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HomeMy WebLinkAbout7572-zFOBDi NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ~ ......................... 5 W~T~K VI EW ~l..f%treet. Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~..~ ?.'.7,.. ,~..~., 19 ~ .~. pursuant to which Building Permit No.7.ff..7..~. .Z, dated ~- 1~/...'~.~ was issued, and conforms to all of ~e requ~ ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to ~ ~ ~ O ~ ~ ~ ~ ~ ....................... ......... of the aforesaid building. Suffolk County Department of He~%h Approval ......... ~ .......................... UNDERWRITERS CERTIFICATE No. ~ ~ 3 ~ & I ~ HOUSE NUMBER ~ Street ~A7~ ~ ~k~ ~ ~ V~ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Nm. Y~. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7572 Z Permission is hereby granted to: I~;Z&u~...~',e:,~z~.....,c,../..C...Sa~to....,D~.AZ,'~ ....... .......... ~3¢....~e...~.ve .................................... ...................... a~.:t.t,h.t, ov~. · · · 4- 4.7 87 ................... to ~t~l,td...new...m~e ...~.mn~,.:L.F-. ~weZ.-Z..&n~ ..................................................................................... at premises located at ..~/~...We~telt,141.e-~..[~l,~.~ll ............................................. ~ .............................. .................................................. ~outl~o:~cl ....... N.,~., .......................................................................... pursuant to application doted ........................¢~)~-..-.~0 ........... ~, 19.~.;~..., ond approved by the Building Inspector. Fee $.~'0~ ........... - [ Building Inspec'td¢ L TOWN' OF ~SOUTHOLD , Building Depa~tment 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), Nomconforming 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: 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 ........... ..~....C... f.... ~..t('. ,.../...~.. Z ..~. New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. 635 L~'A-TIZ'~V'~F_~d '~R~VL~ ~ Location Of Property ............................................................................................................................... : .... Owner Or Owners Of Property ...... ...~...~.~....M.....'~.....O. ................... .~....L;.!...'.~,. ......................................................... Subd v s on .,.~...- Lot No ,-- . Block No .............................................................. , ........................ House No ............. .................... ale ur term T a ; ~xp'plicam x ................ ~967 ~o/. I 5~'~23~ --. . .............................................. Health Dept. Approval ........................................... kaoor Dept. Approval . Underwriters Approval..~........~...3.....~....0...!...~.. .............. Planning Board Approval ....... ~.!L.?.-~... ................... Request For Temporary Certificate ........................................ Fined Certificate ' Fee Submitted $ ..... ~ .......................... ................ day of ............................................ Notary Public .................................... County Construction on above described building and permit meets all applicable codes andregulahons.' App,cant .... ............................................. ,aA o/7 - Sworn to before me this ~0 ~ {~-7 9' O (stamp or~see'la )=~r' / 0 ~, 0 ~/ THE NEW YORK BOARD OF FIRE' UNDERWRITERS 9, ~975, .~,.,,.,,,,,,,,,,'o.,,.f,,,, 8o67~B N 234618 Jo-Mal Oonstr.Oorp., 635 Watervlew Drive, Southold, L.I. ~,~,,,~o~..~;o,. [-~ n..~,.,,..~,~[~ ~t~. [~ ~,~ Yr. outside o2 2r - ' 3 -Furnac:es: Oil 1-~./~hp, *Futuroapplianoe-. ,f',,.'-der/s'. 2-2#10, 2 Photo Cel_ls 1-3#8 SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY l, Applicant_ ~ i,~'~/a~ Phone Address 2~bm~)l~mm.. 2, Property - Village 3. Public Water Company 4, Lot size: Widthg~ feet lO, Sewage Disposal System: 5. Subdiv. 6. Section 7. Lot Number 8. Private Well Township ~-~el 9. Public Water no Distance to n~in Length 3~_ feet (For Health Dept. Use) ll. A. 900-gallon septic tank: PrecastX , Equivalent , Block__ B. Leaching pools: Number of pools ~ Precast Block Special____X If private well, fill following blanks: A. Tank capacity 42 B. C. D. E. in the gallons Pump G.P.M. S Total well depth Depth to ground water Amount of water in well The undersigned CERTIFIESi "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. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the O~nion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot.~' ......... ,/,~j~f,f~,~_~ APPROVAL DATE_ /~f~,~ SIGNED ,-t~ -~r~c~,~f,- S-15 Rev. 4/l/73 .... 9' BUll. DING DEP*RTMEN~'~ ~ ~ ~ ~- ~,~,~ ......... ~..~....~....,.., ~...c.7 ?,~ ~ .~~ ~. ~.Z..~ ........ ,.. ~ . .......... : ........................... , .................................. :.....~....~_ ~, ~ ~ , _ , .............................. ... _ -~ o~. (~ ~ ~ ~. ~l~ .... ,:~..~....:....= ............... .,.....~....~ . ~ _ / ~ ................. ~.~ ........... ~~ .............. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted n trp icate to the Buildina' Inspector, with 3 set~ of plans, acc~lr.e, te~.Rlot plan to scale. Fee accordingto~saheclule. b. Plot plan showing location of lot O~d of buildings on premises, relationship to adioinina oremises or oublic streets areas, and giving a detailed descriptiort 6f~la~ut ofproperty must be dra~n On ~th· ~i~g[am widish is part of ~l~is applicati~.