The URL can be used to link to this page

Home My WebLink About6799-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. -Z6~3.~ ..... Date . N&l*elt 46 ................. , 1976. THIS CERTIFIES that the building located at F-~s~&rd. Court;, .......... Street ' Rastvard lianox, l~ttttuek, Map No ............. Block No ........... Lot No .... 1~ ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . August. 47 .......... , 1973.. pursuant to which Building Pemit dated -Au~tst .$?~ .......... , 197.~ ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pti-rate..One. Fami..~-y .D~l.l~ng ........................................ The certificate is issued to -Thomas. ~empe..{For~..E,. tto~ton. &. Sons. lac, ) ..... (owner, ~t ) of the aforesaid building. Suffolk County Department of Health Approval .M~..~e.h..~..1..~.6....RO. b.~.:..~!..i~.. ..... UNDERWRITERS CERTIFICATE No... I~. 2728~.~. ................................ HOUSE NUMBER ... ~7~ ....... Street ..... Eastwar~l .¢oux~.t .................... Building Inspector lvO~ NO. ~t TOWN O~ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N; Y. BUILDING PERMIT (THIS PEPuMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6799 Z Permission is hereby granted to: ~ HoR--re~ ~ ,.Ce,,/_- ~'~C__ H~"~ ~ -rU¢'~ ......... pursuant to application dated ............... ' ! ~ ~ ~'~' 19Z.~.... and approved by the Building Inspector. PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY REGRAD1NG LC~T ~ DRIVEWAY ~('?~ Tr~.lJCliON ~ -- CFSSPOOL CONS ~ P,!jCTION ~ CELLA~ CQNSTKUCI'ION OTHER ~ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Depar~ment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANGY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--($-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Ntultiple 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), 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 $1.00 $5.00 .5../.1,6./.76 Date..... ................................. .... .. . New Building ...... ~v~ .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...~.$...~,D.~i.t:~;C.~..~/[L1;lg~.~.....~.~.~:~.~.]R.~....h'..s..~..*. ........................................... Owner Or Owners Of Property ......~:-..~....,~...,H.~.s...-.....'.n~....°..~..a...s.....R~,.~..e. ............................................................ Subdivision ..... .~..a...~.~.a.~.d......~....n..o.?.. ......................... Lot No....~.. ....... Block No ............. House No ............. Permit No....6,.~..?. ........ Date Of Permit ...8./..]:?./..~...~..Applicant ..~..~.e..Tt..e.~.G..~?~.~..~.~.~.~.~...~.~.~.~..S.~.~.~.~.~.[..~..c.~.* Health Dept. Approval ......... ~ .............................. Labor Dept. Approval ................................................ Underwriters Approval ............. ,~.~ ........................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .... ~ ................................ Fee Submitted $ ...5...q..0..0. ......................... Construction on above described buildingra,nd~permit meets all appel, cable codes and regulations. Sworn to before me this of ................. otar Pub,ic ............ Cou.ty NOTARY PUBLtC,, Sta L~ N<), 52.8[25850, Suffotk Co~Y~ Tiem E~p~s M~rch 30, tg~ (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS dl BUREAU OF ELECTRICITY I 85 JOHN STREET. NEW YORK, NEW YORK 10038 "ate March 9, 1976 ,~pp"~."o-~'o.o-.f"e820331 N 272847 THIS CERTIFIES THAT only the electrical equipment az described below and introduced by the applicant named on the above application nu tuber in the premise~ of Eugene Horton & Sons, e/s Eastward Court Locust avenue & Cardinal Drives, ~ttituck~L.I. in thefollowinglocutlon; ~Basement L~/st FI. [] 2nd Fl. out sideSection Block Lot u'as exa,nined on March 5, 19 7 6 and fouud to be in compliance with the requirements of this Board. 13o D~S i FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT NO, OF S E -- , METER OF CC COND. i [z50 CB x 2/0 OTHER APPARATUS: RANGES COOKING DECKS OVENS DISH WASHERS SPECIAL REC'PT[ TIME CLOCKS BELLIUNITHEATERSUNIT HEATERS MULTI-OUTLET 113°/ R V I C E EXHAUST FANS DIMMERS NO OF Hi-LEO A w.G. OF HI-LEG 2/0 Motor/s: 1-1/2hp Dettner Elec. Co. Box 482 Rl~erhead, L.I. 11901 LIC# E643 P~,- GI:NI:EALD~, ,~MANAG II ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number Village ~(~-~rkJ~.)¢_ 3. Public Water Company Name 4. Lot size: Width~m~feet 10. i~ewage,~sposal System: ]~!: O~gallon septic tank: Precas~'~Equivalent B. Le~hing pools: APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Applicant ~ ~~&~Phone~5. Subdiv.~ 'Address Location 6. Section Property.. 7. Lot Numb~ 8. Private Well..~~ ll. Block Nun/~er of pools Preca~ck__~pecial 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 Township Length_~feet 9. Public WateF Distance to main (For Health Dept. UsG) 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. Date ~--.~1/ Signed~~~~~m~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 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. APPROVAL DATE XZ '7/77 SIGNED ~ -- ~ __ S-15 Rev. 4/1/73 :/G,...,4 y ~ ,~' TOWN OF SOUTHOLD *'/~/'~"' ?