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HomeMy WebLinkAbout6848-zNO. ~ TO~VN OF SOUTHOLD BIBT.BING DEPAR~RNT Town Clerk's Office Southold, BT. Y. Certificate Of Occupancy No.. ~,~13 ..... Date .............Dee ....28 .... , THIS CERTIFIES that the building located at... ~a3,ta-:Lre. Way. & .Set~l~ Map No.Sa~t. A~re. I~ck No ........... Lot No... 2 .....Eatt~,t~k..~.~ ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........~ept...7..., 197.,:~. pursuant to which Building Permit No.. dated ..........6ept. · .7. .... , 19.73., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to . .E. :.S :.T. :..g.o.n.s.t..r.u.c.t..u.i.n..C..or.p ...... . .0~m..e..~..b..uS..1.d.e.r. .... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ...Dec .. 2~... ~ 97~ .. by..1~,..V.{,l~.a.. UNDERWRITERS CERTIFICATE No...lt. ~21+19 ..... $~pt...~.1 ...~.973 ........... HOUSE NUMBER ..... ~0 .... Street ....~qalLt, 4~{.re .kl&y ...................... vgo Sound ¥2ew · ............ · 'O~ NO. 2 TO~VN 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? 6848 Z Date ............................ 2ett~&.....~. ........... , 1~..~ ..... Permission is hereby granted to: · % ]Y~, · ~...T .... ~Jan~t~c ~zo_..~.o~.p ........................... .... ~.%.~L. bu~k ..................................................... ................................................................................... at premises located at. l,~xt;..~...2....2ia2Ll~..Juiz,.e..~is.t~.t~a~ .......................................................... ................................. Ikmr~...~.i~w.,.Ave..&.. ~aLta.2~.e..,,~t~ ........... ~',a.tt &tuek ........................ pursuant to application dated ......................../L~I{~....-~ ................. , 19~.~..., and approved by the Building Inspector. Fee $.~8,,..~Q ........... .... ~....~.,.,..., .................... ~. ........ ~ ....... ~.~ ..................... i Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. ~-~--//, APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant ~%~ (~'%~,g~¢'~-~,.) C~¢CPbone~J'~'f2~. Subdiv..~,~.C ~~f Address ~, '~, ~~C~ ~ ~',~, 6, Section 2. Property location $~- ~'~q~ ~pJ~ ~%~ 7. Lot No. ~ %~ ~% f~%%~L~ ~ 8. Private well ~ Village ~,%~OC.~_ ' T6wmship ~%%~ 9. Public water ~ 3. Public Water Company name ~C ~ Distance to main 4. Lot size: Width, k~ feet Length'~.QO feet (Enter on center plot below) 10. Sewage Dispos~System: A. (9D~ gallon septic tank: Precastt~quivalent. Block B. ~aching pools: Number ~ Precas~ Block . Special If private well fi in blanks below: Tank capacity Pump G.P.M. Total well depth.__ Depth to G.W. Amount of water in well Test Hole Data Feet 0 2 6 8 10 12 14 16 18 The undersigne~ CERTIFIES: "Construction of authori ed installations wtl be in accordance with the Suffolk County Department of Health's current stand- . ards thereto~/ / Date /'~ ~ '2'~ Signed ' Ow~z o u lder FOR HEALTH.~DEPARTMENT .USE ONLY. Based on the information presented herewith, i is the opinion of the Health Department, that an adequate and satisfactory Sew Disposal SystemiZe installed on th~ ~____._.~.~ S-15 Revised 4/~/72 TOWN OF SOUTHOLD Building Department Town Clerk~ Office Southold, N. Y. 11971 APPLIGATION FOR CERTIFIGATE OF OGGUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted ~n duplicate to the Building ~nspector with the following; for new buildings or new use: I. Final survey of property with accurate Iocahon 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 ~nstallation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and similar buildings and installations, a certificate of Code comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming uses, or buildings and "pre-existing" land uses: ]. Accurate survey of property showing all property lines, streets, buddings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspechon of buddings or premises, or other pertinent formation required to prepare a certificate C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...... ................. New Building ~ Old or Pre-existing Building Vacant Land Location Of Property ..... .~...~.~.?...~.A.~...`~.~..~.~.~.~.~.~.~.~.:~.~...~.v...~.~z~..~..~..~...?...~..~.~~`~ Owner Or Owners Of Property ...... ...1~..~..'~'......~..~..~.~...(¢..?.~...~..~..~.......C..~..¢..?.. ............................................. Subdivision ...S.'.,~...~.,~..,?.~..~..,.~......~.~,.~..~,..~..~.~ ................ Lot No ..... ~ ....Block No ............. House No ............. Permit Ida...~....~..,.~...~.. ..... Date Of Permit .................... Applicant ..... .,~,..$.?....~.~...~...'¢.,..'~.....?..?~.~..~...,~... ............... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ..N.'..:."..~..~.~.~...~..~. ...................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $..~...~ ................. ..... . ..dayof ...... ...... .... Notary Public .................................... County Construction on above described building and permit meets all applicable codes and regulations. Applicant ~ ' ~~ (stamp or seal) ~ ~71~ MAP F/LEO/N 1"/~ OF~/¢~ CL~t~I~ OF SLIF~OLK ~OUIVI'Y ON .Ews~o.s YOUNG & YOUNG 4oo OST,^,D£, ^V£NU£..,~V£,,£^O. ,EW YO,K ^-OEN w. ~ou.~ .ow^.o w. YOU.a SURVEY FOR: MST CONSTt~UCTION CORP. LOTNO. 2,"SALTAIRE ESTATES" AT MATTITUCK GUARI NTI :ED TI~ ~'~l ~" TOW. OF SOUTHOLD SUFFOLK CO., N.Y. e~'~.~,,/,~~ '~^~': ,": ~0'. I"~'': ~u,Y ~.,~ j.o. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY I$ A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW THE LAN0 SURVEYOR"S INKED SEAL OR COPIES OF T~IS SURVEY MAP NOT BEARING .Ews,o.s YOUNG & YOUNG~_~~ ALDEN W. YOUNG SURVEY FOR: PA~ KNIG~,T a ~RY KNIGHT LOTNO. 2, SALTAIRE ESTATES MATTITUCK SO.HOLD S~0S BANK ,',, ~ ,~, ;: TOWN O[ SECURITY TITLE & GUARANTY CO. ~r~ '~-~ SOUTHOLD ~he se~aBe disposal and ente~ Supply ~aciltties tot this loeatlonlmve been /nSpected by this department and ~ound to be satZsfactory. Se~vloes MONUMENT SUBDIVISION MAPFILEO IN T~ OFFICE OF T~E CLENK OF SUFFOLK COUNTY ON TOWN OF SOUTHOLD BUILDIN~ DEPAIII'MENT TOWN CLIE~K'$ OFFICE SOUTHOLD, N. Y. Examined ........... ~....