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HomeMy WebLinkAbout7353-zI~0~'~' NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~I~IT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .~../::/*. ~?.~.~., .D~., .ff...~. t.N..~... Street Map No... ~-..~.~'.6.. Block No ........... Lot No. conforms substantially to the Application for Building Permit heretofore filed in thl. office dated .............~ .L .x/O.H~ 19..7~. pursuant to which Building Permit No. ??...~..~. Z-. dated .............~.q..."J.//.¥~ 19.7.~/., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which thl, certificate is issued is ... ~ .... 0~.~. .... F..~.~?.~..L.:(. .... .~.~..~..L..L..,..~.!..~ .......................... The certificate is issued to..~.1..N.~..~...~...~..~. ?.L...~.....'~..~..L..b-..~..I..~. ! ._~. ............. of the aforesaid building. Suffolk County Department of Health Approval DNDERW~["~,~S CErTIfICATE No ............................................. ..................................... ....................... ......... ..... Building Inspector FOEI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N:. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 7353 Z Permission is hereby granted to: ...... .~t~..~.c~ .................................................... at premises located at ,...],.~.t~,.~.~ ....... .~?,~.~.~...~.Q.t~.....~.~,"f,~.~,~,~t .............................................. ................................... ...~.~l~ar..~!r...&..~.. S.t ......... ~1 ................................................... pursuant to application dated .........................~..,.l~...e......2..'l. ............. , 19..~..., and approved by the Building Inspector. Fee $...~,.~. ......... THE NEW YORK BOARD OF FIRE UNDERWRITERS t&b BUREAU OF ELECTRICIflL~ ~ '. ~ 85 JOHN STREET. NEW YORK. NEW.:~ORK iQ038 'j -' '' N 184486 THIS CE~IFIES THAT inthefoll~ingl~ation; ~ B.ement ~ IstFI. ~ 2~ Fl. Outs[de ~tlon Bilk ~=.~i~ao. Septe~e~ 20~ 197~ ' a~.foa~ to be ia ~m~ia~e ~ith t~e r~u~remen~ of th~ ~. FIXTURE RXTU~ ~ES ~iNG~Sl "O~N$ ~SH WA~ER$ EXHAUST FANS I D~ERS ~RNA~ ~TORS ~ A~A~E ~ ~1~'~ TIME~s ~ UNIT~ATE~ ~LTm~T~ ~MMERS METER OTHER A~ARATUS: ~ P~k P~oe ~ ~Pa~ehosue~ L.I.11772 COPY FOR BUILDING DEPARTMENT.. THIS COPY OF,ClERTIFICAT~;MUS~T NOT. : BE ALTERED IN ANY MANNER. TOWN OF $ouTHoLD , 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 fO t Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location o7 all buildings, property lines,? unusual natural or topographic features. 2. Final approval of Health Dept. of Water supply and sewerage dlsposal~(S*9 form 3. Approval of electrical installation from Board Of Fire underwriters, 4. Commercial I~uildings, Industrial buildings, Multiple Residences an~ similar installations, a certificate of Code compliance from the Architect or Eng the building 5. Submit Planning Board approval of cc~mpleted site plan re~lbiremenfs where B. For existing buildings (prior to April 1957), Non-cOnforming uses, or buildings and land uses: 1. Accurate survey of property showing all property lines, streets, buLldings and or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy 3. Dote of any housing code or safety,inspectioh of buildings Or premises, or other, 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 3. Copy of certificate of occupancy $1.00 Date New Building ................ Addition ................ Old or Pre-existing Buil~ling ...... :... Vacant L0nd Owner Or Owners Of Property Subdivision ................................................ ~..:.. ........... Lot No ............. Block No. ;.... Permit No ..................... Date Of Permit .................... Applicant .......... i ...... ;'~--,~?: ............ Health Dept. Approval ............................................ I~bor I~pt. Approval ............................ Underwriters Approval ................ .............................. ¢lanning Board Approval.......,,.._...,.,,,.,,........,,..~ Request For Tempo~rtificate ~ .......................... Fee Submitted $ .....~...:. ................... ....... / Construction on above described building and[~/~ Applicant ...~.~.~ Sworn to before me this / GARY ................ day of ............................................ Notary Public .................................... County Main Road :' : Matfltuck, L L, N.Y. 11952 TOWN OF SOUTHOLD Building Depar~ment 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 aH 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, o 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 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 O.g..¢. gh .~.~.... ~. ,.....1. ~..7..~ ............ New Building ......X. ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....D..e`..~-~.~..~...~.....D.~..~..e.....&~....G..~...~.~..~..S...~.~.~e.?.~..M..~...~.~.~.~ ................................................ Owner Or Ow ers Of P operty ~..D....~,..O..~..,~..S..~.....Z..N..C..:. Subdivision ~.!..s..;~..~.y.~..+,..e...s. .............. Lot No. _.3..6. ...... Block No ............. House No.....3..~.~g Permit No..Z.,3,~.~..Z..... Date Of Permit ..6./...~.~/..7...~...Applicant .~.~..~.D....~g.~,.~...S.~....Z.~..C.... ...................... Health Dept. Approval ..... ,]-f)/~/?..~ ...................... Labor Dept. Approval ................................................ Underwriters Approval .,.?../..~.0.../.~.4.,. .......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....¥..e..~. ............................... Fee Submitted $ ..5....0...0. .......................... Construction on above described building and permit ~ets all appli~f~ al~d/~ions.~. ,,.,~ Applicant .,Z..~...I¢.A....N...D.,..~..Q .Nl...~..S..~....Z...~..C........~~ Sworn to before me this ~ ................ day of ............................................ (stamp or seal) Notary Public .................................... County SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant Inland }Ice,a, Inc. Phone ~9/3-i~96 Address ~ il';; ~t~tit~l% ~.