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Home My WebLink About6819-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC~umANCY No Z-25284 Date SEPTEMBER 30, 1997 THIS CERTIFIES that the buildin~ DWELLING Location of Propert~ 63165 COUNTY ROAD %48 House No. Street County Tax Map No. 1000 Section 40 Block 1 Subdivision Filed Map No. GRE~NPORT, N.Y. Hamlet Lot 14 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 23, 1973 pursuant to which Building Permit No. 6819-Z dated AUGUST 23, 1973 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DW~.ING WITH GARAGE DNDERAS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 MARTIN C. & DORIS PFEFFER 3-SO-120 - AUG. 27, 1979 B-053490 - JANUARY 13, 1997 Building In/ector FOF, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6819 Z Date ........................................................ , 1 ........ Permission is hereby granted to: ~l-t~n Pfeffe~ t l~ld new ~mo family dweZling at premiss ,~at~ at S/S ~0~ ~ (C~) ...................... ~.~eenport R.Y, ........... pumuan, to a~lication dat~ ...................... ~......~ ................. , 19~..., and approv~ by the Building Inspector. Fee $....~O.~..tO ...... Building Inspector Form No. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of ccmpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '~pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees "1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. ~2. Certificate of Occupancy on Pre-existing Buildinm - $i00.00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50400 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction .... ./%. ..... 01d Or Pre-existing Building ................. Location of Property..~J~.~JJf[... /~g(~ z/.~. .'.~.~./~.zy/~.;¢/:: .~/.:~/. House No. Street Hamlet Onwer or Owners of rroperty ...... ~% ...... ?.' .................................................. county ~ax Xap No 1ooo, Section.~?~'MZ.f£..Bloc~...i ........... Lot..~¢. ................. Subdivision Filed Map Lot .......... Fermi= o.¢iR ..... ate of ermit...*pp,icant ..... ..... ' ..... ........ Health Dept. Approval ......... .~. .............. ,Underwriters Approval . ~ ........ Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Ceruicate.....~ ..... Fee Submitted: $.. ,~.~ ,, ,i' . APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS 8~64086 BUREAU OF EI. ECTRICITY [-- 85 JOHN STREET, NEW YORK, NY 10038 D.t. JANUARY 13,1997 Appl~cation~o.o./ll~ 13163297/97 H O5349~ THIS CERTIFIES THAT MARTIN C. PFEFFER, RD BOX 63165 R?.48, GR~NPORT, N.Y. in r~-f~.X I.~tlo.; [] B.~..~nt ~ Ist FI. [] Z.~ Fl. GAR/OUT .~e~t;o. Block ~.~ examMed on JANUARY O7,1997 &,~d.~o#.dtobeMcord~d~.,tZAt. AeNndom~F. iecrri, c~C~b. Lot nxnm I.---- .] _..__. ] RX~ MT, K.W. OiL H.P. GAS H,P* AMT. NO, ENTIRE PREMISP. S - SMOKE *NO VISUAL D~FECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious -~nsatisfactory condition was found. MARTi~ C. PFBFFER RD. i BOX 63165 RT. 48 GRE~RPOR?, NY, 11944 ¥ I C IH wm MUtTI-OUTI~T NO, OF RNT EXHAUST FANS AMT. #. P. This certificate must not be altered in any mapr4r; return to the office of the Boord if incorrect. Inspectors may be i ' by their credentials. COPY FOR BUI~L~DING DEPARTMENT. THIS COPY OF CERTIFICATE NUST NOT BE ALTERED IN ANY HANNER. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z966/* Date ...S.e.P.~.e.m.'9..e.:'. ~. ., 197.9. THIS CERTIFIES that the building ................................................ Location of Property 6~q69 Court.fy .R.~.a.d..~7. .................. ~us~ ~/'o. ' ............. Street Hamlet County Tax Map No. 1000 Section ....~.0... ..... Block ... 0.'1 .......... Lot ..... .1.4 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .A.u.g~..s.~..~.~ ......... ,197.3. pursuant to which Building Permit No... (~'I.gZ ............. dated .. P~UgLtS.~, .23 ............... 19 .~.3, was issued, and conforms to all of the requirements of thc applicable provisions of thc law. The occupancy for which this certificate is issued is ......... ........... .