HomeMy WebLinkAbout5724-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
O P D AT E D
Certificate Of Occupancy
No. g. ~..q 3.3.4. .......... Date .... .5.a.n.u..a.r y.. 3. .8 .................19.8.3.
THIS CERTIFIES that the building ................................................
Location of Property . J.8.0..5 ........... .C.e.d.a.r.. ?.q~..n.~..D.r..iy.e..g..a.s.'q ....... $9.u.e.h. 9.1.d...
House No. Street Hamlet
County Tax Map No. ]000 Section . .0.9.2. ....... Block . .0.1 ............ Lot. P.q~. ............
Subdivision....C.e.d..aT..~.e..~.c.h..P..aT.~' ........ Filed Map No..9.0 ...... Lot No..8..8 ..........
conforms substantially to the Application for Building Permit heretofore f'ded in this office dated
·..~.a.r.c.h. ............ , 19 7.2. pursuant to which Building Permit No..5.7..2¢..g ..............
dated .... M...a.r.c.h...3 ................ 19.7 .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 .........
.... .a. ~.r..i..v.a~e.. 9.n.e.-. ?.a.mA%y..d.w.e..z.Z.%n.~: ........................................
The certificate isissued to EDWARD R. DEUTSCH & OTHERS
(owner, fe~oT [~71~7~
of the aforesaid building.
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO ..................................................
Board of Appeals granted insufficient front yard set-back variance,
Appeal #1480 on 12/9/71.
Seasonal C.O. Z 5259 was issued on 7/13/73.
.......... ~4~.. ~ .......
~ Building Inspector
Rev. 1/81
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? 5724 Z
Permission is hereby granted to:
................ lJ~ert,"~J~J~ ................................
........... · JL~O · .~J,emm~.. ~).e, ee .............................
..................... lJ~,e~'t ......... t~J':~ ....................
to ....l~,li~J~l.. J~t'...~I~IL. f RJll~..lJ,1,1~l~ ...............................................................................
at premises located at ........ ~'J~"J~'""CJ~J~'~"~'~'~li"~,':~ ..........................................................
................................................. ~ mtat ..I~..Be, I-~ ..i)~, ................ 'J~,'l~m'J.d'....ih,.'J., ......................
pursua:n~ to application dated ......................... J~l~.....~j .................... , 19...~., and approved by the
Building Inspector.
Fee $.....J~(j~ ......
FORM NO. 4
TOWN OF SOUTHOLD
B[~,BING DEPARTMENT
Town Clerk's Office
$outhold, N. Y.
Certificate Of Occupancy
No. Z. ~9.~ ..... Date ............
THIS CERTIFIES that the building located at Cedar..Poir~t .DrAve. Ernst. Street
Map No~eda~ .Be~eh ~lo~e~ No ........... Lot No. 1~8... ~outllold .... 1~,¥., ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ............. 1,~a.r. ah. · .3 19.72. pursuant to which Building Permit No....~?2~g
dated ........... Earah.. 3..., 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
is . Private..one. Y. ami~..dwelling..-. (sulmer. ~oupaney.l...app.'ore& .by
issued
- B~a~d of Appeals
The certificate is issued to .Edw~d. tt...Delltsch...ovner ...........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .July..2r .~-97~...by. R, .¥~3.1~ .....
UNDERWRITERS CERTIFICATE No..l~..1 (~.7. J? ..... Jtme..~ 2 .. ~ .~.~ .............
HOUSE NUMBER .... ~ 8.05 ..... Street . Cedi. ar. P.o~nt. J~rIF~ .Eaat ..............
Building Inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at
MapNo ..... :?..V....BlockNo ........... ,ot o .... '
conforms substantially to the Application for Building Permit heretofore filed in this office
aated ............ .~....~..~.'~, !0. ,~.~4~ursuant to which Building Permit No. 5..7.
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .. ,~. ..... ~ .~.k.'- ...... fi.& .~.( .t-.,( .... H 9. U~..~T .......... ..s~.
The certificate is issued to '~¢ ~ ~ 1F 7- /~,
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE No ........... .'~,[..b,/..I?!..h/..~.. ........................
,DUSE NU~aER... ! .a O..ff...Str~t.....C'.~:P.~...~.~! .~.T....~.~ ! .V.¢...t.--3 .S.T .......
