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Home My WebLink About6960-zIvO~M NO. 4 TOWN OF SOUTHOLD BUr[.r~ING DEPARTM~.NT Town Clerk'~ Office Southold, N. Y. Certificate Of Occupancy No. ~t'2~ ...... Date .............Apr$;L...23 .... , 19.7.~ THIS CERTIFIES that the building located at ~ .]Rd. ~.. 214-.8/~..N01'.~h .t~v~e¥ Rd Map No...X~ ....... Block No. ~ ....... Lot No..x~.. ~a~tho3.~l... ~[,¥., ........ conforms substantially to the Application for Building Permit heretofore filed in ~hi.~ office dated .............0et~..30., 19.73. pursuant to which Building Permit No. 6~0Z.. dated .........!~)l~.~.. 3.0. ..... , 19.73., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi.~ certificate is issued is ....................................... The certificate is issued to . .Ri.chard. N~klla~ ...... O~nel'. ........................ (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . Apr~.l.. ~8.. 19.7.~ ................ UNDERWRITERS CERTIFICATE No. ~2182~.$ .... .AI~ · · ~ .3... ~ ~'7'~ ............ HOUSE NUMBER ... 800 ....... Street.. i~&wate..ReaS, .~. 2.~ .................... 'Building l~.~oector ~ I~ORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C:LERK'$ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6960 Z Date ..................... O~tr~e~. ....... ~1~ ....... 19.7,~.. Permission is hereby granted to: ..~J,~a.*:~..~J~3,~ ......................................... ............ ~.~.~.t,~,~ ................................................. to ..~.l~...~t~(..~e...;~.~.~,~...~.~.,.~ ................................................................................... at premises located at ..~'~J..~3~Z&~I..~,~..~. ............ .-....IJ~.~..]~I~I~A13,..~I~..~I~. ........ pursuant to application dated ........................~.....~O ............... , 197~..., and approved by the Building Inspector. Fee ~e~ .............. TOWN OF SOUTHOLD Building Department 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 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 19.57), 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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use $,5.00 3. Copy of certificate of occupancy $1.00 Date ...... 7'- .................................... New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~/~E ~' '~03 .S-Oc/~'I~ Owner Or Owne~ Of Property ..~.)..~..~..~.~.~....~.~..~.~.~[~ ........................................................... Subdivision ................................................................ Lot No. Block No ............. House No.. h~.. ...... ............. ............ ................. Permit No. Of Permit ~.~.~.~pplicant Health Dept. Approval Y~.~.~ ....... ~.:.~.~.;.(.~.~Labor ~pt. Approval .................... ~.~. ............... Underwriters Approval .... ~...~..I...~..~.~..~ ............. Planning D~rd Approval Request For Tempora~ Ce~ificate ........................................ Final Ce~ificate Fee Submitted $ ........ .~..~ ......... Construction on above described building and permit meets all applicable codes and regulations. Sworn toxbefore me this- SERVICE r~iSCONNECT NO. OF t ' : ' : S ' E Furnaces, oll:l-1/8hp, 2-t/12hp. Motors: 1-1hp THE' NEW YORK BOAR'D OF FIRE UNDERWRITERS da BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT Cedar Or. Southold, L.I. inthefoll,,wlnghscetlon; ~ B~,e,nen, ~ IstFI. ~ 2nd FI. outside ~,~ .~..,i.~d o, Ap ri I 7, 19 7 5 and fox, nd to be in compliance with the requlremen~ of th~ B~rd. 2/0 Paul R. Burns Town Harbor Lane Southold, L.I. 11971 GENEEA[ MANAGER This certificate must not be altered ~n any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant~f£~/~ /~/z~/fZ V/J PhoneY/~=3YF~5. Address ~IA~;~ b'~": ,,5oO~H~L ~; ~. ~. ~j ~ 6. 2. Property locati6n~l~T~ ~,~odT~OLD ~ g. 7. Subdiv. Section Lot No. 8. Private well 9. Public water Distance to main Village ~'~U~gO Township ~o 3. Public Water Compan~ name 4. Lot size: Width~,~"feet Length ~OO~ feet (E~ter on center plot below) Sewage Disposal/-~stem: A. ~0/~allon septic tank: Precast - Equivalent Block B. ~g~ching pools: Number ( Precast.-~Block __Special__ _If private well fill in blanks below: Tank capacity~als. Pump G.P.M. y Total well depth__ Depth to G.W. Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The undersigned :ERTIFIES: "Construction of authorized be in accordance with ~he Suffolk County Department of Health's current ards thereto." Date ~))~ Signed ~~. ~ · Owner or Builder installations will stand- FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Mealth Department, that an Disposal System can be installed on this plot. Date ~/~ ,~u~- -f~7 7 Sign e (k_ adequate and satisfactory Sewage S-15 Revised 4/]/72 - -- CO~flE5 OF mis SURVEY M~,P ~T ~ssm S~L ~ ~ ~ co~sm~m ~U I~ICATED H~N SHAL TOWN OF SOUTHOLD /~ ~'~.~ ~/~ -- -- ~ BUILDING DEPARTMENT ...... ~, TOWN CLERK'S OFFI~,~ SOUTHOLD, N. Y. ~'~~ u'x %~.~ ~ No ................ ............... , .... .rm t ............................ Disapproved a/c ~.....~ ................................ ............................. APPLICATION FOR BUILDING PERMIT Dote ...... ...~...~ .....~.....O.. ................ ,9..Z.~.....' INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 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 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 Jn 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 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 applicgnt, or name, if a corporation) -~'Address at applicant9 (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. State whether applicant is owner, lessee, (~,.t, architect, engineer, general contractor, electrician, plumber or builder. . Name of owner of premises ~-/.~.~.~.,~.D ~.~..~.~...~.~/I/' If applicant is a corporate, signature of duly authorized officer. ~ 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 ,~,.~J. J~,T..F-~ ~.& Municipality 2. State existing use and occupancy of premises and intended use and OCcupancy of proposed construction: a. Exisiting use and OCcupancy ... ~,,,~.,,.~...~...~.~-,.~,..~.,~:~ b. Intended use and OCcupancy ~LJll. 3. Nature of work (check which applicable): New BU'ildihg';,.~.~....... ...... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition...;.... ............ Other Work ................................................ ~ ..... (Description) 4. Estimated Cost 3.0.:) OOO .............................. Fee (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, sPecif~ 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 ............... 7 ...... 8. Dimensions of entire new construction: Front ...... .~.../. ........................ Rear ...... ~.../. ................ Depth .....~...~.. .............. Height ....../...,~...I. ....... Numbe~ of ~tor ~S ~'/')' 0'"/~'"~" .... ~" ~'"'"'j~ ........................................ 9. Size of lot: Front ...... ./..?..~..~..~. ................. ,,. ............ Rear ..../.~...~..'....~..~ ..................... DePth ..~..o...o. ....... .~ ........... 10. Date of Purchase ...'~..~'.~......~.,~./..~...~.~. ................ Name of Former Owner .Q.~ .................. ~...---------~..~.~........~..~.E,. 11. Zone or use district in which premises are situated ............. , ....................................................................................... ]2. Does proposed construction violate any zoni~Jaw, ordinance or regulation: ........................................................ ]3. Will lot be regraded ....~.~. .................Will e~cess fill be removed from premises: ( ) Yes (X') No 14. Name of Owner of premises .~..J.C..~./~.~:D.i.i~..O.~..~...~..?....~..'... Address'..~..~..~.~./~....;..~....'~....: ..... Phone No. ~('~.~.~...?..~...~ Name of Architect .............................................................. Address ..................... ;.. ....... ;. Phone No ....................... Nome of ContractOr ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings whether existing or'pr0posed, and indicate all set-lx~ck dimensions from property lines. Give street and block number or description to deed, and show street names and indicate iterior or corner lot. ,4/6'//7' o~' w~ V co~rR~cT~f COUNTY OF .*::~'.~.~.....~.J' ~? .................. E~..~...~ ...... .-. .... ~.~.F. ................................ being auiy sworn deposes and Says tlq~t he is the opplicanl / (Na'm~/of individual signing contractO ' --/(-te is the ................. .................... ~'~ ~''"~...~......~_~-,~V__,~,%_: .............................. "." ...... i .................. : ................. / (Contractor, agent, corporate officer, etc.) . of said owner or owners, and is duly authorized to perform or hove 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 tha~ the work will be performed in the manner set forth in the application filed therewif~. Sworn to ~ ~ tho~S-~~ ~. ' 9"~ ~.. ....... ',~OffH t. BOKEN (Signature of applicant) ~,lotafy Publlc, State of New York No. 52.0344963 Suffolk Coun~' Commission Expires March 30, &PPROVED NOTIFY BU LDING DEPA~TMEN~ .~ ~NSP~C~O,s~ ~ ~IC~AR~ ~ ~L~ APRIL 3o~ 1?Ta R. LEFT ~ClDE ELEVATION II I I Ill I I I t i F~ONT ELEVATION RIGHT 5t, D£ ['LE:VATIoN REAR F.L£VATIOAI $c^L£ ~:l' APRIL 3~, R- £. N ORI~LUtl 0-0! .I. .o -,D 0'$ 0'£! · , ,,o;h ~(ITc/4£N ~ED RO01~ = ~' /?' ¢" ¢1 '- 0" FLOOR PLAN APRIL 3O, I'i73 R, E.NORKLU,V o~ ¢1-o ,~OUNDATION PL/~ R;E, NORttLUM I I'1 I'1 I I I I't I I I I I I I I I I I I i I I I . I I I ' ] - I I I I I I I I I I I I ri i ~1 I I -I I I, I '1 I I I I I I I ! 1% II I I I I I I' I ,I I ,! I I I I I I I I I Ii1,11~ ~ II I, I I I I I I I '1 I I I I I I I I I I .?. I I I ! i, i I I I I ' I I I I I I · IIIII I1 LEFT ,5'1 DE ELEVATION RIGHT SIDE ELfVATIoN F ONT ELEVATION [-1 I::1 ,1'~ ,, ,. , : _ ', ,," ,,, El. ._ r-:--:-; ' ,' ,' ~H :' 't'l, I'; r'l ~ I ~-'1 ,' -~--..-~., I..~ I..' " *~-,~: ,.~_.?.g ii i i ii .. ~_. Fl.. ::,'r.: ,, !, ~-~ : IJ I'_ ~_,, ' '". ~.,,' ~-: '-.-~. -. '-, Il 11 :i I::l : C3, C, ~-,.,- PL _ __ JJ__,~_~_: _...._ ', ,, '; ,, ,-', - -- ~ r- - -.-~,--, ....... ,,_. ....._.,, _ I--I h ..... .......... · ~ -- --*-.---..~- -~' · -~ ~-...-.~. .... .J_ _J REAR .~'CA LE ~9'=1' R. ,,0 ;Z · o ~£/ ¢1 o FLOOR PLAN sc^~ ~"-~ I' APRIL 3O, 1773 ~.£.NORKLUN o~ f 2~-o L FOUNDATION £LA~I ~CA£E Y~/' ~. E. N OR K LU/~I