HomeMy WebLinkAbout6526-zNO. 4
TOWN OF SOUTHOLD
Buu.rHNG DEPARTMENT
Town Clerk's Office
Southold, BI. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at . ~;~.t; .D. I';~'.~ ........... Street
Mar No..C. ap.~ .K.t.dd. Block No ........ Lot No, .PT. .l..o.~..!2....l~.a..t.t.i.t.u..o.k. ......
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ......... Apr . 30. , 19.7.3. pursuant to which Building Permit No..
dated .... .Apr. t.~...~.0 .... , 19.73., was issued, and conforms to all of the
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is P.i,,iy.a.t..e..o..1~...1'..ami. ly .c!.w.t~l~.ln. g ...................................
The certificate is issued to . .J.~,.e.s.T.al.as. .... . .0j~m.e.r ........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .. B.ep.t . be....i9.?~ . bY. ..R:.
UNDERWRITERS CERTIFICATE No. R2~799. .... .;[.an. ~9... ]9.7k ................
HOUSE NUMBER .... ~a~... Street .811remit; .Drztve ...........................
FO~ NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PER J,AIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
6526 Z
Date ........................ ~pr~l ....... 3D ....... , 197..3...
Permission is hereby granted to:
Emanual Zarbls A/0 James ~alas
............. i~.~.....P.9 ......... S~..A~.~ ........................
.................... ~,1,~,~ ............ 113~.8 ..............
Build new one f~ly. dwelling
~O ........................................... ; .................................. : .........................................................................
........................................................................................ ./. ........................ l ..........................................
at premises locoted at ......... N ./..~;~...lg.~....l~...Q~p.t,..I~L1,d-.d-_..es.t,,..(s~rb,..b~..R,~...1.9~9.)· ......
I'
pursuant to application dated ................. ~p~.t.~l.7, ...... .~0. ............ 19. .., and approved by the
Building Inspector.
FOB~ NO. $
TOWN OF $OUTHOLD
, Building Deparement
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This apphcatlon must be filled in typewriter OR ~nk, 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, aha
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. Commercml 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.
El. 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
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
.. XZ¥ ....
New Building ......~.. ....... Addition ................ Old or Pre-existing Building ................ Vacant Land ..............
Location Of Property ...~..Z.~.. ..... ..~. z~?..Z..~.. .... ; ..... ~ ...... ~..¥../...~...~. ....................
Owners Of Property ........ ~K~....~..~..~.~. ...... iTd..K~....~....~....5.........~,.......~...~-- ......................................
Owner
Or
.............. Lot No ............. B,ock ............. House
Subdivision
Permit No.~...~.~.:.~..~.....~..-/~ Dote Of Permit...~/./.~.'r.~.~..~....Applicant ~-'~4~.~.,(~4.~.~...~:.....~...r~....~....~../.~.. ....
Health Dept. Approval ..~.~..~.~.7..~.....~'...~.~.~.~..Z'~....Lobor Dept. Approval ..... ...~.... ....................................
Underwriters Approval ~'.~.4'....&~..~7~...~....7...~....~,. ........... Planning Board Approval .... ~ ...............................
Request For Temporary Certificate ........................................ Final Certificate ....... ...~..... ...........................
Fee Submitted $ ~,~,,..,.~.,, ......................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
].5/75--~=1 BUREAU OF ELECTRICITY D[JP'[-IC~'~ 0P N140572
85 JOHN STREET, NEW YORK. NEW YORK 1OO3B
THIS CERTIFIES THAT
James Tallas, S-~it Road,-~riam Rd. Capt. ~dd Estates, ~ttituck, L.I
in lhe folh,wl,~ location; ~ Basement [] Ist Fl.
wese~aminedon Januar~ 25,1974
F~XTURE 13 FIXTURES
OUTLETS IECEPTACLES SWITCHES ~NCANDESCENT FLUORESCENT
13 27 14
[] e.d ri. outs t.de Sec.o. Block Lot
and.(ound to be in compliance with the requirements o~f this Board.
RANGES ICOOXlNG DECKS J OVENS J OISH WASHERS
1 ll.t .5
SERVICE DISCONNECT NO. ~ S
METER
~T ~ ~P ~PE EQUIP. 1~2w t 3w 3~3w 3~w NOOF CC. COND.
~ ~2oo ~ ~
OTHER APPAEAIUS:
~ster heager: 1-4.5~.
~lec.
;PECIAL REC'PT.
1 3O
V I C
MULTI-OUTLET
SYSTEMS
NO. OF FEET
EXHAUST FANS
DIMMERS
4/o I 2/0
room heatess: 1-3.0, 5-2.0, 1-1.75, 1-1.50, 2-1.25, 4-1.0, 2-.5kw.--
Goodale Electric
R.R.L. Box 15A
Main Road
Ma t tituck, L. I. 11952
must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identif~d~ylthe~redentiols.
