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Home My WebLink About7221-zFOF. M NO. 4 TOWN OF $OUTHOLD B[rr[.BINC. DEPARTifI*.NT Town Clerk's O~ce Southold, N. Y. Certificnte Of Occupancy No. ZT00.~. ...... Date ............ May .... ~ ....... ,199.6. THIS CERTIFIES that the building located at . Gull..Pond..Lane .......... Street Map No. For. clha~ ~,c ~Block No ........... Lot No...16 ..... ~re.enpor.t.. l%.X, ...... conforms substantially to the Application for Building Permit heretofore fried in thi.~ office dated ........... May.... 2..., 19.7~. pursuant to which Building Permit No..7.221Z. dated ......... l~iay...2 ...... , 19.7~., 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 . Private..one. family .dw.~lllng ....................................... The certificate is issued to .Bernice..V.a~I.ynl~g .... Owne.~ ......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval .. ~.o.v.. 12...197.h:....by..~ :. y.l.l.~_~ .... UNDERWRITERS CERTIFICATE No. NI ~5J.05 ..... Sep.l~ .30. J.97.~ ................. HOUSE NUMBER ..... 1.5~. 5 ....Street ..... ~l~ .Pon~ .Lane .................... I/ Building Inspector F~ NO. 4 TOWN OF $OUTHOLD BUIT.DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy o ............. Date ...........~)~.. ',~ ........ , lg .~. THIS CERTIFIES that the building located at 0~1.1. l~olld. Lan® ........... Street Map N~.. ............ Block No ........... Lot No..~t~ ... ~e~o~t .... li,~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............~..Y..~...., 19..~.. pursuant to which Building Permit No.7.2~lZ... dated .........~..~.... ~ ...... , 197..~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which ~ certificate is issued is ...~..~..~..t,...~..,..f..~...x.r..~..~.,.~.~..s~. ...................................... The certificate is issued to .~.9..l?l~..a.9..~..a~...ll~l~g ...... 0¥~t~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .NgT...~...~.~....bY. ~ .¥~l& .... UNDERWRITERS CERTIFICATE N~.~..~.~ .0~.....~.$~.t.. ~.0....~..~. .................. HOUSE NUMBER...1.~2~ ....... Street.. (~/,~11.1~. L~I® ....................... Building Inspector l~U~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFfiCE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7221 Z Permission is hereby granted to: ............. Y~at.~rzL~g...C~ams.t~t~on..Ce..Ine A/C Bezel.ce V-n l~ .......... ~.~1..~. ......... .lJ..~..~..~.~ ............................... ........ ~.,.~.,...gJ,.t;~......~ .,~.~......1.1..~ .~ .~ ................... t ~uild new one fa~ilv dwelline at premises located at i...~,~..o.~....1..~. ....... ?..~.~..,~.~JI .................................................................. .................................... ll~LJ...~.ond..L~a~ ........... G~aenpm~t.....~.~.. .......................................... pursuant to appIicati0q dated ................................ ~ ....... ~. ....... 19.~:.., and approved by the Building Inspector. " F~ $ ..................... / / / FORM NO. 6 TOWN OF SOUTHOLD Building Deportment 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, anti 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. [3. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-ex'sting" 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: 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 $1.00 Dote .. ~o.v. en~bez'...2.5 ~...]..9.7..~. .... New Building ..... X. ........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Owner Or Owners Of Property ...3.~iD.~...~..~i~ ........................................................................ Subdivision ..~O~b~..~Q~R...% .......................... Lot No...%.