HomeMy WebLinkAbout6600-zFOB,M NO. 4
TOWN OF SOUTHOLD
BUffn[N6 DEPARTM~ ,NT
Town Clerk's Ot~ice
Southold, N. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at . .MoC, anu. Lane ............. Street
Map No.E~.~q~..~1~. Block No... S.~C~...Lot No..3 ..... Gt*~.e~$]~ 9~'.~...N.o.Y. ,. ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ............ A~ll...l~ 19.73 pursuant to which Building Permit No..
dated ........ .~a.~'...2.3 ......, 19..7.~., 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 ...l~riv~te · c~e. family, dwet.liz~ .....................................
The certificate is issued to.. C~aig ~ickter ......... Owner ........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . Je~. · ~9. · .1.~. · by. Re..Villa...
UNDERWRITERS CERTIFICATE No. N.~37.16~ .... J.a~..~.Q.. ~9.~ ................
HOUSE NUMBER ...~.~5. ........ Street ...~c.C.ar~u. I~ ..........................
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEFARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 6600 Z
Permission is hereby granted to:
Craig Richter
.................. ~.e...e..a.~..?~.~ .....................................
Ncgann La Oreenport N.Y.
pursuant to application dated ...A.~...~.~...~,?...../...,,.~.~.....2..~. ........... , 19..?..~..., and approved by the
Building Inspector.
REGR,~,Dit:~G LOT
D~tMEW~Y cONSTRUCTION
C~S~O0~ CONS { ~UCT~ON
CELLAR CONSTRUCTION
oTHER, - --------
Building lnspecto~
Approved ........................................ ,
TOW)4 OF SOUTHOLD
IUILDING DEI)AI TMEHT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Disapproved o/c ............................................................................................
APPLICATION FOR BUILDING PERMIT
....... .............. ,q
INSTRUCTIONS ~
a. This application must be completely filled in by typewriter or 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 buildin~ on premises, relationship to adjoining premises or public streets or areas, an~'
giving a detailed description of layout of property must be drawn on diagram w~ich is pert of this application. ~
c. The work covered by this application may not be commeneed before issuance of Building Permit. ~
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit,she be kept on
the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in pert 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 Zo
Ordinance of the Town of Southold~ Suffo{k County~ New York, and other applicable Laws, Ordinances or Regulations, for the construction O~r
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/f applicant, or name, if a corporation)
......... ..........
(Address of applicant)
State whether applicant is owner, levee, agent, architect, engineer, general contractor, electrician, plumber or builder. -
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's, License No ..........................................................
Plumber s ,L_icense No ............ ~..O......~...... · i
E ectrician s License No ............ .~....~....&[.......
1. Location of land on which proposed workWill'be'd°ne"MapNo.....~.~'...L.~...'~...(~"'""" '"' '"'"'" '"-'"" -'"~ - -- -- ................... Lot No...~'~ .................
Street and Number ...U...C....~.(~..~{.t~. ..........L....~.....~..~.~. .............................................................. : ............................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... '...~..t~L.~.~.hr£.~.. ....... L..O....'~.. ................................................................ ; ................
b. Intended use and occupancy .~ .......... . .~L.....~..... J~..~ ...... CJ,..~j...~. ~ J~,jr j~ .~,~ --~ ~
3. Nature of rk (check which apDlicable):~ New Building ............ ~.. Addition ..................... Alteration ............. ;.
Repair ......................... Removal ......................... Demolition ........................ Other Work. ...................................
~ (Description)
4. Estimated Cost .~..~..I~,.O.~....,.../;1.Q .......... 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 ....~....?~.t~J,..~. ........................................................... ~ ........ : ......................... ; ...................
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 wrth alterations or additions: Front ...................... Rear .........
Depth ............................................. Height ......................................... Number of Stories ........................................
/ / ,
8. Dimensions of entire new construction: Front ....~..~. .............. Rear ....~ .................. Depth ..~...~. ........................
Height ......... ,/~....'. ................................ Number of Stories ...... /. ........ i ........................................................................
9. Size of lot: Front ....... ~...~.~..,., .................... Rear .... ~..~...0...~ ........ /
...................... Depth ....Z~.~. .....................................