T.S.D'.FEOLK COU1/T~ DEPARTHENT OF HEALTH ~/0~
AP~ICATION FOR AP~ TO ~NSTRUCT PR~A~ S~AGE DIS~SAL SYST~
Approval to co~t~ct said systems ts requestS,pertinent data here~th: ~te ~-~-~ ~
1-Applicant ~o~ ~ /~/~ z¥~ f P~e7~ ~'fc~ 6-Sub div
Address ~ ~ ~t DI~ ~ ~- 7-Section
2-Detail~pe~y location · 8-~t No.
~mlet ~,D~ ~d~ ~ To~uu~ 9-Private ~l? ~
3-~blic ~ter ~pply ~me Distance to nearest ~in ~
4-~t Size: Widthll~ ft. L~EthZ~ ft. (also enter on center plot plan below:)
5-~elling: Single Family ~ T~ Family? ~ ~Cellar? ~ ~lab? ~ ~Crawl S~ce? ~
lO-~o~s~ ~st~: Septic ta~ ~/~Precast ~ yCess~ols / YS~llow ~ols Y Yother ~ ~
il-Septic ~ inside dimensions:~ol~e ~Gals.Len~th ft. Width' ft. Liquid depth ft.
12-~ecast sections: ~yNumber~Square Ft. Cesspools: Block sizeL incs.D ~s.H i~.
Total blocks below inlet: ~1 ~2 ~3
~T PLAN
Data ~eet
0
2
4
6
> 8
10
: ~: 12
14
16
c::, 18
~ Street ~/ /~T~_. ,~
The Undersignc~:t CW. RTIFIES: "Con~gme~5on of au~hor~ 5n~gallagSon~ dll b{~n
aeeo~ane, ~h ~h~ Suffolk Coun~7 H~al~h D,~n~~ e~reng Sganda~
a~ amendments thereto, covering Private S~ge Dis~sal Systems".
Date ~ Stgn ·
' ~er or ~ilder
FOR ~ALTH DEPART~NT USE ONLY. Bas~ on the info~ation presented here~th, it is the
opinion of the H~lth De~ment, that an ad~te a~ satis~Dis~sal System
can be installed on this ~ot.
Date ~ S~gn~
8-15
APPLICATION FOR APPROVAL TO CONSTRUCT PRi~ATE 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 ~ain thorofare, also Hamlet/Village & Township
3-Enter name of Public Water Supply District, together with the distance to their main.
~-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 "Vw items applicable to the proposed new dwelling.
6-Name of sub-division
7-Section Number
8-Lot Number
9-Private well: Enter "Now if Public water supply is available. Enter '~es" otherwise.
PROPOSED SYSTEMS: Answers to Items number 10, 11, & 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 " w w , w " Septic Tanks
Part IV " " " " " " Unusual soil conditions
Part V " " " " " " 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 shown on face of this application.
Surface waters-Streams, Lakes, & Hays, 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 to the Applicants proposed Sewage Disposal Systems and
Well.
Where 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.
WELL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the
following Standards must be observed:
Well-100 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-10 feet minimum distance from lot lines to center of cesspool
Cesspools ex~erior must be 100 feet minimum distance from nearest well
Septic tank exterior must ~e 75 feet from nearest well
Cesspool "Center" must be ~2 feet minimum distance from nearest water line
Cesspool "Centerw must be 15 feet from house foundation
Cesspool exterior must be 50 feet minimum distance from surface Waters, Streams,
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 of 1 food to maximum of 2 feet
Bottom of Cesspool to ground water must be held to minimum of 1 foot
S-9
SCHD
SUFFOLK COUNTY
DEPARTMENT OF HEALTH
JUL ~ 1973
Date
Bldg, Permit No.
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure
(Give deed location~ / ~'
located
have been inspected by this department and found to be satisfactory.
dUt ~ 1973
Chief of General Engineering Services
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 arid 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 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 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 informa-
tion required to prepare a certificate.
Fees:
I. 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
JArl - J 1983
Date ..........................
New Building Old or Pre existi g~Building I'~ Vacant Land
Location of Pr~r~/' i i~...'.~.~.'.~.~...'~.~.~.~. ~i;~ ~ .........
Owner or Owners of Prope~ .................. ~. · ~J ........... ~ ...........
CounWTax Map No. 1000 Section .. ~, 0 0 Block ~/*OP Lot
....... ,,,., ,o... .... ,o.. ........
