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Home My WebLink About5834-zFOB, M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.z?oI~ ....... Date .. Ray. 9.~, ................. , 19.. 76 THIS CERTIFIES that the building located ~t~iga~2~.ne .l)r[~e ...........Street Map No. Bal, bol, .Li.g.~J~ck No ........... Lot No....~9 ..........~outhol~ ........ confoms substantially to the Application for Building Permit heretofore filed in this office dated . 'AI~'i' 2'~,. ......... , 19.7.2. pursuant to which Building Permit No..~!~. dated ... April. 2~;, ......... , 19 'F~', 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 . 'P~':LW&te'-Om. F~;~t].~' .gwe.llL~g ................ ' ...................... The certificate is issued to ...&~:thur. & .L~ae~lZe. ~tl~le~en ....................... of the aforesaid building. Suffolk County Department of Health Approval (owner, ~ · .A'ag~,. 8. ~ 9'?~. by .Ro..Vlll~ ...... UNDERWRITERS CERTIFICATE No .... N. 27..~16 ............................... HOUSE NUMBER 2.120 ......... Street ... ]~lrlga~;.tne. l)~J.~® ..................... FO~I,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? 5834 Z Permission is hereby granted to: ................. ~....~,~,.. Jain .....~ ...................... at premises located at ,.~t~,~...~....J~r)Del,,J~J,~tt~.~,~- ........................................................ ........................................ ~,J4aat4~. JJ~e ........... ae~tlael~....I.,1~o ........................................... pursuant to application dated ................... ~,J~l~J.,~,....2~ .............. , 19...~, and approved by the Building Inspector. Fee $.e~l~.e, .~ ........... Building Inspector pERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE pREMISES BY RFGRADING LOT DRIVfWAY CONSTRUCTION CESSPOOL CONS f RUCTION CELLAR CONSTRUCTION OTHER --' -- FOltM NO. ¢ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .Brigan$~e .~r~v.e ....... Street Map N .o~..~b.°.r...L./.ght~lock No ........... Lot No. ~9....~..o~.t.ho.l.d ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Ap.r!.! ..2~.., 19.72. pursuant to which Building Permit No. dated April 25 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 ...P.r.I.V&~;~..9n.~..$...a~..1.$..d..w~.l..1;I..n[ ..................................... The certificate is issued to ...~T..th?.~...&...~.1.1..1.~..Ap. d.~.x,.s.e.n ..... .O~n.. e?.~' ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. $.ug....8...1.9.?.2..b~r..R.:. V./.1.1.& ..... UNDERWRITERS CERTIFICATE No. P.?.~d..$~.g .................................... HOUSE NUMBER ...2.~. 29. ...... Street..B.r.i.g .a~..t..i0.e..D.~ ......................... NOTEI Temp. C/O &- Bldg permit expire Oct 1975 f~,. ..... ....... B~i~ing Inspe~t~ .... FORM NO. 6 TOWiq OF SOUTHOLD , Building Department Town Clerks Office Southold, iq. 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 19§7), 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 May 25 1976 Date ......~. ........ ~ .............................. New Building ...... 2{ ....... Addition ................ Old or Pre-existing Building .....~.6~.~5.oVfc~O, nt~ea~d ~'UY'T~ ..... Location Of Property ~.q1~..~.~..5...9.~....H..a...r..b...q.r.~...L..i..c/.h...t..s.~...E..s.~.t..a...t..e..s..~.....2..~...2..~.~...B..r..~.~.a...n..t...i..n..e..~..D...r..i...v..e..~. Owner Or Owners Of Property Arthu. r A. and Lucille Woolis Andersen Subdivision Harbor Liqhts /^. No......5..9..... Block No ............. House No ............. Permit No. 5834Z Date Of Permit .4./...2..5.../..7..2. Applicant Arthur and Lucille Andersen Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate ....x.. .................................... Fee Submitted $ ....5......0..0. ........................ Construction on above described building/and/ perrn~meets all9 applicable ~:~xles and/Aulations. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or ~ ~. f~ FORM NO. 6 TOWN OF SOUTHOLD Building Delm0tment 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 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 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 3. Copy of certificate of occupancy $1.00 $5.00 Date . .D..e..c...e..m..~ .e...~... ,3..0. '.....]: .?. 7..4.. ...... New Building ........~. ........... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..2..Z...2.~....~...~.c]..a..~...t...j:.n...e..~`~.~..v..e..~.~...~..~..~...~.~.~.~...~.~.~.~ ................................. Owner Or Owners Of Property ..A...~.