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Home My WebLink About6362-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z. 5J.77 ..... Date ...............4~..~ ..... , 19.7.2 THIS CERTIFIES that the building located at D.e]m~t~ .Drive ........... Street Map No. ~au~'el..~t;y l~lo~c~k No ........... Lot No. 7 .... Lall~rel..I~ oy, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 1973.. pursuant to which Building Permit No...6362Z dated ........... Feb ... ? .... , 197~., 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 .. lqrivate, one. family, dwelling ..................................... The certificate is issued to .. ~tpl~¢.r~;..W. :. Me.~¢;* ..... 0~n~.r. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..Nay...2~1...197~...bY..R.~..V;~.~a .... UNDERWRITERS CERTIFICATE No.. ~..090.7.~9.. ~a~7.. ~1.~..19~t ..................... HOUSE NUMBER...'~0~ ..... Street.. D~.]fkaa. ~..D.r.:~ .v.e ................................. Building ln,,l~CCtOr [ SOU'~IOLD, H. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL. COMPLETION OF THE WORK AUTHORIZED) 6362 Z Per~nigsion is hereby granted to: ...... ~.~..~.~.~.e...~.~....~ ........... :... ......... .~.~..~. ....... ~,,,!~,~...:..i ...... : ......................... to ..'..~-~3,{L~3ev..mte...f,~=~ ! 3r...d~e:Lt. iag ......... ..' ....... :.: ......... ;....; .............................................. ................................ ~/.~...P. ~.1~...l}~r~.~.~ .............. lattr~l..,....li.,~, .............. :...., ................. ...... pursuant to .application dated ..i ...................... ~,,,~- ....... ! ............. , 19..~.~.., and opproved by the Bdilding Inspector. TOWN OF $OUTHOLD Buiidlng DePOrtment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and sul~mitted in triplicate to the Building Inspector with the following; for new buildings or new use: i. Final survey of property with accurate location of all b~ildings, property lines, streets, and unusual natura~ or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--($-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 iArchitect or Engineer responsible for the building. .5. Submit Planning Board approval of completed site plan ~equiremenfs where applicable. B. For existing buildings (prior to April 1957), Non-conforming u,~es, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, s~?eets, buildings 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~ls 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 Date ....... .~..2.. · ~ .~. ~.... ~..9.7..3.. .............. New Building ..... .¥..e...s. ....... Old or Pre-existing Building ................. i ........... Vacant Land ............................ Health Dept. Approval ............................................ Labor Dept. ~pproval .... , ........................................... Underwriters Approval ..~q2.qZ.~..'~..SZ~ZZ.3.....Planning Boa~d ~proval ........................................ ~equest For Tempora~ Ce~ificate ........... . ............................. Final Certificate ............ .~.~ ...................... Fee Submitted $ .......~.s.gg. ................... Construction on above described building and permit meets all a~plicoble c~es and regulations. ~.. day of ..~ .......... ~.. (stamp or sea) ~ ~ ~t~'°°~zzO,O, Suffolk Coun~ ~xp'res ~arch 30, ]9~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY, 85 JOHN STREET, NEW YORK, NEW YORK 10038 v.,. May 17. 1973 ~,t~.~o.~'o.o. fto 633 Q7 N S CERTIFIES THAT Robert Meyer~ w/s Delmar Dr., Laurel, N.Y. Job 17g ~YER$ :~VICE DISCONNECT S E NO, O~__ C OF CCCOND. L~ture appliance feeders: 2-3 //8, 1-2 'otors: 1-1 hps George Z.uml ~.nI~haus )I Park Place Patchogue ~ UNIT HEATERS MULTI-OUrf~-'~ DIMMERS I 4 //14 awgs SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference N o~--/~ APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTE~ Approval to construct said systems is requestsd~perttnent ~ata herewith: t-Appl:l_ean+~ RObO~ ~, ~O~;OZ Phons 4~7~2~-Sub div Address 41] Sola~vie~ Rd,, i:~t~.~,~tOt'Z : 7-Section 2-Detailed p~perty location.. W/$ D~ ~$V~ : 8-~t No. 7 Hamle~ ~u~ml To~ $~m~hold 9-Private well? ~eS ~-~blic ~ter supply name DistanCe to nearest main 4-Lot Size: Width ~ ft. "Length~t. (also enter en center plot plan below:) 5-Dwelling: Stngl~ Family ~ Two Family? ~ f Cellar? f~f~lab? f f Crawl S~ce? ~ 10-Pro~sed system. Septic tank f /Preca~Cesspools ~Shailow pools ~Other ~ ll-Sept~c ta~ inside dmmensions~ ~ol~e~ls.Length~C~. Width f~. Liquid.dept~ft. 12-Precast sections: ~Number~Squa~. Cesspools~ Block size~zncs.~zns.~ins. Total blocks below inlet: ~1 ,,~ ,~2 ~3 PLOT PLAN Date 1126173 ~aurel Countrf t e No~th ~st H ,le Data eet 0 2 4 6 8 10 12 ~6 Street D~ Drive 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 1/~/?~ Signed Owner or !Builder FOR HEALTH DEPARTMENT USE ONLY. Based on the i~formation 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 ' ,~//7'~ (~o/65 Revis. ) S-15 Signed Ta~ Capacitys~_~Gals. +~oo --J BUILDING DE~,A. ItTMENT TOWN CLERK S OFFICE Approved ........................................ , 1~......-'. Pemit Ho. .................................................................................................... .......... ................................ · APPLICATION FOR BUILDING PE~IT Date 1/29 ................................................ , m.ZA ...... INSTRUCTIONS · a. This application must be completely filled in by typewriter or iR ink and submitted in triplicate to the Building Inspector, wit~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on pl:em~ses, relationship to adjoining premises or public streets or areas, an~J 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 o~) 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 Ocougancy shall have beet) granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depertmi~Pl for the issuance of a Building__P~mit pursuant to the Building Zone ,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 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 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. .............................................................................. ~.eN.i%k..~.9.~.~.~.q.~9.~ ........................................................................ Name of owner of premises .............................. .R...o..b..e...r.~..~.......M..e.¥_,,e.x'.. .............................................................................. If applicant is a corporate, signature of duly authorized officer. Builder's License No ........................................................... , Plumber's Licens~ NO ........ ..5..i..7..~.P..iJ~,'. ........... ;..~ ...... ~ ....... ' Electrician's License No ..... .2..7...3...-...B. .................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No.....5..4..8...6. ........... ~ ....... ............. ..Lot No..~,~..~ ............... Street and Number 18/S Delmar Drives Lauzel Countzy l~states, Laurel . Muni~pahty 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 ................... ..1.....F...a~...i..l.Y......D~..-e.~..l..'.=~..-q ..................................................................... Nature of work (check which applicable): New Building ......... ..X. ........... Addition ..................... Alteration ......... ~... Repair Removal Demolition Other Work (Description) ,20,000.00 ...... F.e. ....... ......................................................................... 4.Est ,,,o~ ,~ .......................................... , (to be paid on filing this application) · ' ' n 6 5. If dwelling, number of dwelling units ..... ~1, ......... Number of dwelhng units o each floor ......................................... If garage, number of cars ....................... ;~;..~. ........................................................................................................... 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Del3th ................................... Height ........................................................... Number of Stories ............................................................................ Dimensions~o;~-sa'me structure with alterations or additions: Front ..........................Rear ......................................... Depth ............................................. Height ...... ..~ ................................. Number of Stories ........................................ 71 ~ 8" - -~. r ~sa Depth ....... .~..6.. ..................... 8. Dimensions of entire new construction: Front .................... ;.... near ......... ~.~...~ .......... Height .....[.8. ........................................ Number of Stories ................. 3. ..................................................................... 9. Size of lot: Front .......... ~.~..~J.~. ............ Rear .......... ~,~,~a~3~.~. ................ Depth ........ .3....~..O..~...O~....~ .......................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises am situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be re~raded .........~.e...s. .................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ....~...o.~..e..~...l:..~..t...M...~E~..s. .............................................................................................. (Address) (Phone No.) Name of Architect .................. ..~..~.l....a~..d....~.~.~.~...~J3.~.~ ............ ~.~&..~]~ ...................... 7..,3~.-.~,,17..~. ............ (Address) (Phone No.) ~.~.,.~+~. Inland Ho~es. Inc. Selden. NY 732-2177 Name of .................................................................................................................. ~ .......................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~)ack 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 YORK' ~ ~W' ) 5~ COUNTY OF ............... ~"~'-'7'7-'~LW-~ ................. ) .................. .~.~.~...~....~.~.~.~....~ .......................... ~ing duly sworn, de~s and says that he is the appli~nt above na~. - :~::'; (~e:of'in~vid~J~fngcon~t):.; ~ ':; : : DOLORES SCHOMBS "~ '' NOTARY PUBLIC State of New Yore He is the .................................................. ;. .............................................................................................. ~..~:~.~[~a~.~y ..................... {Contmctor, ~t, co~mte o[~cer, ~tc.) ~rm ~pires March 30, ~97 of said owner or owners, and is duly authorized to ~orm or have ~rformed the said work and to make and file this appli~tion; ~ all statements contained in this application are true to t~ ~st of his knowled~ and ~lief and tha~ t~e~q[k will be ~orm~ in the ~n~r ~t fo~h in the application filed therewith. NOTARY PUBLIC, State of New York ~ : ~ ' ' , ; No. 52-884[[00, Suffolk County .................. joSEPH 8 Lo~ 7 Lot s~.ft. AreO, 2~,81~ LOt inspected by this department and found to be satisfactory.~~ ~ ~ NO~ · U~DIVIS/ON M~P PILED IN THE~ICE Services dONE~ REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL I~NGIN~:I~R AND LAND SURVEYOR LOTNO. 7, "LAUREL CO~Y ,, GUI ~RAN ~ ~: ~' TOWN O. SOUTHOLD X~_,_ / / joSEPH 8 got scl.ft. Area' ~,81~ Lot ,, DELMAF~ WEST" I~llOll YOUNG & YOUNG 400 OSTRANDER AV£NIJ~, RIV£RHEAD, NE'~ YORK ALDI~N W, YOUNG HOWAI~D W. su~ Fo~: ~ o~ ~ LOTNO. 7, "LAUREL ~ ES AT LAUREL ~c~+~~. ~wN OF SOUTHOLD ~, su~o~ co., ..~. '--' ,-= .o, I--:~A,.~.,,~,~ I~- ,~ -F 'I J IJ'/°