The URL can be used to link to this page

Home My WebLink About6411-zNO. 4 TOWN OF SOUTHOLD BIm.n~G DEPARTW~Fr Town Clerk's Office $outhold, N. Y. Certificate Of Occupnncy THIS CERTIFIES that the building located at I~,0,W., .R/& -¥eu~s .Ro~d. Street ,. conforms substantially to the Application for Buildl,g Permit heretofore filed in this office dated ...........i~r .... 1.3.., 19.?~. pursuant to which Buildin~ Permit No..61~1.1Z. dated ...........Nam .. · t6 ·., 19.7~, was issued, and conform~ to all of the require- ments of the applicable provisions of the law. ~l~ne occupancy for which this certificate is issued is .. P4,iva.to .or~ .family. ~lwelling .......................... The certificate is issued to .. Daniel .T ,. Latham... ][~I][1[ .~.i.W. lf..e.....O~...r.s. ....... (owner, l~ssee or tenant) of the aforesaid building, i Suffolk County Department of Health Approval . · Oot...$7.. '.t973. · · .by. ri, .Villa.. UNDERWRITERS CERTIFICATE No.. Il .1120.72 ..... AUg..".30...1973 ............. HOUSE NUMBER .. ~ .~0 ....... Street . .¥omalts. l~d.., i ....... ................ Building I~pector / FOE~I 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) N? 6 11 Z Permission is hereby granted to: ...D~.~:~,e 1 ..La ~ha~ ............................................. .......... .O~.~_e~d; ....................................................... to....l.~...~. ,t. ~, ...z.~. ~:~ · · P;~. · .;L~ ~'~-,~. · .d ~.e -~. J- ~,ng ................................................... : ............................... at premises located at ...~Ah~,~.~....~/,~.....~.g..~.¢o~:Cl ................................................................ ............................................. ~z:~L. ez~ ......... .~%.-Y..o ................................................................................. pursuant to application dated ........................... }~, ........}~. ......... , 19~.~..., and approved by the Building Inspector. Fee $ ~.~.,~0,~ ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS 111111 BUREAU OF ELECTRICITY ~ B, Jo., BT,..T. ,.W YO,K. "~K '00'B THIS CE~IFIES THAT in the follmving location; [] Bazement [] 1st FI. ~vas examined on August 27, 1973 ~ 2nd Fi. outside Section Block Lot and found to be in compliance with the requirements of th~s Board. RXTURE RXTURES RANGES ~)VENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 25 29 DRYERS SERVICE E R V I C I~ OTHER APPARATUS: W~ter Heaters: 1-~kw Elec. Boom Heaters: 3-2.5kw, 3--2.~kWR 41o 1-1.5kw, 4-. 75kw Peter Bogovie Main Road southold, N.Y. 11971 Per- COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Snstructlon$ A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the follgwing; for new buildings or new use: 1. Final survey of property with accurate location of all l~uildings, 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 plon requirements where opplicable. 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 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 .... ................................. New Building................'~ .... Old or Pre-existing Building ................ ! ........... Vacant Land ............................ Subdivision .............. ~ .............................................. Lot No ........ ~.. Block No. - House No.....U ...... Permit No ..................... Date Of Permit, pplicant ....... ~.*.~ ....... ~..; ....... ~ ......... ~ .............. Heelth Dept. Approwl ............................................ ~Dor ~pt. Approwl ................................................ Underwriters Approw[ .............................................. Plenning Boord Approwl ........................................ Request For TemporQw Ce~ffic~te ........... ~2 .......................... Finq[ CertfflcQte ......... .~ ............ ~ .............. Fee Submitted $ .~.~.~?. .................. Construction on ~bove described building ond permit meets o]1 e~pliceble codes end regul~tlons. Sworn~to before me this TO~N 0~ $O~THOLD Building Department Town Clerks Office Southold, N. Y. '~1971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Enstructlons 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 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, [ndustrial buildings, Multiple Re{idences 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 $I.00 $5.00 Do,e ............ ........... New Building x~ Old or Pre-existing Building Vacant Land Owner Or Owners Of Property ~,~,~:~1 ~ '~ ?:/'~, Subdivision ........... :7~. ................................................. Lot No ...... C...:.. Block No ............ :House No..:'.~ ........ Permit No. ~ z///- ~ Date Of Permit ....~.//~ ' ~*'~ ~/ / ~,a~, .......................... Apphcant .~:: ........................... ; ............................... '~ ~" /~/~/ Labor Approval ................................................ Health Dept. Approval ......... ~ ..............................Dept. Underwriters Approval .............................................. Planning Boa~d Approval ........................................ Request For Temporo~ Certificate ................. ~ ................... Final Certificate .......~ .............................. Fee Submitted $ ..... .~.:..~.~ .................. Construction on above described building and permit meets all applicable codes and regulations. · , , · ._. ~?, ~ .,.z",;"2, ..... ~ .......... ADp,icon, :';'"' ....................................... Sworn to before me this ..... O,.d y · ..:~& ...: ......... (stamp or seal) Cornm~sslon ExpiteJ March, 30, JD/////////~? SUFFOLK COUNTY DEPARTMENT OF HEALTH EASTERN DISTRICT, R IVEPJ{EAD ,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DIS[OSAL SYSTEMS ~ . Date ~//~/ Approval to construct said systems is requested,pertinent dst'a herewmth: ! / 1-Applicant /~/~/t~/%=~/- '/~" .~/9~//%/;~ Phone~6-Sub div Address /~/~/~Y ~, ~A~/y~/4/f/,Y, ~ ?/~9 7-Section 2-Detailed property ~ocation 8-Lot No Hamlet. ~P/~/4~/~/-~ Town y2~/~/~/~ 9-Private well? 3-Public water supply name ~--- Distance to nearest main 4-Lot szze. Width 2/~ ft. Length~/~ £t. (also enter on center plot plan below. 5-Dwelling. Singl.e Family?~L~T~-~ily?~__~Cellar?~Slab?/ /Crawl Spac. e?/ / lO-Proposed system. Septic ~t~...~Precas~Oesepoo ~_~$ha~'~w pools~Ot~ il-Septic tank inside dimensions:Volume~G~ls. LenEth : ftoWidth ft. Liqui~ depth' ft. l~-Precast sections:~Number~_~quare ft. Cesspools:B~k sizeL ~nSo~ ins. H Total blocks below inlY, t: ~1--~2... ~3.._. -- H.O. efere ce PLOT PLAN Street Capacit%(~/Gals Ind~ No Test Hole ~ The ~arsigned CERT~FIF.$: "Construction of a~thor$zed installations will be in accordance with the Suffolk County Health Departments'~urrent Standards,Bulletins, and amendments thereto,covering Private Sewage Disposal Systems". ,.~ / / Owner FG~ MEALTH DEPARTMENT US~ ONLY. Based ~n the information presented herewith,it is the opinion of the Health Department,that an adequate and Satisfactory Sewage Disposal System can be installe~d on this Plot. (10/65 Revis. ) S-l~e APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL INSTRUCTION~: Applications must be submitted in duplicate. 1-.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 & T~nship 3-Enter ~=e of Public Water ~upp]~ District,together with the distance to their main. ~-Enter Length and Width of Lot under appropriate heading,also enter these dimensions on the center plot plan shown on the face of this application. 5-Dwellings:Check-ma~k.V"itema applicable to the proposed new dwelling. :The Sub-division,Section and Lot numbers may be obtained from the Applicants'property map,or from the office of the Town Tax Assessor. 9-Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. PROP(~F~. SI~JT~: 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., ~'art II-Residential Sub-surface Disposal Systems covering Cesspools Part III " ,, . . " " ~eptic Tanks Part IV " , . . ', " Unusual soil conditions Part V " ,, . . " " Shallow Leaching Pools PLOT ~.LAN: 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 c~ Applicant's Lot lines, must be shown on the plot plan also. Wells and Cesspools now cn adjacent Iota must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systeam 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. W_ell lo~ation- To locate the well & sewage disposal systems on Applicant's lot,the following Standards must be observed: Well-lO0 feet mAnimum distance from the nearest ceaspoois Well-2~ feet minimma distance from