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Home My WebLink About7672-zFORM NO. ~ TOWN OF SOUTtiOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z .~?.~.~. ...... Date ............ N~ .... ~[ ....... , THIS CERTIFIES that the building located at .. S/I~ .~" l~Oad ....... Street Map No. :~ ......... Block No. :~ ....... Lot No..~...l~O~.~hO]~...~,][,. .......... conforms substantially to the Application for Building Permit heretofore filed in thls office dated ............. .1~0...2~, 19~.~.. pursuant to which Building Permit No. dated .......... I~ .... i~..., 19. ~,., was issued, and conforms to all of the require- ments o£ the applicable provisions of the law. The occupancy for which this certificate is/~'~'~ The certifi~at~ is issued to . ~.~ .B4t.~.l..F. &..~.1~ .t~...C~..~.o ........ .~.8 ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval &~ .~...¶~?~...blt..R,..~[~ ...... UNDERWRITERS CERTIFICATE No. ~..~.~...~1~... ~...~9'~.. ................. HOUSE NUMBER ... ~J[..~0. ...... Street . .S.~. ~l.~, .......................... Building Inspecto TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST I~E KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7672 Z Dote .......................... Permission is hereby granted to: ....... .~....,~o~:L~ ..}~ll~...~ond ................. ................... ~z.t ..~'~p.t.eA ............................... to ..hufld..n~m...o~te ../*amil~...d~ellin& .......................................... : ........................................ at premises located at ..~/~..~aD'.~.~,~...P,J~,~L ................................................................................... .................................................. ~u.thold ....... K ,.'~., ........................................................................... pursuant to application dated .......................... .~.~.~....2~'. ............ , 19~.~...., and approved by the Building Inspector. Fee $.~.~.*~. ........... dl THE NEW YORK BOARD OF FIRE UNDERWRITERS [--- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,,,,,,~,~,.,~,e s, 19'~s .,,,,,,,c,,,,o,,,.,o.o,,,.,,~.i, 851ssN 228847 Michael Colavlto, 6150 Main Bayvfew Rd., Southold, L.I. June 2, 1975 }~J, ec., Room Heater/s: 1-2.0kw, 1--1.5kw, 5-1025kw, ].-.~'kw, 1-.Skw '1! FORM NO. 6 TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, H. 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: ,L Fihal 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. Appraval 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 ar premises, or other pertinent 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 Date ....... .~..1_ ...... ~ ......................... New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ............................................ /. ..................................................... ~ .................... ...............................................................................44 , r :..5...o. , v o p/ ................. Owner Or Owners Of Property r~........:. Subdivision .................................................... . ........... Lot No ............. Block No ............. House No...~..../.~.*.~ Perm,t No.... . ZZOote of Permlt ........................... Health Dept. Approval ...~..(4..'"~.....:~.~.~...'.?: ........... Labor Dept. Approvo ............... .~.~: ........... Z Underwriters Approval ............. /;..~.:.~.. .................... Vlanning Board Approval ................ : ....................... Request For Temporary Certificate ........................................ Final Certificate ......... .~...~;.~.. ...................... Fee Submitted ~ ................. ; .................. Construction on above described building and p~nit meets, nell a~codes and regulations. pp ............. ,:....: .................................................................... (stamp or seal)~/~ aOTARY PUBLIC, State of New Y~k ~/ .SUFFOLK [.OUNTF DEPARTMENT OF HEALTH SERVICES Health Services Reference Numbar~_~ APPLICATION FOR APPROVAl. TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant Michael F. Colavito- Pbone CH 8 4036 Address ,]-~_D~by St~ _F~a_~_~_~Ti'l"~i~ji_o~. LI.~f_~596 2. Property Location_M_ain Bay_v_J~e~_Road & Corcy _c~_ Southhold ~]T~ge. Southhold Township. Southhold 3. Public Water Company ~e N/A _ 4. Lot size: Width feet Length. lO. Sewage Disposal System: A. {~-galton septic tank: Precast~quivalent Block__ B. Leaching pools: Number of pools ~ Precast_ ~ Block Special__ If private well, fill in the fol- lowing blanks: A. Tank capacity qL~_gallons B. Pump G.P.M. '~ C. Total well depth D. Depth to ground water E. ~ount of water in well feet 5. Subdiv. N/A i_6. Section N/A 7. Lot Number~. 8. Private. . Well ~_- ~. 9. Public Water N/A / ~tance to main. ~/j (For Health Services Dept. _Us.e..) SEE" 'SURV Ey~pgqI~E XE~O ........ The undersigned CERTIFIES: "Construction 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. FOR TIlE DEPARTM[NT OF ttEALTH SERVICES' USE ONLY. Based on the i. nformation 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. APPROVAL DATE / ~ ~ ¢ S~6NED__, Rev. 411/73 x~'~ ' .~.-~.~ . ~ BUILDING DEPARTMENT ~,te~u - ' ~-~,~ .c~ ~ , ~ ~ ~~4~ ~ pphcah~ No ................................. I ~pr~ .................................... 