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Home My WebLink About7547-zFORM NO. 4 TOWN pF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin~ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....... ~I0~18 .... Date .... ltarch..t.2, .................. 19.8.1. THIS CERTIFIES that the building ................................................ ~'~o~~ ~o: cu t~.ho~,e.,..~... ?.o?.k.,, Location of Property Oak. ~t;z'eo.t,, .......... ~l~t' ............ Ham/if County Tax Map No. 1000 Section ... 136 ...... Block ... 01 .Lot 03'/ Subdivision. £u~en.a .He:l. gbt,, ............. Filed Map No. 8.5.6. ..... Lot N03.8 .'.3.9.'~ .4.0 ...... conforms substantially to the Application for Building Permit heretofore filed in this offic~ dated · · 3~ptami~or. P. ll .... ,19..'~{turSuant to which Buildin~ Permit No ...................... dat~ ...&eptembar. aO .......... 19..~$wuimu~cl, andconformsto ~ ofthorequimments oftheapplicablepmvisio~ ofthe~w. Theoccupancy ~rw~chthis~rtifl~to~issu~d~ ......... ~lY D~9~lin and Garage · ................... Eviv&te. Ome~ ....... g ................... The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval ....1'2/. 1 3/.?.8. B~.l~q ~'.t.. A ~. y.i.l. 1..a .......... UNDERWRITERS CERTIFICATE NO ........ N. 5!0.l~10 7 ............................... · Board of Appeals ? Approved#1867 Rw. lJ~1 FORM NO. ~ TOWN OF SO4~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7547 Z Permission is hereby granted to: ~Z~S :~. ~ ~ .. ~0~.'~ tA~ug~x' ............................... .Bex.. ~,~,.....~les~,oek...l~ ................................. ...k~'~:J.a..~ea~,~. ...... ~L,v. ............................... to .bx~.~..n~.~n~..fa~t~-¥.~e~:L~..~&~.~arag~cappr~a&~bY~3~App~a~ S ) Lots ,~8 ~0 ~..l$.zene Hei 'chi at premises located at .................... t,.~.& ...................................... g ................................................. ................................................... .0....a~.....~.~eet gutcho~ .. I~ .Y, .... pursuant to application dated ......................... D~P,.....~8 .............. , 19.~.., and approved by the Building Inspector. Fee $..~.~ .~ A.'J.t~ ........ .......... ~;Idino Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Depaf[ment Town Hall 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 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 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 informa- tion required to prepare a certificate. 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 Date... './~'..~..~. ~'~/...//.../..~.~. .... New Building . ~ ........ Old or Pre-existing Building ............ Vacant Land ............. Loqation of Property.. ~.'...~. ...... .~.~. Hou~ No. ~t~t ~ Ham/et Owner or Owners of ProperW ~~. ~;. ~~~ .................... C~nty Tax Map No. 1000 Section ...~ ....... Block ...~. / ......... Lot..~.~.~ ....... Subdivision ~~'~-- Permit N.o.~ ~. Date of Permit ~..Applicant Health Dept. Approval .'~/~ U nde~riters Approval ~. ~.~ ~ ....... Planning Board Approval R~ue~ for Tempora~ Certificate ..................... Final Ce~ifica, Con,ruction on above de~ribed bu ilding and permit meets all applicab,e c~es and regulations. Applicant~ .... ~.. THE NEW YORK BOARD OF .FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK t0038 at. 26, on/,,,, N507407 THIS CERTIFIES THAT only the electrical ~iulpment as described b~[ow and introduced by the appJlcant ~amed on the abot~ application number i~t the premises of N.M. guett~r, e/s Oak St. ~9.50, O.~tchaSue, N.Y. in the follorvlng location; [] Basement [] 1st FI. [] 2nd FI. ~l~J~~1~ Section Block lot wo~ exam;ned on J~ '~2 ! L~1 and found to be in compliance ~vith the requirements of this Board. FIXTURE RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUG~ESCENT VAPOR 38 42 27 38 DRYERS FURNACE MOTORS FUTURE AFgUANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS HO. Of FEET SERVICE DISCONNECT S E R OTHER APPARATUS: Yz)r.o=/s ~ 1-F NO, OF CC. COND. PER .~ OF CC. COND. 4/0 C NO. OF HI-I~G OF HI-LEG Towl~ & ~ Inc. 33 T.~ncoln Ave. NUti~ Beach, N.Y. 11951 Lt~ .550 a This certificate must not be altered in any manner; return to the office of the Board if incorrect. be identified by credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN SUFFOLK COUNTY OEPARTMENT OF HEALTH SERVICES Health Services., ~ , Reference Number~/~J ~-f 3~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant~ ~hone &~/- ?o~ 5. Subdiv. Address ~~.