~. II0~ 2. Property Location ~/a ~n~a~; l~l~ ~i~ i Village ~.m~ Township S~ut~la 3. Public Water Company Name 4. Lot size: Width 12~3 feet Length Z5~ feet lO. 11. 5. Subdiv. Laurel Co. Estate 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main Sewage Disposal System: A. ~O~-gallon septic tank: Prec~t XEquivalent Block B. Leaching pools: Number of pools Precas{~lBlock Special If private well, fill in the following blanks: A. T~k capacity__42 gallons B. ~mp G.P.M. 5 C. Total well depth__ >q,~ D. ~'p. th to ground water 4© E. AmOunt of water in well 4~,~ (For Health Dept. Use) The undersiigned 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 June 7; 1[97~, Signed II~ H~aes. Iri~./l~.w. ~hu~bex, .................................................................... ...... 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 plot. S-15 Rev, 4/1/73 Lof ~5 Y NG &YOUNG 400 OST~NDEI~ AVENUE, RIVERHEAD NEW YORK SURVEY FOR: ~' ZOT NO suFFo~ co.,... Lof ~5 .this location have been S~rviC~s UNAUTHORIZED ALTERATION OR ADD~T;ON TO THIS SUEVEY IS A VIOLATION OF SECTION ?~O9 OF THE NEW YORK STARE EDUCATION LAW COPIES OF THIS SUNVEy MAP NOT BEARING THE LAND SURV£YOR'S {NKE0 5£AL OR THE .[OC.~TIOF, OF WEZI,$ ,~ND CE$$PO~L~ SHOWN HEREIN ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS NOTE: · ~ONUM~T ~U~Ol VIS~N MAP FIL ED IN TH~ OFFIC~ OF THE CL~RK OFSUFFO~ C~NTY ON JUNE ~, 19FO AS MA~ N~ ~ 4~6, .£V,S,ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOE: INLAND HOMES, INC. LOT NO. 36 "LAUI~EL COUNTRY ESTATES" AT LAUREL SOUTHOLD SAVINGS SF~RITY RTAF~ GUARANTY CO, SOU THOL D /"= 40' I TOWH CLERK'S OFFICE S01JTHOLD, N. Y. · / ............. ....... :..... -_ _ _ _ ..... ...................... ::::::::::::::::::::::: .............. . ....................... ................... APPLICATION FOR BUILDING PE/tMIT INSTRUCTIONS o. This application must be completely filled in by typewr ter o~ in ink, and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule, tn b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets-to~ areas, and giving o detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 i~sue 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 part for any purpose whatever until a 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 ,~pplicable Laws, Ordin,~nces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, and regulations, and to -dmit authorized inspectors on premises and in buildings for necessary inspections. .... Inland Homes, Inc. (Signature of applicant, or name, if a corporation) .... So~.. ~l~.,...M~t Zi~;~n.~.. N ,X.,. 11952 .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... Ge~er a.1...G oJ~ ~;c a,G .~.Q 3;' .......................................................... Name of owner of premises ..... D~ao~.~nd..~o~tl&..~.eleJ~.:L~.~ ............. .. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ..... ,~,7...-~. ................................ Electrician's License No. ..~7..~.~F,, ............................. Other Trade's License No ............................................... Location of land on which proposed work will be done. M~p No..~.....~'....e..1.....C...o..u-...~..t..r.~.....~..S.?L-ot No ..... ,~(~ ............... Street and Number ..~.~,1~..~,~..~.3:~,Y..~...~...(~;~D~....~:~.~.~..~.~....~...~.~...~.~X.~ .................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construc:ffon:' a. Exisiting use and occupancy ........................ ~oz~e ............................................................................................... b. Intended use and occupancy ................... ~,~laG .................................................................................................. 3. Nature of work (check which applicable): New Building .....X.~. ......... Addition .................. Alteration ............... Repair .................. Removal .................. Dernolitior ..................... Other Work ................................................ ~... ,_ ~; (Description) 4. Estimated Cost ~{ .zt0,OOQ,0.O ............................ Fee ..~'..~t..~ .................................................................... (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 ....... 2 .................................................................................................................................... 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 ................................ ....... 0.9 ......................... Rear .....6,q: ................. Depth ........................ 8. Dimensions of entire new construction: Front t 38.2' Height 16' Number of Stories one 9. Size of lot: Front ..................... ~L~q8 ............................ Rear ..... J..38 .............................. Depth ....... 1.5.7..,.g8 ........... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district Jn which premises are situated .................. ]H.o.m~.a ....................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... iN'.(;'. ....................................... 13. Will lot be regraded .......Y..~.$. .............. Will excess fill be removed from premises: ( ) Yes (X) No 3 ??~ Delmar Dr. ~Lau.~el . 14. Name of Owner of premises ....Z;tirzQs..JE.~.leki.cli~ ............ A~cl~ .................................... mane I,~o..~.~.v...q~..~.:.~.... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...~,.n..1.~.D..d.....H..o..~.e..s..,....!.n.C..r ............... Address .B...°..x.....1..1..7..~...~..a..~.t..il~%b~n!& No....2.~..8..':,g-O. CL6.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property Jines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. O~ STATEOF NEW~~ ~sO , COUNTY OF ..... .................. ~..~.,...~ ................................... being duly sworn, deposes and says that (Name of indNidual signing contracf) above named. (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 contained in this app]icotion ore true to ~he best of his know~edge and belief; and that the work will be performed in the manner set fo~h in the app~ation filed therewith. Sworn to b~fore ~e this ~ t~gnat~ o~ppncant) N~-~2-0344963 Suffolk Coun~~