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Home My WebLink About5735-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . N~. l).e~a~..D~ ........... Street Map NoLa~a~l. ¢.~ .g~l[ock No ........... Lot No. ].9. · · La~ol..N.][e ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ I~O]~...8, 19. ~. pursuant to which Building Permit No..573~. dated ........... ~f,l~Ola.. ~.., 19~r~.., 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 . lar.~.va.~, on~ .fam$1y. dw~l~Lug ....................................... The certificate is issued to .$ el~,A e. Enterprises .... 0vr~l~ ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .&IIZ..2.1...l 9Fl..bY. il,. ¥tll&... UNDERWRITERS CERTIFICATE No ..... ][. 3.~-~7 ..................................... HOUSE NUMBER. 2~.~ ....... StrecL Delmar D~ .............. Building Inspector ~ 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) No. 5735 Z Dote HllLl'Oh 9 19..~ Permission is hereby granted to: lhumll .~x~ A . ~e ........ ~.s. ~.~..,...~.~.~...~ ...~... .......................... to .l~u~lA. Jx~ .W...ezx~..$..~,3,~......~...e..~ ~,..~..1 .................................................................................. at premises located at ............... ~O~..I.~....~,4LIATI~.I...~.O~..~II.~.~I. .................................... ................................................. ~.~.... ~.e~.~..~....~r .......... ~ .~r...e.~.. ....................................................... pursua:~ to application dated ........................... ~.8-.~.gh ....... ~J. .......... , 19,...~,., and approved by the Building Inspector. Fee $.....~J'~..'lO ....... H.D.Reference No $(;-/~ P~ The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage DisposalSyst~. Date Signed Owner or Bui~ FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Se~rage Disposal System can be installed on this Plot. Date ~f~~-- Signed ~ ~/6~ Revis.) G.P.M. ~f ~rade CapacityZ/~Gals. Indi No Data Feet 0 2 4 6 8 10 12 14 18 J EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval t~ construct said systems is requested,pertinent data herewith: ~' 1-Applicant ~=~,/./~ ~,! /-/~..~ c~ ~3~-~ .J'~% Phone~.~,~P~D/??6-Sub div~W~'~/~ ~, ~,, / Address ~' ' ~.~ ~ ~F,~ ~ ~ 7-Section / 2-Detailed property location c~',/~ ~c~/~ ~ ~ ~]/~(< 8-Lot NO. Hamlet ~ ~ ~ ~J.~ / To~ ~ ~ ~ c~ / ~ .9-Private well? 3-~blic ~ter supply name Distance to nearest ~in 4-Lot Size: Width/~ ft. Length/~g ft. (also enter on center plot plan below:) 5-~elling: Single Family ~M~ Two Family? / ~Cellar? /~/~lab? ~ yCrawl S~ce? / / lO-Pro~sed system: Septic tank ~ /Precast / /Cess~ols ~YSha~low pools / /Other / il-Septic ta~ inside dimensions: Vol~e Gals.Length ft. Width ft. Liquid depth ~ ft. 12-Precast sections: / /Number/ /Sq~re Ft. Cesspools: Block size~ incs.D ~ ins. H ~ns. Total blocks below inlet: ~1/-~ ~2/5~ ~3 ~OT PLAN ~'~ng ~epartment 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 in- formation required to prepare o certificate. New Building ........ [ ......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ......... ~/.$..D...e....];~?..~..~...a~...e. ............................................................................................. Owner Or Owners Of Property ............. ...B~...A.....l~..t.9..r~.T.~.s..e.~ ........................................................................... Subdivislon ..... I~P,~3;~3,..ggi333,¢~7..~.~a.t~e~ .............. Lot No .....~.~... Block No ............. House No ............. Permit No ........ 5.?,~5~... Date Of Permit ..~.~.7~ ...... Applicant [NT,AND E0[~I~S. lng. Health Dept. Approval ..... ~. . .8. /. ..2.1. /. .7..2 ............... Labor Dept. Approval ............................................... Underwriters Approval .:Z/.~3,/..'/2..N;~42~.7. ................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....................... .X.. ................ Fee Submitted $ .........~.t..0~... .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ]~ ..L~. HO...~..S: .INO./Rob..ert E: Hilt.z .......... ................ day of ............................................ (stomp or seal)7~'~x ~,;/~ 7 ~ Notary Public .................................... County /~,,,,~y ~ ~-;~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date 14 August 1972 Bldg. Permit No. ~7~Z TO WHOM at IT MAY CONCERN: The sewage disposal facilities for a structure located V/S Pnl~ Drive Lo~ ~lq T~el ~om~e~a~e~ T.~ (Give deed location) have been inspected by this department and found to be satisfactory. Chief of General En~i~eer~ ~'~.,~ Services AIJ6 ~, ~ 1972 BUILDING DEPARTMENT,~///~ TOWN CLERK'S OFFICE ~UTHOLD, N. Y. ~//~.,~. APPLICATION FOR BUILDING PERMIT ' ~ ,~2.z~ ' ..~ ~/,,~.~ ~ ~ Date ........ .8...Yr~:,.r,c,.,h.. ...................... ; 19...Z~. .... ~:'~-'"~ 's~""~/'-- '/Z~ 7~ ~r~'- ' INSTRUCTIONS o. This application must be completely filled in by typawriter or in ink and submitted in duplicate to the Building In~ctor. : · b. Plot plan showing location o{ lot and of buildings on premises, relationship to adjoining premises or public streets or~, areas, and giving a detailed description of layout ofproparty must be drawn on the diagram which is I~r~ of this application.~ c. The work covered by this application may not be commenced before issuance of Building Permit. , , d. Upon apprOVal of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been. granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordnance of the Town of Southold, Suffolk County, New York, and other applicable JaWs, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolit on, as herein described. The applicanf agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Inland Homes, Inc. (Signature of applicant, or name, if a corporation} Selden, New York 11784 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................................... .................................................................................. Name of owner of premise~ ....................... ~..P..A......