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Home My WebLink About6943-zFOI~ NO. 4 TOWN OF $OUTHOLD BUTLI~IN(~ DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No.Z~..~. ~ ....... Date ..... .J..~....i.~. ., 19~... THIS CERTIFIES that the building located atW~.8..B.&Y.be .r.x~.R .~. 4..~.~..l; ..... Street Map No. ~&SS.:. P.~.,.. Block No..A~...*. ~... Lot No. ~ 20 ...... ~..u~h.°~..~.. N...Y.: ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ 0e~...23.., 19 .~.3. pursuant to which Building Permit No..~..~. ~.Z.. dated ........ 0.~.l;.. 2~ ...... , 197~.., 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 Pl'.i.~.~.~.e. 0~e family dwelling The certificate is issued to ~le.~..o?~. ~o..h.~ ...... .0.~..wn. #.x· ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approvall~Y.....~0...i.~..~....b.y...R....¥ .i.1..1~. ...... UNDERWRITERS CERTIFICATE No. N..~..[~. ...... .~. y....i.~... ~..~..~. ............. HOUSE NUMBER .... ] ~30. ..... Street ... ~.~yb~r. ry. 1~ ~[ .................... ....... (,.~..~, .... ,~'. . . . . mldmg Inspector FORM NO. ~ TOWN 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? 6943 Z Permission is hereby granted to: C~us~..go~t~,...,~tC.....~,.l~im ............ ..... ~.....~, ,,..~le....'~t,h ....... Se.l.~ .... at premises located at ..~...~....~II~?.~,....~.~,B~&~,..~..Q~I~..~ ........................................ ............................ ~££..~be~.~..Ro~ ......... ~a4seu...~.~.t ....... e~teb~ ....................... pursuant to application dated ................... ..~.~.....~ ................... , 19.~..,~..., and approved by the Building Inspector. Fee ~6~ ............. . THE NEW YORK BOARD OF FIRE. UNDERWRITERS SW BUREAU OF ELECTRICII~ l-- 85 JOHN STREET. NEW YORK, NEW yORK 10038 THIS CE~IFIES THAT o~y t~ e~t~M ~u~nt ~ ~scHb~ ~ a~ i~t~ ~ t~ ~t ~ o~ the a~ ~pl~a~n numar in ~p~mi~s of in t~ ~ing I~ation; ~ B~ement RXTURE OUTLETS SWITCHES FLUO~ESCEI~T 32 6~ 38 32 ~ lstFl. [] 2nd FI. outside Section Block Lot a~ fo=nd to be in cornpflance with the requirements of this l~oard. RXTURRS RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS MOTORS FUTURE /IEDRES TIM,'CLOCKS DIMMERS SERVIC~ DISCONNECT S E R V I C E OTHER A~ARATU~ *Furnaces: 1-&/Shp, ;.;otor/s: 1-3/~hp 2-1/2bp OF CC. CO~D. 3/0 NO. OF HI-LEG ~ HI-LEG 3/o Gray Electric Inc. 29 Seabro Ave. North Amttyville, New York 11701 FOF, M NO. $ TOWN, OF SOUTHOLD Building Deportment 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 Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location 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 farm 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 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-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 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 dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 .......... New Building ...~.......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~...~....~.~....A~.~../~......~.~.. ....... ..~...~....~..~....~.....~..~.../.'...,~....~.. ...................................... Owner Or Owners Of Property .~...~ ..~..,~..~.. ............................................................................ Subdivision ................................................................ Lot No. ~.~..~.... Block No ............. House No ............. Permit No. ~..~....~...~...... Date Of Permit .~.~.~..e~..~.T~..~'Applicant ....~....~.~....~....~,~'~,~....~..~.~...~..,..~....~'...~...~...... Health Dept. Approval ..~./.......o~.../.~..y... ................... Lobar Dept. Approval .............~....{..~Z. ......................... Underwriters Approval ,~.,../5,d~,.~'..~. .................... Planning Board Approval ..... ,~,....~,., ......................... Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ .......~.~...~ ..................... Construction on above described building and permit~,~eets all app].icable codes and regulations. Applicant .......... ~.~..~...~ ........................................... Sworn to before me t~.. ......... /.,'~. day of ....~.~......7....y. ..... (stamp or seal, Notary Public .................................... County SUFFOLK CO Reference Number .~ ~A~~ FOR APPROVAL TO CONSTRUCT ~TE SILAGE D~SPOSAL SYSTE~ AND A ~ATER SUPPLY Applican~,~ ~6~</~; PhoneZ~- ~7.~ 5. Subdiv. Address ~ ~ ~,-~y~ ~ ~~ 6. Section Property Location~~~ - ~,~ z~ 7. Lot Number Village ~ ~,~ ~,~ Township ~,~ ~/~/ 9. Publtc Wate~ Public Wa~eh c~pa~y Name - ' ' Distance to ~in Lot size: Width ~ feet Length ~[y feet 10. Sewage Disposal System: ll. (For Health Dept. Use) Precast~ Equivalent B. Leaching pools: Number of pools ~ Precast~/ Block Special 900-gallon septic tank: ~-' Block If private well, fill following blanks: A. B. C. D. E. in the Tank capacity~2 gallons Pump G.P.M. ~ Total well depth~ Depth to ground water2/ Amount of water in well~ The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application 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 Department that an. adequate and satisfactory Sewage Disp,o~al System and Water Supply can be installed on thins p~ot. S-15 Rev. 4/1/73 '~ TOWN OF SOUTHOLD 2_/ / BUILDING DEPARTMENT//~/~ ~/ , /.~ TOWN a:ERK'S OmCE MUTH~D, N. Y.