10. Date of Purchase .......... Name of Former Owner .,i~'9.'~-..~....~-.. ...... :.~...0..,,~..~.~_{~ .............................
11. Zone or use district in which i~emises are situated ..~.~.,~..~..~.~.O."['.l'~..J~.~ .......................... , ................................
12. Does ~oposed construction viotate any zoning law, ordinance or regulation: ...~.0. ..................................................
13. Will lot be re~reded ..... ;]~.~. ....................... Will excess fill be removed from premises: [v~Yes [ ] No
14. Name of Owner of premisas~.~C~...~)~.Lc,~.~',FC:.l.~.../.~J~,.{,~...~'.;..~'...~'.£P~C:E..~.R..~...
..~.7.~.'-" ./. ~--~..
(Address) ~ (Phone No~)
Name of Architect [~JJ~.[i.~.J~....~..J,~.~/,...~.~,.~.!:~,....J.~.(20...~)..,
{Address) (Phone No.)
Name of Contractor~(..,..~.~C.~.. '.~.~..~i..~..~..~.~..,..~.~.~.?.~.~r~..;..C,;...~..~.. ..~Z
~ . . ................. ~. ............ ~ ........
(Address) (Phone No.)
PLOT DIAGRAM
Locate clearly and distiactl¥ all buildings, whether existing or proposed, and indicate all sat-beck dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whath- ·
er interior or corner lot.
LoT
LoT 3
~. -.-- I?0'
t4c- C,. 13,~,t ~
STATE OF NEW YORK, ~__ )
COUNTY OF ........ ..~. ',~...~.~;~.~,.. ...................... )
~ ~ JJ~-~. being d uysworn, de ,s and sa sthat he i sthea I,~nt ab ve
............................. ~ ':'"'. ':" . . ' ................................... ~ Y PP' 0 nameQ.
.. , ,,e ................................................................................................................................................
( Cont~ctor, a~nt, coyote officer, etc.)
of said ownar or o~nars, and is duly authorizad to ~rform or ha~a ~rfor~d the said work and to make and fils this a~lication; ~at all
statements contained in this a~lication are trua to t~ ~sI of his kno~sd~ and ~liaf; an~ that the work will be ~orm~
~t forth in tbe'a~plication filed I~r~wlth. I[RRI ~E
~ ~ day ~ N~Y PUBLIC. State of Ne~
.......................................................... . .......
......... ".: ............................ ................
{ ~ o[ appl~can t J
FORM NO. 6
TOWN OF $OUTHOLD
Building Deportment
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This opphcatlon 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 hnes, streets, and
unusual natural or topographic features.
2 Final approval of Health Dept. of water supply and sewerage d~sposal--(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 s~te plan requirements where applicable.
B For ex,sting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property hnes, 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
o,e ....... ................
New Building ~x Addition ................ Old or Pre-existing Building Vacant Land
Location Of Property .... ~. .............................................
Owner Or Owners Of Property ..... d(l'~.a,l.g ....... ~.,..,.,'J:'~.~......~._~..,~. .l~..../l:.......~-..! ......... ~.l...C,..a~..~...~.. ......
Subdivision .~~..-'~.... ...... Z~....,.....Lot ~o ..... ~ ..... B,=k~o ............. ~ouse ~o..'Y..~.--...
Permit No ....~..~...~...~ Date Of Permit -~ .~...~...Applicant ...~.~6...~ ................
Hea,th Dept. Approvo, .J~Z/~ ...... ~:.U..'.......' .....~obor ",pt Approva, ........... ~:...~'. .....................
Underwriters Approval ....~,...,L~,,7..L,~...~....~.~..~.,.Planning Board Approval ....... --'"~"f"'~f ..................
Request For Temporary Certificate ........................................ Final Certificate ........~, .............................
Fee Submitted $ .....~.~ ....-~r~..[ .................
Construction on above described building and permit meets all applicql~le, codes and regulations.
.......... ........ .................
