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Home My WebLink About6594-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No. ~F.~ ...... Date .............. 8Op.t...~.] ..... , 19..7.3 THIS CERTIFIES that the building located at . .Cap~ .Kidd..Dr. & .Bh~ .~[~treet Map No.Ca~t. iCtdd..~&k No ........... Lot No...167 ..... Matt itu~.. I~..X. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 1~.... 22.., 19.7.~ pursuant to which Building Permit No..6~Z. dated ........... ~ .... 22., 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 :'mTh~ certificate is issued to . of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) ~l*~ · . ~pt. ~g.. 19.7..~ ·. b~ .I~...V.~ll~ .. UNDERWRITERS CERTIFICATE No.. 11 .'~'~'~' ..... I~p.t..19.. '.1.973 .................. "lOUSE NUMBER...'[g~ ..... St;cot ....l~od~CΠ' ~,d.,~l~lF .............................. ' Building Inspector FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 659 1 Z Permission is hereby granted ~ J.T. Construction ~ox 791 ~ttituck Build ,~ew one family dwelling lot 167 Capt Kidd Estates at premises located at ............................................................................................................................ Capt Kidd Dr & ~hoda Road Z~tt~tuck pursuant to application dated ~-y 2~ ~"~' ........................................................ , 1~,?....., and approved by the Building Inspector. 27.7o Fee $ ........................ .... ~.~`~~"~I~Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ' ' es JOHN STREET, NEW YORK, NEW YOF~K.100S8 ~ September 10, 1973 669182r ..,, - A,,.,,c,,.,,,. No. o,,/,,,, N 115374 THIS CE~IFIES THAT in the ~ol~ing l~ation~ ~ B~e~nt ~ lst FI. ~ 2n~ FI. O ~ ~ ~ d~ ~ction Bilk ~t ~ exumi~ on ~ ~ ~ ~ e ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ o~ ~ound to be ~n COmpllance wlt~ t~e r~uirements o~ t~ B~rd, FIXTU~ ~E~A~SI SWITCHES I fiXTURES I R~GES I~KINGD~KSI OVENS ~DISHWA~ERS ~HAUST FANS NAC T lURE A~ NCE ~HR ~ LR~'~ ~E KS ~ U ITHEATE MUL RS SERV~E DI~N~ ~-~1 s E n V , c , ~'1 !50~"' C~ ~P~ "~ "~x "~ ,,~w ,o.o~.1 °~%~'w~'2/0 ~.o~ .~ o~'.,%% ~.o~.~u,,~l ~'"~%'~2/0 Electric room heater/s: 3- · 75kw 1-post Ronald R. Ennls P.O. Box Middle island, L.I. 1-2.Skw, 2-2.0kw, 1-1.Skw, 2-1.25kw, 1-1.0kw, k 11953 Per .../~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD Building Dqmdment Town Cledm Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in tripJlcate 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, 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. 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. 'Oate 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 New Building L,/ Old or Pre-existing Building ~ Vacant Land ............................ Location Of Property q~...~...~..(~ ~0 .'~ ~-..~-.~. ~ _ I~*q~'rt,r~e_iO.. Owner Or Owners Of Property ~A~'['" ¢~,,~TI~u¢.~'IO~ Subdivision ~I~'1% ~\~)'ID tr..~.~1'l~ I~t ~ Jf~'~ Block No. House No ............. Permit No. ~.~.~....~.....~.... Date Of Permit ........ ~./.! ....... .~ppllcant ....... ...I~....?......C...O...~.~..~..c.~ .~....~ ........... Health Dept. Approval ............................................ Labor Dept. Approval .............. ~ ................................. Underwriters Approval .............................................. Planning Board Approval ............ ...~... ...................... Request For Temporary Certificate ................ ..-~.. .................... Final Certificate Fee Submitted $ ..'~...!. ............................. on above described buildin~ets all a~pplicable~,.~des and regulations. Construction Applicant )~...~.....~/ ~- ~ -~- ~'~ ~-' ,~,,~ , ......................... Sworn to before me this ~'~r~'~l /?7 "/ ....... ~..,J~. day of ..~ ................ (Stamp or seal) Notary Public .................................... County SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. ------- At~PLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant I',~"'T" (~,~%1~.~-~ C~ Phon;~'j'~'! 5. Subdiv.~.,~%". Address · ~t ~tW ~%~ ~. '6. Section~~ ' 2. Pr~per~y location. D~ ~ ~%~ ~ ~ ~ 8. Private well Village ~~(~ Township ~~ 9. Public water Public Water Company nameC~. ~,~ ~, Distance to main Lot size: Width~ feet Length ;~ feet (Enter on center plot below) Sewage Dispos~ystem: A. ~/ gallon septic tank: Precast~Equivalent Block B. ~aching pools: Number % Precas~Block Special__ 4. 10. If private well fill in blanks below:/ / Amoun$ of water in w~ll Test Hole Data Feet 2 4 6 8 10 12 14 16 18 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards thereto." Date ~}1~1~ Signed ~'qT~~''~ ~ ~wner~ Builder 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 Disposal System can be installed on this plot. Date ~2~ Signed ~/~ -~ -- S-15 Revised 4/l/72 ~ 0 NOTE: m = MONUMENT ~;~ SUBDIVISION MAP FILED IN THE OFFICE OF THE ~O~ ~) CLERK OF SUFF, CO. ON dAN. 19, 1949 AS FILE NO. 1672. REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: NICK KAVOURIAS ~ MARY KAVOU~ AT MATTITUCK ~ · · OWN Or SOUTHOLD SUFFOLK CO., ,. Y. DATE: MAY ~ ~4 SCALE: I" = ~0' 4, 1973 17 = ~,tOOsq'~' DIETZGEN 135 ll846 ,_ f NOTE: m: MONUMENT SUBOIVI$10N MAP FILED IN THE OFFICE OF THE CLERK OF SUFF. CO. ON JAN. 19, i949 AS FILE NO. 167P'. \ 1..or REV'S,ONS YOUNG & YOUNG MAy 11,197:3 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK JUNE 8,197:5 ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: NICK KAVOURIAS & MARY KAVOURIAS LOT 167 OF "CAPTAINeeKIDD, ~ ES~ TOWNOF SOUTHOLD ,~,..~ '~ T!~ /'...,, ik,,. ~ ' -- , SCALE' ,I , I~ATE' ~O~,~i~* 'l =30 I 'MAY 4,197~17 TOWN OF SOUTHOLD /~ ~ ~/~ :~.-z-X ~'~'~ BUILDING DEPARTMENT ~1,-~ ~ ~ ~ TOWN CLERK'S OFFIGE ~ ~ 0 ~UTHOLD, N. Y. ~./~, ~ ~ ~ Examined ....... ~.~..~...., 19.~ [App ............ __ ................... ....... ....... ....... Di~pprov~d o/c ....................................................... ~ ........... (~uiffding Ins~or) APPLICATION FOR BUILDING PERMIT ........ ......... .... 1~ST~U~IO~S a. Ibis a~pli~tion mu~t be com~l~t~l~ fillod in B~ t~writ~r or in ink and submi~ed in tri~limte to the Buildin~ 3 *~t~ of plans, a~urat~ ~lot plan to *cale. Feo aecordin~ to scbedul~. b. Plot plan *howin~ location of lot and of buildings on pr~mi~*~, relation*hip to ad~oinin~ ' prommes or ~ublic 8trs~t$ or area~am ~Ninfl a detailed de*eri~tion of la~out of ~ro~rW must de drawn on diagram which is pert of thi~ a~plieation. ~. Th~ ~ork co~r~d b~ thi~ ~plicetion ma~ not ~ commen~d b~for~ i~uance of Buildin~ Permit. d. H~on a~ro~al of t~i~ a~01ication, t~ guildin~ In~or will i~*u~ a Buildin~ ~rmit to tho a~plicant. Such ~rmit ~h~ll be k~t the pr~mi~ av~il~bl* for in~ction throuflhout the work. ~. ~o buildin~ *bell ~ occupied or umd ~n whole o~ in pert for an~ ~ur~o~ whate~er until a Gertificet~ of Oeeupene~ *hall ha~n ~rant~ b~ th~ Buildin~ In*~etor. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zon~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demol'ition, 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 of applicant, or name, if a corporefionl .............................. ~ ..x. ,: .......... t ............... .v~., ~....~T.., .I.e. ...... {Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ................... ................................................................................................................ Name of owner of prem see : .:...1..: .............................................................................. · If applicant_.Ls,a cor. porate,,ei~ature of duly authorized officer. ............. ti~lum~ancl [l[le~ porate officer) 1. Location of land on which proposed work will be done· Map No.: .................... Lot No.....