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Home My WebLink About7185-zFORUM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No..Z~.0.~.~. ...... Date .............. ~a].~. · · · 26..., 19.~. THIS CERTIFIES that the building located at . .!//8- .Liml& .Roa~ ......... Street Map No~ap.t .]l[~.~d .E~liock No ........... Lot No..~2~ ..... l~a.~t;i~k.. ]/.aY · ...... conforms substantially to the AppLication for Building Permit heretofore fried in this office dated ............ &P~.~...iS 19. ~. pursuant to which Building Permit No..?l dated ............ ~:L1....~6, 19~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is pF~.wa~:$..o~, f.~mJ.~..d,~e.ll~ ........................................ The certificate is issued to .I/,//,T,. ~ola~f, lvaet:l.oll. Coa*~ .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~/tx~ .ii..~9~1~...by- 1~, .V~.I.I~ ....... UNDERWRITERS CERTIFICATE N~.l?0973 ...... July... l?...197~ ............... HOUSE NUMBER . .Il0 ......... Street .. ~A31d& .]hm~ ........................... Building Inspec~br FOu.'~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7185 Z Permission is hereby granted to: M :.§.t.?..,....g..o..~g .~J, ga .. g.~ ......................... Mattituok ~ Build new one fam$..1.~..dw.e..1...1....i~..& ..... at premises located at ..~...0.~....~..~...~. ....... .C...a.D..~....~..:~.c].qTL..~a~ .................................................................... ........................... ~.~....~...~. ......... ~.~,~.~1~ .............................................................................. pursuant to application dated .................. .~.~..~..~;~......1.~. ................ , 1~. ..... and approved by the Building Inspector. Building I~s~ector 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 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: 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 Dote ........ .?..l..~...~... !.?....~,. ................. New Building .......~.. Addition ................Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ......... ..~..}.,.~...?...~.......C~....~.....~....I~....~...~..?.}.,~..~,..~...I~... .......................................................... Owner Or Owners Of Property I~' C-,.~,.~..V'C~,.~.,'t"'tO~.J Subdivision ...Q..~...~' .~....~..? .~........?.~.,~..~....~...~ ...... Lot No...!.~../'r... Block No ............. House No ............. Permit No....~-..!....~...~....~'.. Date Of Permit ....~.l./..~..j.~..~'.Applicant .... ..~-....~..?.....C....G...~...~.~.y.~.~..~.....~, Health Dept. Approval ........ ..'~.....~...~.....~...k~. .............. Labor Dept. Approval ................................................ Underwriters Approval ...~1.. ......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ '~" Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me thjex ~/~,,J~(~. 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 ~A~' C~k'~I~(A',O~ C~e4~Phone Address ~ ")q~: I~-'~,'r~c,, ,~1. I'~ 2. Property Location ~ ~ i%~ : ~ Village Township 3. Public Water Compan~ Name ~m~ ~m 4. Lot size: Width ~ feet Length I~ feet 5. Subdiv. CA('l'. 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to n~in lO. Sewage Disposal System: A.ff/~-gallon septic tank: Pr~st ~Equivalent Block B. Leaching pools: Number of pools ~ Precast~'Block Special ll. If private well, fill in the following blanks:. ~lf~ A. ~k capacitl~_7~allons B. -]p~mp G.P.M.~U~_~ C. :!~?tal well ~epth D, Depth to ground water (For Health Dept. Use) E. Amount of water in well The unde~$gned 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. FOR HEALTH DEPARTMENT pSE ONLY. Based on the information presented herewith, it is the opinion of the Health ~epartment that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~'~,,x SIGNED Rev. 4/1/73 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW~ yORK 10C~38 THIS CE~IFIES THAT inthefoll~ing~atlon; ~ B~ement ~ ~tr~. ~ 2~ Fi. outside ~ot;o. m~ ~t 126 13 24 15 13 DRYERS j FURNACE MOTORS FUTURE APFUANCE EXHAUST FANS DIMMERS AMT, WATTS mFu~nacem: Oil 1-1/8bp, 1-1/12hp Ron~ld R. Ennis P,O,BOX 20~ Middle Island, L.I. 11953 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. roved .... ; · ~' ~ ~-"~' ? ~r~"T' .......................... ./ ....... , ................... Disa'""roved aic ................................ ~ ~ 'W,,~,~,:~.J~ ~ ,~ ~'o h'rd' t . Date ................. ~l;J~'.:J,~......1.~. ........ ,, 19....