~?....3...~.. ...... Date Of Permit ..3./..~..O.../.~..~...Applicant .....Z...~....a~......~[~..~j...,T~.~., .................... Health Dept. Approval ...... .8../...]:..4.../.~..~. ..................... Labor Dept. Approval ................................................ Underwriters Approval ........ .~./...~..3./.~.3.. ..................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............. .X. .......................... Fee Submitted $ ..... ..5.....0...0. ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ~ Z-Z(3N]ESA ~C./K~aneth t~. ~z~u~t)ez ......................... ....... Sworn to before me this (stamp or seal) S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date 14 August 1972 Bldg. Permit No. 577~Z TO WHOM IT MAY CONCERN: The sewage disposal at facilities for a structure located ~505 De~m~ Drive, Lo~ #25 Laurel Coun~r~Es~a~es~ I~urel, Ney York (Cive deed location) have been inspected by this department and found to be satisfactory. Chief of General Engineering Services September 12, 1972 xi, i,l~c.t~,,.,~'o.o.f~l~ 580646 S.P.A. Delmar Dr. Job157, Laurel, L.I. d,,,j'oll,,,ci,,;h,catio,t~ ~ Basetnent ~ L~tFI. ~ 2nd Fl. & outside ,,',,~,,,',,',,~""'~"" September 8, 1972 ~ ,EQUIP ~2W 1~3W 3~3W~3~ P~R~ ~ OFCCCOND ' 0 H'EG ~;' Motors 1-3/4hp 1-1/12hp oil SUFFOLK COUNTY DEPARTMENT OF HEALTH APPLICATION FOR APP~FAL TO CONSTRUCT PRIVATE SEWAGE DIsPOsAL SYSTEMS Approval to construct said systems is requested,pertinent data herewith: Date 1-Applicant .... ,_~_ ~ Pho~-Sub div~m~ ~ ~*. 2-Detaileproperty location ~/$ ~ ~ 8-Lot No. Hamlet ~ Town ~%~ 9-Private well? 3-Public water supply name Distance to nearest main 4-Lot Size: Width~ ft. Length ~ ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~ Two Family? ~ /Cellar? ~.~_Slab? ; ~Crawl Space? 10-Proposed system: Septic tank F ;Precast ~ ;Cesspools ~/Shallow pools ~__/Other ~_/ il-Septic tank .inside dimensions: Volu~.e l -Precast sections: ! :Numb: ZJ_S uare Total blocks below inlet. ~1~2~3 PLOT PLAN Street,i .' The Undersigned CERTIFIES: Gals.Lengt,h~_~ft. Width ft. Liquid depth_ ft. Ft. Cesspools. Block sizeL~__~incs,D ~ins. H~-~ns. Capacity~Gals. rth 0 2 6 8 10 12 Indi No "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". Signed FOR HEALTH DEPARTMENT USE ONLY. Based on the i formation presen~e~ opinion of the Health Department, that an adequate and satisfactory Se~age Disposal System can be installed on this Plot. Date____~_~__~---- (lo/6 evis.) s-t5 Signed Approved ................. e~...:f......~., 19/....~... Pemif No. Disapproved a/c (Building a. This application must be completely filled 3 sets of plans, accurate plot plan to scale. Fee b. Plot plan showing location of lot and giving a detailed description of layout of c. The work covered by d. Upon approval of this application, the premises available for e. No building sheU be occupiec[ or granted by the Building Inspector. APPLICATION I~IT ~ ....... ..................... , INSTRUCTIONS ~ by in ink and submitted in triplicate to the Building.Inspector, witlt~ schedule. ~ on premises, relationship to adjoining premises or public s~reets or areas, a~ must be drawn on diagram which is part of this application. :- , not be commenced before issuance of Building Permit. - ~- Building Inspector will issue a Building Permit to the applicant. Such, permit shall bekept o in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been APPLICATION IS HEREBY to the Building Department for the issuance of a Building Permit pursuant to the Building ZoneZ Ordinance of the'Tow~ of Suffolfl Oounty, New York, and other applicable Laws/Ordinances or Raguletiomifor the oonstruction of buildings, additions or or for removal or demolition, as herein described. The applicant agrees to comply with ell applicable law~ ordinances, building code, and regulations, and to admit authorized inspectors on premises and in buildingr ~or necesse~y inspections. (Signature of applicant, or nama, if a corporation) .......................... . {Address of applicant) State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or builder. - . Bu:I.~.d®~ Name of owner of premises ..... ...~...~....~.e...~..z'...