Permit No ........... Date of Permit .......... Applicant ............................... ~
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~oermit meets all applicable codes and regulations.
vv\CO.~-\~ , ..... ~'; ,z ........ > .......................... _
JOSEPH N. RIZZO, ~l~.
January 5, 1983
Mr. victor Lessard
Town of Southold
Building Department
Town Hall
Southold, New York 11971
1805 Cedar Point Drive East
Southold, New York
Kindly be advised that the undersigned represents Mr. and Mrs.
John Sullivan, 870 Plandcme Poad, Manhasset, New York, contract vendees of
the above-captioned premises.
Pursuant to our telephone conversation today, enclosed herewith
please find application in duplicate for Certificate of Occupancy,
application fee of $5.00, and survey dated December 7, 1982, all in
connection with the above.
You may be advised that an earlier Certificate was issued by the
Town, No. Z-5985 on July 1, 1974 to the present o~ner, Edward R. Deutsch,
for "su~er occupancy" only.
I was informed yesterday by my client's lending institution,
Southold Savings Bank, that an unqualified Certificate of Occupancy is
required prior to closing, which is presently scheduled for January 20,
1983 in Southold. Therefore, I would appreciate every effort to expedite
this now urgent matter.
In the event you require any further information, do not hesitate
to contact the undersigned at your convenience. Thank you very much for
your anticipated courtesy and cooperation herewith.
JNR:sel
Enclosures
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S oFFIcE
· 'F"-'- ..................- / __ ppticaTion MOA ............ R~....I.. ......... ~'~.
Approved ................. ~ .................... , 19....~.. Pemit No..~...7......'~...~(.....~.... ......... / r /
pp~ a/c ...~.~...~...~.~...~ ..................... ~...~:~ .........
...... ................
~' ~ APPLICATION FOR BUILDING PERMIT--~~
. ............
~. lhi~ o~li~ti~ mu~t be compl~t~l~ fluid in b~ ~writor or in ink ~nd *ubmitted in ~1~* ~o th~ ~uildino~
b. ~lot plan ~ing I~tio~ of lot ond of building~ ~ pr~mi*~% relationship to ~dlolning premi*~ or pub
~r~% ~ ~ivi~ ~ d~t~il~d d~ription of I~o~ ofpr~*~ mu*t b~ drown on the diagram wh ch ~ ~ of thi*
c. ~ ~k c~er~ by ~is o~licotion moy ~ ~ comme~ before issuance of Building Permit.
d. U~ o~r~ol of this opplicotion, ~e Building Insp~tor will issue ~ Building Permit to the ,pp ~.
shall ~ ~t ~ ~e premis~ available for inspection th~ghout the p~ress of the work.
e. No buildi~ s~ll be ~cupi~ or used in Whole or in pa~ for any pu~e whatever u~il a Ce~ificate of ~cupancy ~/
~all have ~en gmnt~ ~ ~e Building Ink,tar.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building P~mt~: pursuant to the ~
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other al~gi~ LaWs, Ordinances or ~
Regulations, for the construction of buildings, add t OhS or a terat OhS, or for removal or de~l~tion, as h~--;~ ,~,,;k.. ~ '
The opphcant agrees to comply wtth all apphcable laws, ordsnance~l~uddsng code, houstng c~e, and regulation~ ~,
' : J[Signature of applicant, or name, if a corl~i:~;'i ........
(Address of applicant) ~ ~ (, ~._?
State whether applicant is owner, lessee, agent, amhltect, engineer, general contractor, electrician, plumber or builder.
. _ . . · .
~'~'~'~ Zer of '~;~[~"i' ".'.~..~.'~'"i~':'"i~i~'~'~""'"~~'~ ~'~~~ ......................
If applicant is a co~omte, signature of duly authoriz~ officer. ~ ~,
.................. ~"~"~l~"~"~'~ ......... ~-I;~ ~/7 ~
1. L~atio o la~ on which p~ ~or~ wi~ be done. Map No.: ......... (.~.~ ................ ~ ~....y ...............
Street and Numar ..~~.~.~.. [~ ~~.. .... ' ~
-'""~i~ii~ ...................................
2. StYe ~isting use and ~cupancy of praises and intended use ~d ~cupancy of p~osed c~stmcti~:
a. ~isiting use and ~cupancy ~ ~ ~ ~ ~'" . .
b. Intended u. and ~cu~ncy S(~ ~ '~ '~ ~/'~.
