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Home My WebLink About7571-zi~~'tar NO. 4, TOWN OF SOUTItOLD BU~.nlNG DEPARTMI~T Town Cl~k', Of[ice $outhold, N. Y. Certificate Of Occupancy No. Z6~.81 ...... Date ............... lla7 ....27..., 19.. 7.~ THIS CERTIFIES that the bui]di~ located at .. ~jah.~.s. La~® .......... Street Map No.El:~Jah'40~ ........... ~ Est~ No ........... Lot No. '7 .... gattituek 15o.¥, ....... conforms substantially to the Application for Building Permit heretofore flied in this office dated ........... ~pt...30., 19.71+. pursuant to which Building Permit No. ?~',~l~.. dated ......... 0el; .... .1 ..... , 19.71~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which t_hi.~ certificate is issued is t~riva.te, o~e. fa~tly, d. welt.~.ng ....................................... The certificate is issued to . l~lanct .Item. s. tho ......... l}~i~ .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . Al~r~' ' '30" "tg?~' "by' i~; '¥i'~la' ' UNDERWmTERS CERTIFICATE No. l' ~.O~.f-.~ }. ..... .Z~u .~l..lp?~ ............ HOUSE NUMBER .. ~'~9~ ....... Street ...Eli.}ah~ .':.a .......................... Building Inspector FOI~M ~0. ~ TOWN OF SOUTHOLD RUILDD4G DEPARTN~ENT TOWN CLERK'S OFFICE SOUTHOLD, N'. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 7571 Z Permission is hereby granted to: Iz~la~l...]~.~c~e.~...!~q ................................................. at premises located ot ...L...O..~....~......~..~...i.~..~..}.~.~.~..,L.~.~..~../~ ................................................................ ....................................................... ~.z..~.~...~.~?. ............ ~!~.~.~.t.~.,.~ ............................................. pursuant to application dated ......................~..o.~.~...,.~,O. ................ 19.~..~..,., and approved by the Building Inspector. Fee $..6..?..,...~0. ........... FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 o( 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: I. 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 May 23~ 1975 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Pr~perty~.~.~.~.~.~.~.~.~.:i:~..a:~3.~.s.~.L..a.~.~.~.~...a.~.~.~.~.~...k.?. .......................................................... Owner Or Owners Of Property .Inland..l~o~e~.~....I~o ............................................................................ Subdivision ................................................................ Lot No....'f. ........ Block No ............. House No ............. Permit No.~..5..~?:..Z. ......... Date Of Permit .................... Applicant .... ~.~..~.a.~.d....H..°.~.~..s...L....X..n..?..'. ................... A--rova' 4-30-75 - ~ Health Dept. up . ............................................ Labor Dept. Approval ................................................ Underwriters Approval . .1. .-. ~ .1. .-_ .7. .5. ............................. Planning Board Approval ...y.?...s. ............................... Request For Temporary Certificate ...n...o. ................................. Final Certificate yes Fee Submitted $ ..5..:..O..0. .......................... Construction on above described building ~//p~~a~cable~iegulations. Applicant ............. L ............................... : ........................... Kenneth W. Sworn to before me this ...... · ~'"~/... day of ......'~...~.......~........~..~./..~........~.. Notary Public ...