This
certificate
THE NEW YORK BOARD OF FIRE UNDERWRITERS
· D.I.~ BUREAU OF ELECTRICITY* *
[~ 8S JOHN STREET, NEW YORK, NEW YORK.1Oo38
N 405?2
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by th~ applicant natural on the abo~e a£,plicatlon nu tuber in the premises of
James Tallas, Miriam Rd., Su~mit Rd., Capt. Kidd Estates,
Mat~ ituck~ L.I.
in ~he fallmvi~g locatlo~; l Y~ ~asement [] ~ r~. [] ~.d r~. outside Sectlo~ Block Lot
was examined on January 2.~R ~74 andfoundtobeincompliancewlththerequirementsofthlsBoard.
DRY~:RS FURNACE MOTORS FUTURE APFUANCE FEEDERS
A,~T. K+W. OIL H*P. GAS H.P. AMT. NO+
RANGES
1 11.!
SPECIAL
I 3O
COOKING DECKS OVENS DISH WASHERS
~ 1.5
TIME CLOCKS Ill.it ~ii:aT~EmUNiT HEATERS MULTI-OUTLET
BELL ~ Y T M
SERVICE DISCONNECT I NO. OF I S E
I 200 C~ METER X ~ ^.w. ~.
A.,~T. At~p. TYpE EmUIF. 1~TM ,~3W 3~3W 3~4W NO'O~E~C~COND' OF CC. COND.
OTHER A~ARATUS:
R I C
NO. OF HI-LEG
OF HI-LEG
EXHAUST FANS
DIMMERS
NO. OF NEUTRALS OF NEUTRAL
4-1. Okw,
Water heater: 1-4.5kw
Elecoroon heaters: 1-3.Okw,
Goodale,
1...9!,(,,
5-2.0kw, 1-1.75kw, 1-1.50kw, 2-1.25kw,
Robert A.
525 Orchard '*
New Suffolk, L.I.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
OWNEF~*
NOTE:
· -'MONUM~FNT
SUBDIVISION MAP F/~ED IN THE OP~'IC£
OF THE ¢£ ER K OF S UFPO~ K COUNTY ON
dAN. 19,15~gASFILENO.
REVISIONS YOUNG & YOUNG
400 0STRANDER AVENUE, RIVERHEAD, NEW YORK
ALDEN W. YOUNG HOWARD W, YOUNG
SURVEY FOR:
JAMES TALAS ~~
PART OF LOT NO. 12
"CAPTAIN KIDB ESTATES"
AT MATTITUCK G Ui~TE rr'~ ~q'O; ; 'i ~ \! ~
TOWN OF SOUTHOLD '::~' :;:k't:: i~ i~ J!!~!f.~
SUFFOLK COUNTY DEPARTMENT OF HEALTH
H.D. Reference No.
APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM
1. Applicant ~_~,1~i,~,'¢'~'~3~,_ ~-d~15 . Phone 5.
~%ddress
~-,~ ~,[ .~2;~,v~P.,~ ~ 8. Private well
· ~ ~llage *~'r,r~ Township ~o~qf, ~]. ~ . 9. Public water "9EJ
~.~blic Wa'ret Company name Distance to main[O~ ~
~.~L~t size: Widt~_____~fee~----~ength feet (~nter on center plot below)
l~.~S~age Disposal- ' 'S~stem. ~
~ ~ I' A. 9~0 ~allon septic tank: Precast~quivalent Block
~'~'~ ~ ~ ~hing pools: Number, I. Precast 7(~lock 'Special
If private well ftl
in blanks below:
Tank ca~ Gal
Pum~ G.'
D~pth to G.W.
~ Amount of water in
~ well
o
Test Hole
~ Data Feet
o 0
~ 2
= 4
6
8
10
12
14
16
18
The undersigned CERTIFIES: "Const uction of authorized installations will
be ~ntaccordance with the Suffolk County Department of Health's current stand-
a~d~ ~hereto." -~
· ~ b'wner ~r Builder
~OR' H AL'TH DEPARTMENT USE ONLY;~,Based on the information presented her'ewit~,
is tb~ opinion o£,thA Health Department, that an adequate and satisfactory Sewa
· isposal System ~e installed on this plot.
Date ~/~h ' Signed ~ ...._~-~_~_ ...... ~;
S-15
~evJsed 4/~/72
TOWN OF SOUTHOLD
BUILDING DEPARTMENT /
OFFICE
SOUTHOLD, N. Y.
^, , tico,io, No. ..............
.,~o
Examined ...~ .........................
19 ........
Apnroved
Di~pproved a/c ..............................................................
APPLICATION FOP, lUlLDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector,
3 sets of plans, accurete 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 pert 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 kept ofl~L
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 Ce.rtificate of Occupancy shall have been
gtented by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructiol~ I~
buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all ag~licabie ~
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 e corporation)
........
(Address of applicant) I (C'/.~ ~.~o
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
· . ............. ...... .......... .......... .......................................................
Name of owner of premises ............ ..~....~...~.....~...~... ........ . .~..X~,~.a(,.~.....-~... .......................................................................
If applicant is a corporate, signature of duly authorized officer. _ ~-~ _, _~
[Name and title of corporate officer) ~ ' ,~
Builder's Licen~ No ..........................................................