~...?..~.~.p..~..~.Z..e...~. ......................................................................................... If applicant is a corporate, signature of duly authorized officer. Robert Hiltzf Pres. .................. ......... T,~urel ¢o ~,et~te t #19 1. Location of land on which proposed work will be done. Map Nod,,cm~.u,l~.., .......................... Lo No ....................... Street and Number ................................ ..~..~....°...~......~.~,..a~'...~'~''..'t~$'~'q']' .................................................. ~ ~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of prepared construction: a. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy ................... .~....~.~.......]~...e...Z.~..~...z~ ................................................................... 3. Nature of work (check which applicable): New Building ...... ,~ ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitior .................. Other Work (Describe) ........................................ eo. ooo ' ..... ...................................... 4. Estimated Cost ............................................... ~ ................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~ ................ Number of dwelling units on each floor ............................ lk x eo 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 ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front 59' 8n Rear ..... ~..~.'....~.'.'. ........ Depth 26 Height ........ ~.~ ....... Number of Stories ...................................................................... 7] ............................................. 9. Size of lot: Front ..... ~.~(~.(~0 ......... Rear ...... ~,~.~.~.~.~. ................ Depth .....~.~.0..,...0..0.. ............. 10. Date of Purchase .......................................... ~ ............. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ..~..o. .............................................. 13. Name of Owner of premises ..~....~......]~..~..e..~.~..~.~.~e...s...AzJdress ......l~..~..~..t,..u...c..~..~...~:...~..,..... Phone No ..................... Name of Architect .....I..:...]....a~...~.....E..o...~..e..e..t.....I.~..~.~. ....... Address ....~.e...[..d..e..~.~....~..t..~..t ....... ..... Phone No.~.].2..-...2.~..7.7... Name of Contractor ..~[~0~l,l~0,~l...~.O~.~.~...[T~.c., ....... Address ....~.9..~..~.e.~.m...~.,.~:. ........... Phone No. '~..2..-....~1:...?.~.. 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. STAT OF NEW~YO,R '~,~ .................... ~.J. ..... ~...~.~.'~.... ....... being duly' swam, deposes and says that he is the applicant .......... (Name of i,ndividual signing aj;~plide~ip~o) (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 that the work will be performed in the manner set forth in the applicatio~ filed therewith. Swam to before me this. ..................... No. 52-812585~, Suffolk COU. l~[ Term Expires TH~: ¢',t:'£W YORK BOARD OF FIRE UNDERWRI'FERS ",,," ,y,,1¥ ;:~, ~'~ .,.,,,,,..,,~.,,¥..o.~.. 57z7~ N 34257 S.P.A., Delmar Drive, Laurel, L.I. Job ~151 ~ ~. FL Section ~o~ Lo~l9 '-~. ' i / I i l'T I 1 I I .~. 17 ~3 2~! ~[ !~ 1· f[ I ~ , z ,, ~oo c~ I i ~ / z I 2 I z i ~Future appliance .... cu::r/~. 2-3#8, 1-~#14. ?.%tots: 1-3/4 bp. NO. $-$G0~80 Lot 19 Lot 18 Lot REVISIONS YOUNG & YOUNG AII'R. gtI~*?2 400 OSTRANDER AVENUe', RIVERH£AD, N£W YORK MAY I t IgT~ ALDEN W. YOUNG HOWARD W. YOUNG JUNE 19,1972 P~OFE=SION~C ENGINEER AND LAND ~URVEYOR SURVEY FOR: S.~. ENTERPRISES, INC. LOT NO 19, '~UREL C~NT~Y ESTATES: GUARANT~EO TO: SECURITY TITLE Tow. o~ NO/E: ·: MONIJMENI' OF tHE CLE~t~ OF SUP'POLK OOUNrV ON zO ~ ~ L.O' ~_. LOt REWS,ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: S.P.A. ENTERPRISES, /NC. LOT NO. 19, "LAUREL COUNTRY ESTATES." AT LAUREL GUARANTEED TO: SUFFOLK CO., N.Y. DATE TOWN OF SOUTHOLD Building Department 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 in- formation required to prepare a certificate. New Building ........ ,T. ......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ......... ~/...S...~..e~...~...~....e. ............................................................................................. Owner Or Owners Of Property .............. ..;~...A.....~:...~..e..z~.~.e..a. ........................................................................... Subdivision ..... ~ltl~e[..~g~13.t;z~..~d~.~;&t~a. .............. Lot No ......[~... Block No ............. House No ............. Permit No ........ 5~,:~5~... Date Of Permit ..~.~.72. ...... Applicant ...~...~..0...~...~..~....~'...0..,. ........................... Health Dept. Approval ..... ,.B2~......8./...2.~./.?..2. .............. Labor Dept. Approval ................................................ Underwriters Approval .~Z/.3]./..'Z2..N~A25.'L ................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....................... .Z.. ................ Fee Submitted $ .........,~.t..0~)... .................. Construction on above described building and permit meets all applicable codes and regulations. .............................. Sworn to before me this *'~' ......................... ~~/'~'~'~ c-~ ~ ................ day of ............................................ (stamp or seal) _/~7~/?~> Notary Public .................................... County ~,/ ~/..~'5/o '1 &[