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Home My WebLink About6637-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED No Z--26184 Date DECEMBER 21, 1998 THIS CERTIFIES that the building DWELLING Location of Property 75 LAKESIDE DR. SOu'£'~ SOuT~OLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 90 Block 3 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5~ 1973 pursuant to which Building Permit No. 6637-Z dated JUNE 6, 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 DWELLING WITH ATTA~D GARAGE, P/~ARWOOD DECK AND COVERED FRONT PORCH AS APPLIED FOR * The certificate is issued to of the aforesaid building. DANIEL JENNINGS (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 3-SO-67-APRIL 24~ 1974 UNDERWRITERS CERTIFICATE NO. N-149408 - MARCH 20, 1974 PLUMBERS CERTIFICATION DATED N/A * THIS UPDATES CO Z-5876 D~r~u APRIL 30, 1974. ~)ector Rev. 1/81 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TO~'N CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6637 Z Date ............................. ~X,,me..... 6 ......... , I973-.- Permission is hereby granted to: .................... ................ ~...3~ ............................................ .................. Ja~...~.a~ea....~3~, ..... .1.1.7~0 ........... to .... ~.~;k~..~a~...oae..J~_~] ]t...c~tel3Aag .................................................................................. at premises located at .../,o~,..6~....Ced~a.~..~ae~..-ga-:e~ ..................... : ......................................... ....................................... aoatJm],~t ......... JJ,X.~.. " pursuant to application dated .........................~ ....... ~ ........... , 19..~.., and approved by the Building Inspector. Fee $..~"~, ~ .......... FO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~] 587b Date ......................... , 19 .... THIS CERTIFIES that the building located at ~_~ ...... Street Map No.. 9 ~ Block No. ~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... , 19 . _pursuant to which Building l~ermit No ..... & dv,,,e . dated ......... , 19 ...., was ~ssued, and conforms to all of the require- The certificate is issued to of the aforesaid building. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .~. /,'N ~ V/x ~ ~ k.',' E) L~' £ ~- k ~ ~t ~ (owner~ lessee or tenant) Suffolk County Department of Health Approval ................. UNDERWRITERS CERTIFICATE No ........................................... HOUSE NUMBER 7'-'g' . Street ~i O O T tq u t_ ~, 1,4 y Building Inspector FORM NO. 6 TOWN OP $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled ~n typewriter OR ~nk, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use. 1. Final survey of property w~th accurate Iocat,on of all buildings, property lines, streets, and unusual natural or topographm features. 2. Final approval of Health Dept. of water supply and sewerage d,sposal--(S-9 form or equal). 3. Approval of electrical instollahon from Board of F~re Underwriters. 4. Commercml buildings, Industrial buildings, Multiple Residences and sim,lar buildings and instailahons, a certificate of Code comphonce from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requ,rements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~shng" land uses: 1. Accurate survey of property showing all property hnes, streets, buildings and unusual natural or topographic features. 2 Sworn statement of owner or prewous owner as to use, occupancy and cond~hon of buildings. 3 Date of any housing code or safety ~nspect~on 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 dwelhng or land use $5.00 3 Copy of cerhficate of occupancy $1 00 Date ........... .~.Z'3~ ..... /..~...~.. ............... New Building ..... ...~....... Addihon ................ Old or Pre-ex~shng Building ................Vacant Land .............. Lo:at,on Of Property ........................ .C ...... ~,, ................ ,~ x~~ ...................... ~ .... /~ ...... ~,t~ Owner Or Owners Of Property ..... ..~....~..~....~..~. .... .k~....~-c~ .... /,r~H..~..[D.~C~......L~.Z~: .................................. Subdiv,sion .... .~...~.....~.?.-- ....... .~..~..~......}7':~..~.~'e~.....~.Lot No....~.... Block No ............. House No ............ Permit No ...~...~..,~.~...~... Date Of Permit ...~/...(~../.)~.Apphcant .,, .~..?..~...~...4'.....~...~¢ .................................. Health Dept. Approval ...... ~..~..~....O..~.~...~. .............. Labor Dept. Approval ............................................. Underwriters Approval ................ICZ~...../...~..~....~....0...