rear,and rear sides of property lines Well-lO feet minimun distance from front,and front sides of property lines Well-50 feet minimum below grade for well point Well-SD feet minimum into ground water for well point. Well- ~ feet 6 ins minimum below grade to well head and lateral water pipe. Cesspools location- Upon determination of the Sewage & Waste disposal"type of systems" required,the following Standards must be observed for the location of same: Cesspool-lO feet mtnimum distance from lot lines to center of cesspool Cesspools exterior must be 1OO feet minimum distance frcm nearest w~ll Septic tank exterior must be 75 feet from nearest well Cesspool ,Center'~ must be 12 feet minimum distance from nearest water line. Cesspool "Center"' must be 15 feet from house foundation. Cesspool exterior must be 50 feet minimum distance from surface Waters,Streams, Lakes and Bays, etc. Cesspools must be 20 feet mtuimum distance from large trees Cesspool center to Cesspool center must be at least 16 feet Cesspool cover top to grade must be held to minimum of 1 foot to maximum of 2 feet. Bottom of Cesspool to ground water must be held to minimum of 1 foot. BUILDING'~ DEPARTMENT ~,~ -~-.,~. TOWN CLERK'S OFFICE ~ Applicafi~ No...~..~..~ ................. Approved ..................... ~ ................ , 19..../.~_.. Pemit No....~...~..L(...~....~.~i)7/,~ c,,.//,,,/~F_ / Disapproved a/c .................................................................... to- f~-. ..................................... .... -::;: -- Date ........ ~L~ ............... , 19 ..... INSTRU~IONS ~. Thi~ ~limtion mu~t ~ ~mpl~t~l~ fill~d in b~ W~writ*r or in ink and ~ubmi~d in tri~li~t~ to th~ Buildin~ ~ ~ of plans, a~urate plot plan to scale. Fee a~rding to ~hedule. *' b. ,~Jot plan showing location of lot and of buildings on premises, relationship to adjoining premiss or public str~ or areas, --~i~ a ~tailed description of layout of pro~ must ~ drawn on diagram which is ~ of this appli~tion. c. T~ wo~ ~vered by this appli~tion may not ~ ~mmen~d ~fore issuan~ of Building Permit. d. U~n ep~oval of this appli~tion, the Building Ins~ctor will issue a Building Permit to the appli~nt. Such ~rmit.shall be kept t~ pmmi.s available for ins~tion throughout the work. e. No ~ildi~ shall ~ o~upi~ or u,d in whole or in pa~ for any purpose whatever until a ~ifi~te of O~u~ncy shall have ~ by the Building Ins~or. ~l¢~TlO~ 18 ~fi~SY ~Dfi to th~ ~uil0in~ ~a~nt for th~ issu~n~ of ~ 8uildin~ ~rmit ~u~u~nt to th~ 8uildin~ Ordin~n~ o~ I~ Town of ~uthold, $uffolk Count, ~w ~ork, ~nd oth*r ~p~licabl~ [~, Ordin~n~, or ~ul~tion~, for building, ~dition~ or ~lt~r~tion~, or for r*mo~l or d*molition, a~ h~min d~ri~d. Th~ ~licant ~m~ to ~m~l~ ~ilh o~in~, ~ildin~ co~, hou~in~ ~d~, ~nd r*~ulation~, and to ~dmit ~ut~ori~d in~o~ on ~r~mi~ ~nd in buildin~ for n~mss~ (Signature of applicant, or name, if a corporation) t.! .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ .~ ..~..C.....el~.....~.~g.~. .............................................................................................. If applicant is a corporate, signature of duly authorized officer. ..................... ............. ... . . Builder~s, License No ...... ..~...~:~..~..~..~...~...[.~.~ .............. Plumbers License No....~..~.~.~...,.~.t~,~,,t~......,~, ,C,..,~..,~,c.....~o{~ El~rician s Licen~ No .~.~....~U~. ~/~ Y ~ ~ -- ...... Uther/raae s L~n~ No ..... ~.....~ .................. 1. Lo~tion of land on which propo~d work will be done. Map No ................ .~ ................ ~ ......... Lot No..~. .................... ............ Strut and Numar ~ ~ ...................................................................................................................... MunicipaliW 2.S~ exi~ing u~ and o~u~ncy of premiss and intended use and ~cupancy of pro~ con~mction: a. Exi,ing u, and ~cupancy ..... ~ ~,.~.~ L ~ ~[a ~.....~......~....~C.C~ ............................. b. ........ ......... 3. Nature of ~k (check which applicable): NeW Building ................... Addit'on ..................... Alteration ........... -.... Repair ~ ........................ Rembval ................. ~ ....... Demolition ........................ Other Work .................................... · (~/- ~: ~ , / ~'?'~--'"'- (Description) 4. Estimated Cost ........~.0...0..a. ...... [!jb ............. Fee ...... ..b.. ....................................................................................... i~., (to be paid on filing this application) 5. If dwe)ling, num~ O~welling u~.. ...... Number of dwelling units on each floor ......................................... If garage, number of ~;~'S :,:.a~'....C..'/r~...x:~..~.C~.f,'..T.....O..~...&......C'-.-~..~ ............................................................................ 6. If business, commaS!or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existi~ structures, if' any: Front .....................Rear ........................... Depth .............................. , .... Height .................................................. ~.~ Number of Stories ............................................................................ Dimensioned( same structure with alteratiOq~,~s, or additions: Front .......................... Rear ......................................... Depth .....; ....................................... Height ...~;~ ................................... Number of Stories ........................................ 8. DimenS!ons of entire neW~Onstruction: Front ....~.~.....~. .......... Rear ....,..~..~...~. ........... Depth ................................. He ght......',, .................... '"'.... ~,,~ ...... Number Of Stories ...... !...~.~......S....-~r,q.{~ ....... I~..~./~. .......................................... 9. Size of lot. Front .......... /...~:~;,~,,.,, ....... Rear ........... ~O..w~'.~. ..................... Del)th ........... ~.~/.~ ............................... 10. Date of Pumhase ....... --~' ~ '~'~'~9/~.~.',a~.~'~i~".'ii, Name of Former Owner ....~..~.~..r.d.......~..,......./':~....'/~..?..../~,. ........................ · · i ' i Z::~,,~,~/, - /V oJ R[~l~(~i.~.'; / 11. Zone or use dlstngt in which larem sas ares tuated ..,.~,...~.~/.. ........... {~ ...................... ............................ 12. Does l)roposed constructiO9 violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot beregraded __;___,~.~.~.;.,~.,." ........... Will excess/fill be req~aved, frl)m p,r~rpjsas: [,<.] Yes [ ] No 14,, Name °fdWner of premises ......~j~...e~.i..~.......T.......Jr...a?~a~. ...... .(~l.~..~..~...r.~(;~.. ............... ~(.6...~...3~..~.:...,~.~.~.~. .... ~. . . ~,' (Address)/~ ~ (Phone No.)/. of: Archi t ............................................................................................................................... ............... ', ~ ,< ~ ~ , /~ , ,/ /3 ~dclress _ ,/ (Phone n~o.j ~:Of ~treCtO r .... A/~L(t~ .~../,~J['!..~k..../~ .~.-...-.~j ................ .u~l~ ~.(Addre~s) ....... ~'%'~"/ ............. ~/' ~'"" '7~a~'""'/" *~' ~*"""'(Phone No.) PLOT DIAGRAM Locate clearly and distinctly a)l 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 YO~K. /~/~ ik ) COUNTY OF .......... .':~ ..~...1:.~.~.1. ..................... ~....) ~ .... · .....~..-..~-..-e~..i...'~-!..-....~.~----L~.--~...-~..?~.. ......... ' .................................. being duly sworn, deposes and says that he is the applicant ,bo, named. (Name of individua[~ signing contract) He is the ........................................... ~../,~,..~/.~.,~ ............................................................................................................................................... of said owner statements set forth in the Notary Public, (Contractor, agent, corporate officer, etc.) h's, and is duly authorized to perform or have performed the said work and to make and file this application; that ell ~al~plication '~re true to the best 6f his knowledge and belief; and that the work will be performed in the manner lfled therew;th- .............. ' /.~. ~/ No, fy Public State of New Yo~E ...... ........................... ~erm Expicos ~.arc_~__3~ L~ (Signature of applicant) / fo~ thi.~ location ~ve been this de~nt ~d fo~d ~Le~ of Genii d t M,A,p 01:' SUG'VEYE:D ~nspeoted by this depar~ent ~d fo~d Ch/e~ of ~eneral ~ginee,/~ Se~/ces DANIF,.L"'['. ~ PAT~I¢IA L. LA,THAI'Cf AT ECw. r DA MAP OF LAND N I EL LAT HA l',,.t "TOWN OF' .~co ~: 40'~ 1"