9. ~X~ 7Z ~ ~, ~ . ~ ..~ P,~,t,No ......... . ............... ~ ......... _e ~ ........................................................................ ................. a /~ c. ,~ O~ APPLI~TI~ FOR BUILDIng PE~IT ~ ~'~ ~-'~f b. Plot plon showing I~otion of Eot ond of buildings on premises, relotlonshi~ to ~;oini~E~Z -- - u. c. The work c~ered ~ this o~l cotion moy n~ ~e commenced before issuonce of Building Pe~it. d. Upon opprovol of ~is opplicotion, ~e Building Inspector w;ll issue o Bui[din~Permlt to the ~licont. S~h permit~ s~oll ~ kept on the premises ovoiloble for inspection thr~ghout the work. '~ ~ ~ ~ e. No building sh~ll ~e ~cupi~ or used in w~ole or in po~ for o~y pu~ose whoever until o Ce~ific~ s~oll hove bee~ granted by the Building In~ector. ~PP~I~ION I% HEREBY ~DE to t~e Building Depo~ment for the i~uonce of o Buil~i~ Permit ~ont to the BuiJding Zone Ordinonce of the Town of ~ut~old, Suffol~ County, New York, ond other opplicoble ~, O~inoncK or~ ~u~otions, ~or t~e constru~ion of ~uild ngs, o~ffions or o terotions, or for ~movol or ~emohtl~ Qs hem:n The opp cont ogrees to com~ v with oll o~'~-~:- ' ...... ~ ............ ' ' , ' Name of owner o m ses · ~ ~...~.~...~ ..~ ~Y gO ~ V D ...... p ....................................... . ......... ~ ............. ~~ : ........ If appli~___.~orot., signature of d* authorized officer. 1. ~._ . ' ~ · officer) ....... Builder's Lic~se No ..................................................... Plum~r's Licen~ No. ~~ &~ /~/~ ~ ElectriciQn's License No. Other Trode's Licen~ No ............................................... 1. L~etion of lend on which p~osed work will be done. Mop No.: ........................................ Lot No. ~--~ · Street end Number ..... .~.~.~ ...... ~.~.~.....~.~a ........................................ ~.~.~ 2. 5tote existing use ond ~cu~ncy of premises end intended use ond OCCupency of pr~o~d c~stmction: ~. ~islting use and ~cup~ncy ................. ~ ~ ~ ~ b. Intended use and ~cu~ncy .~ ............................ ~ .................................................................... 3. Nature of work (check which applicable): New Building-. ................. Addition .................. Alteration ............... Repair ................. Removal .................. Demolition .................... Other Work .................................................... ~ ~ (Description) ]I It i~te~ Colt ............................................................ ~e .......................................................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ............................ Number of dwelling~its on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commerc, ial 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 ....................................Redr ........................ Depth .......................... J ..... Height ............................ Number of Stories .................. ~. ............ 8. Dimensions,,~of/~ntire new construction: Front '""~"'"~"~/4- ...................... Rear ...... .~...~ .............. Depth .....?...~... ............ 9. Size of lot: Front ................ /..~....~.....'" ....................... Rear ............ .~_.~...O.. ..................... Depth ....... ..~....~....~.... .......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12; Does proposed construction violate any zoning law, ordinance Or regulation: ................ .~'_.O, ............................... 13. Will lot be regraded ..........~....'~...~'. ......... Will e~.cess fill be removed f_rom premises: ( ) Yes (,~ No 14. i'~am~ ,~ .~. . ,~ ~ ,,,,~.~.~ ____ ~ ___ ___; .............................................. .~,.-- ............~. ..................... . ,~.. ....................... Name of Architect . . .~.~.~/J~.~.... J~. el [..~1~,~.~ . 1, ...... Address ...... ...,~.....~...5-.~...' ......... Phorle No ....................... Name of Contractor ~' ~'~ ~,,$/'-7 016/'~ . Address .~....~'..°. ........................................................... ~ ......... ~ ............ N..............~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck 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 NEW YJ~,Ir~/ ,~ ,p' ~ COUNTY Of ..~f (Name of individual sigr ng contrc above named. He is the ......................................... 1 ................ (Contrc .~es . and sa he is the a~ ,~ cf) .... ctor, 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 contained 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. Sworn to befoje me this u- ~J~nature of applicant) N~ UNAUTHORIZED ALTERATION OR ADDIT(O~ TO THIS SURV)JY IS A VIOLATIQN OF ' - 4L , . / / KINGSBERRY ARCHITECT KINGSBERRY BY ,~,~5'~' ~*~-~ - "7~o COPYRIGHT ~ I9~BY DIVISION OF ~c~g ~eR --. ALL RIGHTS BE{OW TOP OF HOUSE FOUND WALL, 8" x 16" FOUNDAT[ON VENTS iN ACCORD. WITH F. H. A. MFS 604-3. TOP OF HSE. FOUND, WALL, 28 x 20 ACCESS DOOR AND A~REA~AY IF REOUIRED IN ACCORD. WITH F, H. A. MPS KINGSBERR'( HOMES RE~ DATE BY CHK. COPYRIGHT @ IgG':IEY KINGSBERRY HOMES DIVISION OF BOISE CASCADE GORP. .~,~ /o//t/7~ ~ ALL RIGHTS RESERVED CONSULTING AR~ITEC~ - ~N~MIN ~l~ - ~ 1.~, J CONSULTING ARCHITECT DATE BY BOISE CASCADE CORPORATION COPYRIGHT O 19 BY KINGSBERRY HOMES DIVISION OF BOISE CASCADE CORPORATION. ALL RIGHTS RESERVED