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Home My WebLink About6903-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~.~.9.~ ...... Date Ma~ 1~ 19.7~ THIS CERTIFIES that the building located at ..... 8.o..u~.d...V.i.e.¥..~.v.e. ...... Street Map No... ~ ....... Block No. xx .... Lot No. xx Southold ~1 DY · conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 0.9 .t .... .~..., 19.?.~. pursuant to which Building Permit No..6..9.0.~.Z.. dated .......... ~c..~...~. ......, 19?3 .... , was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one family dwelling The certificate is issued to Sidney T~bb 0~ner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ~a.y....1.~....~.9.7.1~....b.y.. ~.; .V.~.l~a... UNDERWRITERS CERTIFICATE No. N 1 ~198~ April 3 1975 HOUSE NUMBER .... .1.~.2.~.~.... Street Sound View Ave Building Inspector FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEI~tT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N°. BUILDING PERMIT CI-HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6903 Z ' Date ........................ .0..0...~..... 3 .................. , 1~.~ .... Permission is hereby granted to: ....... ~..o..~.~h~.!¢ ......... ~..q~..336~ ...................... to Build ne~ one family dwelling ~t premises located at ......... .~..~..?..~.....A..~...O. ..... .(..O...~.~.r..~9...~...~L.~....o.?....~..~..b..)' .......................... Southold N-Y. pursuant to opp{icotion dated ...................... .0..¢.~;.....~ ................... , 19.7.3..., and approved by the Building Inspector. Fee ~.?...~..0. .............. ill lng rnsp{ cror FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Sou~hold, N. Y. 11971 APPLICATION FGR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcat~on must be filled ~n typewriter OR ink, and submitted ~n DUPLICATE to the Building Inspector w,th the following; for new braidings or new use: F,nal survey of property with accurate location of all buildings, property hnes, streets, ano unusual natural or topographic features 2 F,nal approval of Health Dept. of water supply and sewerage d~sposol--(S-9 form or equal) 3 Approval of electrical installation from Board of F~re Underwriters 4 Commercial bulld,ngs, Industr,al buildings, Multrple Residences and s~m~lar 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 ex~stmg buildings (prior to Apnl 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 prewous owner as to use, occupancy and condition of bu~ld,ngs 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate C Fees' Certificate of occupancy $5 00 2 Certificate of occupancy on pre-existing dwelhng or land use $5.00 3 Copy of certif,cate of occupancy $1 00~/' . ..~..././, .~..~...~ .~.... Date ......... New Bu~Idmg . /er. ...... Add~tign ................ Old or Pre-existing Building ................ Vacant Land ......... oca ,o, Of P ope ty ............ ........................... Ow. r Of ...... ........................................................... Subd~wsion ......................................................... Lot No ............. Block No ............. House No ............ Perm,t No ~..~..~....~....~.. Date Of Perm,t/.'.~/.5..~..7~ .... Apphcant .~. !~'~..f~../..,ff~.....~: ..~.....~..~.. ..... Health Dept Approval--A~'~'~'"/"~/"/'"~' .~/:~'/~..~../..~...~. .. Labor Dept. Approval ........ --"~'~"'~" ....................... / Underwriters Approval ...~.....-.../'..~..~..~.~.../. .............. Plann,ng Board Approval .... ~.~...~.. .................. Request For Temporary Certificate .................................. Final Certificate .......... .~..~"~... ............... Fee Subm,tted $ ....... ..~,..../..~..O. .............. Construction on above described building and permit meets all_applicable codes and regulations. Sworn to before me this ~----~,/g~2 ~ ~_..~,~, ........ /...'~... day of .... · .~.....~.....!..~....l...c'J....'/...~.. (stamp or seal) ~,~ /_.~/y~ Notary Public .................................... County ~'c/ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled ~n typewriter OR ink, and submitted m DUPLICATE 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 hnes, streets, and unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage d~sposal--(S-9 form or equal). 3 Approval of electrical installation from Board of F~re Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installahons, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where apphcable B. For ex~sting buildings (prior to April 1957), Nomconformmg uses, or bu~Idmgs and "pre-exist~ng" 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 inspection 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 dwelhng or land use $5.00 3 Copy of certificate of occupancy $1 00 Date ......