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HomeMy WebLinkAbout6965-zFORM NO. ~ TOWN OF SOUTHOLD BUff,r~ING DEPARTMENT Town Clerk's Ot[ice $outhold, ~. Y. Certificate Of Occupancy No. Z~'7~2 Date Jail 21 19. ~t~ THIS CERTIFIES that the building located at . Del, liar..&. El~a.....1~..i.v.e.. Street Est, Map No. L2~J, .¢.ty. Block No ........... Lot No.. 2.~. .... . .I~..u~..e.~....~.,.Y.: .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............OC~;...29., 19..?3 pursuant to which Building Permit No..6..95.~... dated ..........Kov... 2 ...., 19.73., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The Occupancy for which this certificate is ~ued is ~.r..i.v.a.t.e., .o.n.e...r..~.i..x.y..d.¥?~:~i.n.g. ..................................... The certificate is issued to . .I.n..1.a.n.d...}I.o.m.e..s...~.9. ~.o..h~.. g..a~..U. ....... ~'.O~n..e.~. .......... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .D..c.c...2..7...1. .9.7.3....b.y..R.....V.i.1..1.a... UNDERWRITERS CERTIFICATE No.~l.~..~.. ..... D.c..c...1..9...1.9..7.3 ................ HOUSE NUMBER ...~..0~..~. ...... Street....D.c...l~a..r...D.l'.i.v.e. ........................ Building Inspect~ FOB, M NO. g TOWN OF SOUTHOLD BUILDING DEfARTMENT TOWN CLERK'S OFFICE SOUTHOI.D, H. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PP, EMIS/E~NTIL FULL COMPLfiTION OF THE WORK AUTHORIZED) . 6965 Z Permissio~ is hereby granted to: l~la.ud..~o~m~..Ine.....~O.....~olm.~ ..... to .au/l&.~w...mm .. ~l~..&welL~t .................................................................................... at pmmMs Ioc~ed at ..J, ot...2$1 ....... /,m~ra3,..P,~;nm~..~t4~ .............................................. pursuant to application dated ......................... ,OO.t.....~ ............. , 19..~.~.., and approved by the Building Inspector. FOI~M NO. 6 TOWN OF $OUTHOLD 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 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 Dote .... Z,.....z. ............... New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~ Co~Bnor of Emma Drive & Delmar Drive Owner Or Owners Of Property Mr. John Canu Laurel Counl:ry Estates 29 4045 Subdivision ................................................................ Lot No ............. Block No ............. House No ............. 11/2/73 Inland Homes Inc./ A/C J. Canu Permit No..6.9...6..5......z. ..... Date Of Permit .................... Applicant .................................................................. 10/25/73 Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval .... ,1..2./..~...9./.?...3. ...................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... $ 5.00 Fee Submitted $ .................................... Construction on above described buildin~~;~ al~ ap~b~//o~ Nd regulations. App,,cant .................... Sworn to before me,his ~ ~) ....... ~...~,.. dayof ~.....<..?.?...~. ...... (stamp or seal)~ Notary Public .................................... County . ~,~..,~-, H.D.Reference No APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is requested,pertinent data herewith: 1-Applica~~ Address~ AAg~ ~~ ~e~e AA~ 7-Section 3-~blic ~ter sup~me ~ Distance to nearest ~in . ~-Lot Size~ Width ft. Length ' ft. (also enter o~ center plot plan below.) lO-Pro~s~ syst~. Septic tank il-Septic ~ inside ~mensionsi~l~e Gals. Length ft. Width ft. Liquid depth ft. 12-Precast sections: ~Number~q~re Ft. Cesspools: Block sizeL incs.D ins. H ins. Total blocks below i~et: ~1__~2 ~T P~N Street Capacity4~Gals. G.P.M. 5 ~th T,st ~ Data ~eet 0 2 6 8 10 12 14 16 N Indi No The Undersigned CERTIFIES: "Construction of authorized installation~ will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". 