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Home My WebLink About6619-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..Z608~; ..... Date ............. Aug ..... 50 ..... , 19..'/."it THIS CERTIFIES that the building located at . .Donna. Dz'tve ............. Street Map No. Deep. tIote. Cl~o~tl~o ........... Lot No. 2,9... P~at.tl.~;~0,~...N...Y.: ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~,]a,y.. 31., 19.73 pursuant to which Building Permit No....6.6.~.~.~ dated .......... June ....] .... , 19. -7-3, 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 .... Pri.v.a~;e..one. f~m$1y..cl~r~.~]-l~g .................................... The certificate is issued to . L,y~m .... l~l"m~.el ..... .~tne~ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ,~ug.. 29.. ~.97.~ ................... UNDERWRITERS CERTIFICATE No.. Aug.. 2[~. ] 97.~... ?.,..q~in~.a..n .............. HOUSE NUMBER ... 900 ....... Street .... D~ua. D~'Ave .......................... ........ ! t~-~ . .'..~... :~ .... -:--. ........~. Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CI-HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 6619 Z Permission is hereby granted to: ..... Lyau~.... ~a~r~aa,~ l. ........................................ ......... .?!.e..,a.~..q.w.....n.~.,n..e. ........................................... Ma t t i tuck to ..~L:_~J_~t~..~et~t..one..£ami&~..dw~l.~.in~ .................................................................................. at premises located ot .... 3,o.t....2,9.....Dee~p..~ote..~.eek...E&ta.~e~ .......................................... .............. .(..P..V~..I~ ........ [}.oxtna.. D~zzg. e ........... Ir~t.~.i~ack ......................................................... pursuant to application dated ......................!.[.a...y.. ...... ..~..1. ............... , 19Z.$...., and opproved by the Building Inspector. Fee $.~..6..,.~ ........... Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS Lb BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 o, te August 30, 1974 A..he.t,o. No. ou/.e686 91 N 180034 THIS CERTIFIES THAT only the electrical equipment ~s described belo~ and introduced by the applicant named o~ the above application number in the prem~es Mr. Ross Manarel, Donna Drive, s/off New Su£ffik~ve., Mattltuc~, in the following location; [] Basement [] 1st FI. wasexaminedon August 28, 1974 [] ~.d rt. Outside ~ctlo. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 16 2~I DRYERS TIME CLOCKS SYSTEMS NO. OF FEET E R NO. COND. O~ CC. COND, ~/0 OTHER APPARATUS: Electric Room Heaters: 1-2.0KW 1-1.5KW 5-1.OKW V I C NO. OF HI-LEG A. W, G. 3-. 75KW 6-. 5KW NO. OF NEUTRALS A. W, G OF NEUTRAL 1 4/0 Ross Manarel Me, ow Lane Matt~t~ckR L.I.11952 ~ ll COPY FOR BUILDING DEPARTMENT. THIS COPY OF ,CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 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. 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 $5.00 3. Copy of certificate of occupancy $1.00,, ~(~ ~ [.?..~ ~.. Date ............ New Building ..... i~ .....Addition ................ Old or,.l~re-existing Building ................ Vacant Land .............. Location Of Property ...... ~.~ ........ ~ ............... ...~.~ .......... Subdivision ...~..~..~...~...~....~ .............. Lot No..~...~ ..... Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval .~...~...~.:../.~.?...~ ........... Labor Dept. Approval ........ ..~....~..!..~... ......................... Underwrters Approva ....~..A~/.....,/.....~. ............. P annng Board Approval .../~../...~ ....................... Request For Temporary Certificate ........................................ Final Certificate ......~t~. ............................ Fee Submitted $ .C~.... ............................. Construction on above described building and perm,], meets all applicable codes/and regulations. App cant ~,. ~ Sworn to before me this ........ o, (stamp or seal) .I SUFFOLK COUNTY HEALTH D~?A~TM~NT Tbs sswage disposal and water supply facilities for this location have been tnspeoted by this department and foun~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ,,~Jx~v,4/ .y~, ./?_y~//~,~?c-~. Phone ~.~-~'~.~' 5. Subd!v.~e Address ~x ~~/~/~'.,~ //~ 6. Section _ 2. ~rRperty Location /~J~2~ /~/~)~ g~Y'~c 7. Lot Number ~~m~A ~/~m~a~ a~z~ ~/~/~. Private Well Village ~J~7~m/~ Township ~ m/~ 9. Public Water 3. Public Water Company Name ...... Distance to ~in Lot size: Width //~ feet Length /~' feet Sewag~ Disposal System: A.(/~allon septic tank: Prea~st~.Equivalent Block (For Health Dept. Use) B. Leaching pools: Number of pools Precast~B1 ock .Special ll .<~>~f pr$~ate well, fill in the ~ ~ol 1 owl ng bl an ks: ,-~. TaX capacity ~ ~ gallons ~. p G.P.M. ~ ~. T~al well depth D. [~th to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. Date /~/ Z ~ fi~ ' Signed F~/~'/(. ~Y~6//--I~J/~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ......................... FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~'/~?