~'..·..I....~...,~. ........................... Street and .................................................. '~'~,~'~ '~S~' .....................'~j"~'~)' ~y~ ................ 'l~i~i~'ii't~ .......... 2. State existing use and occupancy of premis~ and intended use and occupancy of proposed construction: · - ~ ~J~.-b ~, ... a. Existing use and occupancy ............... ....~ ...................................... ~ .......................................................... b. Intended use and occupancy ................ ..~......l~....~...~.....~...~..~...~,..e~...~...~.... ......................... .... 3. Nature of work (check which applicable): New Building ....................... Addition ......... ~. ........... Alteratio~.~.......~..'. Repair ................. -~. ....... Removal ........ ~ .............. Demolition ............ ..'.. ........ Other Work ........... ..--. ...................... (Description) 4. Estimated Cost ..... .....-........~..~... .......... 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 ............... ...~.....~...~ ........... ~ ........................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......~.....C~... ...................... 7. Dimensions of existing structures, if any: Front ........ ..~.~..1~...i,. Rear ....... ~ ................ Depth ......... ..-~... ..................... Height ................................................... ....... . Number of Stories; ..................................................... ....... . . .......... .... Dimensions of same structure with alterations or additions: Front ........ ..l~...L.~.. ....... Rear .......... ..-?. ........................... - 7.. Depth ........................ ~ .................. Height ......................................... Number of Stories ..................................... 8. Dimensions of entire new construction: Front ..... "~'""~,..?.... ......... Rear ...... ~.~.._.... ......... Depth .......2'....~..I ................... Height ~ ~o t ................................................. Number of Stories ................. .I. ...................................................................... 9. Size of lot: Front ........~ ..................... Rear ~ t ~' Z.. e .......................................... D pth .................................................. Height ................... .-. ............................... Number of Stories ............. ..--.. ..................................................................... ..................................... Name of Former Owner .......... ~ .............................................................. 10. Date of Purchase · 1 1.Zone or use district in which premises are situated ........... ~...~.....~......~..~....~.t..~ ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded ..... -~.....~;...~.. .................. Will excess fill be removed from premises: [ ] Yes [~ *-'- ~'~ 14. Name of Owner of premises ~ ~,~'- C,~)~-,&~-~..~t ¢.3't~v,~ ............ Name of Architect ................................... (Address) (Phone No.) Name ct Contractor ........................... .'. ...................................................................................................................... (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 interior or corner Io~. .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of 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 set forth in the application filed therewith. ~[RRI LIE £LAK ~ ~. #~ PUBLIC, State of Ne~York ~) Q~'* ~Xtx I No. 52-6[65~95~7 ~) £~*' ) ............. ~ ................ day of ......... ~...~. ),E~/.¥ ..... ~lalili~. ~,. Su~i~gcn~i~l~ ......~V_,_._~ __ Notary Public, ....~.....~..~..n~. ............ County ..~1~'~ ......................... (Signature of ~pplicant} T-ZI