~.~....~.... ....... New Building ..... /~. ..... Addition ................ Old or Pre-ex~stmg Building ................Vacant Land .............. Locot,on Of Property .................. ~.O.~.~ .~.~ ......... ~'~..., ....... ~ ......... ~ ................ o, ............ .............................................. Subdivision .......................................................... kot ~o ......... Block No ............. House No ........... ,~/, Underwr,tors Approvol ~Z/~,~4 ..................... Plonn~n~ BoorO ~pprovol ........ ~ .................... Request For Temporary Certificate .................................. Fm~l Certificate ........... ~ .................. Fee Submitted $ ...... ~..~.Q ................. Construction on above described building and permit meets alJ,~pphcable~ codes and regulations. Apphcant ... ~. .-~ ..... -, . ................................ ................ day of .......................................... (stamp or seal) Notary Public .................................... County iVA¢ AN?,~ 5C_~,LE-40' ~ i" I / / ~e '~age d~spo~al ~ ,~ter ~1~ ~acilittes for this I~,w~i=n ~'~ ~b¢~ ~nspected by this ~ ~f of 10. ll. DI~UA~t~]~-R_,. _...r EPARTMENT OF HEALTH Health Department ~,Wt- '' Reference Number ~ ~: ~PLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY ApplicantE~,-'-~_~.J/xy~ ~/~/~_hone ~-/~ 5. Subdiv. Address ~/ ~ ~_~ ~ ~~ ~ 6. Section Property Location ~,~m ,, ~ ~. ~/.~ '~ ~,~.. Lot Number ~.~_,~ .- ~ 8. Private Well Village. ~,~ Township. ~~.~ 9. Public Water Public Water Company Name Distance to ~in Lot size: Width /'~feet Length ./~. feet Sewage Disposal System: A. 900-gallon septic tank: Precast ,/Equivalent Block B. Leaching pools: Number of pools ! Precast ~/Block Special If private well, fill in the following blanks: A. Tank capacity ~F'~_ gallons B. Pump G.P.M.. ~"~)M 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 accordanc: with the Suffolk County Department of Health's current standards thereto. This applicatio will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Departn)ent that an adequate and sati~sfaci~o~ry Sewage Disposal System and Water Supply can be ~l~lJed/o~ this pl,ot. ./'~~~~:~:~ APPROVAL DATE --~ SIGNED ;]/ ~~~ ~ S-15 Rev, 4/1/73 5,52.'05' lO" 175.0' 5,52 05 10 ITS.0 SOUND W[W ~v.e:__nV_D_~ ¢~, ~' ,~LALE 40 ,t THE NEW YORK BOARD OF FIRE,UNDERWRITERS ~ ak BUREAU OF EL.ECTRIGIT~i . · 85 JOHN STREET NEW YORK NEW YORK 100~8 ~"Ap~z ~, z~7" ~..,,....-~..o.z,,. ;o~ N 151981 THIS C~l~ltS THAT Salva=oPe Cap~tano, n/szae =ounavze~ Ave.~ juu, e~ ~o~ n ~n s ~outhlld, inthefol~ing~ation; ~ B~e~nt~ ~stFl. ~ 2~ ~. ou~[de ~tion B~k ~t ~am~o~ April 1' ~97 a~ou~incomplia~ewiththe~ui~ntsofth~rd. FIXTURE FIXTURES RANGES COOKING DICKS OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 16 28 22 16 DRYERS FURNACE MOTORS FURORE APflUANCl FIIDLqlS TIME ClX)C:KS UNIT NIATIRS MULTI-OUTLET SYSTEMS NO. OF FEET S E wate~ heatert 1-q. Skw Eloo.room heatel~s~ 5-2.0k~, 1-1.251o*, R v I c 3/0 i 3./0 1-1'0kw, 15-.75lO(, 2-.5~ W.B. Ruland, Mattituck, L.I.11952 : ~ ,. ~OP~( FOR BUILDIHG D~ARTMEN~. TH!~S ,COPY OF CERTIFICATE MUS~T NOT BI ALTERED IN ANY MANNER. Examined ..... ~......~... ............ , 19..7~... ~ Approved .......... :.( .......... ~. ............ c~.. ~..d ~ ~ .... , 19.~.~... Pemit N ................................ TOWN OF SOUTHOLD ~-' BUILDING DEPARTMENT y/~/~,/ TOWN CLERK'S OFFICE SOUTHOLO, N. Y. -2~,L~..~,,/.~,,~' ~,~ ~ ~ ~'~ Disapproved a/c ............................................................................................ ~°~6'~vl/! /'~ ( ui ding nspector) ~ APPLICATION FOR BUILDING PERMIT~ INSTRUCTIONS wi~ a. This epplication must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, 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. 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 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 bee~ granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zo~ Ordinance of the Town of Southold, Suffotk County, New York, and other applicable Laws, Ordinances or Regulations for the construction buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable lawJJ, ordinances, building code, housing code, and regulations,3 and to admit authorized inspectors on premises and in buildings for necessary inspection c ~L~ ~' ._~,*~s ...~.~.~..~.~..~.., .................... (Signature of applicant, or name, if a corporation) . .......... (Address of applicant) State whether applicant is owner, lessee, a~nt, architect, engineer, general contractor, electrician, plumber or builder. .............................................................. ~.,., t...q .~.~.-..