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"