The URL can be used to link to this page

Home My WebLink About7527-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.Z~37~. ...... Date ............ ~r0b,... ~....., 19.~.~. THIS CERTIFIES that the building located at . .l~ew. 8u.f£o~k. ~,.v4 ........ Street Map No. Deap .Ho].e. (~oc~o ........... Lot No...1~ ..... .~a.t.~;$~;.u~..k....lq.:Y., ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... AU~ .... 20., 19.7~. pursuant to which Building Permit No..7.~27~. dated ............. F, ap~;...9., 19.7.~, 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 Pr~,~a~;e..one. ~.~Y..~l¥.e.J,~t4~g ........................................ The certificate is issued to .. Fr~ncea .Roz.e .l~olaes ......... . .0~..e..r~..b.u.i..1.d.e.r. ....... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval [~ar... ] 9..197~...by. .V£ la ...... UNDERWRITERS CERTIFICATE No.. N..20~;7.~-%.. · Jan.. 21~.. ~.9~ .............. HOUSE NUMBER ... ~9~0 ...... Street .... lle~..Suf£o~k. Axe .................... Building Inspector FOaM NO. 2 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7527 Z Permission is hereby granted to: ..~&Z~8..~c~e.. ~n~e~...T.l~, ........................ ..~.~...1~3~ ....... ~.~.~z..?.g~.~. ........................ at premises located at ....~.~....~.....~.~..~.~.~,~...~,~:.~.t,d~td~.E .................................................... ~ ~ .....~..~.~.~.~.~...~ ................................................... ............................................. ...e~...~......~..~..e ........... pursuant to application dated ................... ~,13~ ....... ~,(~ ................. , 19~,..., and approved by the Building InSPector. FORM NO. 6 TOWN OF $OUTHOLD , 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 end 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 ....... ....... New Bq Iding ~..~.. ~ Addition 0 d or Pre ex~shn Buddln V · "~'- ......... , ~ ................. ' ' g ' ' g ................ ocapt Land .............. Permit N~..~..Q'..? ..... Date Of Permit-- ........ ApplicantT~.~ ...................... Heo th Dept. Approval ...~/...~..~..././..~</. .................... Labor Dept. Approva ................................................ Underwriters Approval ~....O...~,~.~..?..~.~.. .................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ...~.~--~ ............................. Fee Submitted $ ....~.,.~ ............ Construction on above described building or'permit meets all applicable cock~ and regulatigns. Sworn to before me t}fl~I , ~//~~-- --~(~a~ ./~ - - ...... '~"'"'[ day °f "'"'~" ~'/~'"~"~" ) ................ (stomp or ,/~'~ ~, ~._ Notary Public ...... ~ ~... Coun~ 7 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-~u~l~cateto the Building Inspec- tor 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 installa- tions, a certificate of Code compliance from the Architect or Enqineer 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-ex'sting" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owne~ as to use, occupancy and condition of buildings. ,3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate., C. Fees: 1. Certificate of occupancy :$5.00 / 2. Certificate of occuDancv on ore.exi~t n ~~d ' /land --J're-Exist~.ng C.O. $15.00 · ' ,,, .. . g____ use C' 3. Copyofcert~flcateofocc. Vacant land C.O. $ 5.00 Date . . .~ ....... ~ .......... . I~ew Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............ ~? r,~/ , House No. ' Street ......... I'/am/et Owner or Owners of Prope~ .... -~ ,ooo ,c,,o ........ ....... ........ Subdivision ~ No ......................... Lot No, Permit No Date of Permit Applicant Health Dept, Approval ................ Labor Dept Approval Unde~riters Approval ........................ Planning Board Approval ..................... Request for Tempora~ Certificate Final Certificate Fee Submitted $ Construction on above de~ribed building and permit meets a~l applicable codes~nd regulations. R~. 10,10-78 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~IS~CE~IFIES THAT ~ttituck~L. [_ ~ 10[ 28 14 ~ ~lYm ou CS £de ~,~'tlon Block RANGES COOKING DECKS [ OVENS FANS Four ;otnC Elec. Iac. 863 U. Jericho Tpke. hith=eun, L.I. 11787 D SUFFOLK COUNTY DEPARTMENT OF HEALTH ~~ H.D. Reference No. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM t. Applicant 2. 4. 10. .:'R.~--mC!;iS PC~E .~[O~-m---'-e I-~.C. Ph°ne~14 Subdiv.oEEp HOLE C~F~K ESTA~S Address ,~O ~ I~,~,,,~,~A~; ,.,._~C~X ~ ~f,K~ P~. Section Property location i~/~ ~.~1 ~[l,.~i~ A~,; ~.~'7. Lot No. ~6 =~n ~,m:~a ~ 8. Private well ~ Village ~A~PITH~f- -~T~--S~II~N~L~ 9. Public water ~O Public Water Company name Distance to main Lot size: Wid~.~r~eet Length~ feet (Enter on center plot below) Sewage DisposM1 ~s~em: i86' l~eg A. /90~ gallon septic tank: Precast X Equivalent Block B. ~L~ching pools: Number ] Pre~a~t X Block ~cial -- in blanks below: Tank capacity zl~Gals. Pump G.P.M. M C, ml,.= Total well depth_~oJ__ Depth to G.W. Amount of water in well 40 A~l~ Test Hole Data Feet 0 2 4 6 8 10 ~/ 12 16 18 The undersigned CERTIFIES: "Construction ~ au%horized installations will be in accordance with the Suffolk County Department'*of H$~lth's current stand- ards there_to." \// Date~ ~ 1,7~ Signe~/l~/~~~ ~ ~ / I O~4'ner or Builc~/- FOR HEALTH DEPARTMENT USE ONLY. Based on the information ~resented herewith, is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this plot. Date ~ Signed S-15 Revised 4/]/72 Examined ~'e~ ...