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Home My WebLink About6577-zFORM NO. 4 TOWN OF SOD'THOLD BUH.DING DEPARTMENT Town Clerk's OEice Southokl, N. Y. Certificate Of Occupancy No. Z$[8¶0 ...... Date ............. Feb ..... 2~ .... ,19..71, THIS CERTIFIES that the building located at . R,0 oI~., .off. E/8. Ills. JuleS~La~t Map No. XX ......... Block No .... u ..... Lot No. xlc~..l~attituek., li,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ :lia), .... 17, 19.73. pursuant to which Building Permit No...6~?~Z dated ......... Na~...t~ .... , 19.7.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .Prl.v. at$. sa~e. family. .dwl~ling ...................................... The certificate is issued to J. Qbll. 3.QhltlJ, er ..... 01~el' ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Fab.. ~...1.~. · by.R,..I/ilia ...... UNDERWRITERS ~ERT~FICATE No. ~. 1 lY.~a~ ...... .0.Ct. ~...197~ .............. HOUSE NUMBER !...-3~8~ ..... Street .0Ze .,Yule .Lane ......................... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6577 Z Permission is hereby granted to: .... ~1~ ~ .. ~e.i-~ m~ .. ~/C~---~eh~ 1-~e~ ...... ~'a~.~.h~ven .................................................. ........ ~:a~e-epez,~ ...... -~.,.~, ................................ to .... ~.~,lO,..;u~y....~e...£~.~ty...O,v.e~!Lug ................................................................................. o~t premises located at .g.~.:r..~q,~,~,..~£~..,Ole..Jt~le...i,e::ae ........... ~ ............................................ .................................. ..~.~.~,~ ....... .~.,.g., ....................................................................................... pursuant to application dated ....................... ]~tay. ....... .~.~. ............. , 19..~.~., and approved by the Building Inspector. Fee $..6.~ ,l~) .......... RECR ~'L:~ ~G L~T DRWIZWAY CONSTRUCTION CESSPOOL CONS fRUCTION CELLAR CONSTRUCTION FOl~1 NO. 6 TO~/t,I OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Th~s apphcation must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building inspector w~th the followtng; for new buddings or new use: 1. Final survey of property w~th accurate Iocahon of all buildings, property lines, streets, aha 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 mstallahon from Board of F~re Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and similar buildings and ~nstallations, a certificate of Code comphance from the Architect or Engineer responsible for the building 5. Submit Planning Board approval of completed site plan requirements where applicable. B I--or ex,sting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" 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: I 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 ....~...~....G~..~P.. ~..Jb..~...~....~, New Building ....... .~...... Addihon ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~.~..~2~.',.~.~,,)PJ.~.~,~ ......... ~./~.-~r~..~.~..~...~....~...~ ......... ~.:.~..: ................................ Owner Or Owners Of Property .... L~(~ ..... ..~.~.~t~.....~..~.'.*..t..[...~.~. ............................................................. Subdivision ................................................................ Lot No ............. Block No ............House No ........... Permit No .................... Date Of Permit .................... Applicant ...~..~.~..O..~....~)....~...~.....~.....~.....~..~...~.....~.....~...~. · Health Dept. Approval ...~'..~-,.,J-~,..~.(,,~.~..J,..~'.~...~B....kabor Dept. Approval .................. ..~...~.(..~.... ................ Underwriters Approval .............................................. Planning Board Approval ....................................... Request For Temporary Certificate ........................................ Final Certificate ........ ~ .................. Fee Submitted $ .................................... Construction on above described building and permit meets all applica/ble c. odes and regulations. App,,cant __ ...... ..... Sworn to before me this .... ¢ Notow Pubhc .,~. .,~ ........ x~ County r~ --' ~/ ~ ~ ~ JUDITH T BOKEN No, 52-0344963 Suffolk Coun~ Commission Expires March 30, 1~ (stamp or seal) ~'~ ~ ''~ / 6~ ¢~ .,,,~THE NEW YORK BOARD OF FIRE UNDERWRITERS j.