The URL can be used to link to this page

Home My WebLink About6360-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Cleric's Office Southold, N. Y. Certificate Of Occupancy No..g~'~.82 ..... Date ............. ~.u,n®...6 ...... , 19. THIS CERTIFIES that the building located at . .~,~/$. }{i¢~k~.~.~O!l. R~ad. EXt; Street Map No. x~ ......... Block No...x,~ ..... Lot No. Y'~:... JSl~ee~pol'l; .... ~I,~.~ ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Fe~ .. ~ .... , 19.7.3. pursuant to whiph Building Permit No. dated ............ .F~... ?..., 1973.., was issued, an~ conforms to all of the require- ments of the applicable provisions of the law. The occUPancy for which this certificate is issued is . P~iva.t~. olle..fa~t3,y, dw~ lling ...................................... The certificate is issued to .. i~twara, i4ulllall ..... ~er ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No.. gendiag...(f}~l~;, t. ~¢-~ .I,~11..,.{1) ................... ttOUSE NUMBER...1~+20 ...... Street. Building Inspector s~J?#~'L~, ~. Y. . BUILDII~G PERMIT (THIS PERMIT MUST BE KEPT OI' COMPLETION. OF THE WORK AU'Ii No. 636'0 Z PermiSsion is hereby granted to: THE PREMISES UNTIL FULL -tORIZEb) at premises located at ..Wi{~..~d~,~le~.~Load,i!~xt~t£ot~ ............................................. G~.eea~or.t....'.....~.~t.~.....'~ .................................................................... ~ ......................... ! ................................ ; ....................... ~[ ............................................................................ pursui3nt to application dated ........................ Fe~, .......... ~. ......... , 19r~.3..., end approved by the Building Inspector. Fee $ 5~4'11t~[ ........... Building Inspector / THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ BW 85 JOHN STREET, NEW YORK, NEW YORK 10038 "at'A,:,rn 18, .~.~74 +,,,"eat,o. No.o.,,,e 63:m~7 N 154411 THIS CERTIFIES THAT -~, ~,.U.U~a~.LR ~ ~U i,.~G~£e~o~l t~o,~ ~reertpor~R L,£, Jo~ in the followlng location; [] Bazement [] ~.~xomin~do. April 15, 1974 FI. [] 2nd FI. o~t~de Section Block Lot and found to be in compliance with the requirements of this Board. DRYERs I FURNACE MOTORS FUTURE APPUANCE PEEDEE RANGES 1 11.7 SPECIAL REC'PT ,-oo,.o,,.s OVE..,. °,.,WAS,= TIME CLOCKS BEL UNIT HEATERS MULTI-OUTLET V I C E OF CC, COND, 2 EXHAUST FANI AMT. H, P. 1 ? DIMMERS AMT. WATTS SERVICE DISCONNECT O. OF S E ~"1 100~' CB~"~ OU,R.iEPER ,~w ,~Wx ~w ~,w .o. %~.CC~CO.Ol OTHER APPARATUS: *?urnaces: 1-!/8hp, 1-1/12bp ,o.o~ H,*o j ^.w.o. "O.O~UT"^~S ^.W.O. OF HhLEG OF NEUTRAL George Zimllnghaus q Park Pl. Patchogue, New York 11772 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Building Depa~ment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and sqbmitted in triplicate to the Building Inspector with the following; for new buildings or new us~: 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 sewekage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Unj:lerwriters. 4. Commercial buildings, Industrial buildings, Multiple Rdsidences and similar buildings and installations, a certificate of Code compliance from thei Architect or Engineer responsible for the building. §. 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-ex'st'hq' land uses: 1. Accurate survey of property showing all property lines, ~treets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, oJ:cupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildin~]s 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 $1.00 ~ Date ..... b~u~e"~l¥'"~'%~;3 .............. New Building × Old or Pre-existing Building . ......... Vacant Land Location Of Property ........ W,LS..biz~d,l~e.to~.l~oa~..FocZei~.t~J~h~...Gr~enp~...~,¥ ................... Edward Mulh&ll Owner Or Owners Of Property ....................................................................................................................... Subdivision .... ~ ........................................................... Lot No .......... ~.. Block No ............. House No 6360 Z 2-7~73 Permit No ..................... Date Of Permit .................... Applicant '"$~IJl~I~D'"J~JI~S'~'"I~¢C'; .................... Health Dept. Approval ..5,..3O,.,73...:.