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Home My WebLink About7019-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sou*hold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .l&~oo~ .DI~ .......... Street Map No. ~$~'~.o.~. l~ock No .... ~ ..... Lot No..~ ...... ~h~...~,~.* ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. ~...~., 19~. p~suant to which Building Permit No.. ~.0~. dated ........... D~... ~..., 19.~., was issued, ~d conforms to ~l of the requffe- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is The certificate is issued to ~. ~~ ...... ~e~ ........................... (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval ~e...~.. ~.. b.~. ~. ~ .... UNDERWRITERS CERTIFICATE No.. ~. !~3.3~ .... ~. ~... ~ ............... HOUSE NUMBER .... ~3~ ...... Street . .~a~. ~l~ .~ .................. '" B~idi~g Inspe~t'o'r' -- '[ ' l~O~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7019 Permission is hereby granted to: ...~ ....... ~..C.C....~.~.~.*.L~.~..~.Z.5 ......... at premises located at ............................ ..E,,.~.~.L...~..~.~ ....... ~!.!:~.~. ............................................ ............. ~.~..~. ........ ~.~.:...o.. .......... ~.....z....~ ..................................................................................... pursuant to application dated ~ ,I~EC 19..~..~,., and approved by the Building Inspector. Fee $......~......~......~...~.v... PERMIT INCLUDES APPI~OVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY REGRADING LOT DRIVEWAY CONSTRUCTION CESSPOOL CONS I RUCTION CELLAR CONSTRUCTION ~ OTHER Building Inspector ~ORM NO. 6 TOWN OF $OUTHOLD Building Depo~tment 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 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 Date ....... J~..~.,... 3,9.~.~ ............ New Building ....~, ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....... ~.~'~.t~..~.~.~.~...~9~.~QQ.~.~).~.~.~..~..~.5..~..*.~..~..Q~.~.~.~g.Q~...~g.~.~¢~ Owner Or Owners Of Property .......... ~'...S~.~t'~,]~l~. ........................................................................... Subdivision .l~.~,~.t~w'.oo~...~,~fl,~.~.~ ........................ Lot No.....~.0..... Block No ............. House No ............. Permit No...~..0.~...~..... Date Of Permit .~./~./..~..~...Applicant ...~.~.~...o..~.....~..o...~..e..~...~?...o.... ......................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building an~/l~errnixi~ rr~ts all applic, abt~'codes and regulatior~s.~x ....... Sworn to before me this '/ 2~ ~ 7y 5th ,-la,,of June, 1974 (stamp or seal) ~ZF~-['fO O/ARY PUBLIC State el New York' Notary Public SUFFOLK County No. 52-8740085 Suffolk County ]~'m [xpues ~a~cl~ 30, lg?Z/ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK T0038 N 158333 THIS CERTIFIES THAT Roy Schoenhaar, e/side Eastwood Drive, 250' n/o Midwood Rd., Cut chogue~ L.I. in thefollowlng location; ~[ Basement [] ;,t FI. ~/~.d Fl. 0 Ut, aide Section Block Lot was examined on .~ay ~R 19~l~ and found to be in compliance wlth the requirements of this Board. 1 2 12 SERVICE DIKONNECT NO. OF S E R 1 2 OTHER APPARATUS: RANGES SP~IAL EEC'PT 1 ~0 V COOKING DECKS OVENS DISH WASHERS AMT. K, W. A,V,T. K.W. ~T. K.W. TIME CLOCKS B :LL UNIT HEATERS MULTI-OUTLET ¢ E NO. Of: HI.LEG OF HI-LEG 1 *Furnaces: Oil 1-1/Shp, 1-1/]2hp ~otor/s: 1-1hp EXHAUST FAN~ DIMMERS AMT. WATTS OF NEUTRAL Towle & Sons Inc., 3~ Llncoln Ave., Mastic Beaehp L.I. 11951 m ~N~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant y~oj/ jdj~o~--~/~l~ Phone Address ' ~'~ ~y 2. Property Location ~x~ ~ ~..,~y ,y~,H, 4~ ~'~ Village ~- /~ Township 3. Public Water Company Name 4. Lot size: Width /~- feet Length /~ feet 5. Subdiv. ~"~?Y77w~ 6. Section 17-~ 7. Lot Number 8. Private Well 9. Public Water Distance to main 10. Sewage Disposal System: (For Health Dept. Use) A. 900-gal~gn septic tank: Precast ~/Equivalent Block B. Leac_hing pools: ~-~ Number of pools t:~recast_ Block .Special ll., If pri~te well, fill in the fol 1 owing blanks: ~ .A. Tan~=capacity ~ gallons B. Pu~'~ G.P.M. S-- C. Total well depth D. Depth to ground water E. 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 l~cal Building Department Permit is in effect. Date ~ - ~ ~/~,,/~ Signed 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 Disposal System and Water Supply can be installed on this plot. APPROVAL DATE //~"z~ f:-~'~ SIGNED EXCAVAlION INSPECTION REQUIRED S-15 Rev. 4/1/73 (Building Inspector) X~) APPLICATION FOR BUILDING PERMIT ~J '/ :" ') 19../.~ ....... Date ................................................. INSTRUCTIONS ~X a. This applicetion must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi~ 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, ~ 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 kC,, > 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 been granted by the Building Inspector. >~ .