~., ......................................................................................................... Name of owner of premises ........... (.2~. ....... .,(~'../~..~. ........................................................................... If applicant is a corporate, sim~ature of duly authorized officer. IName 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. Map No ..............................................Lot No ......................... Street and Number ...~.~,,~,~......~ ....... ~..~...//...~..'~... ...... ~.....~..[;~....~....~...~.....~.~.......~.~ ........ ~ ~ ~4-J~/-,~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~,.~ ................................................................................................... b. Intended use and occupancy ......... ."~.....~:.~...~ ................................................................................................ 3. Nature of work (check which apl~licable): New Building .................1~..... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ..... ~.,(.~ ..................... Fee ...~..l ......................................................................................... (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 ............................................................................................................................................ 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 .....-,~..~ ............ D ~ epth ................................. Height ............. ~ ............................... Number of Stories ....... ..~. ............................................................................... 9. Size of lot: Front /?..5~ Rear ........... .~'...~,~.-~..... .............. Depth /~'--~ 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: ............................................................ 13. Will lot be regraded .......... ~....C..-~.. .............. Will excess fill be removed from premises: [ ] Yes ~:>~b, No 14. Name of Owner of premises ............ ~ .............................................................. ;~'.. .......................................... (Addrbss) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ...................................... ~.....¢~: ................................ ...~.....~. ....... ~..~....,,~fi.' ..... (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 indicate wheth- er interior or corner lot. STATE OF NEW YORK, ) COUNTY OF ...................................................... ) (,~ ................. ~¢~.-,.~.........,~.~-.....L~g ~ul~eposes and says that he is the applicant above named. {Name~ . ~of individual signing contract) ~ He is the ................... ~~ ....... .., ,~.,.....~.....~.~ .................................................................................... / (C~ntractor, agent, catr~fiorate officer, etc.) of said owner or owners, and is duly authorized to perform~ 9[r,hpv~,~rmed the said work and to make and file this application; that all statements contained iri,~his application are true to 'd~e~b~sl~fr~is~hee~vkl~ey~r~l ~t~ellef; and that ~the work will be perf~d in the manner set forth in the application filed therewith. No, 52-0344963 Suffolk Count~,f~'~' / ) / Commission Expir~LMarch 30, l?.~.~ ' (Signature of applic~t} ~AVLD t, Ail work to conform to ~ulee local B~ildin~ Dep~rt~ent. a~d regu~at$~ns of ' 10~ Pr~vi&e double tion~ ~allel All ?lu~bing work to be install, ed in 'strict dance to. oozes. ~lect~c~ ~rk to be ~re Underliners ~o~. ConOr~cr .to verify ~1 ~mensions ~d a~e ~rk ~ee p~or ~o ·eotings ~e desired ~or t~ (2) ton soil, sub- J~t ~o d~ta ebt~d ~ actu~ Og~rete foundation w~ls ~d footi~ ~d floor ~hor ~ts sill wi~ ~/~ d~'-6" io~ bolts a{ 6}~" on cen~r. 8._~rmi=g ~o be pla~e~ t~e 2"x4" at 16" Co~r brae with l"x4" le~i= or, ~pr=ved bea~s ~er all posts 1i, Br~g~ng 5/4"x~' not ~o'excsed 8'-0" OG I2, Con~or ~o notify ~eer ln~tt~ ~ fie~d eoGAttia~ other ~ ~O~e Iho~ ~ere. 1~. ~ro~ide t~pora~ bracing to protest from oe~st~otion lo~s. NOII~¥ ~tUILDINiS O;P'A&TMENT .Ar SALVATORE CAPITANO P.E. 1 C6#SULTI#G ENGI#[ERS ,~4~ JE~I,CHO ~ ~ N. ,Y. 11792 r \ I-;, 4 ~I ' r; LT--, ~lc~ ~r~:;L.. F-7.~ ~4 ,~,~:" I2 :~ THE OFTICE OF DWG. NO. SALVATORE CAPITANO P.E. ~ CONSULTING ENGINEERS 6243 JERICHO TURNPIKE WOODBU~Y, N. ¥. 11797 _.fi_u_ ii ,? i THE I~ICE OF DWG. NG. SALVATORE CAPITANO P.E. :3 CONSULTING ENGINEERS THE OFF~ O~ SALVATORE CAPITANO P.E. CONSULT!ItG ENGINEERS B243 JERICHO TU~NPtKE mo r ~GALV, M [TA L J rI THE OFFICE OF DWG. NO. SALVATORE CAPITANO P.E. GONSULTING ENGINEERS i'243 JERICHO TURHFIIiE WC)ODBUIY, N. Y. 11797 I i I I r' ..... 41 ' 'SALVATORE CAPITANO P,E. CONSULTING ENGINEERS