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HomeMy WebLinkAbout7001-zTOWN OF $OUTHOLD BU~.r~ING DEPART~k~r Town Clerk'~ O~ice $outhold, lq. Y. Certificete Of Occupancy THIS CERTIFIES that the building located at .. I~L~7~..Dr..& .$~1~ .Dx'... Street Map No.L.&~rsl .Cty. oEB~r No ........... Lot No, .. 3.0. ..... I~..e.~, .... }~' ,¥.. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........l~nv... 26.., 19..7.3 pursuant to which Building Permit No. ~.q0] dated ............. 1~¥.,...~(~., 19.7.3., was issued, and conforms to aU of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Frivate one famil[ d~el.~ing .............................. The certificate is issued to Inlznd I~o~"es Inc .0~mer (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval .Ap.r..~....!...~.~.?~...b.y.R...¥~,~I~... UNDERWRITERS CERTIFICATE No....~t ~. 31....Apr~J, .~.~..1.9x.~' ....... ....... HOUSE NUMBER... hO~;0 ...... Street ..... DaL~ar..Dr£~e ...................... Bui]dtn~ Inspector FO]~ NO. ~ TOWN OF SOUTHOLD , BUILDING DEPARTMENT TOWN CLERK'S OFFICE~ SOUTH~OLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7001 Z Permission is hereby granted to: ~r~.,Hc~mas...~e ......................... : ................. ....... ~:~tJ~:t ~uek..., ~,~, .................. i ................. ~o...J~d ...l~.w.. aae-~; £a~l ~..d~e &..~m~j. ....................... :. ......................................................... at premises located' at ~..~0 ....... ~l[~,~[¢,~al~,.~ .......... : ..................................... ................................... .a~--~a~..~0~...,~..~:~..., ...~;~a~....: ................ : ................................ pursuant to application dated ................... .JJ~l~ ......... :Jj-~J. ......... i,...~ ]9~f!,; and apl~roved by the Building Inspector. ............. t; ~'r"'~ ,L~'~ *; ..... ; .......... -" 't~ ............. t~ui)oing Inspector BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEWiYOEK 10038 Inland Hof~e~' Ino, e/~mde Delmar Drive, 500' n/o Emma Drive~ I' ' ' Laurel, L._I~.:' ,Jo~ 207 ~- ¢,,,¢,,.r,,n,,,~,¢,,.~,,,.~u,.,; ~]¢~,.~,,.~,¢ ~] ~,r~. ~ ~,,~ r~. outside s~.,,, m.¢~ ~#$0 ~ OVENS INCANDESCEN~FLUORE$CENT S E R V NO, OF CC COND A W, G ~ i 4/0 ~, 1-1/8hp, 1-1/12hp ¢:'Future appliance feeder/s: 2-3//8~ ~,,o uor/~. 1-1hp 1-2#12 George Zimlinghaus~ 4 Park Place~ Patchogue~ L.I. 11772 ,., Th~s certificate must not be altered in any manner; return to the office of the Board if EXHAUST FANS ¢ GENERAL MANAGE~ rrect, Inspectors may be identified by their credentials. FORM NO. 6 TOWN OF SOUTHOLD: Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOP, CERTIFICATE OF OCCUPANCY This application must be filled in typewriter OR ink, and st~bmitted 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 natura~ 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 thee Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site ptar} requirements where applicable. For existing buildings (prior to April 1957), Non-conforming iuses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. owner or previous owner as to use, ~ccupancy and condition of buiJdings. 2. Sworn statement of 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. 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-existing B~ Location Of Property ...~...~...~...~...:~;:?.....~...~...L....~)...~...~......~...~,!.~.~... lilding ................ Vacant Land .............. .............................................. Owner Or Owners Of Property .,~..,~.~.~1~...~......~.....O....~....~..~..../.i~.....~..: ..................................................... Subdivision ~?...~...~.'.~...~.#M~'~.~.~....~...~.......Lot No. 3..~..~..,. Block No ............. House No ............. Permit No..~...~..~../.......~/.. Date Of Permit ../.~..~..6"ZZ~.>Applicant ~....4~..~....~....~.,~...~..~..~....~..../...~....~.:. ....... Health Dept. ApprovaJ ....~..,/../.!Z..~.. ......................... Labor Dept. ~pprova ................................................ Underwriters Approval ....~//'~..~../.~..~. ....................... Planning Bo~rd Approval ........................................ Request For Temporary Certificate ........................................ Finai Certificate .............. ..~'....~. .................... Fee Submitted $ .................................... .... icable ac~d~ es and~regul~tions. Applican .................. Sworn to before me this~ / . da of /q' Notary Public ......~~ County (stamp or seal) S FOLK D ARTMENT OF H.D. Reference No EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPRC~AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is requested,pertinent data herewith: 1- licant ~ ~ ~' Phone ~~-Sub div ~ App . Hamlet ~ Town ~ 9-Private well? J-Public water supply name Distance to nearest main 4-Lot Size: Width~ ft. Length~ ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~ Two Family? / /Cellar? ~/.Slab? ; ;Crawl Space? lO-Proposed system: Septic tank f /Precast /___/Cesspools ~F,/Shallow pools / /Other / / il-Septic tank inside dimensions. Volume~)OGals.LenEth ft. Width ft. Liquid depth .ft. 12-Precast sections: /$/Number~quare Ft. Cesspools: Block sizeL incs.D ins. H ~ns. Total blocks below inlet: ~1__~2 PLOT PLAN Street Ind] No ;ate ~th Data ~eet 0 2 6 8 10 12 18 FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfact~o~y Sewage Disposal System can be installed on this Plot. Date ~--~f~ Signed (10/65 Revis.) s-15 The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date 1~$/~ Signed ,, . /.~ ...... ~, ~ ..-r' l~,;~ ~¢. .... a. O~ner or TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~N ~ERK'S OFFICE ~Z/~ ~ Approved ............ :.~........~i ................. , 19..?.~.. permit No...?...~....,d../...~ .......... Disapproved a/c .. (Building 'inspector/ APPLICATION FOR BUILDING PERMIT $OUTHOLD, N. Y. App,ication ................. INSTRUCTIONS a. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the Bui[dllng~ Inspector, wit, h 3 sets of p!ans, accurate plot plan to scale. F. ee accqrding to schedule. b. Plat plan showing Iocotiot~ Of lot and of buildings on premises,' relationship to adjoining premises or public streets areas, and giving o detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this appl.icotion may not be commeqced befgre issuance of Building Permit. d. Upon approval of thi~ ol:fplicafion', the Building Inspector will issu& a Building Permit to the applicant. Such perrnit~ shall be kept on the premises available for inspection throughout the work. LJ e. No building shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy)II shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,'e~d~olk. ~ount~,~w York, and other applicable lows, Ordinances or Regulations, for the construction of buildings, addit~ns or alterations, 0r for removal or demolition, os herein described. The applicant agre~s~t~cOenpLy with all applicable laws, ordinances, buildingcode, e/~u~.~. ~* ......... cede~fli:l regulahons,' and to odrr~ ~'~tR'oJ~'ed inspe-Efors on j~remises h~l in bu~ih~;~r necesg6~/]n~66c~tJon~. Inland Homes, Ina. /, (Signature of applicant, or name, ill, corporation) ~ Box 117, Mattituck, N.Y. 11~52 ~ ~ - (Address of applicant) State whether applicant is owner, lessee, agent, architect, !engineer, general contractor, electrJcian,:~lumbel;: or builder. ...,~3.e.~ne..~i~l ~A~.~o~ ........... x ......... ,'~ Nome~of owner ,~,( ~,remi~es~ ~,~ .,..~.n.~l...a~... Homes, Inc. ~ . . If applicant is a corporate, signature of dUlyJ<mthorhled ~ Kennet~ W. l~nurber, V~ ~, ~,[ (Name and title of corporate officer) Builder's License No ....................................... y..~/.tt,.,, _.- ., ~ .~ p!um_b_er's~License ~ ,..e~.T...-.~..., ........................... ' Electrician's License No. 27~ ,-(~ *¥~ ,~, . .~ Other Trade's License No ............................................... Location of land on which proposed work will be done, Map No.: ........................................Lot No. .30 Street and Number ~C~:~xe~;~J~a~D~*~&~e~"q~v~,~e[~L~ ......................