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Home My WebLink About6045-zFORM NO. 4 ~ TOWN OF SOUTHOLD, Town Clerk's Off,ice Southold, N. Y. Cerlificate Of O, Date :cupancy ......... Apt. il... ~ ....... ,19.7:] THIS CERTIFIES that the building located at l~lttr, t~].1~ .&. A~baeo~. Street Map No. g~hoJA, gl'~l~No ........... Lot o! .~.~... I~®~l~org.. ~ o¥o..¢sowl;hoJ~ I R,~,D) conforms substantially to the Application for Buildimg Permit heretofore filed in this office dated .......... July ... ~ 7.., 19.72 pursuanf to which Building Permit No.&~+~... dated .......... ~..AU~ .7, 1972., 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 Pr&vat®..o~e..f.a~]r .dwelling...~ .................................... The certificate is issued to .i'etel,. &. ~elin .. 0t~om~al~ ..... Ob'~el, I ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Ma~...26...1973...by. R, .Villa .... UNDERWRITERS CERTIFICATE No. Il..~..80~ ~..Mal'...111....1973 ........................ HOUSE NUMBER..~O~t~. i ..... Street .... ~.b&O~l~$. ])~. ............................... .................. .~.o5..~.., ~x..~.~. ~a.r.x..~.,, ~ ...................................... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6045 Z Permission is hereby granted to: 7m~,~l~..C~n~t~ ~-..~-.&~...l~te~'..&.. t~..~ ~ .... ~0'"' ~m.~m~ "~$~w/' ........................ ......... s.~:.~:[~,...., w.; x.;;....1.1.782 .................... to ~eA~. ~t ..~...e~e...f. ae&.~y.. 4wet t.~ ...................................................................................... at premises located at ....~.~t~,...~l3 ....... ~Bt~O'l~"f~/'e~ .......................... ~ ................................... ................................... A.~beee~e.~)r..&..~l~_n''~ ............ t~'~n~por'~ .................................... pursuant to application dated ..................... d'lL~7' ...... '~'~' ............ , 19~..., and approved by the Building Inspector. Fee Sf~SV~O* ........... Building Inspector / "FASTFA~N' DISTRI~T,~TRHFA~,~.Y, H.D.Rsferems No. ~0 - Ap~l ~ co~t~ct e~d syst~ i~ r~uest~,~ent ~ta her~th: " 3-Pubic ~' supp~ n~e ',: .; .-. ,t, - , . ~a~ce to n~t ~ ~p.~. P~ P~ . ~ .~:~1 '~Y'~' ~ · :'I. : , ~ata ~bet 16 Ind~ ~t The Undere~ed CE~TIFI-~: "Construction of authorized installations wLU be in accordance with the SuffOlk County Health D~par~ents' current Standards,~,11~tins, and amendments ,thereto,covering Private Sewage Disposal ,-' ~ or Builder ,../'F~ ~ALTH U~A~T USE ONLY. Bued on ~e ~o~tion presented her~th~t is the, optn~on of the H~lth De~t,t~t ~ ~ate ~d ~at~fac~ S~e ~s~sal Syst~ APPLICATION FOR APPROVAL TO CONSTE~¢T PRIVATE ~Ew~GE DISPOSAL SYSTEM~ INST~b~'A'-u~$: A~plications must be submitted in triplicate 1-Means Owner or Builder. Address to ~hich mail should be directed. 2-Means detailed description of property location, together with street name and distance to nearest intersection of main thorofare, also Hamlet/ViLlage & Townshi~ . ~Enter name of Public Water Supply District, together with the distance to their main. 4-Enter 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 Number 8-Lot Number 9-Private well: Enter ~No" if public water supply is available. Enter '"~es" otherwise. PNOPOSED SYSTEMS: Answers to Items Dnmher 10, il, & 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 1~ " " " " " " Unusual soil conditions Part ¥ " " " # " " Shallow Leaching Pools PLOT PLAN: The following information is required concerning the Applicant's Lot: Lot size-Length and Width in feet to be indicated at the Lot lines, of the heavy lined square in the center of Plot Plan sho~m on face of this application. 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 aisc. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. %~ere no Buildings exist on adjacent lots, state "Vacant" on the plot plan. Streets adjoining applicant's lot to the right, left or rear, enter street name. WELE LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the following Standards must be observed: Well-lO0 feet milt--ma distance from the nearest cesspools Well-25 feet minimum distance from rear, and' rear sides of property lines ~' Well-lO feet minimum distance from front, and front sides of property lines Well-50 feet minimum below grade for well point We]_l-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-10 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, Lakes & Bays, etc. Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center must be at least 16 feet Cesspool cover top to grade must be held to minimum o,f 1 food to maximum of 2 feet Bottom of Cesspool to groun~ water must be held to minimum of 1 foot FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. ¥. 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: 1.Accurate survey o~ 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 .~..Z.~..Z~,~... Dote blew Building .................... Old or Pre-existing Building ............................ ¥ocont lo, nd ........................... Location Of Pr ertv ~./..'~... ~....(~..~'..~...~1~'......~.Z~...~.......~. ~¢' Owner Or Owners Of Property ...~......~.....~./~.........~..~.~.......~..~.~..'..~.. .............................................. ..~..0.?..~...~i)ateOf Perm,t ZZ.~ ~..e~DDhcont ~.~.~...~..~.. ~*~~ Permit No ................. ' ....... ~.. ~_ ' ............................................................. Health ~p,. Approval .~Z~Z~.~.:~(~abor ~pt. Approval ................................................ Approval ~ 7~0/~ Planning B~rd ~provo, Unde~rite~ .............................................. ~ ........................... Request For Tempom~ificate ........................................ Final Ce~ificate .......................................... F~ Submitted $ .........~ ...................... Construction on above described building and permit meets all c~plicable codes and regulations A hcant ~ .//'~~ ' pp' . ......... ~;~..~....~, ...... ~"'"'YfL .............................................. (stamp or seal) ~ ~ ~'; Swo~rn~before me this · .e day o, Nota~County NOTARY PUBLI~', S~at~ ol Now York No. 52-1~3~ ~ua~fied in ~,a~iol~ County ~n Exp~Fes M~cb 30, 197~ · q~. ' SUI~VEYED FO[ SCA L E · 40' = [" ~ = IF/.OIq PIPE · ~ = TAC.~ED STAKE PETER LI:LIA OUZOUNIAN ..... $ITU~,TF. AT AIZSI-IAMOMAQU E: TGWN OF $OUTHOLD, N.Y. · · NOTE: LOT NUMBEE$ SHOWN ~EFEF. TO # MAP OF <JOUTHOLD SHORES" FILED IN TN£ SU[~FOLK COUNTY CLEIZ, V.'S OFFICE AS MAP N9 IA~ ~T~t*,T',ON o~ 'to ~ su~'Aw is * v~Tt~ m TO~S~I~T~C~~AV~. $ SURVEYED · JULY ~,~-~,-~- VAN TUYL a SON m~s~~ LICENSED LAND MAP OF' Pl]OPEi]T¥ SUE. VEYED PETER ~ LEL[A OUZOUNIAN SITU&T~ AT "A ~SHAMOMA,QU E" TOWN OF SOUTHOLD, N.Y. ..... ~k~ .- ~ SOUTROLD SHORES" FILED IN TUE SUFFOLK . ~-' COUNTY CLE~'5 ~FFIC~AS MAP N~ ALBACOREDR. ~X~ ~."' ~ANAL ,,;-.r-~"""'"""".,,'-' '~ " MAP OF PROPI::RTY , ',. $'&~'$2' ~O'E. 5UR.¥EYED FOE. '"" P[TF_R LI::;LfA OUZOUNIAN SITUATE - AT /..- ,. ~ .,...0, , _ /~. ~ o::\ e_ o ,~ · NOTE- . -~ ..~ '-.. ~./,,~,\4a ' ~ \ ,.~ ~ ~..~ SOUTI4OLD $140RE$" FILED IN TIlE SUFFOLK .. -'T.~--~.. ,_,~ L ~ ~,,~"' ~,"t, . ¢ ~/'~, ~ ~, .~, COUNTY CLEE. K'$ OFFICE, AS MAP N~ : ? ~ ''~ $0-w ¢' ., \~ ~ ~ TOSEC~.;ONTHtS'SURVEY?20t OFISTHE NEW YORK STATE ~M,OS~..'~, ~^[ ;~;~,~ .~T ~ co~s,~,m ~ URY EMil D 1~ C.. 19. 1 9TZ SCA L E 40 [ ou^,,,...:$ ,~,=~?E~ ,,~,::,-_,., ~.^,.,,,.,. "JZODER1CK VAN TUYL, I~t = MON U M E kit TITLE COh':~^:':¥, G;>VL:~<ki~N,AL AC~kNCY Ai'"~ BUILDING DEPARTMENT . -- -- TOWN CLERK'SOFFICI ~//g-~_.~ .***~=.,~'~'~ ~/~" .A/.,..,~,q~'~- ~,,~__. ..................... ~'"':" .............. ' ......... . ~.~J,~. ~~ I _ ~. ....... ~, ............... ,~..~.~. ,__,,,,_~..~ ~.' ..... i: ............. . ............. ............................... *PPLI~TIOH FOR BuILDIHG Fl~l~~ Ju 1 1 2 ~ ............. ~.....Z~.,.,.gZ ...................... , ~9 ............ Thl~ ~ppli~ati~ must be ~let~l~ {111~ in b~ ~rl~r ~Jn In~ und ~mi~*~ In ~11~ I~r. ar~s, a~ 'g~l~ a d~a~ ~rlml~ of ~ ~p~ must ~ d~ on h dl~mm ~h c. ~ ~ cM~ by this ~licati~ ~ not ~ c~me~ before inua~e ~f Bu?dJ~ d. U~ G~al of ~Ls a~licmi~, the Building In~ctor~lll In~ a B~I~I~ ~ ~ ~ ~lJ~nt. ~all ~ k~t ~ h pmmiHs ~ilable for in~ti~ th~g~o~ me p~ o me wo e. No buildl~ s~ll ~ ~cupi~ or uMd in whole or in pa~ for any pu~e ~ate~r until a ~lfic~ of shall h~ ~en gmn~ by the Bulldl~ In~r. