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Home My WebLink About5851-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate O[ Occupancy No. Z'~O~ Date December 2~, 19 80 THIS CERTIFIES that the building ................................................ Location of Property h~o..0 Clear'view Avenuet ............ ~.o.u.~..h.o.J,.d.~..N...Y.: ..... · ' .................... Street Ham/et County Tax Map No. 1000 Section ...0.7..0 ...... Block ....... 9?. ..... Lot ...... .0.~.6. ....... Subdivision Smithfield Park .Filed Map No. h770 .Lot No. 6 conforms substantially to the Application for Building Permit heretofore Fried in this office dated .... MB~..5 ........... ,197'2. pursuant to which Building Permit No .... ~.8~.q..Z. ........... dated .... N. 0y..~l.b. 97..q..6~ .......... 197..2. , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ~rivate One Family Dwelling The certificate is issued to .... Theodore..and. Re, cie. L~bL~.t,ob ....................... (o wn*r, te~teefctesl~ of the aforesaid building. ................... '1 80 Robe~ A. Villa Suffolk County Department of Health Approval S0-'1 '105 Dec:. ./! .................... UNDERWRITERS CERTIFICATE NO .... NS. Q2..67.8. ..................................... Building Inspector Rev 4/7g ~0~ ~0. 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 AUTHORIZED) 5851 Z Permission is hereby granted to: ........ ...................................... ................. aentlzel4 ........................................... to ...~11,%~.. ney.. ane...£ala~'...d~ ll:l.llg ................................................................................... at premises located at ....]~t..~.....~Ua~..P&Fk .................................................................. ................................. · ~eaa'~'~l~v.. &we ......... 8ea~J~td.....B,.~., .................................................... pursuant to application dated ...................... J~/......~ ................... , 19.~2.., and approved by the Building Inspector. Fee $..Jl'.~ e I~0 ........... ur rang nspeTr FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S49 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion 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 ~/~ -~'~- New Building .../.. ....... Old or Pre-existing Building ............ Vacant Land ............. o ,. , ...................... Location of Property ../.~ :~.. C/e~l~/ ~ .~ House No. Street Hamlet Owner or Owners of Property l hg'ojo~'~-~ ~r ~ 2¥ c_ ...L...~.)q!.~.l.~..[, .................... County Tax Map No. 1000 Section . .Q.'~. ~:) ....... Block .O..~., ~.~. ..... Lot. Subdivision ~ .no.l.~!,.~.l.~;~.~...~-~.( ............... Filed Map No. 4~ 7 7C~ .Lot No...~ .......... Permit No...~.~.~..~./.. Date of Permit ~.:~ ~...Applicant..~. .......... - ...... ~.'.. Health Dept. Approval....~..D..).)..0.~..'~. ......... Labor Dept, Approval ........................ Underwriters Approval..~..~).0..~... ~.,~. ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~, .'. ,~.~ ..................... Construction on above described building and p~.rnlit meets all applicable codes and regulations. Applicant...~'/?.'~.....~...~.~ .......... ~ S-9 SCIID TO WHOM IT MAY SUFFOLK CONCERN: COUNTY DEPARTMENT OF HEALTH Date ~ldg. ~mit No. The sewage disposal facilities for a structure located (Give deed lo~ation) ~ have been inspected by this department and found to be satisfactory. l)hlef of Seneral Engineering Se~wlces THE NEW YORK BOARD OF FIRE UNDERWRITERS ~1~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..te Deeemlx~ 9, 1.980 Ap;o,ic,,t,o. No.o,,.me [01.672 N 50267~ THIS CERTIFIES THAT only the electrical equipment as described ~_ ~1o~_ ~ an~introduced b~[ the app~ican~t~n~_lla~d o~t t~ above application number in the premises of in the following location; was examlned on ~ ~ , ~.~0 and found to be in compllance with the requirements of this Board. ~uXTTLUEI~[ IECSPTACLES SWITCHES FIXTURES "v~'"C?~o~Y RANGES COO~KT!N D~,CwKS ~ ENOw' D'~ AS~cHwE.RS DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL EEC'PT, TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS SERVICE DISCONNECT NO. OF S E I V I C OTHER APPARATUS: [] Basement [] 1st Fl. [~2nd Ft. Section Block Lot EXHAUST FANS DIMMERS ~O. OFHEUTRALS A.W.G. OF NEUTRAL 2L20 61:h F. amC M~tdo~, N.Y. This ce.ificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ~ ~nti~l~_ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~NNER~ SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference No~?-//Ji~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is .requested,pertinent data herewith: , Address K*,,e~¥gA $~ I~-C. .~,~,~'r~ ~,~. /l~71 7-Section 2-Detaile~e~lo~,t,~o.~. ~#?~ ~,'~ ~le~v~e~ ~,~ 8-Lot No. ~amze~ ~2.~ k'.,.. ~.,/~, 9-Private well? 3-~blic ~ter supply name ' Dis~nce to nearest ~in 4-Lot Size: Width l~ft. Length Aff~t. (also enter on center plot plan below:) 5-~elling: Single Family ~ ~T~ Family? ~ ~Cellar? ~ ~lab? ~ ~Crawl S~ce? lO-Pro~s~ system: Septic tank ~ ~Precast ~ yCess~ols ~ /Shallow ~ols il-Septic ta~ inside dimensions: Vol~e ~als.Length ft. Width ft. Liquid depth ft. 12-Precast sections: ~Number/ /Square Ft. Cesspools: Block sizeL incs.~ins. H ins. Total blocks below inlet: ~11~0 ~2~3 ~T P~N .P.M. .Grade I ~ Street Data ~eet 0 2 6 8 10 12 ~6 18 The Undersigned CERTIFIES: Ind~ "Construction of authorized installati~ will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date~$~ ~)1~7,~,t Signed Y2~_~/m~ - or- - ilder FOR HEALTH DEPARTMENT USE ONLY. Based on--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 ~-~ ~/~ ~ (10/65 Revis.) S-15 signed TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .......................................................... 19 ........ ~1~! a o(°Wr~°r~th°l~Tage~ ~f~°~l~[~ ~,,. ¥ (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .......................................... Other Applicable Laws, Ordinances or Regulations ' ~ at premises hereinafter described in that ...................................................................................... ~ ......... (state chcl~.r of violation) · ~,'~'"'r~'/'~,~' ........ ~'i~"~"'"~ ........ ~i~ ~'i' fi'Vi~"~;~'[: ....... ~'~'""~"~/~'i;/~ ;~' ....... .............................. ........... .................................................................. in violation of ........................................................................................................................................ (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and t0.,~;ly the conditions above mentioned forthwith jrt or,before the ,Ju~.¥ 1~, .................................................. ~ ................... day of ................................... : .................... 19 ........ I'[tO ~JL~/l~/tJ'-~ I:~' es! to ~J~ich ~'0 ~? f-l{~::)/,, .~)this ORDER TO REMEDY VIOLATION refers are situated at ................................................................................ County of Suffolk, New York. Fcfilure to re.reedy the conditions aforesaid and to comply with the applicable provisions of law:: may constitute an offense punishable by fine or imprisonment or both. Building Inspector _~ -- TOWN OF SOUTHOL~ ~ ~ ~'F~' BUILDING DEPARTMENT x~. I~ ,~ ~,_~ ~UTH~D,N.y.//~V ~ ~ ~ ~ ~,~,: .......... ...................................................................................................................... · ~-~ -- APPLICATION FOR BUILDING PERMIT~ 3 sets of plans, accurate plot plan to scale. Fee accordi~ to s~ed~ ~ ~ b. Plot plan showing Io~tion of lot and of buildings on prem~hip~ ad~[~i~~reas, a~ giving a detailed description of ayout of pro~r~ must ~ drawn o~ffm ~hi~ p~i~n.- 'c. The wo~ ~ve~ by this appli~tion may n~t ~ ~mmen~d before issuan~ of Building Pe~ d. U~n approval of this application, the Building Ins~ctor will issue a Building Permit t~ ~i~nt. Such ~rmit shall ~ k~t o~. the premises available for inspection throughout the work. ~ e. No builUi~g Shall be occupied or used in whole or in part for any purpose Whatever until a Certificate of Occupancy shall have beeni granted by the Building Inspector. . * . ~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zo~ Ordinance of the Town of Southold, Suffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the oonetruction ~ buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply With all applicable laW~, ordinancas, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) State whether applicant is owner, Ieee, n~nt, nmhit~t, engin~r, ~nernl ~ontractor, electrician, plum~r or bu der. O~ey Name of owner of premiss .~ oY~... ~ I~lc %~'- If applicant is a corporate, signa~ re of duly authorized officer. ' .................... j ..................... 1. Location of land on which proposed work will be done. Map No.: ...... ~ ........... L,, ,~ ............................................. Streetand Number ~/earVl'e~u ~Ve, ~'a~c)~ejJ~, ~ MunlC~li~ 2. Sram exi~ing u~ and o~upancy of premiss and intended u~ and ~cupancy of propo~ con~ion: 3. Nature 6f w~rk (check which applicable): New Building ...... ~ ...........Addition ............... ~.~.: A[~eration~...:......L.. Repair ......................... Removal ................ ....... . . Demolition ........................ Other Work .......... (Description) 4. Estimatec Cost ...'~....~.~..~..~.g'ff ......................... Fee ......~....~..~...~.?.~ ................................................................... (to be paid on filing this application) 5. If'dwelling, number of dwelling units ..... .! .......... Number of dwelling utfits 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 ..;..w .................................. Depth ................................ .. .... . . . .. ~.. He!ght .................... . . .. ................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...7../...'~-~ ...........Rear ...7..~/...7.. ............... Depth Height ~.i~.~.OX' 000! ' / '- Number of Stories ! 9. Sizeoflot: Front ..... ,]..~...0..~. ...................... Rear ...... .7...~.. ............................ De th Height ................................................... Number of Stories ..................................................,, ... ,......,,,...,,,......,.,,,.,,, .............................. Former Owner. ~ ~ ~ ~.?..~!.?.. ...... CoY . 10. Oate of Purchase 6.ff. tr"~5')~7°~' Nameof_ ,_ ,, ................... ,~ .......¢ ....................... ~' ~' '' "' i~esare~tua~ed'..; ...... ._.___...______~.--~?.-~--~-~--.-~-!--~--) 11. Zone or u~ d~stnc~n~mch prem 12. Does proposed c0n~ru~c, tion violate an~ zoning la~. ordinance or regulation: ...... ..~....O.., ............. , ............................. 13. Wdll(~t*beregraded-__:~___%.~.. ................ ,....,. Will excess fill be removed from premises: [ ] Yes [t~/No ................. ~. ............................................................. Name of Architect ...!. ................................................................................................................................................ (Address) (Phone No;) Name of Contractor ................................................................................. (Address) (Phone No.) property lines. Give street and block number or description according to deed, and show street er interior or corner lot. ," 7~' ~ 0"----~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from names and indicate wbeth- . ~; .i' couNTY OF....;... ~ ....................... ) :.~...~i.....:.: ......... .../..~:..~ :...r~.......~...~v. ................... being duly sworn, deposes and, says that he is the applicant above named. (Signature of applicant) (Name of individual signing contract} (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 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 in the application filed therewith.