~r.Lv.a..~.e...~..e..~..~.~..~¥...~..e.~.~.~.n. g ..................................... The certificate is issued to I~,RTTN .~. ~. ?.F.~.F. ]~.~.. ........................... ............ (owner. of the aforesaid building. Suffolk County Department of Health Approval . .~a~Oa.l.20...6.UgLtS.~ ·27,..'~979 ........... UNDERWRITERS CERTIFICATE NO....P.~ .n.ct.~.~g ...................................... Building Inspector Rev 4/79 7G5.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ~ULATION [ ] FRAMING [C~INAL [ ] FIREPLACE & CHIMNEY /~. / DATE)/9/~~//' ' I NSPECT~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. i ]] :OUNRAMiDNA~ION 2ND [ ]FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] RO/UGH PLBG. [ ~,,]"INSU~TION [ ]FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE ~/~'/~ INSPECTOR ~~.~/'~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~IFINAL DATE IINSPECTOR~~.~_ SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date ~/~ /~ ~ Approval to~ ~onsJ~ruct sm.id_svstems_ia ~equ~ied,pertinent data herewith: Address ' ~ ' - 7-Sectio~ 2-Detail~c~ation ~]~ ~A'~'$~ ~ 8-Lot No. ' Hamlet ~$;~'~n~'~ Town ~$~,~.4~ ~ 9-Private well? 3-Public wate~'suppl~ n~m-e' Dista~ to nearest main 4-Lot Size: Width.~ft. Le~gth~t. (also enter on center plot plan .below:) ~-~elnng: Sing~ ~amlly A~ T~'~amily? L/Cellar? ~.Slab? ZJCrawl o~ce? ! ! 10-Proposed system: Septic tank ~_/Precast ~/CesspooIs ~/Shallow pools / /Other ! / l 1-Septic tank inside dimensions: Volum~ls.Length.~__f%.. Width_~'ft. Liquid depthFF ft. 12-Precast sections: ~Number~Sar~'-~. Cesspools: Block sizeL incs.D___ins. R ~ns. Total blocks below inlet: ~1 ' $2 PLOT PLAN Capacity Gals "~ IE G.P.M. O ~ ~ c .Grade ~m GW.L. 0 Data ~eet ~,~ ~ 6 ;ill I I I'-" ~1 ~ I~ I I_ ~I ~ ~: I I / · 2' I I T~~: "Construction of authorized installati~ will be in acco~a~wit~e Suffolk County Health De~rtments' current Standa~ulletins, a~ am~ments~ereto, covering P~ivate Se~ge Dis~sal Systems". Date Signe~ FOR ~ALTH DEPART~NT USE ONLY· Based the info~ation presented he it-is opinion of the Health De~rtment, that an adequate and satisfacto~ Se~ge Dis~sal System can be installed on this Plot. Date ~ /~/7~ Signe~~ (10/65 Revis.) r%~%~.~'C'~ "~:~'~"~'~ ~'~ TOWN OF SOUTHOLD-'/~;~._/'~ ~w.~,~' ~,,,.~- ~,~..~ BUILDING DEPAItTMEN'F~'~! '~' -, r~ .~. ~,~ /~c,~ TOWN CLERK'S 19 ............ ote ............................. , 'Z._~ '/6. INSTRUCTIONS -'~'- 7 ~ a. 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 and of buildings on premises, relationship to adjoining premises or public streetS or areas, an_~ 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 ssue a Building Perm t to the app cant. Such permit .shall be kept,qr~ 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. ' APPLICATION 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, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructio~n of 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 necessary inspections. (Signature of applicant, or nanfe, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... 2(az:f, in..C.,./=~f/'ez.. ......................................................................................................... If applicant is &co'or'm, s~gnature of duly authorized officer. ~Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No .... ~~ Electr c an's L cense No ~ Other Trade's License No ................................................... ~/ 1. Location of land on which proposed work will be done. Map No ................... (....~. ................... Lot Street and Number .Nn.,LI,.~g.~,~.,..~qa~,~,~n.-../{~..L~;~.c_.~3.~9..~,..Ngr~h.~.~...~.,~b~ ............................. Oz'eenpo~t,s New Yo~k Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... }[~ ...................................................................................................................... b. Intended use and occupancy ....