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .~..acanl: .... b. Intended use and occupancy One family., dwellin.~. 3. Nature of work (check which applicable): New Building ...~ .......... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... 4. Estimated Cost ........ .~..~..~..t..O...O..O......O..O.. ........................... Fee ~'~" ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units .....o.b.e. ................. Number of dwelling units on each floor ........................... f One If garage, number o c~rs .................................................. . ....................... 6. If business, commercial or mixed occul~ncy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .................... Rear ................................ Depth Height Number of Stories Ji~ .................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 55.6 ~ 55.6 29 8. Dimensions of entire new construction: Front .................................... ~eor ............................ Depth ........................ One Height .................... Number of Stories ............................................................................................. 9. Size of lot: Front ~'~'7'8~'t Rear 2~'4'60t .~ .- 146.94 .................................................................................................. ueprn ................................ 101 Dote 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: no 13. Will lot be regraded ....... ~..e.~ .............. Will excess fill be renj~o~d ~r:~ premises: ( ) Yes ( ) No 14. Name of Owner of premises ...]:...~..]'...~..n..d...~.°..~...e.~.s....?...n..?.: ....... Address ~.~,~g.~.~ Phone No. ~,..~...8..-..~.6..~.6.... Nome of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor Tn~.&~d ~omes ~ linc. Box ~'17 ............................................................ Address ~..~.~..~.~.~..9..k..,.~.e..Y..Phone No..~.~.8...-.?..6..~.0.... 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. STATE OF NEW~//~,~ Icc .......................... T....~ ............................. being duly sworn, d~oses and says t~t he is the opplicom (Name ~f ~ndw~dual s~gmng c"' '' ' "'' ~ ' 0ntrdc~ above named. ~ ~~ He is the .......... ~ ............................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke end fi~e this application; that all statements contained in this application are tree to the best of his knowledge ~nd belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Swam to before me this ............. .............. .... ............ ~.~2-0344963 5u~l~ Commi~*ion ~pirm ~arch ~0~ I~~ NO? ~ : ~O~¥~$~ONt~AP F//.£o nv THE THE ¢/ ~/~K Of' $ UP'FO / K ¢ O U N T YON UNAUTHORIZE0 ALTERATION OR ADDITION TO THIS SURVEY iS A VIOLATION OF SECTION 7209 OF THE N[W YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING T~E LAN0 SURVEYOR'S IN'(ED SEAL OR AGENCY AND LEN01NG INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE :~O~:N(~ & YOUNG ;400 OSTR~NDE vENuE, RIVERHEAD, NEW YORK ALDEN ~,-. YOUNG L HOWARD W. YOUNG PROFES~tONA~ ENGINEER AND ~ ~ LAND SURVEYOR LAND SURVEYbR.,N'Y~' Lid. ~0, ~2845, ,' ~, N.Y. S, LIC, NO. 45693 SURVEY FOR: - INLAND HO~ES;INC. LOT NO ~,"LAUREL ~OUNTR~ ESTATES" ~ , ~ECURI~Y',TI'TLE & GUAR~N~O. TOWNOF SOUTHOL~ ~ ~, ~,-. , / The~ewage disposal and wateri supply ~ ~ns~ec~ed by this departmen~ ~nd f~und / ( '~hle~ of ~eneral En~ineerfng / ~of THE LOCATION OF 'WE'~L$ AND CE~$POOr-,,~' SHOWN HEREIN ARE FEOM FIELD OBSERVATION~U~ AND/OB FBOM DATA OBTAU/~D F~O~ OTHERS REVISIONS ' YOUNG & YOUNG MAR. 14, 1974 400 OSTRANDER AVENUE, RIVERHEA ALDEN W. YOUNG SURVEY FOR: INLAND HOMES,INC. LOT NO. 30," ~AUSff~ GOUNT~Y NOTE ~ ~ -' MONUMENT ~ '. '" SUBDIVISION MAP F/LED IN THE OFF/CE QF THE GLE, qK OF SUFFOLK COUdVTF ON AT LA U R EL SECURITY TITLE & GUARANTY CO. i SOUTHOLD SAVINGS BANK TOWN OF SOUTHOLD SUFFOLK CO., N.Y. ~/'~'~'~d~'d~ i I1,0~ 17:4"