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Home My WebLink About6886-zFORM NO. ! TOWN OF $OUTHOLD BUHDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at ....1~.. 9..m~....R.o.a.d. ........... Street Map No.~a..r.d.~.n...H.t.s. Block No ........... Lot No. l~. .... .~. ~.t.~.t.u. qk .... .N :..Y. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... l~pt.. 2~.., 19.23. pursuant to which Building Permit No,6.~O6Z... dated .......... ~.eP~;...2~..., 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 issued is . .Prtv. ate..one, f~t~..rival, ling ...................................... The certificate is issued to . .Charles. l~lof~ ... ~er ............................. of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) ,T..an...1 ~...'t99~. .... by. ,~,. Ytlla... UNDERWRITERS CERTIFICATE No.l~138~J~8... J~u...t6...t97~ ................. HOUSE NUMBER . 320 ......... Street .. F~eO$1~!..8.o~.d ......................... g pecmr TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BI: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6886 Z Date ......................... aetat,,.-..2-~ ............ ~9.?.3.. Permission is hereby granted to: ((~:~].eJl?) .............. ~.~.~.L~.~a~ ......................................... to ~..~....x..a,...~..e,.v.....o.~.a....t:....~,. ;~y...~.~L~..-.~ ..................................................................................... at premises located at ....~.~.~...].~...,..l~.~..J~J,~l~t~L~ ................................................................... ............... a/a....~eeaa~..~mu~ .............. l~t~ ....... ~i,~, ................................................... pursuant to application dated .......................~i~.];I.~....~' .............. 1Sf~.~...., and approved by the Building Inspector. Fee $~, ~1~ ............ Building Inspector FOl~..~I NO. 6 TOWN OF SOUTHOLD Building Depoffment 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 DUPLICATE to the Bu,lding Inspector with the following; for new buddings or new use: 1. Final survey of property with accurate Iocahon of all buildings, property lines, streets, aha 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, Mulhple Residences and similar buildings and ~nstallations, a cerhficate 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-ex~stmg" land uses: 1 Accurate survey of property showing all property hnes, 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 inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificate C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ..... New Building ................ Addition ................ Old or Pre-ex~sting Building ................ Vacant Land .............. Location Of Property ........... ..~.,~...~.......~...~..~'~,.~......~:~....,...~...~. ...... ~.....~....~.....'~...'~...~.~.?.~).~.~...t~...; ...................... Owner Or Owners Of Property ...... '...~Z...~.~..~ ....... .~...,..~-~.....~...~ ........................................................... Subdivision ...~..t~.~ ...... ..~...~.~.~ ................ Lot No...~...¥c...... Block No ............. House No ........... Permit No..L~.¢0'~..(~...~'... Date Of Permit ...~.,!..L,.~',!.?..?...Applicant ...,l~.,f,,T',.....,C~.,,,~.,.~.~.,cr,,,~.....~.,~...~.,.,f~,. .... 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~_,.,_.~,r~ap~~d regulations. ......... ................ Sworn to before me this / /- -J / ~ ....... ~..C~day of ..~~.....?...~...?...LI (stamp or seal)//~/~ ~ ,.i , THE NEW YORK BOARD OF FIRE UNDERWRITERS O~S BUREAU OF ELECTRICj'T~Y. r F-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 o~t, January ltl, 197~ 2pplicationNo. onfile70058~ ~'~ · .,s c.~,.,.s .... N 138188 ~y t~ ~t~ ~u~m~t ~ ~d~ ~ ~ ~t~ by t~ ~.~.T. ~nst~uc~on~ F~em~ Hd. O~d Ave. ~ ~okham Ave. ~ e~ami~ On ~ ~ ~ I a~dfou~ ~ be in ~mplia~e ~ith the ~uirements of thi~ ~rd. RXTUI~ I [ f fiXTURES SERVIC~ G~CC,,.~,-~ [ NO. OF S METER 1AMT' i~oAMP' (~T~ E(~UIp. 1 ,,8' 2W I ,.8' 3Wx $'ff~ 3,,~ 4W NO' C~RCC,~CO~D-1 OTHER AI~ARATUS: WEte~ heEte2'-/n: 1-11.Skw MC, tOF/8: 1-1/2hp RAN~S ~.AT, K.W. l COOKING DECKSI OVENS DISH WASHERS R V I C E 1-.5~Okw NO. OF N~UTRALS A.W.G. OF NEUTRAL PO Box 201~ Middle Island, L.I. 11953 OINIBALMANA~II 11 F SUFFOLK COUNTY DE,~ARTMENT OF HEALTH Health Department Referen~ Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant I~-r ([.~'-~r~-~t'~ Phone~,~' ~ Address ?,~,, ~ ~ ~<~; ~ ~, 2. Property Location ~.~ ~,~- ~[~ ~ ~ - Village ~~r ,~ Township S'~.~ 3. Public Water Company Name ~ o ~ 4. Lot size: Width ~ feet Length ~ ~ feet 5. Subdiv. ~-~-,~ ~i~,l~ 6. Section 7. Lot Number ~ ~., 8. Private Well ~ 9. Public Water ~ Distance to main .... lO. Sewage Disposal System: A. 900-g~llon septic tank: Precast ~[quival ent Block · Leac.F~, ng pools: i' Nun~)e'~'r of pool s P;ecas C~B1 ock .Special If pri?