~. ..... Block No ............. House No..~.~.~.. Permit No..7.2~1~ ....... Date Of Permit ~...~...Z~.Applicant ~D...~D.$.qg..~P.~.~.~.gg.~...~94., Inc. Health Dept. Approval ........................................... Labor ~pt. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ...... ~ ............................... Final Certificate .......................................... Fee Submitted $ .~.,.Q~ .......................... fl Construction on above described building~ermit~e~ a~lica~ codes and regulations. c n, Sworn to before me this ~ / ...... o, Notary Public ...~ ....... County ~:~:~?~,~:~??~t~ sea, Commission ~xpires ~arch 30,19.~-- THE NEW YORK BOARD OF FIRE 'UNDERWRITERS BUREAU OF ELECTRICITY. "." as JOHN STREET, NEW YORK, NEW'YORK THIS CE~IFIES THAT ~ly t~ e~t~ ~u~ment ~ ~cHb~ ~ a~ ;nt~ by t~ ~t M~ ~ t~ ~ ~ation numar ;~ t~ p~m~es of ~eodore V~ ~ning, e/s 19B Oull Pond ~ne, 1500' s/o ~n Rd., O~eenpo~ L.I. inthefollow~ng~atlon; ~ Bme~nt ~ lstFl. ~ 2nd FI. ~slde s~t~o~ s~ ~ot ~do. Septe~er 26, 197~ a~fo.ndtobein~mpliance~iththerequ;rementsofth~rd. RXTU~ [~A [ SWIT HE [ RXTURES C~KING~KS OVENS ~SH W~E~ EXHAUST FANS OUT.TS ~ C~ c s ,~E~Ti Fm~e~TI ~ UKES ~. ~, w. ~. ~, w. I ~: ~.w, j , ~. t w. [ II I SERVICE D~$CONNECT NO. OF S E ~J 200 CBMETER X · .~T. AMP, TYpE ~UIP. lW~ 1~ 3~3W 3~4W OTHER A~ARATU$: a ~ V [ c OF CC. COf4D. 3/0 i 1/0 · Furnace/BI OilR 1-1/8bp 1-1/qhp Water Heaters: 1-q. SKW lOFT 6 Feet Track L/ght. W.B.Ruland Mat~;ltuok. L.I. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAN,"':~. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. ApplicantBmrnice Van Hyr~ing Phone_PO 7-5989 5. Subdiv. Fordh~km Acres Address 19 Fi~lmnd T)~:ixTp; Pnrt- W~hlngrnn;NY 1]05~. Section 2. Property Location l.~r lg nn ~r ~(do nf ~t~ll Pnnd l.~neLot Nu~er 16 · .... ~ 15nO' R~ ~F ~h ~a 8. Private Well 3 ~?~~e~p~ . Town~hip gm,,~hhnld 9. Public Water · ~UDmlC wager bompany~ma~ lllllme~ nf ~r~nnm~ Distance to ~in 4. Lot size: Width lOO fee~ ~ength 287 ~ feet 10. (For Health Dept. Use) ll. Seway~isposal System: A. gO, gallon septic tank: Precast~_c~u,v~en~ Block B. Leaching pools: Numb~of pools ~? Precast~-Block Special If private well, fill in the following blanks: None A. Tank capacitY~~ons B. Pump G.P.My~,/ C. Total wel~epth D. Depth to ground water E. Amount of water in well The unOersigned 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. Signe~ ~)z ~.~-.c~-~ /(.~.~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,.S~pply can be installed on this ptot. APPROVAL DATE ~L~?_?~/~/7~, SIGNED C ~ S-15 Rev. 4/1/73 ~ ~ ~ TOWN OF SOUTHOLD ?/'~.?/? BUILDING DEPARTMENT Town E.,C'S O,,IC SOuTHOLD, N. Y. ~. ~//:~?/?'f '~' .................... , ,~%opllcatlon I~O ................................. ..................... .................. APPLICATION FOR BUILDING PERMIT Date .............. Ma.3~..2., ................... , 19..?..~ ...... "-I INSTRUCTIONS a. This application must be completely filled in by ~pewriter or in ink and submitted in triplicate to the BuildingS' Inspector, with 3. ~ of .plans, accurate plot plan to scale. Fee according to schedule. b: Plot plan showing Iocahon of lot and of buddings on premises relationship to adjoining premises or public streets areas, and giving a detoi ed description of layout ofproperly 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 opp~°vai of this application, the Building Inspe~:tor will issue a 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 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 in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) 11101 State whether oppliCaht is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... C,e~ez~l...C onl:~.ac~: ~. .................................................................................................................. Name of owner of premises ...