~. ......... , 19..~.. Disapproved a/c ' .................. 2:: ................................. ~ ~ ' . 'A.P. PLICATI UlL I G P[al~tel~ . .......~.....: ............. ~ INSTRUCTIONS a. This alaplication must be completely filled in by typewriter o~, in ink and submitted in triplicate to the Building .I.nspector, with 3 sets of plans, accurate plot plan to scale, Fee according to schedule. ' ' b.. Plot plan showing location of lot and of buddings on prenuses, retOtionshlp areas, and giving a detailed description ef layout ofproperty must b~ ~dfawn'on the diagram which is part 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 work. e. No building shall be occupied or used in whole or in pa rt 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 Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regul~io~s, 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 cede, and ragulotions, and to admit auth~,rized inspectors on premJses~ and ir, buit~ngs'~r necessary inspections ..... ......... ;~.. ~.........~.. %..~....;:..~,..: ................... ;. ...................... ~ ........ t31gnarure o'r oppllcanT,' or namei Jr a corporot on/ ......................... .................................... .} ............... b .......... (Address of applicantT State: whether app~licont is owner, lessee, agenti architect, engineer, general contractor, electrician, plumber or builder. Name of owner of p .... ; .................... , ........................ ............................................................................................ If appl~e, signature of duly authorized officer. Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... 1. Location of land on which proEo, sed work will be done. Map No...'~.....~..'?...~..I....1~...~.,.~ Lot No.....'~...:...'~... ........ . ' '" ' " Street and Number ........ ,,~.1~....~.....~....... ..................... ,.....~..~...~... ........ '.~../. .................. Munfcipality 2. State existing use and occupancy of premises and intended use and ocCUl~ancy, of-prc~posed construction: .~, a. Exisiting use and occupancy .................. ...1~...~ ....... ,~..,~.~.. ...... ~..~....~..~.~......~..~......~....l~l..~.~..~... b. Intended use ond occupancy ................................................................................................................................ ~ -N'-a~ure of work (check which appl bio): New Building .4 ............... Add~ .................. Alterahon ........ Repair .................. Removal .................. Demolition ........ ~ ............ Other Work ................................................ ~ ..... ..~..~. (Description) 4. Estimated Cost ...... ~ ............................... Fee .,..~...~.~....~... ................................................................... r (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 c~rs .................. J .......................................................................................................................... 6. If business, commercial or mixed occupancy, specify n~ture and extent of each type ~f use ....... ..1~...[....~.. ........ 7. Dimensions of existing structures, if any: Front .........~...~.,.~J~.. Rear ................................ Depth .................... Height ........................ Number of Stories .................................................................................................................. Dimensions of same structure with alterations or additionS: Front .................................... Rear ............................ Depth ................................ Height ............................ Nu_~b~r of Stories .................... ~ .......... 8. Dimensions of entire new construction: Front ........... ~ ................Rear ....... ..~....~... .......... Depth .......~.....~.. ......... Height ..... J.~...! ...... Number of Stories .................... .~....i ....... .'~...J...~.....~..~. ............. ~:. ......................................... Size of lot: Front ............[..~... ................................... ReOr ............. .[...~ .................. Depth .~.....~o Date of Purchase ........................................................ Name of Former Owner ....J.~....~.......~..1~....~.".¢~......~-~?. ..... Zone or use district in which premises are situated ........... ! ........ .~....~.......~....~....~.~.~..~....1~... ....................... Does proposed construction violate any zoning law, ordinance or regulation: ............. [~..~......'~.. ......................... Will lot 6e regradec~ ....~.~'~....." ...... Will excess fill be ~emoved from premises: ( ) Yes (t~o Name of Owner of remis ....~.....~..T....~...~....~..I~I~....~...C...~..!?....~.. Add~ ... Phone No.~.-....~.....~...~.. Name of ^rch,te ; ..... ,o ....................... 10. 11. 12. 14. Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate.al set-back d mens OhS from property lines. Give street and block number or description dccording to deed, and show street names and ~ndicote whether interior or corner lot. 1 DO STATE OF NEW YORK, Jc S · · COUNTY OF ................ ..~.~:,.:..:.~.J'~,~ ,, .............. ~..,.,.~,. ......... ~4.~.........., ...'~'.,.... .,~.being cl,~y~ says that he is the applicam (l~an~e' of i~d~ual sigr~ing'contract~ above named. He. is the ....................... ~~.~~ ......................................................................... ~ (~=ee~l~;tor, agent, corpdrate 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 applicatibn are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ........................ day of ............................................ , 19 ........ Notary Public, .................................................... County .................................................................................................. (Signature of applicant) 7- t )Z0"