~e¢~;~.. County Thurber, INLAND HOM~$, (stamp or seal) ' i,, the following location; ~ Basement [] 1st Fl. ,~as~x~,,,ia~don January 23, 1975 THE NEW YORK BOARD OF FIRE UNDERWRITERS -- ~r BUREAU OF ELEC'rRICITY 85 JOHN STREET, NEW YORK. NEW YORK 100,38 °"=~J~ua~y 31, 1975 Appli.o,,o.,o.o. fl. 767223 N 208883 Inl~d Ho~s, w/s Eli~atts Lane,28q'.s/o Tabos Rd.,~tti~uck, L.I. ~ob ~ ~,d r~. outside s~,tlo, a~ ~ 223 .:; : ~ XYU~ L { F XTURES RANGES ;PECIAL REC'P :1 J l_~ 00 , CB Mot or/s: Furnaces,Oil: 1-1/8, 2-1/12hp. George Zlmlinghaws 4 Park Place Patchogue, L,I. 11772 SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number .. ~/--//~('~ 1. Applicant Address P.O. ~ 117. Ymttlt~m~lc: 2. Property Location ~li~h~m L~n~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY INfo, ND HO~It~S~ INC. Phone ~98-9t~ 5. Subdiv.~~ Village ~lat~ituc~lC 3. Public Water Company Name 4. Lot size: Width i$3 feet Township Length ~02 feet 6. Section 1 7. Lot Number 8. Private Well ~9. Public Water Distance to main 10. 11. Sewage Disposal System: Ao O~gallon septic tank: Precast ~ Equivalent Block__ B. Leaching pools: Number of pools Precast X Block Special If private well, fill in the following blanks: A. Tank capacity. 4~ gallons B. Pump G.P.M. S C. Total well depth go D. Depth to ground water E. Amount of water in well 40 40 (For Health Dept..Use) 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 Au~lust 22, 1974 Signed '~ ~ :':~>-~t:, ~.,' ..~t 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 pl~ot. APPROVAL DATE Y/~TK~' SIGNED S-15 Rev. 4/I/73 'rOW sou.mOLD,a.E.'S..OmCEy. ......................................... ~..~. ~'~/'/:' 7~ 2 / ~ .f.~./Z ,/?~./, ~Applicati°n No.~ /'--'/": ........... Z..~ ............ ........................... ............ ............ ............................ · /....V.. .......... ~ ........ L..~.....:~..~.: ,~'~' ~,,-'-~ ~ ~,,~ uildin~ Inter,tar) ~'~ ~/":' ~ ~'~ /~/-~ .'- ^PPLm.,,'noH FOR BU'LDmG PER~,T.t~/'r'/~"/ "' 7'.~. ~ ~'~ ~...'~t .~k~..~...~9., .............. , I NS'/'RUCTFO~" U~'~' ~t~, ~J ~u~. ~"'~ ' a. This application must ~ completely filled in by ~ewMter ~ in i~ a~ s~mi~ in triplicate ~ the Bui~i~ Insp~tor, with 3 ~ of plans, accurate pl~ plan ~ ~ale. F~ ~co~i~ to sch~ule. b. Plot plan Showing I~ation of lot end of buildings on pr~ises, relationship ia ~i0ini~ premiss or public stme~ o~ areas, and giving a detail~ description of I~out ofpr~e~ must be drown on the diagram which is ~ of this application. c. The w~k c~er~ by this a~lication may n~ be comme~ before issuance of Building Parfait. d. Upon approval of this application, the Building Insp~tor will issue a Building Permit to the applicant. Such permit shall be kept on the premises a~ilable for inaction through~t the ~rk. e. No building shall be ~cupi~ or u~ in whole or in pa~ for any pu~ose wh~er until a Ce~if~a~ ~ ~cu~ncy shall h~e ~n gmnt~ by th~ Building Ink,tar. APPLICATION IS HEREBY ~DE to the Building Depa~ment for t~ ssuance of a Bui~i~ P~ ~ ~ ~ Building Z~e Ordinance of the To~ of ~uthold, Suffolk Codnfy, ~G York, and other applicable ~~ or R~ulations, for the constru~ion of buildings, ~ or al~mti~s, ~--~r removal or de~liti~, applicant agrees to comply with all a~lica,e I~s, o~ina~es, bu,ding c~, h~si~ c~, a~~~ admit authoriz~ insp~tom ~ premiss a~ in ~il~s ~r ~e~ i~tions. (S gnature of app icant, or name, if a corporation) P.O. Box 117, Ma~tituck NY 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Con~rac~or Name of owner of premises .....~..~...~..~......Z~...C..: ..................... i.'. ............................................................................. If applicant is a corporate, signature of duly authorized officer. ..~9~..9..~ E. 'Hiltz Pres. %\ (Name and title of corporate officer) Builder's License No ....................................... ~. ............. Plumber's License No ...... ..5..3:.?....?. ............. .................. Electrician's License No..2..7...3.....~.. .............................