~..~..u..~.....A...*...~a.~..~.....~...u.?...~.~.~...e.~.~..9.Z.~..~..~.~.~.~. ............................ Subdivision . ~a~.~.g..~...~.~.g..~..~..~. ............................ Lot No. .~. Block No ............. House No ............. Permit No....5...8..3..4....~.... Date Of Permit ...4../.2.5./...?..2...Applicant A...~.~.~...u..~..~..a..~...~..~.TH..u...qj~.]~..[.e.....A..~...~..e...~..s...e.~ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ..................~. ..................... Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit m.e~ts all appli~ca~le codes ond regulations. Applicont ~ .~....~ ~r~ ~ ..... ................................................. Sw°rn.~.°~b~fa°;eofm.~ (~ ~ (stamp or THE NEW YORK BOARD OF FIRE UNDERWRITERS dl BUREAU OF ELECTRICITY 85 .JOHN STREET, NEW YORK. NEW YORK 10038 na,e March 24. 976 ~pplle..on~,'o.o,,fUe 58337:]. N 275316 THIS CERTIFIES THAT o~ly th e electrical equipment ~ ~scribed ~elow and introduced by t~ applicant named on the above application number in the premises of Arthur A.Andersen, in ~he followlng location: ~ B~sement [] Ist FI. ., ........ ,i,,ed,,. March 22, 1976 RXTURE 2120 Brigantine Drive, Southold, L.I. ~ 2nd Fl. outsidesectlo. BIocn and fouled to be in compliance witb the requirements of this Board. FIXTURES ~RiNG C Ni D[ECwK SWITCHES NCANDE$CENT ~4E"CU~V A~A ~SW OA~OKT! S ~ o,, ,uLU.,E ,2. C,O. C2 2 F I * 1 200 CB j x t 3/0 OTHER APPARATUS: OVENS DISH WASHER T KW. ANAT. KW. 1 1.5 UNIT HEATERS MULTI-OUTLE SYSTEMS NO. OF FEET C EXHAUST FANS 3 DIMMERS 3/0 *Special Recp.: 1-20amp, 1-30amp, 1-50amp 1-4.5kw hot water heater Main Rd. Southold, L.I. 11971 ~EN Per ~ -f ~:~Z~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by the' ' . SUFFOLK COUNTY DEPARTMENT OF HEALTH ~.- H.D.Reference No~) c~; 2z~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE S,EWAGE DISPOSAL SYSTEMS D t '~ ' h ,.i ~ · se/' Approval to const?a, ct s_aid sys. tems is requested,pertinent data herewith. ~ rtn a o ~ l_Appticant~UCl~eAWoo~ls Andersen Phone 765-166~-Sub div ~arbor Liqhts Estates Address 685 Bay Haven Lane, Southold, N.Y. 7-Section $ 2-Detailed property location1560 BriGantine Dr 8-Lot No. 59 Hamlet Southold Town Southold 9-Private well? Yes 3-Pabtic water supply name None Distance to nearest main 4-Lot Size: WtdthlO0 ft. Length200 ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~x~ Two Family? ~ /Cellar? ~x/~Slab? ~ ~ Crawl Space? ~ / lO-Proposed system: Septic tank ; yPrecast y /Cesspools/ /Shallow pools / /Oth~ / / il-Septic tank inside dimensions: Volume ~Gals.Length ft. Width ft. Liquid depth ft. I2-Precast sections: ~Number/ /Square Ft. Cesspools: Block sizeL incs. D ins. H___ins. Total blocks below inlet: ~I~To ~2_~_~3 Vacant Vacant 200 Vacant PLOT PLAN Ta~ Vacant ~ :00 100 Vacant .Gradei U Street Vacant 100 Bricantine Drive Vacant Vacant Indi ~ate No rth Capacity ~, ~C~als. O.P.M. T~st H, Data Feet 0 2 4 6 8 10 12 16 (10/65 Revis.) S-15 Date {~ ~'/~ ~--- Signed The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments~theretO,Date~ ]Q~c°vering Signed~~Private/ewage DisposalS. ~ Builder ' FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an sdequate and satisfactory Sewage Disposal System can be installed on this Plot. ~ ~ TOWN C~RK S OFF~ / ......................................... __ .~ This ~p~i~tion ~ of ~*ns, ~ur~:'~ot ~en to' scale. Fee ~0rding to sche~le. · ~ot pl~ showing I~fion of lot end of ~ildi~$ on premiss, relationship to ~d oining premiss or ~blic ~ or ~re~, glw~ ~ M~il~ ~s~ipfion ~ I~out of pro~ must ~ dr~wn on diagram which is p~ of this ~ppli~tion. T~ wo~ ~md ~ this ~ppli~tion m~ not ~ ~mmen~ ~fore issu~n~ of Building Permit. U~n ~11 of this ~lication, the Building Ins~ctor will i~ue ~mi~l ~lt~ for iron'ion throughout the work. No ~ilding s~ll grBn~ by the ~ildi~ In~ctor. kPPLICATION I~ HEflEBY MADE.to the Building De~nt for the issu~n~ of ~ Building Per.it ~ ~':~ Building Ordin~n~ of t~ To~ of building, ~ditions or II~r~tiom, or for removal or demolition, ~rdin~, buildi~ ~, ~sing ~, ~nd ~gul~fions, ~nd ~o ~dmit ~uthorized ins~to~ on p~mi~s ~nd in ~i~ f~ ~ ink.ions. (Signature of applicant, or name, if a corporation) 685 B.a.~ HayeD. La~, .~.t..~..~.ld~ .~.~Y,. (Address of applicant) State wt~ther ~l~plicant,is owner/lessee, agent, architect, engineer, general contractor, electriCian, plumber or builder. Name of owner of premises ............ .~......t~. ,~, ~A~a~-`d~q~c~e~~A~d~e~ ............................................ If applicant is a corporate, signature of duly authorized officer· (Name and title of corporate officer) 1. Location of land On which prop_ose~, work will be do.ne. Map No.: ...5..1...4.7.. ......... Lot No ........... .5...9.. .............................. Street and Number .....~..~..~..%.~.a..a...~.~..n..e...,D..~..½...v~.. ............................................................ .s...o..~.t~......o..1..~. ................ ~ / c:>~O ......... , Municipality ..... · ~',,l,:~ - ,/ . 2. state exmt~ng use and occupancy of premmes and ~ntended use and occupancy of pm~ co~ll~t~jon: · · Vacant : :, ': ~ . · Exl~lng use and occupancy .......................................................................... i.;.~-,., ......... , ...... ,..~.~. ...................... a Single ~amil¥ Dwell*rig --, ,, ', ',~ '~'~ b. Intend~l use and o~upancy .................................................................... ~,~/ ...... ~ ...... ~....> ....... ~,.~ .................... I~atum ~f work~ (check which applicable): New Building .......... ~..'....%.., Addition ..................... Alterat~..~.., ......... Repair ............ .. ...... . .... o Removal Demolition Other Work (Description) 4. Estimated Cost ........~..2..4:.~, .5..0., ,0. ....................... Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ..1. ........ 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 .~.O.I~..,a~P,~J~[.~. ........ , ............. Depth ................................... Height Number of Stories ' Dimensions of same structure with aiterati0ns dr additions: Front .......................... Rear ......................................... Depth ............................................. Height ..... ; ................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......... 42. ........... Rear .......... t[2. ............. Depth ........ 2.8 .................... .IDe. ck along front: 5 x 28) Height ................. ..2..7. ........................... r~umoer ot Storms .................................................... ,k~ ................................ 9. Size of lot: Front 100 100 De th 200 ...................................... Rear Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ...~..e...~..-.....]:.2..t.....1..9..7...2..... Name of Former Owner .,ff...~..e...d..e...~..i..c..~....R...e..e.§..e.....a..~..d.....H..a..~.o...l.~...~.~9 11. Zone or use district in which premises are situated ~n~g~e~a~m~/~D~e~1~1~/~n~g~T~c~ ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ............. .~.o. .......................................... 13. Will lot be regraded ............ ~[~ ........ .......... W[llexcessfiJlberemo~.~adfzomp, rgmises: ix] Yes [ ] No ~r~nur ~. an.~ersen & ~u~ Bay ~aven ~.n. ~4. Name of Owner of premisesLu~e..#e~1~..A~d~ma~n.....SeH~14ty..~.y.w..., ........... .7..6..5..T..~..6..6..9.. .......... (Address) (Phone No.) Name of Architect ~C~a~[~P~H~.m~.e~s~.4~6~E~5~t~h~A~v~e~:~x~C~?~~[~~[ ..... (Addre~s Bay Haven Ln~Ph°neN°.) Name of Contracto ~r%~t~h~u.~r~A~&~L~u~c~i~.~e~W~A~d~e.~r~s~e~n~'~S~u~t~[~t~s ........ 7.,~5.T...1..6..6...9. .......... (Address) (Phone No.). PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give stTeet and block number or description a6cording to deed, and show street names and indicate wheth- er interior or corner lot. Interior Lot Vacant :~00' ~ $1' I~ O Vacant ~ u~ STATE OF NEW ~:IK, ~ ~ [~ ~'~ ) ~S' COUNTY OF ....... ~ ....... ) ...... (Name of in~vi~l si~ing contract) Lot #59, Map of Harbor Lights Estates, Section Three, Bayview, Town of Southold, Suffolk County, N.Y., filed in the Office of the Clerk of the County of Suffolk as Map No. 5147. being dulY sworn, deposes, and says that he is the applicant above named. He is the ......................................................................................................................................... ~ . .:(Contractor, affent, corporate officer, etc.) elrl~wner~ and !s duly ~luthorizad to perform or have performed the said work and to make and file this aPPlication; that all · statements contained, in thi~ application~re true to the best of his knowledge and belief;l~Xl[ohat the work will be performed in the manner set forth in the apP~cati°n filed tll~'ewit~~ N~k%GERY D. , - Yo~ ' , . ! / ~u $.,'7 V ' (Signature of app~t) L ~? I RESIDENCE ~0~' DR'N BY DATE PLAN ,N.O. variations from these d mensions and conditions shown by these drawing . J PI LAS TE~R.:LAM.BEAM HorneF 0 N RESIDENCE FOR DATE PLAN NO __/