Loading...
HomeMy WebLinkAbout6421-zTOWN OF $OUTHOLD BUTLBING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. ~ ~3~).~ ..... Date ........... THIS CERTIFIES that the building located at . .N/~. 3ouadv~.ew. ~.ve, ..... Street Map No ............. Block No..XX .......Lot No.. DS ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........March 'lg't', 19.73. pursuant to which Building Permit No..61+221~. dated ...........14arch .2(}s.., 1973.., 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 · Private 'one' .f,m~ 'l~r-dwelling ....................................... The certificate is issued to .. Howard. ~nd. ~nna. De. Lee~ ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Heaith Approval .Da~ed. A~g~s~-l?t. UNDERWRITERS CERTIFICATE No. ~I. 3,07~3~....Date. I. Aag~ .Ts. 19~f~ ....... HOUSE NUMBER .1~ 62~ ...... Street ...N/.~. ~ogru~v~e~. ~veet ................ ............................................ Southold~ · ~.Yo ................... FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6421 Z Date ....................... ~e '~' .......... 20' .......... , 1~,,~ .... Permission is hereby granted to: I~].a-~J," ~o~e ~,..~ c...k/~ .. Ho~:rd. 'De f~e e'l~r..& ;4ire · .1~,~ ~...Y~. ~l~l.l.e...(~mm.t ry..tta ........................... ....... [~,id,eii. ....... N,.~.,......1.$78~ ........................ to ..~g,;Ll. ct ..z~e~,.. m3a ..~'a~a4,~- [...due.l.Z. &t~g .................................................................................... at premises located at ...~i/.$.....S~I~I~...~$~W...Av~ ....... F,/...L~-~h.t-he~e~-..~t .......................... .......................................... ~t, Ju~:L& ......... ~,..~.. ................................................................................ ..................... ~.~. ....... ~.Q ............... , 19'~..~...., and approved by the pursuant to application dated ~ Building Inspector. Fee I~,..~O. .............. .......... ~'.,g~:~..~.,~: ........ ¢_.,4,-~:..,.:./ ............... ~ V ' Building Insp'e~:tor Town Clerks Office Southold, N. Y. 11971 APPLiCATiON FOR CERTIFICATE OF OCCUPANCY 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 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-0 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), No~-conforming uses, or buildings and "pre-existing" land uses: i. 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 $1.00 $5.00 8/,zgZzg?3 Date ..................... New Building ..Z:¢; ............. Old or Pre-existing Building ............. ............... Vacant Land ............................ ~T/S Sound View Ave, ~ Sou%hold Location Of Property ..................................................................................................................................... Owner Or Owners Of Property .....H..~..,i...,&...~.~.s..t....}:[....°'tff...,.e~,.~...D...e...L~....e..~...~. ....................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. p 6421 Z ~ 3/20/1973 ,. . In].and Homer ermit No ..................... Date Of ~'ermit ......~ ............. ,~ppncanr .................................................................. S .. 3.1.6 ~.19/..~.3 Labor Health Dept. Approval ...... .~. :~ ...................... Dept. Approval ................................................ Underwriters Approval ...6..5...~..~...O..'Z.......8.~7./~l~.~.....Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate XX Fee Submitted $ ......5..QO ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant I..n...1. ~ .d....,H. ?, ,m. e~.....I..n. ~ .e../...K.?. -n.~e...t..h.....W...t · .,T., ,h.u..r..b..e...r. ................... Sworn to before me this ........... ............ Notary Public .................................... County (stamp or seal) ~/~<"3 ~'"~'- THE NEW YORK BOARD OF FIRE iUNDERWRITERS ' BuREAu OF ELECTRI¢~ i ': ' [-- m~'~ 85 JOHN STREET, NEW YORK. NEW YORK 1'0038 THIB CE~IFIES THAT ~y t~ e~t~aJ ~u~t ~ ~H~ ~ a~ int~ ~y t~ ~pl~nt ~ on t~ a~ ~pl~a~n ~m~i~ t~ ~s of Howard DeLeeuw, n/s Soundview ~ve. e/o Lighthou~se., ~outhoz~, u.. [] 2nd Fl. O'J, tsid~ Section Block and ~o~nd to ~ in ~mplla~e With th~ requ~remen~ o~ th~ B~rd. in thefoll°~ing location; [] B~ement [] l~t FI. w.,..mi.~o. August 2, 1~73 RXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT 31 18 13 DRYERS FURNACE MOTORS SERVICE DISCONNECT Lot EXHAUST FANS ~ERS R V I C 4/0 1 2/0 OTHER A~A~TUS: Elec. Room Heaters: 1-4.0kw, 1-2.Skw, Water Heaters: 1-q.Skw ~otors: 1-1/2bp 5-1.5kw, 2-. 75kw George Zimlinghaus ~ Park Place Patchogue, N.Y. 11772 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED. !N..~ER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference AP~ICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,pertinent data herewith: Date 1-Applicant I~z'. & i,~ro. II. DC Loeuv~ Phone 6-Sub div Address ],Of~-2C %~7'i:h ,qq., ]Tor~'a~¢! Eeac!~. ?A' 7-Section 2-Detailed property location ~/,~ Sc-%:,?v3,ev~ Av¢~. 8-Lot No. Hamlet ~?~i~?! ?Tj~ Town S~u'?~,~.~, 9-Private well? , 3-P~blic water supply name Distance to nearest main 4-Lot Size: Width !(}O ft. LengthlD© ft. (also enter on center plot plan below:) 5-[hcelling: Single Family ~,,~ Two Family? ~ /Cellar? f,~-/Slab? / /Crawl Space? 10-Proposed system: Septic ~nk · /Precast /__/Cesspoo~ /,,/Shallow pools 11-Septic tank inside dimensions~ V. plume47_~_DGals.Length f-b~.' Width f.t. Liquid depth ft. !2-Precast sections: ,~/. Numberz~_~Squar~. Cesspools: Block sizeL zncs. D ins. H___ins. ~otal blocks below inlet: #1 ~2 ~3 PLOT PLAN Street .G ~ade ! G ,W.L. Sotuudv'~ er; Ave Capacity ~Uals. Indi No 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 ,~,/~/, ~ Signed !~A~D HOi~S? ~C,/Do Schor,bs~ Sec. Owner or Builder FOR HEALTH DEPARTMENT USE ONLY. Based on '~he 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. s-I 5 Test 5~15 Data ~eet 0 2 6 8 10 12 ~6 DEPARTHEN1 OF HEALTH RIVERHE ~,O, NiY. o~ G~ ~3 AU~ I T, ~ 10: . ~ ~ ~ ~ o ~ ~ ~ ~ ~ ~ ~ ~f ~ ~ ~ ~ ~ ~ ~ ~ ~ -,~ --~_ /__~ ,~ ~- / ~ / IU- ~All}~ __g' [ [ PROFESSIONAL ENGINEER AND LAND SURVEYOR ~-~ -~ %. -, / ~, ~, ~ _.~gl~~ ~ I I ,,,o,u,v,~o,.,.~.,.,,:.,o.,~,,, -~ ~o~'_, ~" . ~' I I suRwY FOR: / 'Su/'''' ~ I I'T SOUTHOLD ,,, , ........ ,~¢,~. ~-c {? 7.3 REVISIONS NOTE~ · = MONU/ZENr YOUNG & YOUNG 400 OSTRAND£R AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNC PROFESSIONAL ENGINEER AND LAND SURVEYOR SURVEY FOR: HOWARD DeLEEUW&ANN DeLEEU~~ ~ , -,.*c . /~ /~o~'~ ~ ,.' ~ TOW~ OF SOUTHOLD co., = 40' [DAT~:MAR. 2,1973 ~o. 7~ 164 APPLICATION FOR BUILDING PERMIT ,~ c ~ ~,~ Date ................. ~.....N.~..R~.h.. ............ , 19....7..3......gi' ! ' - 'INSTRUCTIONS e. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi 3 sets of plans, accurate plot plan to scale, Fee according to schedule. b~ Plot-plan showing location of lot a~d -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 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 Occupancy shall have been granted by the Building Inspector. ordAinPaPnUJoA/:hOeNT lcSwnHoEfR Es~Bu1Yh~MidA, ~uEJ~olrJh;ouBn~ily,di~gJ~Poar~ ii~nnJof1~re/a~pil~Sc~at ?2L o~ oBi ~iilnd2nnLsPeor?l~tJu~:l~oanJ, ~ t,: BJni~:~ngctiZoOnr~f buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ell applicable laWS, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necassery inspections. TNLAND HOMES, ZNC. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, a~chitect, engineer, Jgeneral contractor, electrician, plumber or builder. GENERAL CONTRACTOR Name of owner of premises ......... ~g~II~J~.,II,O,d..ALIlI.I...