10/2~/73 Date Signed O~mer or Builder 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 can be installed on this Plot. Date (10/65 Revis.) S-15 Signed THE NEW YORK BOARD OF FIRE UNDERWRITERS tt.k BUREAU OF ELECTRICITY ' , ' ~ 85 JOHN STREET, NEW YORK, NEW ~'ORK 10038 .,,.,.,,.,,o.,¥o.o.,,,. N 133944 THIS CERTIFIES THAT Only the e~ct~ equ/pment as described below and ifltrod~ced by t~e 6pl~it~tt M~ted o~ t~e abo~e application number in £~le premises of John Canu, co~' Et~na Drive & Delmar Df'lye, Laul'eZ, L.T. Job #203 ,o~,.,.i.~ao, Deeembez' 13. 1973 andfoundtobelncompliar~ewiththerequirement, ofthlsBoard. E R EXHAUST FANS AMT. H* P. DIMMERS A,~T,' WATTS TIME CLOCKS BELL UNIT HIATBIIS MULTI-OUTtET V I C 4/0 i 1-1. Ok~ tOTHER APPARATUS: Water heater= 1-JI.Sk~ Elec.l'oom heate~'s: 1-4.0kw, l-2.Skw, ~-l. Skw, 1-1.25kw~ Motor/s; 1-1/2bp George Zimllnghaus, Park llace, Patchogue, L.I. 11772 m MANA~q COPY FOR BUILDING DEPARTMENT. THIS' COPY OF CERTIFICATE MUST NOT Bf ALTERED IN ANY MANNER. Date O~t.e.. 29~. 3.9'73 73 ........................................... ,19 ............ INSTRUCTIONS ,a: This apl~icotion' must be completely filled in by typewriter o~, in ink and submiff~TI in triplicate to the BuildingS? I ~n~oector, wi,th 3 se~,?,f .pi..a~ ..,.accurat~e plot pla.ri. b: ~ ~.n ~-l~.~ *(~.o.f.4ot a~, ,d*of bu~.ldtngs on premises, relationship areas, ana gtwng a aem,ea aescr,pTton aT myout oTpreperty must be drawn on the d~agrem which is pa~ ~ this applfl:at,on. c. The~ wor~covered .by.thi~. ppplicafion may not be Cemmencpd befog. d. Upon' approval of ~h'~ dl~p~'dat[o~,'the Bu Id ng InSPeCtor ~vfil '$su~ o~Bul dtng shall be kept on the premises available for inspection througfmut the work** e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Oc~,upancy shall have bem~ granted by the Building inspector. APPLICATION IS HEREBY MADE to the Building Department for the issUance of a Building permit Building Zorm Ordinance of the Town of Southold, Suffolk County, New York, and other applicable R~egulat*..mns, for the construction of buildings, additions or alterations, or for removel or demolttian, em ~ne applicant agrees to comply with all applicable admit authorized inspectors on premises State Name of If applicanl Builde, Plumbe Electrician's er applicant is owner, le nt, architect engineer, general contractor! iff icer. ne'th W. Thu~bez~ Licemse No ..................... ~.. builder. s License No ....................... :11 ...................... License No. J~' Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .;~.~..1....~.o..~.t...~.....~_~teNo' ....2..?.~ ............... Street and Number .C..°....z~..e:~l B~]a& D~e/ De/31ta~ Dz'es ][~ell NeYe Municipality 2. State existing use and occupancy of premises and intended use and occupancy of prapased comtruction: a. Exisiting use and occupancy . .V..&~.~. b. Intended use and occupancy o~e :~aM.;[3.y ctwe13.:l, ng 3. Nature of work (check which applicable): New Building XX Addition .................. Alteration Repair .................. Removal .................. Demolition .................... Other Work ............................... ' .~. ~ (Descrtpt~On) 4. Estimated Cost . ~,l~eOO (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 ..... ;....;;; ........ ; ...... Pear ................................ DePth .................... Height ....................N mb of Sto les .... u er r ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height Number of Stories one 9. Size of lot: Front .... :~,~.~. ..................................... Rear ..... ~..O..3..t..5.~ ....................... Depth .....1....~?...e...O~... ............. 1E Date of Purchase' .;;.....c...;;....'..~.