~.~O._..T2.8~..Labor Dept. ,~pproval ................................................ teen Or~ Ligh¢ing · . ....................................... Underwriters Approvg~ ......... ~ .................................. Planmng Boa~d Approval Request For Temporary Certificate ........................................ Final Certificate ................ ~. ....................... Fee Submitted $ ,,,,.~.:..O...0. ....................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ......'~iT:,t~..~iD'. [.ltg~M~' "-' 'I'N~ ~" '/'' ,jf.e~ e.t.h.. ~I .,. ,Thu ~..~ er ...... Sworn to before me ,.this ..... ~... ....... day of ........ ~.....Z./. ~/..' ...... D0[0R~S S¢U0~BS (stamp or seal) // // /z ./NOTARY PUBLIO, State of ~ew York Nota~ Public ~.~ ,~¢~oum FO~M NO. 6 TOWN OF $OUTHOLD Building Deportment Town Clerks Office Southoid, N. Y. 11971 APPLICATION FOR CERTIFICATE OF IOCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new 1. Final survey of property with accurate location of all ~uildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewe{rage disposal--(S-9 form or equal). 3. Approval of electrical installation fram Board of Fire gn~Jerwriters. 4. Commercial buildings, Industrial buildings, Multiple R~sidences 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 d~es, or buildings and "pre-existing" land uses: 1. ~:curate survey of property showing all property lines, streets, but|dings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, o~cupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildin!~s or prem!ses, 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 us( 3. Copy of certificate of occupancy $1.00 $5.00 Date ......................,~ .............. New Building ....... ;~ .......... Old or Pre-existing Building ................ , ........... Vacant Land ............................ Location Of Property ........ ~;/~.~"[~i~2,~J~tt"~;~"]~ ~½'"(~'~¥'"~'{'~'¥'~ ................ Owner Or ~ners Of Property ~ ~l~ ..... .................... Subdivision ................................................................ Lot No ............. Black No ............. House No ............. Permit No. ~]j..~ ...... Date Of Permit .~;~....Applicant .... ~..~:...~; ................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approvalo~..~J,~,~.~-..Planning Boa~d Approval ........................................ Request For Temporary Ce~ificate ........................................ Final Cerhhcate ................. ~ ....................... Fee Submitted $ .....G,L~O ...................... Construction on above described building and permit meets all a~plicable c~es and regulations, Sworn to before me this ..... ~. ....... day of ;;.~:...:Z.~ .......... mO,ES s:,0~d (stomp or seal) r) ~.~ _~ / /NOTARY PUSUC, State o~ ~ew Noto~ Public~J~~ount~o~ 52-884H00, suffolk SUFFOLK COUNTY DEPARTMENT OF HEALTH APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE S ,SWAGE ,DISPQSAL S, YSTE ,MS Approval to construct '~'a{d systems is requested~pertinent data herewith: 1-Applicant ~dwa~d M%~]~h~ll , Phone4?7- ,~l,6-Sub div ....... ~ 7-Section Address 134 S,31,~T,h St~ ! GX'~e~3X~t ~'~ ....... ;, ,, 2-Detailed property location~/$ I4iddle~oll R~ ,i 8-Lot No.__ Hamlet G,~een~or~ ' ,.,Town , ~1iO1(~, ,~,, 9-Private well? 3-P~blic ~ater supply name GreenDort Wate~ DistanCe to nearest main 4-Lot Size: Width 11~ ft. LengthllO ft. (also enter ion center plot plan below:) 5-Dwelling: Singl.e Family; ~ Two Family? ~_/Cellar? ~.Slab? ~ ~Crawl Space? ~_/ 0-Pro sed system. Septic ! /Precas3 SL/Cess o s Shallow pools / /Other il-Septic tank inside dSmensionsi~olume~/~ls. Lengthi,,,,, ft. Width__f.%. Liquid deptb___ft. 12-Precast sections: ~Number/~FSquar~F~f. Cesspools: Block sizeL mncs.D___ins. H__ins. Total blocks below inlJt: #1 .~2 ~3 ...... PLOT PLAN H.D. Reference No~--/~;~ Date 1/23/73 can be installed on this Ploto (10/65 Revis.) S-15 Signed ~ ~ ~ Street ~iddle~o~ Road ....... o m Indi ~ ~ Nc The Undersigned CERTIF~S: "Construction of authorized installations will be in accordance with the Suffolk County Health De~rtments' current Standa~s, Bulletins, and amendments thereto, covering Private Se~ge Disposal S~stems". Date ~/23/7S Signed ~ ~ ~C.