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Home My WebLink About5736-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~..1~. ~.? ...... Date ............ THIS CERTIFIES that the building located at ...De~. D~ .............. Street Map No~, .(~y, .l~]~ock No ........... Lot No.. '3~ ....... /~tl~e~l...I~.~.~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 14al~.et* .... 8, 19. ~2 pursuant to which Building Permit No..~7~.. dated ........... 14~,1~ .... .9.., 19~.., 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~..~V&.~ .~.~..f..a.~. ~],,y..5.w.~.l~.~g ........................................ The certificate is issued to . 8,P.,&,. ~at®x~prt,~ ......... ~ .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . UNDERWRITERS CERTIFICATE No.. 11 .~3~ ....................................... HOUSE NUMBER...~0t ..... Street .....]~O~lll~lr .D$'. ................................ FOF, M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEI:q' ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5736 Z Permission is hereby granted to: .............. i~e~.C,m~ ......... ~;.3~. ................................ to ..aui~..~e~.. e~e..$~l,~ .~I.~:~ ................................................................................. at premises located at ........~..~.~.....~/~.tl~'e3,.. ~4)~a3.~Z~..~;~t~ ........................................... ....................................... Z~..De.3~..~ ......... .~e~ ................................................................. pursuant to application doted ......................... ~;~,~ .........8 .......... , ]9..~., and approved by the Building Inspector. Fee $..l~1;~~. ......... Building ~nspecto~ H.D.Reference No EASTE~ DISTRI~, R~R~AD,N.Y. AP~ICATION FOR APPROVAL TO CONSTRUCT PR~ATE S~AGE DI$~SAL SYSTE~ Dat~ Approval t~ const~ct said sys'tems is requested,pertinent data here~th: 1-Applicant ~ ~/.~zv ~ Address ~ ~:z3 ~ ~ 7-Section / 2-Detailed property location ~/~ ~ ~ ~ ~ ~ . ~(~:~ ~-.,~ 8-Lot No. Hamlet ~ f~ ~/f ~' / To~ ~ ,~' ~ W~ ~/~ 9-Private ~ell? ~-~blic ~ter suppl~ name Distance to nearest ~in ~-Lot Size: Width/~,~ ft. Length/~ ft. (also enter on center plot plan below:) 5-~elling: Single Family ~ Two Family? / /Cellar? ~lab? 10-Pro~sed system: Septic tank ~ /Precast / /C~ss~ols ///Shallow ~ols il-Septic ta~ inside dimensions: Vol~e Gals.Length ft. Width ft. Liquid dept~ft. i2-Precast sections: / /Number/ /Sq~re Ft. C~sspool~lock ~i~eL/~incs.D ~ in~.H ~'-ins. Total blocks below inlet: ~OT PLAN -Test ]Data ~eet 0 2 4 8 10 12 18 ~ (? ~ Street 0 ~.~ --S ~ ~ Indi :ate ~ ~ ~ No 'th The Undorsignod CERTIF~S: "Const~c%ion of authorized ins%alia%ion ~11 bo in aeeordaneo ~i~h ~ho and amondmengs ghore~o, eoverSng SSgnod ~er or Builder~ FOR HEALTH DEPARTMENT USE ONLY. Based on the 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 ~/~ ~---~ Signed ~'~~ ~ ~ S-9 SCHD SUFFOLK COUNTY TO WHOM IT MAY at CONCERN: The sewage DEPARTMENT OF HEALTH Date 14 August 1972 Bldg. Permit No. 5736Z disposal facilities for a structure located E/S Delmar Drive~ Laurel Country Es~a%es, Lo~ #~5~ Laurel, New York (Give deed location) have been inspected by this department and found to be satisfactory. C~i~f or ~eneral ~mgineering Services AUG 1 7 1972 Lof 56 OF TNE CLENI( OF ~IFFOLI( COUNTY ON dUNE ~, 1970 &$ MAP NO. RrWS,O.S YOUNG & YOUNG ,M,4~1~1,9~',~ 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ~/U/V--~/'9~/'~T'~ ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: S. PA. ENTERPRISES, /NC. LOT NO. $5, "LAUREL COUNTRY ESTATES." AT LAUREL GUARANTEED TO: $£CU~/ ~'~' TI ~LE ~ ~UA~AN~Y C~ SOUTHO~O SAVINGS · ow. o; SOUTHO&D SUFFOLK CO., N.Y. Lo! Lot 4~ -' MON/./ME'NZ' REWS~ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: S. ~?A. EAITERPR/SES, /NC. LOT IV0.$5, "LAUREL COUNTRY ESTATES." AT LAUREL GUARANTEED TO: TOWN OF SOUr'HOLD SUFF6LK CO., N.Y. ~~...~~.~ SCAL~: i . ._ ,~10, DA'rE: FE'~.I~ I~?,~ INO'~'~'~-~'O~ I FOB,M NO. I - TOWN OF SOUTHOLD~''/'~/?'L~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o.r in ink and submitted in duplicate to the Building Inspector. ~ b. P at plan show'ng ocat on of lot and of buildings on premises, relationship to ....... adjoining premises or public streets or/' areas, and giving a detailed description of layout ofproperty must be drawn on the dmgram which ~s part of thru apphcatmn. 