~t~ ~ 6. Section . - 7. Lot Number 8. Private Well Village C~ o~ ~ Township ~,~ar ~ 9. Public Water 3. Public Water Compan~ Name Distance to main 4. Lot size: Width ~-~ feet Length ~-~P feet lO. 11. Sewage Disposal System: a}~eptic tank: Precast~ Equivalent Block B. Leaching pools: Num!T/~//°°l s Precast~lock . If private well, fill lo~!ng blanks: A. Tank c~acity B. Pump~(~.P.M. Special __ in the fol- ~gallons (For Health Services Dept. Use) C. T~] well depth. -~2 D. ~epth to ground water · well C) / " - Ej':'~Amount of water in The u~dersigned CERTIFIES: "Co~n of authorized installations will be in accordance with the Suffolk County Department of Health Services' 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 ~-,~ - mo! Signed , ........ ==================================================== FOR THE DEPARTMENT OF HEALTH SERVICESm USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. S-15 Rev. 4/1/73 ............... ........................ :. · I,R' ....... U ....... .i , / ................... .............................. i~t [ ~ ~ ,~ · (Building Insp~tor) ~ ~ ~ . U' 3o z~J ' ~1/ ,~' 4/ '~ APPLICATION FOR BUILDING PE~IT TOW. - '. BUILDING DEPARTMENT;-.z~'~' ~ ~o'~ ]_,4-,-s * ~ ~-~ TOWN CLERK'S OFFICE~ ~ A ~'~ ~ ~ ~' ~UTHOLD, N. Y. ~ ~ ~ ~ ~ ~ · .. Application No ......... L.~.. ..... ~ ~!,.,~ ~' INSTRUCTIONS a. This application must be completely filled in by typewriter o~' in ink and submitted in triplicate to the Building/~' Inspec~o_r, with 3 sets of plans, accurate, plot plan to scale. Fee 0ccording to schedule. b. Plot plan showing location of lot and of buildings on premises relationship to adjoining premises or public streets areas, and giving o detailed description of layout ofproperty must be drawn on the diagram which is port of this opplicotion~.~ 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 o 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 in whole or in port for any purpose whatever until o 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 Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oll applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. Hez~loo~ Dr. Bo= 45'"/.~ Mas~o Beao~ N.Z. (Address of applicoflt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .~../'/l~'a'~ M. gil~e~t/l~.e/· If opplicont is ~ co~orete, si~noture o{ dul~ outhori~ed officer. (Nome and title of corporote/fficer~j ~~ Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... I Location of land on which proposed work will be done. Mop No.: ~k56 Lot No. $8~.39 & 40 Street and Number O~lr Municipality 2. State existing use and occupancy of premises and intended use and occupancy of'propoSed construction: o. Exisiting use and occupancy ........................................................................... ~ z~..)i~' x ................................ ~ ._~._. 'e, ................ b. Intended use and occupancy 3. Nature of work (check which applicable): )Building ....,~,. ........... Addition k. Alteration ..~ .......... ; .... Repai~' .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) ~40,000 ....................................................................................... ~ 4. Estimated Cost ............................................................ Fee ..1 j 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 ................................ ~i~.~ ~'~ ' 8. Dimensions of entire new construction: Front 3'['6~ R 3]'66~ -" ear ............................I.)eptl3 Height ....~ ............ Number of Stories 9. Size of lot: Front ?,D Rear 9'$.18 Depth 256-+ 10. Date of Purchase .~/..~.~/.~.~.. ...................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..~...~.~..~..~...~..~.~.~.~.,~,.~.~.~.../'.~..~.~.~...~.?.,,~.Z. .................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~.~ .............................................. 13. Will lot be regraded' ....~.~ .................. Will excess fill be removed from premises: (Z') Yes ( ) No 14. Name of Owner of premises Address~..~..~.~?......~.~..~.~.... Phone No..~..~.~,,-.Y.?..~..o... Nome of Architect~..e..