3, ~atureo~'worK tcheck which applicable): New :Building ~ Addition Alteration
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost - ....d:....~.., 80 .
· (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 ofexistingstructures, if any: Front .......~:,~gw...~.'..[.; ...... Rear ........ .~. ................ Depth ..~.'.-.
Height .~]~ .............. Number of Stories ....~..~. .........................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................ ~.~t~/ .~ ~
8. Dimensions of entire new construction: Front ....... .¥..~ ....................... Rear ..... .?'...?. ............... Depth ........................
f
Height ...... /..~.. ........ Number of Stories ....~ ................................................................................................................
! ~2_1 .
9. Size of lot: Front ..... ~..~..- ............ Rear ..... ...-:=~.. ......................... Depth ...............................
10. Date of Purchase ........................................................ Nome of Former Owner ..~..Aff~ ..............
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation .......................................... ~ ..................
13. Name of Owner of premises .~k~'~..b....~...?.....PS.:...~...~...~.....S~. ddress~Ti~...~..~.'.~.'.-~..*..°../..~..~/P~ner~, , __ _, -- ~t~r'~u~/~c~/___ _~.,,~ 'x, -,~_~ ~~o./..~..~..e....~..~.....o../
Name of Architect ..................... .~ffJ~5~.~....".i ........ Address ............................................ Phone No .....................
Name of Contractor ................... ..~..~...~.. ............... 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 street and ~block number or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NE'V~'~Ji~K,~/t lee
COUNTY_.OF .....'t~..~ ...~... ........
............. 5~...~....~....~........~.....~.......~...J~..?...~..~ .................. being duly sworn, deposes and says thclt he is the applicant
(Name of individual signing application)
above named. He is the ................. .~.....C~......~....~...~. ..........................................................................................................
(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 all statements contained in this application are true to the best of his knowledge and belief; and
tha~ the work wil. I be performed in the manner set forth in the appli,egtion filed therewith.
Swam to. ..be~ dmaeytho~S .....
.................................. ........ . ...... ............ ..............................
Notary Public, . .................................... /. ..................... County [' (Signature of applicant)
THE NEW YORK BOARD OF FIRE UNDERWRITERS
ak BUREAU OF ELECTRICI .T~
~- 85 JOHN STREET, NEW YORK. NEW YORK 1003EI
THIS CE~IFIES THAT
o~y the e~t~ ~uipme~t ~ ~scd~ ~ ~ int~u~ ~ t~ ~I~M~ on ~h~ a~ ~ication ~um~r in t~ p~m~s of
Edward Dutch, Cedar Beach RD.~ r~ast, UOUt~OA~, ~. ·
outside
in the following location; ~ B~e~nt ~ 1st n. ~ 2~ n. S~t~n
Water heater ~
EXHAUST FANS
DIMMERS
Main Road,
Southold, L.I. 11971 ea~A MANA~E
11
Per , ~
COPY FOR BUILDING DEPARTMENT. THIS COPY OF;:CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~- ~tC 85 JOHN STREET. NEW YORK. NEW YORK 10038
12, 1 74 on,,,. °259,. N 164737
THIS CERTIFIES THAT
only the electricvJ equipment ~s described belo~ and introduced by the applicant named on the abo~e appficatlon nura. ber ~n, the premises of
Robert ^. Hensel, Cedar Point Rd. Eazt, Cedar Beach, 2..
x Outside 90 88
in the follmving location; [] Basement ~ Ist FI. [] 2nd FI. Section Block Lot
was examined on ,~LtH~ St 1974 andf°undt°beinc°mpliancewiththerequirements°fthisBOard'
FIXTURE L~EC~AC~I SWITCHmS I RXTURES
13 / 33, ~.o 13
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS
SERVICE DISCONNECT I NO. Oe I S
METER
OTHER AFPARATUS:
Water lleater/s; 1-4.5KT%
Motor/s; 1-1/2hp.
RANGES
~T. K.w.
1
SPECIAL RE~'PT
R
COOKING DECKS OVENS DISH WASHERS
TIME CLOCKS MiL UNIT HEATERS MULTI-OUTLET
~ S NO OF FEET
V I C
EXHAUST FANS
DIMMERS
Robert ^. Hensel
20 Brenner Pl.
Demarest, N.J. 07627
COPY FOR BUILDING THIS COPY .OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.