~,~ ~* ~ v~ ~ ~ ~')~ ~ ~ ~~ - BUILDING DEPARTMENT~~I~ ~ ~ ~ 0(~ ~ ~ ~ . n,~,,Y ~ ~.~.~,~,~ ~OWN CLERK'S~FI~I (7(- ~ ~ ~ ~ ~ Examined .................... ~ .................. , 19 ........ Application ~o. ,~, ............................. , rove ..................................... ........ ..................................... Dsa roved a c ~1 ' ~ }'~'"~ (B~il~i~"ln~tor)' '~''J ......... ~ ........... ! APPLICATION FOR BUILDING PERMIT / ' Date INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in tripI cate to the Bu Icling~ inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofprpperty must be drawn on the 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 on the premises available for inspection throughout the work. e. No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Perm t 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 a.terations, or for removal or demolition, as herein descr bed; 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 fear ~'e~ssary inspections. Sta e whether applicant is owger, lessee, c~ent,~architect, e~gineer, general cbntractor, lelectrician, plumber or builder ......................... !... ' I licant isa ra s' o uly authl~ed o~Fi~'er. ~ and title of corporate officer) (Signature of applicant/or name, if a corporation) (Addres~ of applicant) Builder's License No ..................................................... ~)~ ~ Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... _/ 1. Location of land on whi~3 proposed.work w be done ~ap No.~...(~Jl~,,~- Lot No Street and Number ..~.~"~'~'...~...~..~.-~ ~,~r~"' '*' I~ .................... Municipality 2. State existing use and occupancy of Pr~l~nises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ... t..~c, - . ............................................................ b. Intended use and occupancy ....... ..~....~...~ ....... ..~.....Q-.'..~..?~ .... ~.....~......~...~.~.~-~ 3. Nature of work (check which applicable): New Building .......... Addition .................. Alteration ................... Repair .............. ..~. I~emoval .................. Demolition .................... Other Work ...................................................... C, eet~.~.~ (Description) 4. Estimated ~ ...................................... 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 c~rs ...........~ ............................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of e~ch type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of s~rne structure with alterations or additions: Front ....................................Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....~.~ .................... Rear ...i~.~ ............. Height ....~/t,~, ........ Number of Stories ..... ~t ............................................................................................................. 9. Size of lot: Front ...... ;1~~. ....................................... Rear ....~.,,I. ..................... Depth .....~..~...,~. ........... ]0. Eh3te of Purchase ..; ..................................................... Name of Former Owner ........................................................ ! 1. Zone or use district in which premises ar~ s~tuated ........ A ......................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ ......................................... be regraded ....,.~ ............ Will excess fill be removed from premises: ~ Yes (' ) No 13. lot 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect ............................................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly ~nd distinctly all bui~ir~gs, whether existing or proposed, and indicate all set-beck dimensions from property lines. G~e street and block number or description according to deed, end shdw street names and indicate whether~nterior or comer lot. STATE OF NEW YORK, t¢c COUNTY OF ................................ · " "~ '" "~'"'~'"'~ ~ '"~ "'"""""}'l~'l;;~Y~i";i~;i~~ .......... being duly sworn,'d~o,s eod~eys ,~, he is the applicon, above nom~: He is the .............. ~.~.,~ .......... ~~ .................................................................. ~ ................... ~Controc~r, Ogeht, c~porote offic~;~tc.) of seid ~ner or ~n~, and is du~ authorized to perform or have performed the said work ~d to ~ke and file this application; tho~ oll stotem~ts con,oined in -this opplicetion ore t~-~ the best of his knowledge and belief; and t~t the ~rk will be.~med 'i~ the m~ner s~ fo~h in the oppl,icotion filed there~it~ ........ ......... .: Nota~ Public, ....~ .......... :....~ ....... ~,,~,~, C~n~ .......... TERRI LEE E~ ~T~Y PUBLIC, S~te 0f New N0. 52-6t63295 ~ui[ified in Suflcik County ~mmissi0n Expires March 30, ,I MAIN ROAD (N. YS. N. 82°20'40"E' LoT5 SUf'FOL!( -7 ,f i , .. The ..... ~hief 't)f'G~neral Engine ~r1~ Services RTE 25) LOT 3 19e.se' - - LoT 4 ~ N. 89028 SIOOR SURVEY FOR THOMAS E. 8 JOYCE g. REMPE AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE ~ I'% 50' FEB. 3, 1976 REFERENCE ' EASTWARD MAhlO, F/LED 5 ~ -21-71 ~JARANTEED $O(ITHOLO $ SECURITY TI RIVERHEAD~ N.Y. 0 TiON.. ST^~T