~D, S~S, Sec. ..... 0~er or Buildert. ff / ~ / FOR ~ALTH DEPART~NT USE ONLY. Based on the infomati0n ~resented ~th, it is opinion of the Health De~rtment, that an adequate and sat~sfacto~ Se~ge Disposal System mte 'th _Data ~eet 0 2 4 6 , 'i0~ i8 N Capacity___Gals. .Grade ~ G-- W.L. AP?LIC~ION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate i-Means Owner or Builder. Address to which mail should be directed. 2-Means detailed description of property location, together with street name and distance to nearest intersection of main thorofare, also Hamlet/Village& Township 3-~ter name of Public Water Supply District, together with the distance to their main. ~-Bhter Length and Width of Lot under appropriate heading, also enter these dimensions on center plot plan shown on the face of this application. 5-Dwellings: Check-mark "V" items applicable to the proposed new dwelling. 6-Name of sub-division 7-Section Number 8-Iot Number 9-Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. PP~PoSED SYSTEMS: Answers to Items number 10, 11, & 12 please consult the Suffolk County Health Department's Standards, Bulletins and Amendments for Sewage & Waste Disposal Facilities. i.e., Part II-Residential Sub-surface Disposal Systems covering Cesspools Part III " " " " " " Septic Tanks Part IV " " " " " " Unusual soil conditions Part V " " " " " " Shallow Leaching Pools P___~)T PLA~: The following information is required concerning the Applicant's Lot: Lot size-Length and Width in feet to be indicated at the Lot lines of the heavy lined square in the center of Plot Plan shown on face of this application. Surface waters-Streams, Lakes, & Bays, etc., located within a distance of 50 feet of Applicant's LOt lines, must be shown on the plot plan also. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. Where no Buildings exist on adjacent lots, state "Vacant" on the plot plan. Streets adjoining applicant's lot to the right, left or rear, enter street name. ~LL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the following Standards must be observed: Well-100 feet minimum distance from the nearest cesspools Well-25 feet minimum distance from rear, and rear sides of property lines Well-10 feet minimum distance from front, and front sides of property lines Well-50 feet minimum below grade for well point Well-40 feet minimum into ground water for well point Well-4 feet 6 ins. mini.mum below grade to well head and lateral water ~ CESSPOOLS LOCATZON: Upon determanation of the Sewage & Waste disposal "type ~?~ -\~ required, the following Standards must be observed for of same: ~ .~ ~/~j' Cesspool-10 feet~g~g~distance from lot lines to center of ,~ool Cesspools exterior ~s$%~g,!?%~0 feet minimum distance from ne~ell ^~ Septic tan~.~rior must, ~y~ feet from nearest well ~,~' ~ Cesspool "Cen~e~' ~st be 1~ ~ni~ ~stance from ne~st wa~ line Cesspool Center ~s~.~e 15 fee~f~om house foundation ~. Cesspool e~t~0~ ~e~ feet ~ni~ ~stance from surfaca~ers~$ams, Cesspools ms~6~,~eet ~m distance from large trees Ces~ool center to ~ol center mst be at least 16 feet Cesspool cover ~p to g~ade ~st be held ~ ~m of I food td~ of 2 feet Bottom of Cesspool ~ ground water must be held ~ ~ni~ of I foot · 0~ NO. 1 TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No....~.....~..,,~.,,0. ............... (Building ~ector) APPLICATION FOR BUILDING PERMIT ~. Date 5 INSTRUCTIONS ' ' '~ a. This 'application must be COmpletely filled in by tyl~ewriter oe in ink and' submitted in triplicate to the Building Inspector, wiG 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ~ b. Plot ,pian-*showing location of lot and of buildings or~ prernisqs, relationship tO adjoining premises or public streets or areas, ar~ 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 he kept the premises available for inspection throughout the work. e. No building shall he occupied or used in whole or in pert 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 Za~ Ordinance of the Town of Southold~ Suffolk County, New York, and other aM:~licabte ~.ews;Orditmm:erm'Regulatfon~, for-tile construction of buildings, additions or alterations, or for removal or demolition, as herefndescrihed. The applicant agrees to comply with all applicable Isw~, 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 corporation) (Address of applicant) State whether applicant is owner, lessee, agent, archi[ect,._engineer, general contractor, electrician, plumber or builder. Gene:al Con~z,~c*o: Name ,of owner of premises E~t~a~cd Mulha.11 If applicant is a corporate, signature of duly authorized officer. .................. ~ Name and title of corporate officer) · ' Builder's License No ........... 