~.,-Z.d...~*...~.e...m..~ ........................... Address Yaf;'l;l~,uclr Phone No. 298-~-885 Nome of Contractor .....~...~..~..~?.. ........................................... Address ................................ 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. J STATE OF NEW YORK, COUNTY OF ................................ ...................................................................... ~ ......................... ~emg duly sworn, deposes and says t~t he is the applicant (Name of i~ividual signing contrac~ ~bove name. 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 ~ke and file this application; that all statements conta:ined in this ~application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Swo~ ~e me this ~ ............. , ..... ............. MATTITUCK,~ N.Y, 298 - 4883 +..4' SCALE: I/4"= IL ou iDATE "THESE PLANS ARE FOR THE CONSTRUCTION Of A sINgLE STRUCTURE ONLY. USE OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WRITTEN APEROVAL Of THE ARCHITECT, WILL THEREBY TRANSFER ALL RESPONS- IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM." 'MATTI~[JCK~ N.., 298 7' ,(3 9.0 SCALE: I:l= ~Zo'-_(? - DATE D~c,:!~'.~ "THESE PLANS ARE FOE THE CONSTRUCTION OF A SINGLE STRUCTURE ONLY. USE OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WRITTEN A?PROVAL OF THE ARCHITECT, WILL THEI~EBY TRANSFER ALL RESPONS- IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM." ARCHi TECT MATTITUCK, N.Y. 298 - ~ Plan ,1~0. '~- FJR~,WN Ely ~ .J SCALE: ~/~."'= JLa' OF' DATE-;_~3:)~'<!~,?; - "THESE PLANS ARE FOR THE CONSTRUCTION OF,A SINGLE STRUCTURE ONLY. USE OF THESE PLANS FOR /MNY ADDi- TIONAL STRUCTURE WITHOUT Tl't/~ WRITTEN APPROVAL OF THE ARCHITECT, WILL THEREBY TRANSFER ALL REsPoNs- IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM," ARCHITECT MATT[TUCK, N.Y. 298 - 4883 PLAN NO. :P. 451 I SCALE: !/4`.`= J!- ~'~ -: DATE- "THESE PLANS ARE FOR THE CONSTRUCTION OF A' SINGLE STRUCTURE ONLY. USE OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WRITTEN APPROVAL THE ARCHITECT, WILL THEREBY TRANSFER ALL RESPONS- IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM." ~ 'i MATT, ITUCK, N,Y'., :298 - 4883'- APPROVED AS NOTED NOTIFY BUILDING D~PAATMENT ~j 765-2660 9AM TO 4PM FOR REbuilt. ~D INSPECTIONS: I, BEFORE BACKFILLING FOUNDA- TION OR START FR~,ING 2. BEFORE COVERING PIP~LINE 3,; FINAL WHEN JOB COMFLETED NOT RESPONSIBLE FOE DESIGN OE CON- 5TEUCTiON EEROR~ 1, "THESE PLANS ARE FOR THE CONSTRUCTION OF A SINGLE STRUCTURE O.LY. USE OF THESE PLANS FOR ANY ADOI- IBILITY FOR THEIR USE TO THE USER AND ~HE AUTHORITy ACCEPTING THE~." MATTITUCK, N~'~- 298 - 4883 -lI~~II~I, "THESE PLANS ARE FOR THE CONSTRUCTION OF A SINGLE STRUCTURE ONLY· USE OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WRITTEN APPROVAL OF THE ARCHITECT, WILL THEREBY TRANSFER ALL RESPONS~ IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM·" ' ' _.. I . I -. PLAN NO. D- ~,~l m ~o~ ~ ~ ~u ~ ~ n " ' THESE PLANS A"E FO" THE CONSTRUCTION OF A SINGLE ARCHITECTm u ) ~---~.~*,.~ ~,.~/*~ . ~. ~. ~ I I STRUCTURE ONLY. US[ OF THESE PLANS FO~ ANY ADDI- · ~ ~~, ~ TIONAL STRUCTURE wITHOUT T"~ WRITTEN APPROVAL OF ARCHITECT MATTITUCK, N.Y. 298 ' 4883 PLaN NO. ~- ;4.-~1 I SCALE: ~J~.'~-- IL? DATE- '~ ~,~ ~: "THESE PLANS ARE FOR THE CONSTRUCTION OF A SINGLE STRUCTURE ONLY, USE OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WRITTEN APPROVAL OF THE ARCHITECT. Will THEREBY TRANSFER ALL RESPONS- IBILITY FOR THEIR USE TO THE USER AND THE AUTHORITY ACCEPTING THEM." $TRUC-TURtI~ O~4LY~ USE OF THESE PLaNS FOR: A!1,1¥, :' WITHOUT THE ,WRIT:¢. ~IEN AI~¥.AL O~ t ['¢%% .... n~/~ Il ~ ~ ~~V~ J J TIONAL STRUCTU~ WITHOUT THE WRITTE~ A~V~ OF I~~~ ~J g ~ ~ I J TH~ Afl~HIT~CT. WILL THEREBY TflA~FE~ ALL ~E~N~. MATTtTUCK N Y 2e8 , 4883 ~ J I IBILITY FOR ~HEIR USE TO THE'USER ~O THE AUTHORITY ~ ACk,TING TH~ 'l STRUCTURE ONLY. USE:.OF THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT THE WR TTEN APPROVAL OF 7:? MATTiTUCK, N.Y. 298 - 488J - ' SCALE: G Of G DATE "THESE PLANS ARE FOR THE CONSTRUCTION OF A SINGLE STRUCTURE ONLY. USE OFI THESE PLANS FOR ANY ADDI- TIONAL STRUCTURE WITHOUT 1'HE WRITTEN APPROVAL OF THE ARCHITECT, WILL THEREBY TRANSFER ALL RESPONS- IBILITy FOR THEIR USE TO.THE USER AND THE AUTHORITY ACCEPTING THEM."