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permtt I~mmanf to the Bud ng Zone Ordinance of the Town of Southold, Suffolk C~ounty, New Y. ork, Grid other .clppl~le ~ ?di?mc.~, ? Regulations, for the construction of buildings, additions 6r altergtions, or ,t.or removal or de,~olltlon, al ~ aeeonoea. The aPplicant agrees to comply with all applicable I'aws, ordinohces,~ld, mg code, housln~ade, and ~lOfll. ...... ......................... -~(S'Jgnature cf applicant, ar nan., I'f a c~tl~n) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ .~l,?,.~.~. ....................................................................................................................................................... er and Lella Ouzounlan Name of owner of premises ......~..e...~. ................................................................................................................................ If applicant Is a corporate, signature of duly authorized officer. ~ (Name and title 'of corporate officer) l. Location of 'ond on which, l~Prop'dcol..oFw°rkAlb&ool'ewlll be done.D/.4_ -.M°P No.:&p.d....~-~]j~fll.].4_l~ .......................... .,~..IT. ,,ottthold ,. ,H'wL°t I~o.: ..~ ....... '~;;'~ 'k~ Stree~ ond Number .... ./. .................................................................................... "~ ...... " ......... ";'";'; ........................ ~: . /~IclIMIIIy 2. State existing use a.nd occupancy of premises and Intended use and occupancy of pmpaled' comfr~:tlon: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupant', One ]~--~.2.,~. ~.e....~..e~....e..e. ....................... Nature of walk (check which applicable): New Building ...... X ......... Addition .................. AlterationS' ........ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cos~ ~2J~,000o00 (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 ............................ Numbe. r of Stories ................................ 8. Dimensions of entire new construction: Front ....~...~.~.~.~. ................ Rear 6~. Feet n,~,~ 35 Ft.lrr, · Height ....~,~...~.~..A.. Number of Stories Ot~.e 9. Size of lot' Front 16b~e Tz'r, e . ............................. Rear ....~9.....~,,1~., ............. Depth ....~.l~.~l ..................... ]0. Date of Purchase .~t~,~r...~,.9.~.~ .................................... Name of Former Owner ..~..?....&....ff.?....~..?..?.~.?. ....................... 1 I. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ ]3. Name of Owner of premises ..~.~...I~.O.!3.~,.~.~. ......... Address ~ellmo~e~ tle~ Yor~c _ _ .......................................... Ph~,.= No ..................... Name of Architect ..~....~lf)~.~JII. .............................. Address ~,o~o~i~Oal&. Name of Contractor ~la~tr..(~.t:~%O.tJ. OZt ...... Address ..,~,5~...~['~,ll.e[..~[1t~'.e.. Phone No .................... PLOT DIAGRAM Locate ¢iearly and distinctly all buildings, whether existing or proposed, and indicate all setJoock dimensions from property lines, Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF YORK, COU ,,. 4a;.....,~.c~./~.i. ................................... being duly sworn, deposes and says that he is the applicant t,om. or individual sl6nlng a~o~c, otion) above named. He is the..~..~...~.~..: ~ .~x.R~.~.....~.~.c~.~ (~ntmctor, agar, co~rate officer, ~c.) of said ~r or ~ners, and is duly aut~riz~ to pe~orm or h~e ~o~ the ~id work a~ to ~e ~d file this application; that all statements contain~ in th~ ~licotion ore tree to ~e ~st of h s knowledge and belief; and t~ot the work will ~ petard in the manner ~t fo~h' in the opplicot~ S~m ~m ~ ~is ~ ...................... o, ..... ............ //_ ~' ta P ...... ~~ ..... ~ ~ $~ ...... ~'1"~ .................. ~"'~/~ ..................... LT ~;-2030 TOMARK CONSTRUCTION INC. Building -- Corrstruc, tion 5250 SUNRISE HIGHWAY SAYVILLE, NEW YORK I I III II ~rJXj'x Lb[ VA'fI~ i i l-lA LT ~2030 TOMARK CONSTRUCTIiON INC, Building -- ConstructiOn 5250 SUNRISE HIGHWAY SAYVILLE, NEW YORI~ NiO/~T LLLVATIO/'A