-~e~.n~ee...V~t~..~.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 ............................................. Other Trade's License No ............................................... Location of land on which proposed work, will be done. M~p No.: ...,,~.5~.c~ ...........................Lot No. ~...1..6. ................. Street and Number .~`~1A~'~.~.~)..~.~.~.~'.~...~..e...~.~....a..e...a..~..~..G..~...e..e..~.~.g~ ................ i ............................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: .3]~.Nature of work (check which applicable): New Building }C' Addition Alteration Repair .................. Removal .................. Demolition.., .......... ~... Other Work .................................................... :~ /,/~,, ~ ~ (Description) " 4. Estimated Cost ....~.~.~,.0.00.^0.O. ................... : ........... ~Fee ....... ~ .................................................................. (to be paid on filing this application) §. 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 ................................ r~ecr ...~.~.....o .............. uepth ...k...../. ............. 8. Dimensions of entire new construction: Front ....5.7..".....-....].0.~.! .......... " /./.i Height 13t-10.~" Number of Stories 1 9. Size of lot: Front .......... ],0.Q.,9.~ ................................ Rear ...... .1..0...3....,6.5. ...................... Depth .2.~.5......7.0....&....2..8...7..:.00 10. Date of Purchase ...1.~..~A.~,]-,.~L~.~..Z)- ...................... Name of Former Owner .....b~,..:...~...,l~..~,.....~.~..,.]....~.~.~.k..~.o.?i Itl 1 1. Zone or use district in which premises are situated ......... A.....ILes.t.clP. zl~l.]. ............................................................. No 12. Does proposed construction violate any zoning law, ordinance or reguJation: ........................................................ 13. Will lot be regraded' .....~]~. .................. Will excess fill be removed from premises: (X) yes ( ) No Name of ;l~a~ Th~odore..T.;...¥art..I~n-~.ng..,B,~EAddress -P.l;.,...'W.-e'Sh;[~gJ;.Qt3~ne No. P.Q..2..~S9.89. Name of Contractor .~/&n...Ji~-~.l~§..C, oa.sl:~.....Co,~tcAddress Lon§...Is.].a,~.cJ ..... Phone No. Z],~,..~3.~],::.... PLOT DIAGRAM C~LCy 2273 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 shew street names and indicate whether interior or corner lot. / . Nrc, O °oo'~' _s D~IVE- V~A'T' 1~' STATE OF NEW"YORK, I[ S S COUNTY OF ................................ f ' ......................... T~-te(~,o~.e...T.....~,~-...[-[~,it~.§: .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..~.rasJ. d~nl;...o£...V, an.l-Zyn~§...C~s~.r.-''C'°''-*-''Inc-''''~''Gener~'l'''(]o~J;~cCg~ ................... (Contractor, agent, corporate off cer, etc.) of said owner or owners, and is duly authorized to p6rform or have performed the said work and to make and file this application; that all statements conta~ined 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 Jn the application filed therewith. / Swam to before me this / / day of ........ ......... / · ........... .................... / Lof 16 L.o~' 4 t M A P OF' J~EPNICE. VAN :9 TYPIC. t~L WALL. 5, E.CT ]~)N 3/-~" ~CALN J~ 5OUTN F-LE'VATI ON J/~"! gC.R L. ~I t , j BEFORE COVERING pIp,:LINE 3. FINAL WHEN JOB COMPLETED ELEVATION5-V,/ALL..~C.TION.- IuiF__Cfl~NICAL,.g?EC_, 0 .? ,/ // .0 / 62.5' TOVON OF_3OUTI-R)LD :-F,2'~)~l~,l 8Cl~:s'5 Er. ;2 M~R,~Sl9 LO'T ~F-t~tTECl'dF.~L FLo~)R PLAN ~ FLOW pLaN m-c~