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Home My WebLink About6701-zNO. 4 TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificete Of Occupnncy No..Z~.0.~ .... Date ........ ..1~.?...2~. ........... , 19.7~. THIS CERTIFIES that the building located at ..... Gra~4. ave ............ Street Map No...x~ ......... Block No....x~. ...... Lot No. ~.....Y~t..tl.t.u. qk...~ :.~.: ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ,~l~y... 2 ..... , 19.7.3. pursuant to which Building Permit No...6.?.0J.Z. dated .......... .J..u..~ .... 2..., 19. ?3., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P..l'.$y.a.~..e..o.n.e., .f.a.m.i..ly..d..w.e.l.l.~..rig ....................................... The certificate is issued to Atlantic. Homea .of. SAfffolk. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .Dec... 21~,(.. 197.3. · by'..R.V/,lla .... UNDERWRITERS CERTIFICATE No..Ii..~ ~292 ..... Da~...lg.. 19.7.3 ............. HOUSE NUMBER . .~.~ .0Q. ........ Street ..... ~..r.a.n.d...A?~.. .......................... Building Inspector ~ ~O~m NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N~ ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 6701 Z Permission is hereby granted to: At,lJntXo Hemoj .... 3~ vZua. e~s ltoaa ~ive~eaA ~attXtuak it',Y, pursuant to application dated ........................~ ......... ..~. .......... , 19~..., and approved by the Building Inspector. FORM NO. 6 TOWN OF SOUTHOLD Building 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 submitted in DUPLICATE 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, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the 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-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 $5.00 3. Copy of certificate of occupancy $1.00 Date Dec. 2~ 1973 B '" New u drag ................Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Grand Ave Mattituok~ N.Y. Owner Or Owners Of Property ~.~0,~.~. .~.o.)~.$....~.~...~.~.~ ~.~.~ ......................................... Subdivision ~ ~ ~ No...2.~...,0~.... ................................................................ Lot No ............. Block No ............. House Permit No.~...~...0.]..~. ......... Date Of Permit ,?.,./..~.,./.~.~.....Applicant .,..,A.~,]:.~...fi..~.?...~.O..~...~.~ ............................. Health Dept. Approval ,D~.(~1~2.~.....J.~.~,~ ............ Labor Dept. Approval .... ~.,,~., .................................. Underwriters Approval ....~..l..~.'~,~....~.......l.~../.?..~,/.?,.~..Planning Board Approval NoRa Request For Temporary Certificate ........................................ Final Certificate ......... ~ ........................ Fee Submitted $ ...~".....0..0.. ....................... C°nstructi°n °n ab°ye described building a/d//P?f:~ tg*f//"~m/ets/aJ/I applicable cedes and regulations. Aoolicant ~..(~.'.~'~. -.{~'...~'J(f---~'~'~'---"~ - Sworn to before me this .......... .2...~.. day of ..... D..e..9..e..~...b..e...~.......1..9.~..~ ..... (stamp or seal) .................................... cou.ty Notaw Public THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-- 85 JOHN STREET, NEW YORK, NETM YORK 10038 .,,re Dece~.r t9, ~.97'~ .~ppl,c,,t,o,,~'o.o,,;ile 6a?~ZO N 133792 THIS CE~IFIES THAT Grand Ave. 100' n/o Woodcliff Dr., ~2nd FI. 0 Lit ~ IJ~e Section Block Lot and found to be in compliance with the requirements of th~ Board. RANGES COOKING DECKS ~)VENS DISH WASHERS EXHAUST FAN! FIXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT DRYERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: Oil, 1-1/Shp, E R V I C NO. OF CC. COND. A.W.G. NO.OF HI.tEG A.W.G. NO. OF NEUTRALS A.W.G. PER .g OF CC. COND. OF HI-LEG Of NEUTRAL 1 2 1 ~ 2-1/12bp Joseoh D. Mazzoni 227 WaverlvAve. 6 !~edford, L~I. Il? ~ OlENEIEAL MANAGER COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ~ ~ Phone ? ~ 7- X/Y! 5. Subdiv. ~.~.~,~[ Address ~-,~.-~~'_ 6. Section 2. P~erty Location~ ~ ~ ~ ~~l. Lot Number ~ ' ' - ' ~ ~ '~ 8, Private Well Village ~~~ Township ~~~ 9. Public Water 3. Public Water Company Name Distance to ~in 4. Lot size: Width feet Length. feet 10. Sewage Disposal System: ll. (For Health Dept. Use) A. 900-gallon septic tank: Precast ~ ~quivalent Block B. Leaching pools: Number of pools ~ Precast~Block Special If private well, fill in the following blanks: A. Tank capacity. ~ gallons B. Pump G.P.M. ~ C. Total well depth ~ D. Depth to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot. S-15 Rev. 4/1/73 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted ]~-~ptlcate to the Building Inspector. b. Plot plan showln~ location of lot and of buildings on premises, relationship to adloinin~ lX~m!ses or public streets or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part of this application. c. The work covered by this application may not be commenced before issuance of Butldi~ Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole ov in part f~pr any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspeetier. APPLICATION IS I-t~I~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zon~ Ordinance of the Town of Southold~ Suffolk County, New York, and other aL~l,~h~e Laws, Ordinances or Regmlatkms, for the construction of build iht:S, additions or alterations, or for renmval or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ordinances, building code, housing code, and regulations. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..... ~...-T... ~ ............................................................. Name of owner of premises .~ .~ ................................ If applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) 1. Location of land on which Dropo6ed wor~ will be done. Map No ......... ~ ....~.. Lot ~ .............. Street and Number ....~.-.-~....'~.r..~rr....;.~ ....... . .x.~-~.~-r~.~ ~. .... ~.. ~L ~ o c.b ' Municipality 2. State existing use and occupancy of premises and_irfzended use and occupancy of proposed oonstruetion. ~:> C*- ~'--~ ........... a. Existing use and occupancy ..... ~.... ............................................... b. Intended use and occupancy ..~.~ ................................................... 3. Nature of work (check which applicable): New Building ........ Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other W~rk (Describe) ...................... 4. Estimated Cost . ~.~..~..O.O..~. ............ Fee i/..~.~'. ......................................... ~ (tO be paid on filing this application) 5. If dwelling, number of dwelling units ...-.~..... Number of dwelling units on each floor .............. If g~age, number of cars .. ~ ................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures, ff any: Front .............. Rear ............. Depth ............. Height Number of Stories ' Dimensions of same structure with alterations or additions: Fro~t .............. Rear ............... Height ............ Number of Sixties .....................................................--~.'.-~.. Size of lot: Front .../..~,. ,ff. .... Rear J..~.~;,. Depth Date of Purchase ......... ~.~.~ .~. ................ Nam, e of Former O~e ~-- -/"z ..................... Zone or nse dis~ct in which prem~s are situa~ .... ;4.~.. D.~. ~ ................................... Does proposed construction v~o.l!~te any. ,z~aing law, ordinance o~r rl~gulation?: ........ ~ ............. Name of A~hit~t'~].~ ...... Address .../.~'~.--...':~... Phone No ............ I~ame of Contractor .... ~ :.-.~ ......... Address ...................... Phone No ............ 10. 11. 12. 13. 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 whether interior or corner lot. ,,/.fr ,~ f----. R ,~ b ~'. STATE OF NE~ ~QR~, )S.s' CO~ OF ~.~A~ .... ) (Name ~ ~dividual signing a~li~) ~t s~ve n~ed. He is ~e ........ ~ ......................................... (~a~r, a~t, ~te ~i~r, etc.) of ~id. own~ ~ owne~, ~ ~ ~ ~ ~ p~o~ or have pe~ ~e ~d ~k ~d ~ m~e and file ~ applica~n; ~at ~ ~e~ ~nt~ in ~is appli~ ~ ~e to ~e ~ of h~ ~owl~ge ~d belief; and ~at ~e ~k will ~ ~ in ~e mann er set f~ ~ ~e app~cation fi]~ ~e~. Sworn W ~fo~ me ~is Notary Public, ~~~nty (Slgntu~ ~ PUBLIC, State of New YOl'# Ns. 52-1168295 Quldified in Suffolk County ~mission Expires March 30, 19 '7~' UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY I$ A VIOLATION OF SECTION 7~Og OF THE NEW yORK STATE EDUCATION LAW , ~e .Sesame disposal ami ~ate~ Sul~ly · :. i~ailitieS fo~ this locatiolt ~ l~ea oo~ COPIES OF THIS SURVEY MAP NOT BEARING NOTE: ~ -' MONUM~-~r TEE [OC~TIOI~ OF WELr. S .q/~D CESSPOOLS SHOWN HEP, EI.r1 ~RE FROM FIELD OBSEI~VATIOr~ ~[~tDIO~ F~OM DATA OBTAINED F~OM OT~IERS REVISIONS YOUNG & YOUNG DEC. 20,1975 40o OSTRANDER AVENUE, RIVERHEAD, ^.o~. w..~ou.~ SUEVEY FOE: ATLANTIC HOMES OF SUFFOLK, INC. MATTITUCK RIVERHEAO SAVI~S BANK SECURITY ~TLE ~ GUARANTY CO. TOWN OF SOUTHOLD su~F0~ co., ..~. '~~~. , ,CA~,: ,..: ~O' I°*":*~.~e,,S~ I~-~,, I I-- APPROVED AS i~_OTED INO[IFY BUILDING DEPARTMENT AT 765-2660 9AM TO 4PM FOR REQUIR. EL~ INSPECTIONS: 1 BEFORE IACKFILLING FOUNDA. TluN OR START FRAMING 2. BEFORE COVERING PIPELINE 3, FINAL WHEN JOB COMPLETED /OODGL FF DR. GROUND 150 SQ. FT. SIDE WALL AREA CHING P WATES SEWAGE DISPOSAL SYSTEM FINISHED GRADE WATEH SUPPLY SYSTEM GROUND WATER 0.0 TO~ SOIL LOAM GRAVEL COARb'E SAND COARGE SAND GRAVEL TEST HOt E NOTE: · = MONUMENT FOUNO ELEVATIONS SHOWN THUG: (~ , ,- PROPOSED LEACHING POOL :~' = PROPOSED WELL ARE REFERENCED'rOAN ASSUMED DATUM YOUNG & YOUN¢ 400 OSTRANDER AVENUE, RIVERHE ALDEN W. YOUNG SURVEY FOE: ATLANTIC HOMES OF OF "MINOR SUBDIVISION" AT MATTITUCK' TOWN OF SOUTHOLD SUFFOLK CO., N.Y. SCALE:: I "I1: 50' DATE: DEC. 16, 1971 71 - 758