~ SIGNED ¢ ~ .~ S-15 Rev. 4/1/73 BUILDINg~ DEPAIrrMB, IT ' ' ~; ~ ~'*' ~ '~ TOWH C&ERIC'$ OFFICE ~ SOUTHOLD, H. Y. Application No .............~. ................. Disapproved a/c ................................................ / AP~LICATI lNG PERMIT, ; .- , Date ........ ~......~.....~../.... ................ ,9..~.~....'7 ..... INSTRUCTIONS a This application must be cam letel filled in b ' ewnter ~, ...... , ~-:_ .. ....... p. ,y. , . y ,t~p, ' o in ink ana suamitted in triplicate to the BuildingS, · Jn.s~, _r,-.w,~.n ,s se~ or pla~s, accuram p~ p~an to scare, rea accordipg to,schedule. -~, b. PIb, t p. la.n showing. Io~, a, tion o.f. lot and of buildings on premises, relationship to adjoining premises or public streets of areas, and glv!ng a detoll~3 aescnpt,on of layout of Preperty must be drawn on the diagram which is part of this application. · c; Th~work covered by thi~ application r~ay not be commenced before issuance of Buiiding Permit d. upon ~ppmval of this appl'ication, ~e Building Inspector will issue ~ Building Permit to the app cant. Such permit~l shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa rt 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 i~ud~fio~Zson, ~orO~ien~onCnsetr~titho~ oT~nui~ Soutl~.l.cl., Suffolk Cou.n. ty, New York, and other applicable Laws, Ordinances or Th . ...... ng~,., ,a~, ~t!ons or alteratmns, or for removal or demolition, as herein described. ' · app.cam agrees to comply w~m a, applicaole laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ......... ........ ...... · (Address or crpplicantl ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... .................................................. . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............................ :.: ..................... Plumber's License No. '~ ~.'~~ Electrician's License No ........ Othe_r Trade's License No ............................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy ............... ...... , ....................... b. Intended use and occupancy ~. ................ '.~..~[ ............................................................................... 3. ~ Nature of work (check which applicable): New Building ..:~i ........ Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Dl~:riptio~) 4. Estimated Cost ......... ~,~....U.....'~.......~.. ...................... Fee ...?....~..~.~.....O.. ..................................................................... (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 ..................... ~..~.~.. ........... ~ ................................................................................................ 6. If business, commercial or mixed occupancy, 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 ................................ new construction: Front ....... ..................... Rear ................ Depth ..~....~'/~..,~ .......... 8. Dimensions of entire Height .................... Number of ~tor es ..O. ~.~. ............ 10. Date of Purchase .................................. N~.mLe of Fqr,mer Owner .................................................. 11. Zone or use d str ct n wh ch prem ses ares tuated ......... ......... ~.J.~...~.~..-/..C]~. ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .Z~..~. ............................................... ]3. Will lot be regraded. ........................... Will excess fill be removed froth premis.es: ( ),Yes ( ) No , . 14. Name of Owner of premises ~.~./~.~. I~..~.i~.~..~... ........ Address ,i~..i~.~,~..~.~Phone No ..... ~..~....~..~.~.'.'. Name of Architect ............................................ , ................. Address ................................ Phone No ....................... Name of Contractor ...~...°...~..~.....~.l~/]~ .................. Address .~./i...~.J~.~...~... 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 whether interior or corner lot. STATE OF NEW_YORK,, !:'~-~: ' COUNTy Of ...'~.~..~.~<4 ...... .;....~--T,'~ . ............. .-.~...~...~....~......~....~..~.~."~"..%L~:J:;;.':;.t','. ....... ':~'~'.L"!:.,.;:t'.:..~>6~'~dUly sworn, deposes and says that he is the applicant (Name of individual ~tg~ih'g, cbntr~cf):;;(:? above named. " ' He is the ...................... ~,~.~...~..~ ................................................................................ (Contractor; 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 contOinqd in this application are true, to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the application filed therewith. Nato. ..... Co.,n ......... .................... - ~/ (Signature of applicant) TERRI LEE £LAK ~IOTARY PUBLIC, State o~ New York Cemtmission Expires March 30, 19