~ce well, fill in the fol 1 ow'i~g bl an ks: A. Ta~capacity ~f~ gallons B. Pump G.P. C. Total well depth D. Depth to ground water E. Amount of water in well (For Health Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's cu[ren~ standards tbereto~. This application will be valid for one year from the date of approval indicated b]low and may be renewed if a current local Building Department Permit is in effect. Date ~ ~ ~ Signed ................................................... :::::::::::::::::::::::::::::::::::::: FOR HEALTH DEPARTMENT USE ONLY. Based on the information presen';ed herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE S-15 Rev, 4/1/73 SIGNED~ Av NU gFP£ 'MAN I -- MONUMENT SU~DIW$10N MAP F/LED IN THE OFF/CE LOt UNAUTHORIZED ALTERATION OR ADDITION TO THIS ~URVEY I$ · VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW GLIARANTEES iNDICATED HEREON SHALL RUN ONLy TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY~ GOVERNMENTAL AGENCY ANO LENDING INSTITUTION LISTED HEREON~ AND TO THE ASSIGNEES OF THE REVISIONS YOUNG & YOUNG DEC. 31,1973 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: CHARLES MELOT LOT 12 "GARDEN HEIGHTS" //"~~ AT GUAR ED TO: ,~':'~ ¢~' MATTITUCK SOUT~~;~ c~ ~ TOWN O~ SECU ITL~;~NTY C . -- SOUTHOLD SCALZ: ~"= ~0' JOATZ:N0V. 8,197~ ~ ' TOWN OF SOUTHOL$ BUILDING DEpA RTM E NT ,,,//.'~/~ - TOWN CLERK'S ........ Examined ~proved ................... ~ .................. , 19.~.~. Pe~i, No .... _.~... ~. AFPLICATION FOR BUILDING PERMIT ; ~-" r~t~ September 2~,o 73 INSTRUCTIONS a. This application must be completely filled in by typewriter oK 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 os areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance.of~ujlding 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. 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, os 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. X (Signature of applicant, or name, if a corporation) ~ .t. tituck ~ N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................... A .e. .......................................................................................... Name of owner of -rem ses ~Cr Melot Jr ~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. /~Aop No.: Garden Heigths Lot No. 1;2 Street and Number ...l~.../..S.....F..r..e...e..m...a..n...,R..o...a..d.. ......... ~.t..t...i..t...u..c..k.. .......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use end occupancy vacant b. Intended use and occupancy ....... .°..,~.,e.....~..a...~.~.~...,~w..e...]:~.~.~. ........................................................................... 3. Nature of work (check which applicable): New Building ..a%?J;~ ........ Addition .................. Alteration ......... :...'.~..% Repair .................. Removal .................. Demolition .................... Other Work ................................................ i (Description) (to be paid on filing this opP!icotion) 5. If dwelling, number of dwelling units ...o..~..e. .................... Number of dwelling units on each floor ............................ If garage, number of cars ................ .Q ................................................... 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 ......... ~,~ ...................... Rear .......... .2.~ ............. Depth ....~..6. ............... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ..... ~.Q .............................................. Rear Depth 200+ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... ~L.....~,~..~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ Z~ ........................................... 13. Will lot be regraded ....n...o. .................... Will excess fill be removed from premises: ( ) Yes (x) No Chester Melot Jr 14. Nome of Owner of premises .................... ~;... ........................... Address .....~..~.~.t.~..~..o.~ ...... Phone No ....................... Name of Architect .............................................................. Address ................................Phone No ....................... M~S~T. Construction C or~dd Name of Contractor........................................................... ress ..~L1;.~,.~.U,~ ........ 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. See filed plank & plot plan to be revised ad returned with additional set plans STATE OF NEW YORK, ~ S S COUNTY OF....... $1~]g~ ........ [ ' Emanuel Tsontakis ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ................................. .~...g..e...~.~...o.~...g..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 oil 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 application filed therewith. Sworn to before me this , ~ ..................... ~')d a y 0f ...................... ............. , ~ ~ ~ ~ N°tary Public,. ................................................... County .......................................... ........................ (Signature of applicant) - Jl ,4