~......~.. ............. 19~_....~, .Application No...../~.~.........~..~......~.~ ' Approved ............ ~.( ........... ~. ........ , 19~.~Pe~itNo... ~ ~ ~,~ ~ Di~r~ a/c ...~~~~ ~ ................................................. , ............................................ AePLI~ ~ ~ mN; P~IT, ~ m~ ~ Dat ........ ...... ....... , INSTRUCTIONS ~ a. This application must be completely filled in by typewriter o~, in ink and submitted in triplicate to the Building~ Inspects, with 3 eete of plans/accurate plot plan to scale. Fee according to schedule. b. Plot pi.on showing location of lot and of b~ildings On premises, relationship to adloming prem~se~ or public streets o~ areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of this application. c: The work covered by this app!ication may .not .be comme_nced before issuance of Building Permit. ~ d.. U.pon.apl~..mval of this apg!Jcation, the Building I.nspee?~ wJl! issue ,a Building Permit to the applicant. Such permit~ shall be kept on me premises available for inspection mtoughout the wor~ 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 Dapartment for the issuance of a Building Permit pursuant to the, Building Zone Ordinance of the Town of Southold, Suffolk County,,Lqew York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteratio~.,~o.r for removal or demolition, as herein dascrlbec~ The applicant agrees to comply with all applicable laws, ordinances~bJuddtng code,~housing code, and regulatiom, admit authorized inspectors on premises c[nd in bu~ldh::~gs, for neci~ ~~..' "(Address of applicant) State whether applicant is owner, lessee, agent, arChitect, engineer, general contractor, electrician, pluml~er or builder. .,~), ~Na, m. ~__a_n_d title of c~rate offtcer) ~_ Builder s License No ..................................................... 26~ ? .................... Plumber's License No ........................... L Electrician's License No. 30~ 1. Location of land on which proposed work will be done. Map~o.: .......... ~l~,ll~t....:..., ........... l:~e1~o ....... ~ ............. M~ay 2. State existing use and occupancy of premises and intende~, use and occupancy of proposed COnstru~len: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .Z.. ............... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ................................................ ...... (Description) Estimated Cost .................... ~...~1,~ ~.(~.,..(~ ........... Fee ......................................................................................... (to be paid on filing this opplic,,ation) ll~ 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 ................................ 8. Dimensions of entire new construction: Front ..... ...~-...~. ...................... Rear'....~...~: ............... Depth ......-~r.~ .... Height ...,/..~.. ......... Number of Stories ............... /.. ..................................................................... ~86'~'~'~'*~'*~'~ 9. Size of lot: Front ..... ..~..~.~...~..0~.~ ................................. Rear ..... .1...]:.0..,...0..~ ....................... Depth 10. Date of Purchase ...... ~tl~r,.l~..~...~.'Z~ .................... Name of Former Own~' ..~j~[~l~...~ ........... 11. Zone or use district in which premises are situated ............... : .................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~. ............................................ 13. Will lot be regraded ......'~...S.. ................ Will excess fill be removed from premises:~[-)' Yes (~N~) No FE~OES ROSE HO~ESs~NC. P.O.~B~ 1033~ROC]~ I~T Phone No.' 744-1414 ! 4. Name of Owner of premises ....; ............................. ; ................. ,~oclress ...................................................... Name of Architect .............................................................. A~b~ress .............................. Phone No ....................... --'"--- [533, Name of Contractor ~..[~.~..~..~..~[{)~elJ~.e ..... Address ..a0C~..~,~J~'... Phone No.. ?..~....-.~.4..]...4.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. 5. STATE OF NEW~OR~ JS e 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 contained in thts opplicatio, p,l~ true t~ the best of his knowledge and belief; and tha~ the work wJlJ be performed in the manner set forth in the al(plic~ion filed therewith. Sworn .to~efore me this .... I / Z ,/ ...... ..¢. ............. ................... , ,,.....?.. \1. Notory Public, ~.~..~...~..F.L..:,..l~ounty ...~ ..~.../.~./~./~., .................................. A lC sCHRAMM/ (Signature o plicant) ~ ~l~V~7.dL. FI~S. No 52-~i30650, Suffolk Counf~ Commissi~n Expires March 30, NE W SUFF O L K ,~ VENUE .~ - s ~°oa'oo'~. ~aoo~'~ ~ , ~oa'oo'~, NOTE J: MONUMENT SUBDI~SION I~.a~ ~EO IN ~ O~ICE OF Y~ C~KRK OF ~0 ~ K C~N T Y ON J~N. ~ 1~5 AS Fl~ [ ~ ~56 Lo/45 lot ~6 Areo= 30714 Lot 71 i1000%~.~ ~ Lo! ~8 REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SUEVEY FOE: BEN M ENDOZZA LOT NO. 46" DEEP HOLE CREEK E// ~-- .~, .,,;.' ~,.,..~,;,~. TOWN OF SOUTHOLD a j{ ~r.~I , I~ SUFFOLK CO., N.Y. ~~~'~g SCALE: i% 40' I DATE: AUG 10,1973 ~u DIETZGEN 135 11846 NEW SUFFOLK Lot 45 La! ?/ x~VENUE Lot ~ Area -- ~0~'1~ sq, ft Lot 4~ iI, J I ,.1 -II .3~ Z/~L,.cy Co,Cs o~u O,o~a~TE. -O " 7-o 0 7-0 7_0, ~ I