~PLICATION IS HEREBY MADE ~o the Building Department for the issuance of a Building Permit pursuant to the Building Zm O~clinance of the Town of Southold, Suffolk 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 ~gith all applicable lan 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) ] ( 9 ~ / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; Name of owner of premises 1. Location of land on which proposed work will be done. Map No.: .................. Lot No ....................................... , Strut and Numar ........... ; .................................................................................................................. Municipali~ 2. Sta~ exi~ing u~ and o~upancy of premiss and intended q~ and ~cupancy of propo~ con,ruction: a. Exi~i~ u~ and ~cupancy ............. ~. ......... ~...Z...~.....:...;.:.:.....: ........................................................................ , b. Intenna u~ and ~upancy .............. ~J; ................. :.:....~..:~"~.....:~ .................................................................... N, 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ....... .-. ...... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost . .... Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... Z..~ ...... 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 ............................ Depth ................................. ight "T/' /x~ He .............~ ................................... Number of Stories ......................................................................................... 9. Size of lot: Front ........... ../..~......~...:. .......... Rear .......... ~. .............................. Depth ......... /.......,..~..~ .......................... Height .................................................... Number of Stories ...................................................................................... 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: ........... .~., ..'L .......................................... 13. Will lot be.regraded ....... .~,..~ ..................... Wdl excess fill be removed from premises: [-] Yes [ ] No 14. Name of Owner of premises ......... ...... ;..;.....; ............................ . ..................... 2...: ...... ~'. ............... i;...;;.,..':;....Z..~ ......... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ..... ~. ........ Z ...... ; .................................................................. ; ............... ,..;,~:.6,..Z,;Z~. ............. (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exist ng or proposed, and ndicate 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 ....... ~..:.~.i..~..~ ............................... ) ..'~ ..................................... /.,.~. ............................................................. being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ........ :: ................ i ........... :.'.::.~ ................ : ........................................... ~."~:z.....,..,~;....:...~ ....................................................................... (Contractor, agent, corporate officer, etc. ) of said owner or owners, and is duly authorized to ~erform or have performed tbe said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ~erformed in the manner set forth in the application filed therewith. WILLIAM J. MOONEY NOTARY PUBLI~ Stote of New Yod~ ~?"A4 ,, . . No. S~-~7,SS~S, ...................................... oay o, ............................... Notary ,ubhc, .,..; .......... ..~.,;'.?;.,........~.. .......................... County ~~..~.~..~ .................. --.~_~. "~ (Signature of applicanff facilities for this location have been insDeeted by this department and found .t~ be satisfacto~. Chief of general Engineering NOTE' · =MONUMENT SUBDIVISION MAP FI4~D IN OF THE C£EI~KOFSUFFO£K COUNTY ON NO'SO, 1964 FI£E NO REVISIONS MAY IT, 1974 ALDEN W. YOUNG ~ HO ~ U SURVEY FOR: ROY SCHOENHAAE LOT N0.20,"EASTWOOD ESTATES,SECT 2" F~EE,:~ ~CK GUARANTEED TO: TOWNO~ SOUTHOLD SC~L~: I" = 40 NOV [ · - NOTE: · =MONUMENT OF THE CLERK OF SUFFOLK CO~T Y ~ NO~30,1~6~ FILE~ ~1~ COPIES OF THiS SURVEY MAP NOT BEARING REVISIONS YOUNG & YOUNG NOV. 2~;,1973 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD w, YOUNG PROF£1]BIONAL EN~INI~R AND LAND SURVEY FOR: ROY SCHOENHAAR LOT NO. 20, "EASTWOOD ESTATES, SECT 2" AT FLEET'S NECK //. :?-~:.. ~?~ .x~ TOWN or 80UTHnLD SUFFOLK CO., N.Y. '9 9^~ TO '1- --' 'il ' ' i.L=_-¢_,~ I Ii i ......... 't 17 '1:1. , 7/I*