~[..~..1,]~ .............................................................................................................. Nature of work (check which applicable): New Building ..... ./; ............... Addition ..................... Alteration..~ ...... Repair ......................... Removal ......................... Demolition ........................ Other Work ......................... ~ ~ /0 I Description) · Estimated Cost .....~.....~':... ................... Fee .../:..d....~:....: ....... .~ ....................................................................... (to be Paid on filing this application) If dwelling, number of dwelling units ....... ~, ....... Number of dwelling u, nits on each floor ............. ~. ......................... If garage, number of cars .......... 2. ........................................................ :....; ................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ............e..e...~...- ............ Dimensions of existing structures, if any: Front ...... ."....-...~..... Rear .....-...,-....-. ............. Depth...~......=- ....................... Height. .......... ..-....-...~..c....". .............................. Number of Stories ....... .~...~..n. ~.. =..-. ............................. Dimensions of same structure with alterations or'additions: Front .......................... Rear .................... : .................... Depth.......-..........- -. .................. = = . ...... Height .........~..7...7....-...= ............... Number of Stories ....~..:...:.~.T. ....................... ' Dimensions of entire new construction: Front .......~3,:. ............ Rear ...... ~, .................. Depth ..... 35. ....................... Height ........... ~,~ .................................. Number of Stories .......... ~.~t ........................................................................... Size of lot: Front ...... 3.6.7../3. ................... Rear ........ ~?~, ............................ Depth ......... .?25. .................................. 10. Date of Pu rchasa ..A,P, gP, clA~...i~.~.~. ............ Name of Former Owner ...... ,} f a3:..~ ^. ,.,~:.e~¢,1,~.¢.9 ...................................... 11. Zone or usa district in which premises are situated ............................ 12. Does proposed construction vioTate any zoning law, ordinance or regulation: ...... )~g .................................................. 13. Will Iotbere~'aded__.~la ........................... Will excass fill be removed from premisas: [ ] Yes []:] No 14. Name of Owner of premises ..Jlaz'+.~- ~C-..]~£a£;~e=,..R.,O~.21~r,.)~0Jl,..~a;t,a, itket~ .......... 75[L.-~LL03 ......................... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Addre~) (Phone No.) Name of Contractor .......................................... ~ ........................................................................................................ (Address) (Phone No.) PLOT DIAGRAM Locate claarlv end dlatinctly all buildings, whether existing or proposed, and indicate all sat-back dimengiorm 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. ,EW :COUNTY OF~ ................... ) (~=me o.f'~:~'~,~'~'~,~r~;~;) .................... being duly s~rn, de~s ~nd says that he is the a~li~nt abo~ na~. He is the ............................................... ........................... ..................................................................... of said owner or owners, and is duly authorized to ~orm or ha~ ~t~ wo~ and to ~ke and file this appli~tion; ~ all Statemen~ contained in this appl cation are true to t~ ~st of his~o~,~li~hat t~ work will ~ ~or~ in ~e ~t fo~h in the ap~i~tion fil~ t~mwith. =2 0344963 Suffolk , ~ Ho. ~ - L ri~l?oTdK O0%TNTY HEALTH ~ AUG 2 7 1979 ~he 3ewage disposal and water sup~l~ facilities for this location have~be~n inspected by this dopartmen$ ~d ~ound Chisf of General Englne~in~ Servteea ) IN/IA P OF' [_.AND