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Home My WebLink About6593-zFO~M NO. 4 TOWN OF SOUTHOLD BUff,DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupnncy No. Z ~.71+8 ...... Date ............ Jan . THIS CERTIFIES that the building located at Centrat..Ave. & .Llnda. Rd. Street Map No.Gapt. lf~c~l. · Block No ........... Lot No.. 121~ ....... F, mttJ. tuck.. Il,Y,... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. Malt" '2~-, 19~3' pursuant to which Building Permit No. 6~93z.. dated ....... 14&it .....22. ..... , 19.73., was issued, and confoms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .l~x.ivete. one. family, dwel.l, img ....................................... The certificate is issued to b~,S ,T., -. Constru~tion .¢orp ..... 0w~®x. ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Heaith Approval I~o-~. · 8 .. ~ ~73.. by. R,..Vil.~ ...... UNDERWRITERS CERTIFICATE No. -1~. ~ ~;37~ ...... ~ept. · '~9" '~'973 ........... HOUSE NUMBER ...2~. ...... Street .. Centra-l- .DX' ............................ .... ........... Building Inspector FOR,~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT 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? 6593 Z Date ............................. ~ ................... , Permission is hereby granted to: H.S.To Construction Carp .................. I~ahtZt~ek ........................................ to ......... ~l,d,.... J~V.. ma~..famL3~. 4ye ~.~4all ............................ ~ .............................................. at premises located at ..... ..~..O..~...~J.~... ....... ..C~..~..t......~....~......~..~...~ ............................................................... ............................................... ...c~.~...z~....~.....e...~.. ~...~....~ ................... ~.~ .................... pursuant to application dated ....................... ..~. ~......~.1 ................ , 19..~.:~.., and approved by the Building Inspector. Fee $. ~.~, e.~ .......... FORM NO. 6 TOWN OF $OUTHOLD Building Delm~tment 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, /v~ultiple 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 3. Copy of certificate of occupancy $1.00 $5.00 Dote ....~..~.. :~?.. ,....~.,fl..'l....~t.. ........... New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ~-~-~-"~-¢"~ ~¢¢-' '[ ~~ ~~ ~ner Or ~ners Of Prope~y ............. ~&.~.....~.~.~.~ ......... ~.~.~, .............................. Su~ivision g.~.~.t~...~).~P.....~:.~.~.~:~ ......... Lot No. ~..~,~.. Block No ............. House No ............. ~ ~3 Permit No...~.~.~...~. Date Of Permit ..... / ...... L.....Applicant .... .~.~...~.~.~.~.%~L~.~..g.g.~ Health ~pt. Approval ..... ~.~.~.~.~T..~.~ .............. Labor ~pt. Approval ................................................ gnderwrite~ Approval ...].)..~.~.~.~ ...................... Planning B~rd ~proval ........................................ Request For Temporaw Ce~ificate ........................................ Final Certificate ~ Fee Submitted $ ~ ~ Construction on above described building and permit meets al~aDplicable codes and regulations. Applicant ............. ~~ .......................... Sworn to before me tl'¢~ ......... /...7. ....... ......... Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ C~fl BUREAU OF ELECTRICITY.! ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~t.e September 19, 3-973 App.,~.tio. No.o./ite 661073 N 115315 THIS CERTIFIES THAT onlyt~ee~t' ' t~ cr~l~ ~z~d' t hy he ' t t a ~ I' et' u 'nt ' of in the following location; ~ Basement [] Ist FI. ~ex.mi.~do. September 13, 1973 [] Snd Fi. o~tslde Section Brock Lot and foUnd to be in complianCe with the requirements'of this Board. RANGES I 10. COOKING DECKS OVENS DISH WASHERS tO. OF S E R V I C ~ ~.~w i.e'3w 3~:~w 3.*'~w NO.O~ CC. CO~O. A.W.~. NO.O~ H,-mO ~,.w.o. · PER ~' OF CC. COND. Of HbLEG x i 2 ]1 100 CB IEXHAUST FANS DIMMERS #Furnace/s: Oil, 1-1/Shp, 1-1/15bp Ronald R. Ennis ~~ P.O. Box 2o~ Middle Island, L.I. 11953 Q~I. MANA~I 1 1 ~::. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant~ ~t' (0,~-~,0~) COK~Phone 2~("~ ~'~ Addres~-~ -7~ I ~w,~ ~ ,~ ~71~ ~ 2. Property Location ~1~ ~o,~ C~- 0'~,~~ Village ~-,~,~.~c~ Township ¥~~ 3. Public Water Company Na~. ~o ~ 4. Lot size: Width ~o feet Length. ~ feet 5. Subdiv.C~? '~-'~>d' 6. Section 7. Lot Number ~ 8. Private Well 9. Public Water Distance to main ~ ~- 10. Sewage Disposal System: A. 90~gallon septic tank: Precast~ .Equivalent Block__ (For Health Dept. Use) 11. B. Leaching pools: Number of pools Precas~Block ~pecial If private well, fill in the following blanks: ~ )~ A. Tank capacity~allons C. D. Depth to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. 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 Dispo?al System and Water Supply can be installed on this plot. ?7] APPROVAL DATE ? '~ SIGNED "i ~ i Rev. 4/1/73 CENTRAL DRIVE SUFFOI~ COUNTY HEALTH DEPART~T, 19'73 ~. ~. ~. ~d:~ facilities for this A:' ' ~ i ~aou Chief of General E~glrlee~tng S8~vicss NOTE: s = MONUMENT SUSD/VISION MAP F/LED IN TNE OFF/CE OF THE CLERK OF SUFFOLK COMNTY ON ¢4N. 1,9,1949 ~S FILE NO. I~7~ ~L~VATIONS 4RE REFERENC~fl TOAN ~SSUMEO D4TUM. Cb LOt .,...,.e / Lot 124 REVISIONS YOUNG & YOUNG dUNES, 1973 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: MST. CONSTRUCTION CORP. LOT 124 "CAPTAIN KIDD ES~ ;k'/¢ TOWN OFsouTHOLD SCALE: DIETZGEN 135 11846 ' BUILDING DEPARTMEN~,JL TOWN CLERK'S OFFICE// ~UTH~D, N. Y. ~. ~ ~ ...... ~pr~ed ............ ~.~ ............ ~ ............ , 19 ........ Pemit No........~. ~i~pproved ~/* ......... ~ ........................................................... .......................... ' . ............ ...... ........ APPLICATION FOR BUILDING PERMIT ~'~ Date ............................. ! ............. , ]9 ............ INSTRUCTIONS ~.~wi .~., a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building In e t sp c o , 3 sets of plans, accurate 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 are~nd giving a detailed description of layout of property must be drawn on diagram which is part 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 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 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 Zone Ordinance of the Town of Southold, Suffolh County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of 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 o.f applicant, or name, if a corporation) ...... (Address of applicant) State whether,applicant is ,ozner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; .... ....................................................................................................................................... Name of owner of premises ................. ~t~.~%-~`~``~C~-~(~ .................................................... If applicant is a co. rporate~signature of du. ly authorized officer. ............ 1. Location of land on which proposed work will be done. Map No.: .................... Lot No .......... .l~'......t.7~...~T ................. Street and ................ I .......................................................................................... ~ ............... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: -~. a. Existing use and occupancy ............................... .IJT~...~......~,~.~.~.... ............................................................. . ..rL,~,~ ~,~r ~' H~e~ ~ .~j~. ........... b. Intended use and occupancy~ ..................... .~.. ........................................................................................... J 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ...... ,: ..... Repair .............. .'. ......... Removal ........... ..'. ...... i.... Demolition ...... .-.. ............... Other Work ................. ~ ...... ~. ...... (Description) ' ~ 4. Estimated Cost ............... ~ ............................. Fee .............................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ t ....... Number of dwelling units on each floor ............ ~ ........................ If garage, number of cars ....... ~ ....................................................................................... O 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use ........... ~ ................... l -" 7. Dimensions of existing structures, if any: Front )~ i~ Rear ........................... Depth ~ ight --" -.'~... He ............................................. .. ...... . ..... Number of Stories ............................................... : ........................ I-~ to,/ -- Dimensions of same structure with alterations or additions: Front ............ I. ............ Rear ......................................... Depth .................................. ...... ..... Height ....................... ..-................ Number of Stories ....... .--.. .............................. 8. Dimensions of entire new construction: Front ...... ~ .............. Rear ............................ Depth ................................. I ' Height ....................... ~.. ...................... Number of Stories ...................... ~ ........................................................... ~ ...... 9. Size of lot: Front ............ L..~.. .................. Rear .......................................... Depth .................................................. Height. ................. ........... ............. .......... Number of Stories ...................................................................................... ~ Na eof Fo erO ..--.. 10. Date of Purchase .............. .......... . ............ m rm wner ........................................................................ 11. Zone or use district in which remises are situated ....... ...~.....~...).g:> ~,,'~C~tt~,--~ ~'* 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................... 13. Will lot be regraded ...... ..~...~;...~.. ................ Will excess fill be removed from premises: [ ] Yes [~]"1~o 14. Name of Owner of premises ' tw*' %-- C~ ,-,-S-r~,~,~r ~ ¢-~,~'~ ....................... : .... :.: .... (Address) (Phone No.) Name of Architect ...................................... ' (Address) (Phone No.J , Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAG RAM 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. STATE OF NEW Y~3RK, COUNTY OF ...... ~..~.~.' ..~ .~..%,.~ .................... )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 I~rform or have I~rformed tbe ~aid work and to make and file this application; that all,. statements contained in this a~plication are true to the best of his knowledg~ an~f; and that the work will be p~rform~d in the m~n~r set forth in the application filed therewith. TERRI LL~ ELAK ~ ) ............ o,f ........ - .o.r II A .J