Sworn to before me(~s ~'---' 7
....... ~ day of ~ ...... (..~.~..? (stamp or seal~~7
THE NEW YORK BOARD OF FIRE UNDERWRITERS
C5 BUREAU OF ELECTRICITY
~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038
,,.....,a.,,,.-.,, ',0. .,,.,.,,.,,....~o.o.,,,,. ' 137164
THIS CERTIFIES THAT
o~ly tl~ ~tr~gai equipr~e~t ms described IJelole ~ ifltrodl~ed by t~ appel Mined o~ the aboee ap~licatio~
Craig Righter, McCanns Lane, Noz~h Rd. & Sutton rlace,
in the follmvimg Io~afion; ~kBasement ~Ist r~. [] 2.d ri. o ut side Section Block Lot
tvase~aminedon ~antll~ 7~ ~49~4 andfoundtobe~ncomplianceteiththereq~irernentsofth~sB~ard.
FIXTURE
OUTLETS
DRYERS
FURNACE MOTORS
OIL H,P, GAS H.P,
V
RANGES
SPECIAL REC'P1
C
]COOKING DECKS [ OVENS [DISH WASHERS
) ~. ~.w. I ~" t',,. ~T. ,~.w.
TIMECLOCKS ~ fI, JNfl'HEAT~$ MULTI-OUTLET
E
EXHAUST FANS
~MMERS
2/0
1-1.25kw, 2-1.0kw, h'.?Skw, 1-.Skw
Town Harbor Lane ~ll&(~il~G~[&44~'
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AHy MANNER.
TO THIS SURVEY iS
SECT[O~,q 7209 OF 1
EDUCATION LAW~
COPIES OF THIS SU
¥1QL~TtON OF
NEW ¥OP, K '~TATE
SUF~OI~ COL~NTY HEA~TH DEPARTMEN~
The sewage dlsp,~[~.~],i~ &d w~ supply
f~cilities fo~ this loc~tion h~ve been
~peeted by this department and found
to bo ~atisfactory.~~ a'
Ohief of general ~ngineering
SeNices
SUFFOLK COUNTY DEPARTMENT OF HEALTH
H.D. Reference No. ~--~.3-~
APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM
Address~[,~ i_D~(.~ .,~:,-e, ~).. Z~o~7 ./tql~/-~ 6 Section
2. Property location [:~]~_~% ~ ~c~c~% 7. Lot No.
~.~.~9~ ~ ~ , 8. Private well
Village C~ ~,...~ Townshipg~hciA 9. Public water
3. Public Water Company name C~'~r~Po~c¥ Distance to mai~
4. Lot size: Width ]~0 feet Length /~f3 feet (Enter on center plot below)
10. Sewage Dispose%System: ~
A. ~ gallon septic tank: Precast / ivalent Block
B. ~aching pools: Number ~ Precast~lock~ '-- Special__
If private well fil
in blauks below:
Tank capacity.__Gal
T o ~1~ 1 ~ depth
D~th to G.W.
Amount of water in
well
Test Hole
Data I ~ee~
] 0
I lO
[ 12
I 16
The undersigned CERTIFIES: "Construction of authorized installations wil
be in accordance with the Suffolk County Department of Health's current stand-
ards thereto."
Date ~/[~i-,~ Q.-, /'/~3 Signed ;Owen ~
r Builder
FOR HEALTH DEPARTMENT USE ONLY. Based on the ~i~formation presented herewith, i
is the opinion of the Health Department, that an adequate and satisfactory Sew
Disposal System can be installed on this plot.
~/~ ~ ~ Signed ~ ------~ ~ ---
Date
S-15
Revised 411/72
Ii I I i ,, -, - ..1:
_
J
I I I
765-2660 9AM TO 4PM FOR REQUIR-
ED INSPE~;TION$:
1. BEFORE~ BACKEILLING FOUNDA'
TION OR START FRAMING
2, BEFORE COVERING pIpELINI
], FIN~ WHEN JOB C~FLETiO
I 0 5 9 - B SHEET-I
PLAN -I TOTAL-3
K/?Ctt£/d C/lJlIV£T
L 1N,' t i--4 G
/4"-I"
I
,?
/I
W-ti"
/
~ L
I 0 5 9 - BSHEET
PLAN -I TOTAL
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P L:O T PLA~
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