~... Planning Board Approval ........................................ Request For Temporary Certificate ....................................... F~nal Certificate .......................................... Fee Submitted $ ................................... Construction on above described building and Dermit meets all a, pphcable c?les and regulations. Sworn to before me this ..... ~..~..,~ day of ...... ~¢~cr_,~r~...../. ~ (stamp or seal) Notary_ Public ......... .~'~. Cou~u,~ ~ ~,.K,~ ~ ~ ~~ 52-03440~3 Suffolk Ccdnl~ ~mmts~n Expires March 30¢ ~9~~ THE Date ~a]Pc h THIS CERTIFIES THAT 149408 w~sway~ uecia~ ro~n~ Dr~ve, has~ ~al{es~e D~.~ ~ou~ho~d, ~.~. NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY. · 8S JOHN STREET, NEW YORK, NEW YORK 10038 l? 7 ~, ~pplicotio. ~o. o~ fle ~' 8 819 3 N in~hefollowinglocation; [] Basement [] ~tFt. [] 2,,a Ft. outside March 18, lqTh ~tio. Bto~ Lot and found to be in compliance with the requirements of this Board. DRYERs FURNACE MOTORS FUTURE APPUANCE FEEOERS MT. K.W. OIL H.P. OAS H,P. AMT. NO. A.W.C RANGES ;PECIAL REC'PT JCOOK~NO OC-C KS OVENS J DISH WASHERS TIME CLOCKS' BELL UNIT HEATERS MULTI-OUTLET %t'A,~PS. .TRANS' .~ SYSTEMS SERVICE Gi~CONNECT I NO. OF J S AMT METER OTHER AFf~ARATUS= R V I C E NO*OF CC. COND. A.W.G, NO. OF HI-EEG A.W.G. PER ~ OF CC. COND. OF HI-LEG 1 2 EXHAUST FANS DIMMERS NO' NEUTRA[~ OF NEUTRAL Robert A. $~odale, 525 Orchard Sb., ~]ew Suffolk, ..I. 1195~r GINERAI, MANAGER Per ~' ,, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ak* BUREAU OF ELECTRICITY : ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ao,. February 27~, 1974 .~p..c.,,o. No.o./.. ?040S3 N 145604 THIS CERTIFIES THAT only the electrical ~Iulpment as d~crib~d Imlow and introduced by the app//c~n t ~ame~ oR th~ abo~e applic~tlon ~um~e~ in the l~emises of Windsway, Cedar Point Drive, Ea~, ~a~:e~oDrxve,, ~ou~no~, ~,~. February ~ ~.Q~ and found to be in compliance with the requirements of thi~ Board. ]-5 ~ Bg 14 15 DRYERS FURNACE MOTORS I FUTURE APPLIANCE FEEDERS AMT. ' K.W. OL H.P. GAS H.P, ~4T. NO. A.W.G. RANGES I 30 SERVICE DISCONNECT NO. OF 1 200 CB ~E~. O~HER AI~ARATUS: S TIMECLOCKS BELLIUNIT HEATERSUNIT HEATER$ MULTI-OUTLET AMT. ~PS* T~NS. ~ SYSTEMS NO. OF FEET V I C Of CC. COND. 3/0 OF HI-LEG EXHAUST FANS DIMMERS WATTS E NO. OF NEUTRALS A W. G. OF NEUTRAL 3/0 ~Wuture appliance feeder/s: 1-2#12, 2-2ff10 ~Unit heater:l- 4.Skw Motor/8: Elec.room heaters: 1-3.0kw, 1-2.0kw, 1-1.75kw, 1-].0kw, 5-.75kw 1-1.5kw, 2-1.25kwB Robert Ao Goodale, 525 Orchard St., Jew Suffolk, L.I.11956 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU.____~LATION [ ] FRAMING ~~=I~AL ~ [ ] FIREPLACE & CHIMNEY~- ...... ~ REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~FINAL DATE /,z/'//-/'//~'~:/:~ INSPECTOR DFC 2 111 8 TOWN, OI~ 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 1% 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 completed 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 all 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. ,Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw4mm~ng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00,, Com~erciai $i5.00 Construction ........... Ol.d Or Pre-existing Building ..... ~ ............ ~wer or Owners of Proper~y ................................................... ,unty Tax Map No i000, Section .... ~.m'. ....... Block ..... ~r.. ........ Lot ..................... ~t'mit No ................ Date Of Permit ................ Applicant ........................... ~lth Dept. Approval .......................... Underwriters Approval ....................... .arming Board Approval ........................ .,quest for: Temporary Certificate ........... Final Certicate...~ ....-- .... .............. · SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. ~'~)~7 APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant ba4,~6~ gj~ ~3,~,~& ~,~gPhone ' 5. Subdiv. ~ ~&~ ~ Address~ ~ &T'~,~ 6. Section~. 2. Property locationU~ &~'~ ~ 7. Lot No.~ -- ~~ ~, ~T ~ ~ ~a~ ~ ~ 8. Private well ~ Village ~,~ Township'_~AQ 9. Publio water ~ 3. Public Water Compan~ name ~ Distance to main ~ 4. Lot size: Width ~, W feet Length ~;~ feet (Enter on center plot below) 10. Sewage Dispos~System: A. ~' gallon septic tank'~_~Precast/Equivalent Block Special~ If private well fi! in blanks below: Tank ca%acityW~Ga~ Total W~ll depth~ Amount-of water in wel~ Test H~le Data '~=-- I Feet The undersigned CERTIFIES: "Construction of authorized installations wil be in accordance with the Suffolk County Department of Health~s current stand- ards thereto." C;~~2, ,, ,,~¢~, Date ~ Signed Owner or Builder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herew~t~, i is the opinion of the Health Department, that an adequate and satisfactory Sew Disposal System can be installed on this plot. Date Signed ~/ ~ S-15 Revised 4/]/72 e ,: Date ........................... l ....... , 19 ..... INSTRUCTIONS a. This application must{be completely filled in by typewriter o~. in ink and submitted in triplicate to the Buildlr~l' Inspector, with 3 sate of plan~, accu!ate ~lot.