~/..LI:.... ~. ' ~ es INSTRUCTIONS a. This application must be completely filled Jn by typewriter o~. in ink and submitted Jn triplicate to the Building InspeCtor, with 3 sets of plans, accu~'ate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot 0nd of buildings on premises, relationship tb a'djoining premises or public streets areas, and giving a detailed descriptiO~ of layout ofproperty must be drawn on the d agram which is part of this application. c, The work cOVered by this c~ppliCation may not be Commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa rt 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 applicable Laws, Ordinances 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 code, and regulations, and to admit authorized inspectors on premises and irt buildings for, necessary inspections. ,~ ~) ~, q l~.S.T.Construction Cerp (Signature of applicant, or ~me, if a corporotion) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner - builder Name of owner of premises ~.S.T. constx~Aetion Corp If applicant is a corporote, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ..... .,,]~,,,,]:,e,~, .............................. Electrician's License No....]~LE~ ............................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ...... .~...~.?..~......]~..d...~. ............ Lot No.~ ~):~ Street and Number ........... ~.~3,~l...~l)&~. ............. ~t~li~ .......... i ........ 'i ..... Municipality 2. State existing use and occupancy of premises and intended use.and occupancy of pralx~,~cl construction: a. Exisiting use and occupancy ,acall~ b. Intended use and occupancy .. O.lJ..e. f~ml'l~ dvell:Lug 3. Nature of work (check which applicable): New ~uJt~Jng=~ .......... Addition .................. Alteration ......... .~- Repair .................. Removal .................. Demolition., .......... ~.../.. Other Work ...................................................... (Description) 4. Estimated Cost .................~..~.~.9...0~....,,~+....:i ........ : ....... ..Fee ..~..00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .O.?.?. ............ 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 ................................ 8. Dimensions of entire new construction: Front ......... ~. ..................... Rear ............. .2..~.. .......... Depth ..... 3.6.. .............. Height .................... Number of Stories ..............O...~..e ................................................................................................. 9. Size of lot: Front .... 90 Rear ... 90 Depth 120 10. Date of Purchase.. ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..... ~.~."...d....i...~..~. ................................................................. 12. Does proposed construction violate any zoning /aw, ordinance or regulation: .......... .~'? ......................................... 13. Will lot be regraded .....~..e...~. ............... Will excess fill be removed from premises: ( ) Yes (:X) No 14. Name of Owner of premises ....~......~......?.:....0...O.?;.~.~.. ................... Address ......~t~.$.t~.~..~..~.... Phone No ....................... Name of Architect ....~ ................................................. Address ................................ Phone No ....................... Name of Contractor Snme ............................................................ 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 comer lot. file plam STATE OF NEWIYORK. COUNTY OF ~ -__' ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract0 above named. He is the Agent of N.S.T. (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 application ore trUe to the best of his knowledge and belief; and erewlth. tha~ the work will be performed in the manner set forth in application Swam to before me this . of , 7l+ Notary Publi~ ... ~ 'O~" o of New yo~l¢ nty -- ~ (Signature of apl Notary Public, State ~licant) No. 52-0344963 Suffolk County,~/' Commission Expires March 30, c EN'I'R A L DRIVE LOt 125 NOTE: · -' MONUMENT SUBDIVISION MiI P FILED IN THE OFPICE O ~ ~E ~NK ~SU~ K COUNT Y ~ REWS~O.S YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALD~'N W. YOUNG HOWARD W. YOUNG SURVEY FOR: dAMES YORK ~ CHRIST/AlE YORK £0TI22, "CAPTA IAI KIDD ESTATES* GUARANTEED TO: MATT/TUCK SOUT~/O~O $4V/N~ $ SEC/./~ITY TIT£E~ SOUTHOLD BY su~o,~ co., ~.Y. cENTRAL DRIVE Lot 121 Lot 123 /../-..4'$'° NOTE: ·: MONUMENT SUSDIVI$10N MA P FlI ED IN T~E OFFI¢~r OF rtt~ CLERK OFSU~'I~OL K CO UN d&~ 19,1949 AS ~L~ ~. REWS,ONS YOUNG & YOUNG API~5~1.97'4 400 OSTRANDER AVENUE, RIVERHEAO~I~=~J;~*~ dU~VE~Odg74 ALDEN W. YOUNG//~'¢~ u' -''v )'0"~'~ G SURVEY FOR: , ~ d~MES YORK a CHRIST/NE YORK I ~~ &OTI2~'CAPTA/N K/OD ESTATES' ~~ /[2 GUARANTEE TOWN OF SOUTHOLD BY surro~ co., ~. ~. ;~2~~__~~ [1 NOTIFY BUILDING DEPA~tTM[NT ~ r ED INSPECTIONS: 1. BEFO~tE BACKFILLING FCUNDA- i