Plumber's License No .........................................................
/~'.~,/ I /.7~
Electrician's License NO .....................................................
Other Trade's License No ...................................................
1.
Location
of
land
on which proposed work will be done. Map No.~.~/jb~,.,.~..,.e~..~ot No .....
Street and Number .....~`?~..~n~/..~C~/~.~r~...~Z~.~.~)~.`x~`.~/~Z./.~...~..~C..~.
MunicipaliW
2. Ste~ exi~ing u~ and ~upancy of premiss and intend~ u~ and ~cupancy of pro~ ~n~mction:
a. Exi~ing u~ and ~u~ncy ............ .~.c..~ ............ ; ......................................................................................
..... ....... ...... ............................................
b.
Intended
u~
and
/
3. ~la~re~f work (check which applicable): New Building ......... ~ .......... Addition ..................... Alteration ...............
Repair ......................... Removal ......................... Demolition ........................ Other Work ....................................
,.~. ~.~. ~ (Description)
4. Estimated Cos~....~..~.y .~.....~...,'....~q... ............... Fee (to be paid on filing this application)
5. If dwelling, number of dwelling units .t/~..~J. Number of dwelling units on each floor ...~(...~.~,,~ ..............
If garage, number of cars ........./.... ((. ~'~-~1 .............................................................................................................
6. If business, commer£ia[ 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~3f Stones' ....................................... ·
8. Dimensions of entire new construction: Front .....~..~.;...~..,... Rear ....... .~.....~ .~.. ..... Depth ....... ~..~.........O. ...........
He ght , ., Number of Stories .~.. '.,~.....~.. - .
9. S~ze of lot: Front .........xt.l:~l.....-;O ............ Rear ............. ~.~.O._..=.~ ....... i"' Depth .......... ..~.....~..k.~ ~ ............
10. Date of Purchase ..................................... Name of Former Owner .~..1
~ ,~ '~'~:"'~'~'""T' .......................................
1 1. Zone or use district in which premises are situated ................ .~ ...... ~..L.~J~EZ........: .......................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........ ~.. ...........................................
13. Will lot be regraded .... ~..~.......~..... ....... ~,.. Will excess fill b~gxemoved from premises: [ ] Yes ~ No
14. Name of Owner of premises ................ ..~..~.,~..,~....~. ....... ..~...d~...~...~. ................... 4..z..!?).....~.(2..~.~..l..7...~...~.. .....
.~ ~ -~ , / ~ (Addres~ _ (Phone No.)
Name of Architect ....... .~....b~..,,~..,/....~. .......... /~./YJ.~..~ ........ q. ........ · ."'~..~..~.~./~.~.~..,...~1~.~......~..~...~...~..~. ........
~ (Address) , ~,/ (Phone No,)
Name of Contractor
(Address) .... {PI~;~'; No.i ~/I inG ~'~
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 wheth-
er interior or corner lot.
COU.TV ......... .......... )
............... ~,'X) ....... ~' being duly sworn, deposes and says that he the applicant above named,
{Name of individual signtng con. tract~ ........... is
He is the ............................................. ~.~.~.........-
{Cont, acto,, .....................................................................
of said owner or owners, and is duly authorized to perform or have performed the 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 performed in the manner
set forth in the application filed therewith.
... day of
~.~ ........................... /~ ....... N~.*-52,6~e295 = .............
· ~ ~ ,v ,Qualified in Suil01k County ~
Notar Public 'C..~ien Exp es.~acch. 30 19-~ '~ ~'~ )
Y , ~..-~ ........................ c,oun'ty ' ' ~ ........... ~~ ......... ~;~..~ ............
(Signature of applicant/
.LIME
.I-IV I F4 ~
MIlE
-I LJ STII cl C OINFIANY,I NC.
A?~-KOVED AS NOTED
FEE:~5
74,,-2660 9AM TO 4PM FOR REQUIP,,
FOR
ADDRESS:
SHEET NO.
APPROVED:
This drawing rs the property of Juslus Co. Inc,, Tacoma,
I
' OF
BY: ~P.~Sl~ Ec;~
Prohibited,' .DATE:
/
,JUSTUS
Il4.11 ~ II-0[
.": Vz
[0~
J
JUSTUS CONPANY, INC.
LAEEWOOD TACOMA INOUST~AL PAE~ TACOMA~ WA, 9849g
FOR
ADDRESS:
APPROVED:
This drawinE is the property of Justus Co,. loc., Tacoma, Wn Unauthorized Use Strictly P*~ohihited,
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]c.~-P.~I~ 5HAKEG- I~:::~t'EXPD6UI~E T'~ 'rile
/I,~/i,fH I~:,w ~,~,tl, FELT:
~TAI Lc
/-%
IFf
4] -
(~0~ ......... CASED OPENING
(e040) ....... W~NDOW SIZE
NOTE: DAS~D LINES INDICATE M~TERIAL TO
OF DOOR AND
LEGEND
WINDOW UNITS.
SHEET NO.