~ c...The ~tork covered by this app_li~ati~ may nat be commencec[ before issuance of Building Permit. . d. U-~aPProval of this appf'~C~i~'~e Building Inspector will ssu& a BuJldi~ Perm t to the applicant. Such permit snail be kept on the premises available for inspection throughout the work. e. No .building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of OccupancyZ shall have been granted by the Building Inspector. APPLICATION IS HEREBY/V~DE to the Building Department for the issuance of o Building Permit pursuant to the( Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or~ Regulations, fOr the construction of buildings, additions or alterations, or for removal or demolition, as herein described/ The applicant agr~s tocomply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary insp~tions. ~/~L .,~. --~ ....................... /..~..~ .............. (Signature of applicant, or name, if a corporation) 235 Hi~le Avenue, Sad.thtxxm~ N.Y, 11787 , t (Address of applicaht): State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber o~builder. Name of owner of premises ..... ~co..rt!~.~ ~a .. . 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 ............................................. 1. Location of land on which proposed work wi!l. be d°ne~ Map No.: ........................................ Lot N ................... Street and Number ...~/~..l~e~'ze~.;~ ..................................................... ~ .................................... Municipality 2. Stale existing use and occupancy of premises and intended use and occupancy of proposed'canstruction: a. Exisiting use and occupancy ...~~..~ ...................................... . ................................................ b. Intended use and occupancy ~z ~ :~Id.2V ~ · - 3.'/Nature of work (check which applicable): New Building, ......~ ...... Addition ..f. ...... ~..~... Alteration` ...,~ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... - <~.e ~ (Description) 4. Estimated Cost ....~)~)~l~l^ ........................................ Fee~...~........~....~. ......................................... (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: ~rant, . ................................... Rear ............................ Depth ................................ Height ............................ Number of Sto~ies ................................ 8. Dimensions of entire new construction: Front ....a~.~....; ........,~....~ ...... Rear ...... ~8.! ................ Depth .~.~. ................. Height ..[8 .............. Number of Stories .(~l~..am~.~~,..,.,,, ...................................................................... 9. Size of lot. Front ....... ~.~;~.~ ..................................... Rear ~ ..................................... Depth~g~.'....(.~....). ......... 10'.' Date of Purchak~.~;:;(~Z~l~..[,923. .......................... Name of Former Owner ...Zda.~o3J[~ ............................ 11. Zone or use district in which premises are situated ..... ~..&.,~g~l,,gg~l;~...".~.~. ................................... 12. Does proposed construction violate any zoning law, oidjr~nce or regulation: ........... 1~O ......................................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .....~J~..~.~J~l~ ....................... Address ~ ............... Phone N .oTP~...~..~...3.~.e...0. Name of Architect ...... .B~!Rm'. 1~1~ ~t. ......................~::lress ~ ............. Phone No. '~.-.SJ)~ ....... Name of Contractor ....~E)~l~..Oalt~..~t~ ................... Address ~ ............. Phone No. ~ ...... PLOT DIAGRAM 724-6396 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 NL~vV ~(/C)R~ yy ~ ~ ~ ................. ~- .~.~..&~...~.~ ......................................... being du!y ,worq~. d~psesgnd says t~t he is the opplicanl (Name of ind~vi~'signing c~trac~ ,- ......- .... . above nam~. He Js the ................. .~.-.~.=....... ......................................... ,....:. ........ :L ~,~,..., ............................................................ (Cqntmctor, ag~t, corporate officer, etc.) of said owner or owners, and is duly author zed to perform at h~e~fo~med the said work and to ~ke and file this application; t~t all statements ~e~d in ~his. ep~li~otio~ ar~e ~ the best of his knowledge and belief; and tha~ the work will ~ perform~ in the manner set fo~h in the dpplication filed therewith. Swam to ~m me this - - ........ ..... ...... ................... Nota~ Public, . ................................................... C~n~ ..................................................... ~ ~nature of applicant) ?,0 9;I9'75. .A~CT gO 1975_ .. The Sewage disposal and ~'ater s~pply facilities for this location hawe been lnspected~ls~par~ment and feqn~ ~o be sat~s~~ Se~tces 0 $30 SANTO -rEST ~ob~ G ECTI 0 t,.I "A-A' ~t~,mu ,.S OO T 14 EL£'VATIO kl N OIZ. TH,~,;~LF-.YAT ~ 0 b3 0 15r:' p ~mO l'~4 ~ , :z:l uTI L~TY P4::'O M ~ ..~F'L coL, Z' O, NALL HAl WEST ELEVAT N Z 90' ~ " 48' ~.s,~ ~. ' k2s D.'ALIA 1~ ES 2,2- REVISIONS 1 D E N C E ,5OOTHOM~, ~J,y, 'ELEVATION~ ~, ,5-E. CTIONi (516) 724 5026 baldur peter, a.i.a. ARCHITECT 2 3 5 M A P L E A V E N U E, S M I T H T O W N, N Y,, 11787 OWG. NO. J oF2~ DATE, ,-~ER 2.4, I f/74 'UPPEF-. LEV F_L, 0 t2* o,~, kI,F.# 2- HTR ,{ LOWF_.~ LEVE. L POOP. ~'-0~ x ~' - ~" H, C. ~CH~DU~F- LgC;kgg ~ 5LIOlk,l~ ' , 't -- ~ -~"' ~ I I~~ REVISIONS D'ALIA P.. E,51 DP,i,4 C P: baldur peter, a.i.a. ,,,., ,~...o~. ,o.. ,o. 7~ A R C H I T E C T ow...o, 235 M A P L E A V E N U E, S M I T H T 0 W N, N. Y,, 11787 DATE: ~[~ ~,I~7~ ROOF PLA.N .+ L__J FOUN[:::?ATtOM. PJ. At',J v~" ,, r...~', REVISIONS D'ALIA R E5 ~ D ~_'~4. C F_..