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ...6...0..6...5. ............................ Lot No.....?. .................. Street and Number ...... ~,],~.j~'l..~.~..~le ........................................................................ ~...l~..~...~.~..u.....o~.. ................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~. Exisiting use and occupancy .V.~.9..~.~.l;.intended use and occupancy ...... ...O~...e.. fn~nil¥ ........................................................................................................... D~ellincJ 3. Nature of work (check which applicable): New Building ;,~....X.. ....... ~. Addition .................. Alteration .................. Repair .................. Removal ........... L...., De~ofition ............... ~:... Other Work ...................................................... 7 ~ (Description) 4. Estimated Cost ...... .~..~.5.~..0..0...O. .................. ~[...f.:...i.~i...Fee .~...." ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling unitsO~f~...;~s3g~13,~.~,P......Number of dwelling units on each floor ............................ If garage, number of cars .............. .~..W..o.. ....................................................................................................................... 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 ......... ,50 ....................... Rear ...... i_5.O .............. Depth ...~,~. ............... Height ....... .~...O. ........ Number of Stories ..~,g~..R&~.C,13. ......................................................... ~ ............ ; .................... Size of lot: Front ........................................................ Rear .......................................... Depth .......... ; ..................... Date of Purchose ..T,,/.TL~.~.~...~.I;~.~g.1~. .................... Name of Former Owner ........................................................ Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...~...o. ................................................. Will lot be regraded' ....~'.e~ ................. Will excess fill be removed from premises: ( ) Yes (X) No Name of Owner of premises ..~,~k~..~...~[~l'..(~.q...".. Address ..~,.1;.1;~1;~/..~ ........ Phone No..g..p..8..~.,6.9..6..... Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ..Z...1})'~....D....H..~.s....Z...~..C..~ ................. Address M&t:t::~t~ck Phone ,, 398-9696 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. ,. 10. 11. 12. 13. 14. ..... i,..;;..;,...~.'~...;.~.. ...... ~ ....... being duly sworn, deposes and says that he is the applicant (N'an~-~>f ind. ividual signing contract0 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 contcfined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. .S..w..o...m...t..o...b.:.f~.r.: dmaeyt:~s ........... ...~.,~_., :9 .~/~ .....~~j~.l~,~ ......................... Notary public, State of New york No. 52.0344963 Suffolk Count~0 i,,o~ AND/OB FBOM DATA OBTAINED F~:OM OTHE;~$ NOTE: a = MONUMENT SUBDIVISIONMAPFI£ED IN THE OFF/CE OFTH£CLE~KOFSUFFOI K COUNTYON FEB. 14,1974 AS MAP NO. OCT. 18, 197'¢ ~ 4o00STRANDER AVENUE, RIVERHF..AD, NEW YORK ALDEN W. YOUNG ISURVEY FOR: INL AND HOMES, INC.- LOT NO. 7,,,"ELIJAH S LANE .'r /4A TTI TUCK SOUFHO D_ EMBOSSED 3EAL SHALL ~0T BE CONSIDERED TO BE A YAblO TRUE COPY ' ~ ' ! ~YOU'NG Rz~S~ONS YOUNG & 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK A~-DEN W, YOUNG HOWARD W, YOUNG SURVEY FOR: . INLAND HOMES,/NC, ~ MA~TiTQCK · ow~ o~ SOUTHO~D .' · , ,: .-~,'' ~.:: .': . ' ' , ~'.-:' ., · '' : ,' ' ,",. ' , ~' ',", . . ;'" . ',-'~, ';,~,;Z~. ~.~ .-~,,' ' '.~ ' : ' ' Z ' , -~ ' " ~. ' ~.' .... ,. .... .~ . . , ,,.,~_~ ..,. ...... , ,, ,lr