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Home My WebLink About6592-zFOB, M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certfficnte Of Occupnncy THIS CERTIFIES that the building located at . ~//.q. Ilesi .Buft'olk. Road... Street Map No...]f~ ........ Block No...~ ...... Lot No...~......~..t.c..h.ol~.e. ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Nay. 2:1,~ ......... , 19.~.3. pursuant to which Building Permit No...6.~..~.~.. dated .... liay. 22~ .......... , 19.73., 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 . .i~rl.v. ate..~e, fzalll~..d~X],/~ng ...................................... The certificate is issued to ...Ia-l,~n_d. Bo~es~..lno., ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .3$P~,. ?S..],9?3....."R.*...V.i..L~a.. .... UNDERWRITERS CERTIFICATE No..N...1.1.2.6.1..0...D.a..t.~.d.s....S.e.l~ .t.,..~.t..1-?.?.~. ...... HOUSE NUMBER . .~.6.~.0 ........ Street .. N..e~...S..ui?.o..~....R?.a.d. .................... ............................................... ...................... Building Inspector ~ORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6592 Z Permission is hereby granted to: :ra~r,a..~.q~e~...;~c ..... AZ.q_.P.~u3~..~ge.~ ....... ........... .%.32....~4.q~dle...Cozm.t.v-y...P~oad. ....... ...... .{~3A.e.u ....... ~.(~I~....1.I ?.{~.b. .......................... ~o .... ~.f..~...~.e,..v.....o.~.o... ~.~...~....~.:l..3,;!,.r~g ............................................................................... at premises located at ...... ~_/..~....~..~.e...~.....~...3~....f....~..k....~.rl...e. ...................................................................... ................................................... ..c..u..~.e.~.o..~... ..... ~.:.~.:. ...................................................................... pursuant to application dated ............................ ~a-~ ......... .~. ......19...~.~., and approved by the Building Inspector. Fee $?.,,~,?,~.,~, ............ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 AFPLIGATION 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, 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 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 8card approval of completed site plan requirements where applicable 8. For existing buildings (prior to April 1957), Non-conform,ng 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 inspect,on 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 dwelhng or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date 9/11/73 New Building ..... x~ ........... Old or Pre-existing Budding ............................ Vacant Land ........................... Location Of Property 1650 Ne~ Suffolk Rd 182' no. of cedars Rd. Owner Or Owners Of Property ..... ~.~,...~....5..~...s..,....P...~..u...1....S..~.u....e..z. ............................................................... Subdivision Sou'l:ttold - - ................................................................ bar No ............. Block No ............. House No ............. .................... 5/23/73 · , Inland Homes Inc. Perm,t No. 6.592 Date Of Permit .................... /%ppficant .................................................................. 3S043- 5/3/?3 ., Health Dept. Approval ............................................ Laoor Dept. Approval ................................................ UmderwrJters Approval .~..~,.~.~..~...3...-.....g./..~./..?..~. ............ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certlf,cate X Fee Submitted $ ........$.~Q.Q ................ Canstruction on above described building and permit meets all applicable codes and regulations. Inland Homes Inc. / KenneJ:h W. Thurber Applicant ........................... .~~~.._/._........ ............. Sworn to before me this ................. day of ............................................ Notary Public .................................... County (stamp or seal) t ? THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY' ~ ~--- &~ SS JOHN BTREET, NEW YORK, NEW YORK 10~38 , THIS CE~IFIE~ THAT ~ - ~y the e~t~ ~uipment ~ ~cd~ ~ ~ int~ by t~ ~i=t ~ on ~ a~ ~i~t~ ~r in 't~ p~ of ~u~eho~ue, L.I. Job ~183 in the/ol~ing ~atlo.; ~ B~ement ~ ~a~ ri. ~ ~.d FI. outside ~io. o~k ~.~.mi~o. AUgust Jla ~9~ andfou~incompllence~ithther~uimmentsofthbB~rd, 20 33 21 20 ~ 1 1.5 1 ~ 3 8 1 200 CB x 1 ~l/0 1 2/0 Watem hea~e~t 1-~.Skw Elee.moom hea~s~ 1-2.5~, 1-2.0kw, 1-1.5~,.'5-1.25kw, 1-1,0~, 1-.75kw l ~ ~ Park Place~ ~ Patchogue, L.I. 11772 11 CO~Y ~OR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iN :ANY~$R. ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH H. D. Reference N~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE S, ,EWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is requested, pertinent data herewith: l_Applicantl4~. ~ }4~. Paul F, ~IIBR Phone4?3'C~d$6-Sub div AddressO-~'v77 Old CO~u~tZ~; Rd. ! Rive~head, N,Y. 7-Section 2-Detailed property location ~/~ ,~,~ ~ff~l~ Au~, 8-Lot No. Hamlet ~kltc~l(~o TownSotl~hg~d 9-Private well? 3-Public water supply name Distance to nearest main 4-Lot Size: Widt~~ ' ft. LengthlS~~ ft. (also enter on center plot plan below:) 5-Dwelling: Singl.e 'Family ~ ~ Two Family? ! /Cellar? ~( /.S. lab? ~ f Crawl Space? 10-Proposed system. Septic {ank .~ /Pre--Cesspools ~ /Shallow pools / /Othe~ / / 11-Septic tank inside dimensions: Vplum ~O~als. Length ft. Width ft. Liquid depth ft. 12-Precast sections: /~yNumber/~quare Ft. Cesspools: Block size~ ' incs.D ins. H Total blocks below inlet: ~1____~2. PLOT PLAN o o O.~ ~ ~ o= .Grade No~th Oa%a ~e~ 2 10 12 ~6 ~~ h.~ ~ Street ~_~.. St~b'O~K AV~2~Jt~ m o The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date ~-~-73 Signed ]~NLAND II~li~;S, I~C,/K. ~, TtlUL"t~/.{t~ ~'77, ~ :r~6 Owner 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 satis£acto~y Sewage Disposal System can be installed on this Plot. Date ~ Signed Q- ~ - (10/65 Revis.) S-i5 HarriSOn ¢ose et al. NOTE: · -- MONUME'NT ROAD cEDARS R£V,S,ONS YOUNG & YOUNG MAYI0~Ig?:~ 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: PAUL SAUER CUTC H 0 G U E ~ t~! IOL~ ~t~8 BANK ~ It ~ [~ /ITY)T~LE ~6~l~. SCALE: I" = 40' DATE: MAY 2,197~99 itt. M. Beel~e W. HorriSOn Caso oral The sewage disposal and ~:a,*er faoilit~es for this loca!ien }t:ve been inspected by this ~me~ Chief of General Engineering ' Services cEDARS REV,S,ONE YOUNG & YOUNG MAYI0,1975 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK JUNE 8,1973 ALDEN W. YOUNG HOWARD W. YOUNG AUG 7, lg~73 PRO~rIESSlON&L ENGINEER AND LAND ~iURVEYOR SURV~ FOR: PAUL SAUER AT CUTCHOGUE 'TOWN OF SOUTHOLD SUFFOLK CO., N.Y. -~~jJ ~ , TOWN OF SOUTHOLD '4 ~ BUILDING DEPARTMENT~//~ / ~ ~WN CLERK'S OFFICE ~UTH~D, N. Y. Examin~~ ~ 9~ · * · ..~ ............... , 1 ..~ -- AppI,cah~ No ........... ~. .................. ,, ,, . ~pr~ ............... ~ .................. , 19 ........ Pem,t No.~.~Z ....................... . ................................................ ............. ALI G PE ..... ............................. , a. Th~s app~t~n must ~ ~mpl~y ~Uied:~ ~ ty~wr:ter or :h-~ and~i~te to the Budding Ifls~or, 3 .ts of plans, a~urate plot plan to scale. Fee a~rding to schedule. b, Plot ~bQwiflo io~tion of lot an~ of~buiJ~gs off premises, [~iofls~i~ ~ ~o~ ~i.s or public st~ts or areas,~a~ giving a detailed description of layout ~*prb~t~'*~ust ~ drawn c. The wo~ ~vered by this application may not ~ commen~d ~fore i.uan~ d. U~fl approval of ~his appli~tion, the Building Ins~ctor will i~ue a Building Permit to the applicant. Such ~rmit,shall be kep~ the premises available for ifls~ction throughout the work. e. No building shall ~ o~upied or u~d in whole or in part for gran~d by t~ Building Ins~ctor. APPLIC~TION IS HEREBY UADE to the Building Depa~ment for Ordinafl~ of the Town of ~uthold, ~ffotk County, New York, and other a~li~e ~s, Ordinan~ or R~ulations, for ~ildiflgs, additions or alterations, or for removal or demolition, as herein descried. ~e appli~flt agrees to comfy wi~ all ~pli~le ordinan~s, building code, housing ~de, and regulations, and to admit authorized ifls~c~ors on ~emi~s and in buildifl~ for ~ry ink.ions. ~ name, if a corporation) State whether applicant is owner, Ieee, a~nt, ar~hit~t, eh§in.r, ~neral contractor, elt~trician, plumber or builder. ............................................................................ ~a3,..~t,~.....~ ................................................................... Name of owner of premises ............................ ....~...~..t...J[ggJ.~.:l; ............................... ,~ .................................................... If applicant is a corporate, signature of duly authorized officer. ................. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ................ .5....~.~.-...~..~ ........................... Electrician's License No ............ ..~.~..3..-..~.. ............................ Other Trade's License No ................................................... 