~IJL.L~.ILI~M ............................................................................... If applicant is a corporate, signature of duly authorized officer. KENNETH ~. THURBER~ V.P. IName 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 which proposed work will be done. Map No ....... .S...e..e..,..S..u,[.v..e,.~.. ................ Lot No. ~,,~, N/$ $oundview Ave., Southold, N.Y. 11971 Street and ............................ 7.~,~..~_~ .~.:~ ............................................................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... One ('1) FiJiiM b. Intended use and occupancy .................................. ... .................. ~' /q /O t?71 , 3. Nature of work (check which applicable): NEW Building ...... ..X. .............. Addition ..................... Alteration ...... Z...,.. · Repair ........ Removal ............... Demolition Other Work .................. (Description) o,ooo.oo 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 .........2. .............................................................................................................. i~ .................. 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 Stories .................................... Dimensions of same structure with alterations or additions: Front ............... , .......... Rear .......................................... ' Depth ............................................. Height .............. ; ......................... Number of Stories ........................................ .., 8. Dimensions of entire new construction: Front ........ ,6..2. ......... :... Rear ...... .6..2. .................. Depth 24 16 . Height ................................................. Number of St°ries"~::'''''1'10 ............................................................................... : 9. Size of lot: Front 100 Rear .......... i~ .............................. Depth 3.90 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded~Y-e.-.a. ....................... Will excess fill be removed frompremises: [ ] Yes ~(~ No Nameof Owner of nremises ~.9.W.a..&..d.. & Anna De .L. eeuw, 163-26 97~ch St., 23.2-738-2913 14. '- "~W"m=d "~'~'~';'"N';'~ ~'"'-~'~'1~'~',~i ................................................................... (Phone No.) Name of Architect ............................. ;; ...................................................... (Ad~lress) (Phone No.) ~#Ir. AND HOMES, INC Selden, N.Y. 11784 516-732-23.77 Name of Contractor .......................................... ~ ............ .'L: ........................................................................................ (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 coiner lot. Sou~dv£ew Avenue STATE OF NEW YORK, ) COUNTY OF .....S...U...F.E.O.,.L..K., ............................... ) ~ KENNETH W. THURRER, V.p. .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. {Name o£ individual signing contr~'ct) , , . He is the ._.~.~,N..~.R. ,A.,L.....C..O,.~,.T...R.'~.,C,..T..O.,R. ...................................................... ' ....................................................................................................... { Cotttractor, 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 cont~ed 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. - TERRI LEE ELAK ~r,j,f' y ~. #OTARY pUBLIC. S~a~e~.! Hew ¥ollt ~ da of ,,~-~.'~ ~ Ho. 5~1{~? ~ ~ A · ...................................... v ............ ................ ', , -- Notary Pu ic, ,~....~--~~~a;o~;:;s ~ta,~,, ..... :.~........~...~.... ti APPROVED AS NOTED NOTIFY i~,UILDJNG OEPART~EN'J' 7~S.%~0 gAM ~ ~ ~OR R~QUIR- 1, G~OKE BACK~L~i~ ',% -, 11;4"