~ ........................................ , pp ca ~on ~o ................................. ........................................ , ................................ ~i~pproved a/c ' ....................... ....... ......... (Building Ins~tor)~ APPLIGATION FOR BUILDING PERMIT Date I NSTEUCTIONS a. This aj~plicetJon must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, witl~ 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, g~wng 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 "~tbe 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 Zone Ordinance of the Town of,~outhOld, Su~ffotk 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) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; Name of owner of premises ~.~[~'.~...~...~...~'....~...-. ,~_~_...~..~..,,J~.. 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.: ...... ~.. .......... ot N Street and . ..?~.. ......... ~ .................. ~ ............................................... 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 ,/ .,,~.1~,/;~,,.~/.~,/ · 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other, Work ........................... ~ ........ (Description) 4. Estimated Cost ;~'~O,- ' ~f ~ ......... ; ...................... (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 .................. ~/ Rear ...~./. .................................. Dimensions of same structure with alterations or additions: Front ...... ~ ................ pth Height N mbe of Sto les ..................... De ...................................................................................... u r r ................... 8. Dimensions of entire new construction: Front ...... ~,..~.. ............ Rear ....~...~.. ................. Depth ..... ..~.~...~. ................... Height ........ ../..~.... ........................... '.... Number of Stories ..... ./.. ................................................................................ ............... ,3 , 9. Size of lot: Front .. ,~ ..................... Rear ........... ~ .......................... Depth .................................................. Height .................................................... Number of Stories ..................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or usa district in which premi,sas are situated ....... .~....~...~..t ................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ...,~....~. .............................................. 13. Will lot be regreded .... ..~...~.. .................. Will excess fill be removed from premises: [ ] Yes [~J' No 14. Name of Owner of premises ....~...a'.~./~..~..~....~...,...~...~..~.....~.~/.'~...~AI~...~..~'~~.~ ....................... [Address) (Phone No.) Name of Architect ......................................................................................................................................... ~ ........... (Address) (Phone No.) Name of Contractor ~...'~....~..~ ~..~-.-.~...~'..-..~-.~.--.~-..~.~..-.-~'.I[ .~..~1~ .~-'~""/"~'~'"'~'"""~'~"~'"'~'?"'"~'"'~'" ................. -- (Address (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-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. ............... ~...~....~....~....~..~.~...~.....~... ..................................... being duly sworn, deposes and says that he is the applicant above named. ! (Nameo£individualsigningcontract) (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 ell statements contained in this application are true to the best (~lt~l~,,~',~_ ~et~J~e~r~elief~and that the work will be performed in the manner set forth in the application filed therewith. __ __ ......................... ...(.(?....' .~...day of .......... ~/"~......~,..~ ......,~. °?..m. !.s.s!,°nl ~x~'.~-.t~. ~--'... ~,~'~'~ ................ ;' ~' (Signature of applicant} / / UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEy IS A VIOLATION OF S£CTJON 7209 OF TH£ NEW YORK STATE EDUCATION LAW. REVISIONS NOTE: · -' MONUMENT LOT NUMBERS SHOWN REFEH TO '~M_ ~.£¢~. M~ a OF S~ C T/ON a POINK ~ F/LEO IN THE SUI;'FOLK COUNTY YOUNG & YOUNG 400 OSTRAND£R AVENUE, RiV£RH£AD, HEW YORK ~LDEN W. YOUNG iURVEY FOE: GEORGE NOHE HOWARD W. YOUNG £6Bg~ NASSAU POINT TOWN OF SOUTHOLD SUFFOLK C0., N.Y, SCALE: J" = 40' DATE:0C'~ 19, 1973 73- 1004 L 69CN Lot 120 / ~ ~5o.~ 00, W J S~$~.,~, , 84. SB ' -- "- / Lo/ 119 S54 4800 ~88.$2' SUFFOI~ COLr~Ty HEALTH DEPARTMENT The sewage disposal and wate~ supply facilities For this location have been inspected by this departmen~ ~nd fotlI~d to be sa tisfactor~~ ~. Chief of General Engineerin~ Services uO~ bof L,O~ // NOTE: · -- MONUMENT LOT IVUIMBERS SHOWN REFER TO 'AMENDED MAP B OF S£¢TION B NASSAU POINT ~ FI£ F'D IN TH~' SUFf'O£K COUNI'Y ~Z ~OC~?~ON OF W~L~ ~ND ~E$$~00~ CLERKS O~FICE AS MAPNO 789 SHOWN HE~EIt~ A~E F~OH FIELD OBSERV~TION~ El ~ ~ d~o ~ ~ ~ ~/~ ~ ~ AND/OR F~O[f D,~F~ O~TAIf~ED FROM OTHE~ ~ ~ ~ ~ ~o ~ UNAUTHORIZED ALTERATION OR ADDII'IONI '1'O THIS SURVEY IS A VIOLATION CF SECTION 720~ OF THE NEW YORK STATE MAY 6,1974 YOUNG & YOUNG 400 OSTRANDER AVENUE, RJVERHEAD, NEW YORK ALDEN W, YOUNG SURVEY FOR: GEORGE NOHE AT NASSAU POINT TOWN OF SOUTHOLD SUFFOLK CO., N.Y. APPROVED AS NOTED DATE ~ FEE: BY NOTIFY BUILDING DEPARTMENT AT ..................... LI- J