1. Locat on of and on wh ch proposed work w be done. Map No ... ............ ,...,t~,..... -Eot ¥0.~-'.,~-~ · Street and Number ..................... #/JJ..~#~.J~I[~'IIIkl~,:JJe...C~lr.c~ ..................................................... ~:)~: :~ ~. ~ ::. Municipal i~ 2. State existing u~ and o~upancy of premiss and intended u~ and ~upancy of propo~ con,ruction: a. Exi~ing u~ and ~cupancy .................................................................................................................................... b. Intended u~ and ~upancy .................... ~..~..~.~g ...................................................................... 3. Nature of work (check which applicable): New Building o.. ~ .......... Addition .................... Alteration ............... Repair .................. Removal ......................... Demolition ........................ Other Work .................................... ....... (Description) · ooo.oo ....... 4. Esttmated Cost .......~......~ ...................... ,.- Fee .................................................... -. ............................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .*./. ...... Number of dwelling units on each floor~ ........... .~....~ ........................ cars ............................................................................................. "", ............. t ................... if garage, number of 1 .. ' ....... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...~ ................................. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ................. . .......... ....... ...... .... . Number of Stories ..................................................... Dimensions of same structure with alterations or additi.o, ns: Front ............... ;...:.::.... Rear ......................................... Depth ................ .... .... ...... ..... .... . Height ..... ......... ;..~ ..................... ,. Nunlber of Stories .................. .~., ................ .... 6'7' 8~.~. ....... .~:.~..7..'..t~. ~ .......... Depth ........... ~3~. ................ 8. Dimensions of er~(ire new construction: F~u.t .......... : ...... ~ .,. Rear Height .............. ./.8. ............ :..: .............. Number of Stories~ ::..: ............................................. .~L,'.'. ................................ 9. Size of lot: Front 1OO 150 ...................................... Rear ............. [..O~. ...................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11,.. ,Zone or use district in which Dr~emises are situated ..................................................................................................... 1Z *Does proposed constructio~ ~Vibla.te.any zonin, g law, ordinance or regulation: .......................... 13. Will lot be regraded ....... ~...e..s...L~.~.:L.....~.... wiNekcess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ~.&..u...1..F.........S..~..~..~...~.Z~....~,~..C4~U3,t,~E..~s. Ei~/e:r..b~a~.....,....: ................ ..........(Address) (Phone No.f · ~ ~...:[IK;, .............. Sm _n____m~ . 3~Z .......... .?.,~;~..-.~;~?.Z ........ Name of Archttect ..................................... : ..... · .............. iPhone No.) (Address) zJe~aa~ ~ ..~gN .............. ~ .!~ ................ 7.~.-.g~2.7. ....... Name of Contractor ......................................... s · .- (Address) (Phone NO.) 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 I '~ er interior or corn pt. -- ~' /,7'g/ I STATE OFNEWYORK, .~ /~ ,~x/~ ) COUNTY OF ............... ...2,~,,~/~ ........ ) .................. ~.~,...~....~..~.. ........................... being duly sworn, deposes and says that he is the applicant above named. He is the ................................................................ ~~ ..................................................................................................................... {Contractor, agent, corporate o/ricer, 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 ell 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 DOLORES SCflOMBS set forth in the application filed therewith. - r , · · . ;.~ ~OTARY PUBLIC ~ate of Nsw ~ r: .... ~'v,.: ?'~Z. ~'~ 'No, 52-8841]00, Suffolk Couflt¥. ~ da of t_~_.,.~.,~,, , 19 7'"P' 'Tlr/n EXpirel MIrch 30, 197{4' , ................................ , ............... ............................. .o,.r..u.,,c ....... . ................................. -f ; r~ 100× t50