___ a],~. BUREAU OF ELECTRICITY 85 JOHN ETREET, NEW YORK, NEW ~'QRK 10038 2, ,,.,.,,.,,o.~o.o..,,,. N 117922 THIS CERTIFIEE THAT oMy the elecrr~e~ eq#~me~t e3 ~.e~cHl~e~ ~ ~ introduced by the app~ea~t named o~ the .~ ~p~t~ ~m~ in t~ p~ o/ John Schiller, OleJ~e I, ane, R~aus Road, Mattltuck, L.I. inthe/oll~ing~atlon; ~ S~nt ~ IstFL ~ 2~ FL mtside ~ao. e~k RANGE iPECIAL SL~'pT COOKING DECKS OVENS DISH WASHERS ~*~T. K, W, I AMT. K.W, ~T. K, W, TIMECLOCKS .BEll UNITHEATBES MULTI-OUTliT ' ! ':1~NS~ '~ N~'Y~o~I~ T SERVICE DISCONNECT I NO. OF I S 1 I00 CB x V I C E EXHAUST FANS DIMMERS Motor/E: !-l/2hp Robert A. doodale, 525 O~chard St., New Suffolk, L.I. 11956 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. iattituok, Long Island May 22, 1973o 5outhold Town Building Dept., 3outhold, Long Island. ~entle~enl Notice is hereby given, that ne~otiatieas a~e being formulated between Ernest and Harold Wilsberg andJohn a~ Lillian 5ehiller, for the pu~ohase of the right of way, 25 ft. in width, originating at the N.5. of 01eJule Lane, as described in the ~ap of the property of Ernest and ~arold Wllsberg on 01eJule Lane in Mattituok, Long Island,N.Y. AttentionS. Howard Terr[ SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No, ~-~-~ ~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM ~'//a~ 1. Applicant-~o ~¥~ ~ Phone 5. Subdiv. Address~L~'K~_ ~T~ r.~ ~,3,~ 6. Section 2. Propertf lo~a~ion ~h ~-~A~.~ 7. Lot No. - ~Ta ~~ ~~ ~~W 8. Private well y~ Village~~ ~ ~ Township ~TkoL~ 9. Public water ~,~ 3, Public Water Company name ~~ Distance to main ,- · 4. Lot size: Width ~ feet Length ~ feet (Enter on center plot below) 10. Sewage Dispos~System: A. ~0~ gallon septic tank: Precast ~q~ivalent Block B. ~aching pools: Number~Precast/~lock "Special If private well fil in blanks belows,,,_ Tank capacity_~.~Gal Total well depth Depth to G.W. Amount of water in well ~A/ Test Hole ~ ~_~_ Data Feet 0 2 4 6 8 10 12 14 18 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards thereto." FOR HEALTH DEPARTMENT USE ONLY. Eased on the information presented herewith, it is the opinion of the 'Health Department, that an adequate and satisfactory Sews Disposal System can be installed on this plot. Date ~ ,~ Signed ~/~..~ -~'~-.. __ S-15 f~ev~sed ~7~772 TOWN CI.~RK'S OFFICE ' ~ SOUTHO~D, N.Y. -~/ /~ ~--~ ~ ~/~ V ~..l.'.~ ......... ~ ~ ~.9.<.~.~- ~' ~ /~ ~ ~~ Examined . . ~plicoti~ No. ~ ~,.~,,~, ....... ..~ ~ ............ ........... ........... . .... m Di~pproved a/c ............................................................................................ ................................................ ........................ · ~U~Tl~ ~0~ ~l~l~ ~lT ~ ~ q ~ ~.~....~ Date ................ ~ ...........~ ................... , I NSTRU~IONS m ~. This ~ppli~fion must ~ completely filled in by ~y~writer or in ink ~nd submi~ed in ~riplie~te to the Building Ins~or, wi~ 3 ~s of plans, ~ur~te plot plen ~o scale. Fee ~e~rding ~o schedule. / b. PIct plan showing location of Io~ ~nd of buildings on premises, relationship to ~djoining premiss or public s~ or ~re~, ~ giving ~ detailed description of I~you~ of pro~rW m~s~ ~ dr~wn on diagram which is pe~ of this ~ppli~tion. ¢. T~ work ~vered by this ~ppli~fion m~y no~ ~ eommen~d ~fore issu~n~ of Building Permit. ~ d. U~n ~pprov~l of ~his ~pplication, the Building Ins~¢tor will issue ~ Building ~rmit to the ~pplicant 5ueh ~rmit sh~ll be ke~t on~ the premiss ~wil~ble for ins~etion ~hroughou~ ~he work. e. No bui~di~ sh~U ~ occupied or used in whole or in p~r~ for ~ny pur~ wh~ever until ~ ~ifi~te of O~n~ shell h~ ~n gr~n~ by the Building Ins~etor. ~ APPL CAT ON IS HEREBY MADE to ~he Building De~rt~n~ for the issu~nca of ~ Bud ng Permt pursuent to ~ Bu ring Zo~ Ordin~n~ of the Town of ~uthol~, Suffolk County, New York, ~nd o~her e~li~ble Lews, Ordin~n~s or R~ul~fionh ~r ~ mmtru~lon of buildings, ~ddifions or ~l~er~tions, or for remowl or demolition, ~s herein descried. The ~pplie~nt ~rees to ~mply wi~ ~11 ~gpli~le I~, ordin~n~s, building code, housing oode, ~nd regulations, end ~o ~dmit ~uthorized ins~¢tors on ~emi~s ~nd in buildi~ for ~ ins~iom. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................... ~..~ ~.~..~.,~.~. ...... .C~.~..