~olan tp ~eele. Fee according to ,~hedule b: 'Ple, t-p.I .on Sho~, ir~.' Iocafion'o.f?ot a.mJ. o(bui~s oq pr~"l~es, .a~l~f~3nshiP t~'adl~°ining premises or public streets areas, aha gwmg a aeta led description of layout atproperty must be drown on the dmgmm which is pm't of this applJcation~~', c. The work covered by this application may not be com.~enced before, issuance of ~u~ldlng permit. . d.... U,pon appm. val of t.his appl!cation, the Building II~r~WiH .l~s~ ~ Building :Far'it' to the applicant. Such permit snan De 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 Perm t pursuant to the~ _Build!n.g. Zon,e O .rdinance of .t..he Town.o.f. Southol,d., Suffolk Cou.n. ty, New York, and other applicable Laws, O~d!nancm or~, I~,egulatlons, Tar the construch0n of buildings, additions or alterations, or for removal or demolition, as herein desc.H_~._.3~, 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 for necessary Inspections. (Signature of al~licant, or home, if a co~5omtlon) · ......... (Address of applicant) I II~ ~ 0 State whether applicant is owner, lessee, agent, ~, engineer, g~or, electrician, plumber or bm~l~~ Name of ~ner of premiss .. {~.~ ..... ~ .. . ........ If applicant is o co~orate, signa~re of duly out~riz~ officer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No..~.~lll~...l~.l,.l~.~,~l~.~ Electrician's License No.. AImJ ... tl ......... ~her Trode's License No ............................................... ,o ..... Street and N.m~r ........ -- .... ~ ~ ~ ~ Munici~li~ State existing use and ~cu~ncy of promises and intended use and ~cu~ncy of prod c~stmction: a. ~isiting use a~ ~cupan~ . ................................................................................................................... b. Intend~ use and ~cu~ncy ............ ~.~.~....~~.~. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (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 ........ ~. .................................................................................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 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 ................................ ~ Height ...:j~[m.~. ...... Number of Stories ......... I ................ ~ .................... .: ......................................... : .............. ,. ......... 10..Date of Purchase ........................................................ Nome of Former Owner .-..~.~...~'~'4~. ......................... 1 I. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~..~. ................. !. ........................... 13. Will lot be regradec~ ............................ Will excess fill be removed from premises: (~Yes ( ) No Name of Architect .............................................................. e -- Address ................................ Phone_N6~"[ ..................... · Name of -- PLOT DIAGRAM Locate cleariy 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. 3. Nature of work (check which applicable): New Building (Name ~ i~w 8ual s gn ng contra~ above nam~i (Contractor, agent, co~orate officer, etc.) of said owner or owners, and Js duly authorized ~o perform .or have performed the ~id work ~d to ~ke and file this application; that all statements contoine~ in,is applieation are t~e to the best of his knowledge and belief; and thay the work will be performed 'in the mann~r~et fo~h in the application filed therewith. Swam t~fore me this RUTH M. MYE~ - k ikONT E L E M A'TIO N F_LEVAT c'I APPI~VED ,AS, NOTED DATE:__ ~ ~ ~'~-~ .~ NOTIFY BUIL'DING DEPARTMENT AT 765-2660 9AM TO 4PM FOR. REQIJIR. ED INSPEC flON$: I BEFORE BACKFILLING FOUNDA. TiON OR START FRAaING 2. BEFORe: COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED , PILOPOSEi) ,, I:LLSIDENCL , FOP., r FOUNDATIONi . -P.L A N o 1 T- L O0 F~ BEAI"I~' q' O.C, - PLUMI31N'~ btAGKAM , YE T iOkl. APPROVED AS NOTED DATE: FEE:__ NOIIFY BUILDING DEPARTMENT AT 765-2660 9AM TO 4PM FOR REQUIR- ED INSPECTIONS: 1 BEFORE BACKFILLING FOUNDA- TION OR STAP, T FRAMING 2. 6~-ORE COVERING pIp~cLINE 3. I'iNAL WHFN JO~ COMPLETED NOT RESPONSIBLE FO~ DESIGN OR CON-