~....; .......................... Name of Former Owner ........................................................ 11. Zone or use district in which premises a~e_situa, ted ..................................................................................................... 12. Does proposed construct on violate a~ny zoning law, ordinance or regulation: ......... ~ .......................................... 13. V~II :tot be ~'egsaded ....~'.~!~...:::.;..'.:.%.. W~[I excess f~l be remqved fram:prerr~ses: (:' Li :Yes-- ( ) No-- 14. Name of Owner of premises ..~.a...3:...a~....~.....~....~..?*l .1'~. (...~.. A~ress .~....a~... 1.3...?.a.~...&..t...t.~.t~r~ No....~...g..~..'....~....g~... Name of Architect ............................ :.; ............................... Address ....; ........................... Phone No ....................... Name of Contractor ..... .Z.~.Z....~...~.....~....o~...e...~.~...~..a..o..e. .... -,, ........ /~aa ress-.T.~.; .......... f', ............... l~ione No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex sting or pr,.~., and indicate all set-bock dimensions from property lines. Give street and block number or description accord ng to deed, and show street names and ind cate whether Interior or comer lot. ' STATE OF Nb'~/~Y~ tSS COUNTY OF ', ...~N~&~e n.~ i~i~-.~~~.~.....:._being------------. ~.-.....- .-~' g g ~dul~,, §Worn, ;depose, ;and ;says the, he ,, the applicant above named. He is the ......................... ~~ ................................ ~ (C~.n~9~:tor, agent, corporate o~ffice.r, ~etc.) of said owner or owners, and.is duly authorized to~pe.rform or havre ~erformed the said work and to make and file this application; that oil statements contained in th3~;-;al~l~li~{lofi;ar~ fh~e f6 :the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................. _ , Nota Publi ........ ..... (Signature of applicant) . ~ JUDITH T. BOKEN Notary Public. State of New York No, 52-0344963 Suffo k Coun Lof .£WS,ONS YOUNG & YOUNG NOW ~5.~e73 400 OST,^,DE, ^VENUE., W~H~^m ~ DEC. 2~,1973 ALDEN W. YOUNG ~ SURVEY FOR: ~L~ND HO~ES ~NC. ,, I AT LAUREL GUARANTEED TO: SECURITY TITLE & GUARANTY 8OUTHOLD 8AVING~ B~K TOWN OF SOUTHOLD su~o,~ co., .. ~.~___~ SCALE: I" : 40' DATE:0cT. 4, 1973 Lof s(].ff- NOTE; ~ =/WONUMEN T SUBDIVISION MAP FllED IN THE OFFICE OF TIlE ¢I ERI~ OF$[IFFOLK ~OUNTY ON 7209 OF THE NEW YORK STATE EDUCATION REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: ~NLAND HOMES, INC. LOT NO. 29," LAUREL COUNTRY ESTA~.~m_ SCALE: I" = 40' IDATE:0cT. 4, 197~~' : ~ ' ' UN~dJTHORIZED ALTERATION OR ADDITION TO THIS SURVEY I$ A VIOLATION OF SECTION LAW. UNAUTHORIZED ALTERATION OR ADDITION TO THIE EURVEY IE A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW REVISION5 NOV 15~ 197:~ DEC 20, 1973 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERNEAD, NEW Y,~E,I~,~--~, ALDEN W YOUNG HOW/~RD-W. SURVEY FOR: - INLAND HOMES, INC. LOT NO. 29," LAUREL COUNTRY ESTATES" AT LAUREL TOWN OF SOUTHOLD SUFFOLK CO., N.Y. tGUARANTEED TO. SECURITY TITLE 8, GUARANTY CO. SOUTHOLD SAVINGS BANK BY' SCALE I" = 40' J DATE' OCT 4, 1973 NOTE: SUBDIWSlON~fAP F/LED IN THEOFFICE OF THE C£ ERN QF SUFFOI K COUNT Y ON JUNE22, 19YOASFILENO. 5~E6. ~vls,o~s YOUNG & YOUNG DEC. 18,1972 400 OSTRANDER AVENUE, RIV£EHEAD. N£W YORK dAN. 8~ 1973 ALDEN W YOUNG, HOWARD W. YOUNG SURVEY FOR: " INLAND HOMES, INC. LOT NO. 2~"LAUREL COUNTRY E .... II AT LAUR EL RIVER H~~A '" ,ow.o, SOUTHOLD . SUFFOLK CO., N.Y,, , ,, ~~ ~ _ '~ Jl~cA~ I~" = tINAUTHOEIZI;D AlTERATION OR TO THIS SUI[VEY IS A VIOLATION OF SECTION 720~ OF ~HE NEW YO!~ STATE EDUCATION LAW. COHE$ OF THIS SUI[¥EY MAP NOT ,,, ' , AI~I~ROVED, AS NO,~ ED , ,, ' ', 1 BEFD}qE BACKFILLING F,~UNDA- ' , ] ON OR STAR~ ,F~AMING :, ' J, FI',~L WHEN JOB COMPLEFED -?