~ ~'~..~. ~,_ ................................................................................................ Name of owner of premises ....-~m,.~h.~.~.....~.C...~..~..~).e:;.(~ ............................. ...................................................................... If applicant is a corporate, signature of, duly authorized officer. (Name and title of corporate officer) 1. Location of ,an~.~ w~i.ch P~4~ work will be done. Map No.: ..................................................... Lot No ............. Street and Numbe'r ......(~.~,J~.~..~"~' ~L?...F~. .......... . .~...~.-j~.~.-~.~.~,~......,......k~.y. ..................... ' ................................... Municipality '2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~.~_~.~).~..~;~...~-~.~.~.~ ........................................................................................ b. Intended use and occupancy ...... ~.l,.~l~,, ...... .~..~I.~'~"~..~,..~......~X~.'~' ........................................................... 3. '~i'atum of work (check which applicable): New Building ....................... Addition ..................... Alteration ....... .%..:.. Repair .............. ~ ........ Removal ............. ~,,,, Demolition ....................... Other Work .................................... ~!,_,~ ~,0 · /' '7 ~'O (Description) ~ 4. Estimated Cost ..~.~..,..~...~...O..., ................... ,, Fee .....;...~.J....~...,~.... ........... ,...., ................................................ ' (to be paid on f ng this application) 5. If dwelling, number of dwelling units ...?...~....~...... Number of dwelling units on each floor ......................................... if garage, number of cars ................... ...~....~..Q. .................................................. 4,: ........................................................ 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 ....c~...r.....~.. .................. / Height ........ .~..~t ................................. Number of Stories ....... C)..~....~... ...................................................................... 9. Size of lot: Front ...... .~......¥~...: ................ Rear ....... ...-~...?..~..~. .................... Depth .....~.~.Lc~....qt.J..' ................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. zOne or usa district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~,~..¢a ............................................. 13. Will lot be regraded ~:__y__~:..~ .......... ~ ......... Will excess fill be removed from premises: [ ] Yes [¥] No 14. Name of Owner Of premises ..-~.n.~n,~....~,.c~..~..'~..~.~. ......... .~..~.ff,~h~,ta.R~9.~ ...................................................... . (Address) N't R'~J~'~'~'u.C~ (Phone No.) Name of Architect ......................................................................... · · ~ :~ _ ~ w (Address~. ' -- (Phone No.) Name of ContraCtor .1~.~,)~:t.~-I~.~....~....~.~=~J.....~..~w.'. ................... .~.~q.L.O..~.~v...~...~ ....... ..~.~.S;.:...~..~..~. ........ (Address) '~qvl~,.Sa~O~' (Phone No.) PLOT DIAGRAM ~q qr'/, Locate clearly and distinctly 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 wheth- er interior or corner lot. STATE OF NEW Y~ COUNTY OF ...........~//~T' .............................. SS .......................................................................................................... being duly sworn; deposes and says that he is the applicant above named. (Name o£ individual signing contract} 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 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 JODITH T. BOK~N set forth in the application filed therew tb ~ ) ~,/ ,,,...~NOtaH Pu~tic, ~tate of New York / '~/~ ~//~/~i~ 'JiffY, 52-0344963 Suffolk County_ .......... i N.5~°56'40 9''' , u I *' ' WELL ~UA~NT~E~ ~ THE CHI~GO TITLE iNSU~NCE CO. EODE~CK VAN ?UYL,PC. ~, U~ ¢~ . TF_E,T HOLE .-- CLEA~SA,'qD 'T EUGSTEI:L \ \ P-OPE tCX VAIv "-' "'~ "' ~ ,. CE&SPOOl. , b,,~ALE- 50 0 :II~ON PiPE J'~OTE. - ELE VAT~ O,,,"4;5, ,,~I:2E EC,,$E:D ON AN ii 'NOIFY BULDNG DEPAR'~,*IENT A£:~'' ' ; , - ': 765-26~0 9AM TO 4~M ~K RE~,, ~- , , BACKFIL~ FO~DA: ' ~ ' ' ~ 1~ BEFORE FINAL WHEN JOB COMPLETED ', ' bi/kL.W GLENN '/ .'1 FOUNDATIcO~' .~ L,A~