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Home My WebLink About6366-z~ NO. 4 TOWN OF SOUI'HOLD B1mLBING DEPARTM~:NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at. ]~JgFR .P.~ht.h. ............. Street Map No...xx .........Block No...XX ......Lot No,. 7,,X .... ~.9~l.thqld...t{ ~ .Y., ........ conforms substantially to the Application for Building Permit heretofore ~ed in tht~ office dated .............. Fe.b. 13., 19.7.3. pursuant to which Buildi~ Permit No...63(~iA dated ............Fen..13..., 19.73., was issued, and conforms to all of the r~quire- ments of the applicable previsions of the law. The occupancy for which t_hL~ certificate is L~sued Ls .Priv. ate..ane, family..dweLling ....................................... The certificate is issued to iievixl .Eii;ahelL ...... (~ner ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .l~c..23...t976...by. R,¥il ~s ..... UNDERWRITERS CERTIFICATE No..Appro.v. ed. b~..Ja. Iiuba~lii...~.~/~.~6 ..... HOUSE NUMBER ...... .~.~0..: · Street .. N~J~rs..path. .... 8outh~14 ............ .N~IE.:..'~'au~t¥. ataira .to. he .ret~acecl..by. o~ner ............................ Building Inspector ¢%¢'-- · ............................... ~ APPkI~TI~ FOR BUILDING~I~e~ ~ ~a, ~ c ~ _ . ~ INSTRU~IONS '- -- -- .[, This appli~tion mus~ ~ ~mpleTely fill~ in by W~wriJer or in ink and submi~ed in tripli~e to T~ Buildi~ I~mor, wi~t~ 3 sets of plans, ac;urate plot plan to scale. Fee according to schedule. ~ b. Plot plan showing location of Iof and of buildings on premises, relationship to adjoining premises or public streets or areas, and 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 be kept the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pert for any purpose whatever until a Certificate of Occupancy shall have b~ln granted by the Building Inspector. API~.ICATION 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, Suffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteretions, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary in~oection~ (Signature of,applicant~,aR name, if a corporation) State whe~nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~ If applicant is a corporate, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... ~ Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on whicl~ p, rop,~ work wi Jr be done. Map No ........ : ............................... ;,,,LOt No ......................... Street and Number ... ;..~...~.J ~.~,~'........~.,X~-~.. ......... _.~..~..~ ."~..~.~....~-.,,~ .......... ..~...L~..;.... i...~ .......................... .......... :" ~ 2. State existing use and occupancy of premises and intended use and occupancy of pi;oposed construction: a. Existing use and occupancy ...: ...... ..~.~..~.,/-~.......~....;________ .................................................................................. ,.. . . b. Intended use and occupar~cy ........ ,.~...~ ...~..., .~..,,.~....~;,,.....;.;..~ ............ ~.:~. ......... -9~ ~;f Addition ........... Alteratic~ ......... 'Nature ofw~l)rk (check which applicable): New dding .......................... ...... ..... . , ~ ~-* Repair ................ Removal ............ Demolition ........................ Other Work .................................... ...................... (Description) Fee ...... ................................................................................. 4. Estimated Cost ....,.,.,.~.,..--. .................... (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 occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ..... ;. ...... ; ....... Rear ..: ........... Depth ....... ; ........................... Height .................. ~: ............................... Number Of Sto,ries .........~ .......................... .:~. ............................ Dimensions of same structure with alterations or add[ticms: Front ..... = ................ Rear Depth ................. ... ... ... ....... .... ... Height ........................ ~ ................ Number of Stories 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height ............................ ,.~,-~ .............. Number of Stori, e;~.v../. ....... 7 .......................................................................... - - - ~'~l ~,... Id o / ~ ~-~ no~+h .... - ............... · ............ 9. size of lot: Front .....~,~'~/'~..'I .......... tl ......... n~a, .............. Date of Purchase . ......... ~/?..z, !/'~../......." ..... Name. of Forme/r Owner ...,.~..~..,... ....... .~..~...~....L ./'.~..~/-~..~../../ ............. 10. 1 1. Zone or use district in Which premises are s~tuatecl ................................................................................... .x...,z. ............... 12. Does proposed construc.ti0n violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded ~ ....... ~./..,,4,.....W[llexgess~fill beremoved from premises: [ ] Yes L[~ No 14. Name of owner of prel~i~,.~ ..... '~'~"/Z/' '~'""~'-/'"~'~"/'~wT';'~;i'"t ................................ i~;~;;['~l'~i ................ ...... N',b ,,, ........... ....... Name OT Arcnltec[ .......................................................r.--.-:-----~ --' ........ iPhone N~ ) ' Name of ContraCtor ....... ...~...~~ ....... ~ .......... .~.~.~.~.~d~r;i~.c~'~~,/ ........ i~.t~'~.i~ii ............... 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. STATE OF NEW ORJ.I.~ ~/~ ) .~-~ I: deposes and says that he is the applicant above named. 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 statements containqd in this application are true to the best of his knowledge and belief; and that the work will be performed in the menrler set forth in the application filed therewith. I~RRI LEE EMil[ [~ ~('~'tla~ ,umc, sa. of .., ~r, I ' - ~ da' of d ~ No. ,57-,6,16~95 ,/~ . / ~ /~ ......................... ~: ....... ~ ............................... ~atr~'~,'~'.'.;~,~'ctm~/ ..... / / - L~ ~ ~ // Notary Public, .~ .............. r~....-~County ......... /.....-.rr,,4~m...~c..'~..~ ..... ;--..~ ............................ / {$i~aamraofapph'cantJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6366 Z Permission is hereby granted to: Kev~n Mttehe11 ..... ..v.~..z..z..~...~..r.~ ............................. i ............. to Build new c,r,e f~mily. · ~euthold N .Y · pursuant to application dated ........................... .?..~...~. ....... ~,,~ ........ '. 19.~,,~.., and approved by the Building Inspector. ......... ' ................ A'-';','""U-: ........... 'F ........................ t~uiloing Inspecto~ TOWN OF SOUTHOLD~ , Building Depmtment Town Clerks Office Sou*hold, N. ¥. 11971 ~ APPLIGATION FOR GERTIFIGATE OF~ OcGuPANcY Insfructions A. This application must be filled in typewriter OR ink, and s~bmitted in DUPLICATE to the Building Inspector with the following; for new buildings or new dse: 1. Final survey of property with accurate location of all 'ibuildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disp0sal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire U~derwriters. 4. Commercial buildings, Industrial buildings, Multiple ~esidences and similar buildings and installations, a certificate of Code compliance from th'e Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site pla~ 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, ~°Ccupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildiDgs or premises, or other pertinent tn- 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 .... ....... ./.3/9...J~..~../...~... .................. .7..~.... New Building ................ Addition ................ Ol~d or Pm-existing Boilding ................ Yacant [and .............. Loco~on Of Property ......... ~'.,~,.~:.. ,/,~.,~,,'..~J.,,~J,.~,...~.:....~,~,,.~,'~;i. .......... ~.~.~..,,('~/.,~,,~,,, . . . ~_.n~r~ Or Owners Of Property... ~.L/.(./b/ ~'~ .~...~.~... '".ii .;"i". "i'i i ................. Subdivision ............................................... I ................ Lot No ........ :,~.,/Block No ............. House No ............. Permit Nc~. ~ ............ Date Of Pe rmit...~...../.~./.L?..TA~pplicant .~....~ .................... Health Dept. Approval .... 2~..?../..~..-..~. ............ Labor DePt. Approval ................................................ Underwriters Approval .............................................. Planning Bcx~rd Approval ................ ~ ....................... Request For Temporaw Certificate ........................................ Find Certificate ...........~..... ........................ ~.. Fee Submitted $ ..,~...'.(~... ...................... Construction on above described building and p/er~it me~s ~.~l~icabl/~codes and regulations. .... day/ x z . H,D. Reference No.__ ~~ SEWAGE DISPOSAL SYSTEM APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE 1. Applicant ~/ CZ~ ,. ..P~ohe ~. Subdiv. Address 7/9 ~V~.~J~,~ ]/~/,~g~ ~o~f /l~f~6. Section 2. Property l%'cltio6__/~f~' '//~'~ -' 7. Lot No. 8. Private well ~illage ~Df~ Township Ad~L~ 9.~ Public water 3. Public ~ter Compan~ name ~ Distance to main 4. on p ot 10. Sewage Dmspos~'~stem: / ~ A. ~gallon septic tank: ~Precast ~Equivalent. Block B. Leaching pools: Number ~ecas~C~Block Special Street be ards below) If private well fill in blanks below: Tank capacity y_~Gals. Pump G.P.M. ~ Total well depth__ Depth to G.W. Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The undersigned ERTIFIES: in accordance with the Suffolk County Department of Health's current thereto."' " ~ -- ~ Owner or Builder "Construction of~authorized installations will stand- FOR HEALTH DEPARTMENT USE ONLY. Based oB the information presented herewith, it is the opinion of the ~Health Department~ that an ~dequate and satisfactory Sewage Disposal System can be installed on this plot. Da te ~//~'~/~ Si gned ~'~-~ ~ S-15 Revised 4/1/72 fa iliti~s for %his louat.on ~ve been in~cted bY2~~ Iepartment ~d fou.d ,,~ sz.ds, i0,.w.,o-l ,o0,. ;2'C "N. SCALE ~ 50'=1" $: %gOM PiPE E): /AONiUIh}HT AP_EA = 1.2S73 ACRES 'AME~PED GUAIZAt, iTEED TO THE /NIAEZICb, N TITLE SNSUg. A IdCE CO~P~Y A5 SURVEYED ~ SEPTE~B~ VAN TUYL a SON ' Z_~ M. 52' 0~'10" E.% L~, 5L~4- A2EA--{.2573 ACI2ES