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Home My WebLink About5772-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. I[l,8~l& ...... Date ........... 8ClOt 1~ ....... , 19. THIS CERTIFIES that the building located at i)lllllI' .I)1'~1 ............. Street Map No[~,i '{~li '~lll~°ek No ........... Lot No.. I~. ...... ]41Il'Il.. ·: .][,~., ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. Mal~ll .2~9. ~. pursuant to which Building Permit No. dated ........ M&3~It ... 2~.., 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 . PI'~I '~11' 1'"~[~ '~'~ll1~.l.t~ ....................................... The certificate is issued to ~ '8,i~ '01~i' ~lI~l~l~illl ......~ ................. o~/[w~er, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . A~I~...~. 1.9~...~. P-e .Vlklll .... UNDERWRITERS CERTIFICATE No... ~[ .11.2~1~...: ................................... HOUSE NUMBER.. ~O~ ...... Street ....1}~1218~' l)~' .................................. :(... / 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 P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5772 Z Permission is hereby granted to: ~ ~ ~ ~ . . ............ ~..:.:.'....~..:....../..~ ..~......'..3..~.. pursuant ,o application dated .................................... .~.....tg:~.~.., 1~.....~, and approved by the Building Inspector. ~~,..~ .......................... ; ..... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date 7 August 1972 Bldg. Permit No. ~772Z TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure at Lot ~4~ Laurel Coumtr~Estates (Give deed location) located 2250 Del:~r Drive, Laurel, NY have been inspected by this department and found to be satisfactory. AUG 9 1972 Chief of OeneralEngineering Services ~OR~M NO. 6 TOWN. OF SOUTHOLD Building Department Town C:lerks Office Southold, iq. Y, 11971 APPLICATION FOR CERTIFICATE OF O~CUPANGY 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: I. Final survey of property with accurate location of all buildings, property lines, streets, anti 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. Swam 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. 13 Se~t,~m~e~ 1972 Date ............................... New Building ....... ..X. .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ........... ..D~...~.....D~....:J:..v...e.~.....~....,~f.,e.l.. ......................................................................... Owner Or Owners Of Property ..................... .S...P..&...,.,~,..,?e.z.P....z'..:J:.?..e..?. ............................................................. Laurel Cou~t=y ~-states 43 Subdivision ................................................................ Lot No ............. Block No ............. House No....~..~..5...O.. Permit No.....5..?'...~..~.~ ..... Dote Of Permit ..~./..~...~../...~..~..Applicant ....[..~.~...e~..,~..~.-(~....e..s.,t...~.~..c..? ..................... Health Dept. Approval ...8.../.~./..?.2. ........................... Labor Dept. Approval ................................................ Underwriters Approval ...... ..9../...~..3.../..?..2.. ...................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .............. ..Y..e.~ .................... Fee Submitted $ ..........5........0~... ................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ~ ..... ............................. Sworn to before me this ..... /~,.-~.. day of .~ .......... Notar~ Public ...... ~...~.. County (stamp or seal) ~/~'~,~. ~ I (~ OCCUPANCY -.,~ opp;icotlon m,~st oe fiiIed in typewriter OR ink, and submitted in tripiicate to the :-~:;~cctor w;th the following; for new buildic~gs or new use: . ?,/~[ s~rvey of property w~th ~ccurate location of all buildings, property Hnes, stratus, ~su~; natural or topographic features. ~ :=,r,;; ~pprowi of Heaffh Dept. of w~ter supply and sewerage disposals(S-9 form or equ~J). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commerc]~ buildings, industrial buildings, Multiple Residences and similar buildings ~ns~;~tions, o ced'~ficote of Code compliance from the Architect or Engineer responsible for 6, ~m~; P;onn~ng Board approval of completed site plan requirements where ac topographic features. ~ 5worn ~z2t'eme~? of owner or previous owner as to use, occupancy ~nd condition of 3. D~ve of any housMg code or s~fe?y ir, specti~ of buHd~ngs or premises, or ocher pe~ir, ent formaz~or, required to prepare a ce~if~cate. ~ ~~ D~:J~III~ J)~:J.~ll~ /~1,~'~'! Date ................................................ .................... au or Pre-e×ll ................ ............................ ~oc~t]or~ ~ ~roper~y ..................................................................................................................................... S~Dd~vJsJon ................................................................ Lot No ............. Block No ............. House No ............. ~:cr i: Nc ..................... ~rmit .................... Applicant .................................................................. ~e~['~ Oegt. Approval ............................................ Labor Dept. Approval ............... ~.~ .......................... d~derwr~ters Appr~. ............................................ Planning Board Approval ........................................ keq~es~- ~or ~emporow Ce~ifica~e ........................................ Final Certificate .......................................... Construed'lan on above described buiiding and permit meets ali applicable codes and regulations. Applicant ......................................................................................................... Swam ro before me this ................ d~y of ............................................ , ,O,~,y Puu;~ .................................... Coun~'y (stamp or seai) EASTERN DISTRICT, RIVERHEAU,~T. Y2 APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,pertinent data herewith: 1-Applicant Tela~ ~m~am X~a. Phone_~l~-Sub div ~{{~'$X Address h'm:;, M~& ~,m,. l~_..qml~m,'~ ~ 1178,~ 7-Section,, 2-Detailed pro~e-rty location I~./a ~tma,, La~.a, - 8-Lot No. Hamlet ~_~.~ Town ~ut~t~,d 9-Private well? 3-Public water name Distance to nearest main 4-Lot Size: Width__{~t. Length_.~ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~_~ Two Family? / /Cellar? ~.Slab? / JCrawl Space? lO-Proposed system: Septic tank / /Precast / /Cesspools ~_~Shallow pools ii-Septic tank inside dimensions: Volume Gals.Length ft. Width f.t. Liquid depth ft. l - ecast sections: ! / umber/ /S re Ft. Cesspools? look sizeLA ncs.D Sns. H-- ms. Total blocks below inlet: ~1_~2_~3 PLOT PLAN ~ ~ ~ .~'ade =~ ~ GW.L. {Data Ceet 0 2 6 8 10 12 14 m6 18 ~ ~ Street Del,~-~ ~ ~o~ m ~ ~ Indi e ~ No th The Undersign~ CERTIF~S: "Construction of authorized installation: will be in accordance with the Suffolk County Health De~rtments' current Standa~s, Bulletins, a~ amendments thereto, covering Private Se~ge Dis~sal Systems". Date 3/~8/~2 Signed XW~ND ~er or ~ilder FOR ~ALTH DEPART~NT USE ONLY. Based on the info~ation presented here~th,i~i~h opinion of the Health De~rtment, that an ad~uate and satisfacto~ Se~ge Dis~sal System can be installed on this ~ot. Date ~7~ Sign~ -'is. ) APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate 1-Means Owner or Builder. Address to which 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 & 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 "V" items applicable to the proposed new dwelling. 6-Name of sub-division 7-Section Number 8-Lot Number 9-Private well: Enter "No" 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 " " " " " " 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 si. ze-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, & Bays, 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 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, Streams~ Lakes & Bays, etc. Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center must bc at least 16 feet Cesspool cover top to grade must be held to minimum of i food to maximum Bottom of Cesspool to ground water mUst be held to minimum of 1 foot Lot 44 \ Lot AlOnE: m -= MONUMENT REVI$~ONS YOUNG & YOUNG M/Ii'l, I,,~'~ 400 0STRANDER AVENUE, RIVERHEAD, NEW YORK ~//.//V~'/~/~,~',_P ALDEN W. YOUNG HOWARD W, YOUNG SURV~ FOR: LOT ~0. ~3, "L4UREL COUNTY ESTATES." ~ow~'o'~ - surr0~ co., ~.~. ~~ ~ 4~ SU~OIVI$10# ~l~ ,t'll.~O IN I~1~' Ot~ 1"ff~ ¢L£1~1~ O~ SUlrl~OLIt' 6'011111"}' ON .EV,S,ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: S P. A. ENI'£t?PRISES,/NC, LOT NO. 43, "LAUBEL COUNTRY ESTATES." su~o~, co., .. Y. ~~ ~ SCALE: DATE~I NO. ~ ' . O/~l,v~ ~,~ TOWN OF SOUTHOLD ~/'~/7~ ~ ~ BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE ~ ~ SOUTHOLD, N. Y. Ex~mined~ ................. /..." .............. , 19 ....... ~ Application No ................................. Approved ~' " 19.2...':.. Pemit No. "' ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date 27 le ,ol: ..... h, a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with'~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and,.~ giving a detailed description of layout of property must be drawn on diagram which is part of this application. ~4) 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 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. ~J APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) SeJdea, I.Z. 1178~. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............................................................................... .............................................................................................. Name of owner of premises ................. ,.~P..A......~...~.e.,.~..~...l.~.e..~ ........................................................................................... If applicant~~cer. 1. Location of land on which proposed work will be done. Map No.: .................... Lot No .............. .Jf.~. ................... ~ ....... Street and Number .................................. ~,,~...]~.![l~ll~,..~dl~. .............................................................................. o~-~- ~0 J Municipality 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing useand occupancy .................................................................................................................................... b. Intended use and occupancy ................................. ~,.~.BIIkt~,~l'..,t~f. ql~,~ ........................................................ 3. Nature of work (check which applicable): New Building .......... ,[ .......... Addition ..................... Alteration ............... Repair ......................... Removal .......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost .......... ~.a.t~.~l.~.l~ .............. Fee .................. ~'l~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...~1 ...........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 ......................................... Number of Stories ........................................ S. Dimensions of entire new construction: Front ........ ~.~..t.~.?..... Rear ..... ~[~.~ ...........Depth ........ ~..I. ................. Height ............. .~...b.~ ............................. Number of Stories ................................... ~ ................................................... Size of lot: Front ........~...~.~.~..!. ............... Rear ............ ~b.~.l. ..............Depth ............... ~J[~.l. .................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use ~listrict in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................ ~ ....................................... 13. Will lot be regraded ................................ Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ........ ,~.,~...&......~...~..'e',~l~..~..~..~.e...~...,~.~..~...~..e..~.....~.,e...t~....~.~..~,~..~,~&...~. ................... (Address) (Phone No.) Name of Architect ....~.,l~,,,,,a~,,,,~,..,,~,?,,.l~,,,~...,~-~,,,e, ............................... ,,E~,,,.~,,~,,.e,,~,z...,,~,,,..~,]',,7..,,~ ....... ,'[~,~...~,~.~.~. ............ (Address) (Phone No.) Name of Contractor ....Z~..?....a~.,,,~.....]~.....~....e...,,Z?..?..,. ............................ ,,~.e...~..~..e...~.~..,,E~.......~....7...~.,. ....... .?..~..2..-..,,R~, ..?..7. ............ {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 ind STATE OF NEW YORK, ) ~S COUNTY OF ...................................................... ) ~)~) ~::~'7- j~/~[ ~.~'T ~ being duly sworn, deposes and says that he is the applicant above named. (Name o£ indi~idual signing contract) lie is the ................................................................................................................................................................................................................. (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 c~ontained 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 (he application filed therewith. ...................................... day of .................................................. 19 ............. r~ ~,,~ _ ,j~:~,/t- Notary Public ...................................................................... County .................................. .~~ :'"'~' Seater. bet 12, 1972 AplHi~'ati°nN°'°"file 57~606 S. P. A. Delmar Dr., Laurel, L.t. i,, ,heJ'ollowi,~glocation; ~ B~ement ~ ~'l. ~ ~ FI. & outside ...... .~,:,,,i,,~,~oa September 8~ 1972 .ndyou.dt..be~ncompliaacewltathereq.lrementso/taisBo.rd. iRECEPTACLES j SWITCHES FIXTURES NCANDESCE~TI FLUOReSCeNT 22 16 FURNACE MOTORS FUTURE ~ 1CO ~:?urnaees 1-1/8, 1-1/12bp oil :,~otors 1- 3/4hp RANGES OVENS DISH WASHERS EXHAUST FANS H P UNIT HEATERS MULTI'OUTLETISYSTEMS DIMMERS . S E R V I C E NO. OF HI-LEG NO. O COND. OF CC. COND, 2 OE NEUTaAL ,~i ~ G. Zimlinghaus ~ .Pa~'k Pl.. ....... . Gi:N~Ri~.MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect Inspectors may be ,dent,fled ~entials. -1