~,~.e.a. .................................. ; .................................................................. If appli~~duly authorized officer. ..................... ..................... 1. Location of land on which proposed work will be done. Map No.: ....... Lot No .............. ~ ........................ Num r ,~ 5/~, ~ 8 ]~e3J~tl' T~Jae Street and be ....................... ~ ........ / ............................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupa cy ...............................! ..................................... ......... b. Intended use and occupancy .......... :.~, .................. .~....~..~Rl~..~.~J....~...~.~r]g~ .................... 3. Nature of work (check which applicable): New Building ir Addition Alteration....". ....... ,. Repair ......................... Removal ......................... Demolition ..................... [.. Other Woi'k .................................... { Description) 4. c.t;~o+=a ~'~t ~22.000 o O0 .... F. ee ..~.: ........................................................................................... (to be paid on filing this application) 5. ' if* ' dwe lng, 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 ............... ..~..e..~...e. ............ 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 ........ ~.Q. ............... Depth ........ ~.7. ................... H.--- 20 ........ , ~.__.._. / :t~ .... / 9. Size of lot: Fron~ ...i...~.[~. ..................... Rear ............. .,3,.~D. .................... Depth ............ ,~.¢/0 .............................. Height ............. ~.~ .................................. Numbe? Of Stories ................ ~1~ ................................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law., ordinance or regulation: ...... ~ ................................................. 13. Will lot be re~'aded .................................. Will excess fill be removed frOm premises: [ ] Yes [ ] No 14. Nameof Owner of premises.....~..,t~.,~.~,~l,~l..~411,g,g.#~,..g~tg~.l~.g~...]latll;~..~..~ ...................... (Address) (Phone No~) XaXan ........ ..... Name of ,-,,,..,tact ................................................................... ~__ .. ~. ....... (Address) fi'none I~O.! Name of Contractor ................................ ; ...... , ............................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Ghnlt'street and blOCk nbmbei- or description according to deed, and show street names and indicate wheth- er interior or c0rn~' lot. / /5o' ~,/to · SI'ATE OF NEW YORK; ~: ' )) ,SS COUNTY OF ...................................................... ................................................................................................ ; ........ being duly sworn, deposes and.lays that he is the applicant above named. {Name of individual signing contract] ~ ' He is the .............. :~. ................................................................................................................................................................................................ {Contractor, agorot, corporate officer~ etc.} of said owner or owners, and is duly authorized to perform or have perfor~d the said work and to make and file this application; that all stetements,contained in this application are true to the best of his kdowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ...................................... day of .................................................. 19 ............. NOtary Public,. .................................................................... County ............. - ........... Lot ~4 i. ot R=WS,ONS YOUNG & YOUNG MAR. 29~I~72 400 OSTRAIqDER AVENUE, RIVERHEAD. NEW YORK MAY I, 197~' ALDEN W. YOUNG HOWARD W. YOUNG JUNE 19,1972 PROFESSIONAL ENGINEER AND LAND IURVEYOR SURVEY FOR: S.P.A. ENTERPRISES, INC. LOT 25 "LAUREL COUNTRY ESTATES" GUARANTEED TO: ATLAUREL SECURITY T TLE & 0UARANTY CO. RIVERHEAD SAVINS$ BANX TOWN o; SOUTHOLD _L.: ,,,=.o, I""' MAF~'aT'IS72,1"°' 72-2.22: , Lot ~6 RZWS~ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: S.P.A. ENTERPRISES, INC. LOT 25 "LAUREL COUNTRY ESTATES" AT LAUREL GU^RANT*ED TO: TOWN OF SOUTHOLD su~o,, co.. ,. Y. SCALE: III 4 0 I -- DATE: MAR.27, 1972