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 permitl 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 d Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building cede, housing cede, and regulations. ................. .. .. ..................................... ,~' (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. General Contractor Name of owner of premises .......................................... .~...~..A......~....t..e..~.~...~..~.~.e..~ ................................................................... If applicant is a corporate, signature of duly authorized officer. ....... ................................... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No..~..~..u...~..e.~....C...°.....~.~..t.~..e..s.. Lot No ..... ~. ............ E/S of Delmar-Ra~n~, Laurel Street and Number ........ ""',,~'~'.~'~"'"~1'17~ ........................... '~'~'i';il~;'i~ ......... i ............................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy .................................... ; .............................................................................. I Family Dwellin$~ Intended use and occupancy .............................................................................................................................. 3. Nature of work (check which applicable): New Building ....... X ........ Addition .................. Alteration .................. Repair .................. Removal .................. Demoliti~ .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ .~. .~. .0. . ,. .0. . .0. .0. ............................... Fee ....~'.~..:..~.~i.~. ......................................................................... (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 ].~ X 20 .. 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 ..... ~..~' ' ....................... Height ~.c Number of Stories 3- .... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ..~.~1.....8..~ ........... Rear ...... ,~.~.1....~.?. ....... Depth ..~...~. .................. Height ......... t~. ...... Number of Stories .............~, ........................................................... 9. Size of lot: Front ..... ..~.~.~. ............... Rear ........ ~ .................... Depth ....... ~,,~.7. ................. 10. Date of Purchase ........................................................ N~e of Former Owner ........................................................ 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 ~.~..ff~.li~.~.~..~.e.R....Address ..~.~.~.~.c..~.~....~.¥. .......... Phone No ..................... Name of Architect ...[.~...a~..~...~.o...m~....~.....~..~..c.... ............ AxJdress ...B....e..Z..d...e.~.,....~..:.~... ............. Phone No...7.~2:.-...~.~..7.7 .... Inland Homes Inc. ... -~elden, N.Y. Nome or =onrrocror .................................................... ~ocmss ............................................ ~x~e No.....................732-2177 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicote all set-~ack dimensions from property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or Comer lot. I~'::- :: STATE OF ................. · ;~ ....... ~~.~ ............ ~i~ ~uly ~m, ~es and say~ ~ ~ i~ t~ applicam ~ame bf indivTdual signing a~~' above named. He s the ..................... ~~'~ ................................................................................................... (~ntmctor, agar, co~orate officer, mc.) of said owner or ~ners, and is duly authorized to perform or h~e performed the ~id work and to ~ke and file this application; that all statements cont~n~ in this applic~ion am t~ ~ the best of his knowledge and belief; and that the work will be performed in the manner set fodh in the ~plic~l~. fil~ ther~ith. Swam to ~fore ................... o ........ ................. , ........ ARY pUBLtC, State/m o',L ' ~..' e!ec ~ca'. eq~ipme~t as described below and introduced by ~ke applicar~t named on the above applicatlon number in the i~rem* ~ . ~ A Delmar Job152, Laurel, L.I. ~l:~*foliowit,glocatlon; ~ Bazemet, t lztFI. ~ Zr, d Fl. &outside Section Block Lot ............. ,~,,~,~o. September 8, 1972 andfoundtobeincompliancewiththerequirementsofthisBoard, ~:~ ~ I RANGES :OOKING DECKS OVENS ',DISH WASI':ERS7 EXHAUST 16 ~ 22 I 16 I : DRY~RS FURNACE MOTORS UNIT HEATERS MULTI-OUTLET ~l DIMMERS SYSTEMS ,,V,T. ? ~* O,L NO. OFFEET i AMT. i WATTS *-- S~RVICE DISCONNECT ", 100! S E R V NO, OF CC. COND. A, W. G. PER ~' OF CC. COND. 1 I 2 C E G. Zimlinghaus 4 Park Pl. Patchogue, L.I. 11772 GE RAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identifie~y thei) credentiak.