517-P Plumber's License No .............. .............................. ~,. ......... .. -l~le~trician's License No~ Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No ............... ~ ....... .~ ............. ;.... ~Lot No .., ........... Street and Number ............................ .~.../..S...M.~..d.~..1..e.,l:..°..a.....~..o.~,d.x.....G~..~Po_....z'...t.z...,,l~,.. .............. , .............................. 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....~.,a~....~..3:.~.....D?..e..1...1..J:.~.~ ....................................................... Nature of work (check which apolicable): New Building ......N.e..w. ........... Addition ..................... Alteration ............... Repair .......... Removal.. ................. ... .. . Demolition ........................ Other Work .................................... ............... (Description) 18 000.00 4. Esttmated Cost ...... .~....~ ................................ Fee ................................................................................................. (to be paid on filing this application) 5. if d~vellir~g, qumber of dwelling units ..,......l. ....... Number of dwelling units on ~ach floor .......... .6, ............................. cars ............................................................................................... ' ................... If garage, number of ' · ........................ 6. If business, commercial or mixed occuoan~/~spec~fy 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 alteratio~s~*b*r additions: F~nt .................. ~ ..... Rear ......................................... Depth ................. ... .... ... .... ...... ... .. Height ......................................... Number of Stories ........................................ _ . 55~6" 55~6" 29~ 8. Dimensions of entire new construction: Front ...... ~ ............. :..~. Rear ............................ Depth ................................. r:[8 ~ , . .............................................. Height ................................................. Numbe of Stories .......................................... 9. Size of lot: Front 117 ~ ' i 117 ~ 110s ...................................... Rear Depth 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... ons~ ucti°n'v~ g I regul no 12. Does proposed c r iolate any zonin aw, ordinance or ation: .......................... 13. Will lot be re~aded .............................. Will exCess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises Edward Mulhal[ A~l~ dress) (Phone No.) ..... ..__, Tnla~d Homes, 'mc,, 1.d...e..n..~ NY .~.~.7.8.4. .7..~...2..-..2...3:.7..7.. mame OT/4rcnlmc[ ............................................................................................................... (Address) (Phone No.) Name of Contractor Tnlazzd Homes, ZnCo Selden. ~ 11784 732-2177 (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 lot. 6 1A I I' UP NI::W YUHr,,, ~, // ~, ~' ) COUNTY. OF .......... h ........,~,~G}~.,~.........) ................... ..K..~...~. ,~.~..t.h....~..~...T...h....'~..~.~..~......V...P. .......................... being duly sworn, deposes and says that he is the applicant above namad. (Name of individt~d sigFtng contract ~ : ..... - _. General Contractor , (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 applicati6h~ 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 DOLORES SCHOMBS set forth in the application filed therewith, t4OT^R¥ PUBLIC, State of Hew · " -/ / (Signature oI applicant/ SUFFOLK CObLNTY HEALTH .~Az'~ MAY ,., = 0 19;3 ~:. Ohief s'f C:::::",: EnginesrJng L 4 -t 17.'4' 14/Io" .? APPROVED AS N. OIED NOTIFY BUILDING DEPARTMENT AT