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Home My WebLink About7110-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificnte O[ Occupnncy THIS CERTIFIES that the building located at . East. L.anQ ................ Street Map No.X .xx..x.x. ...... Block No...LAC. x. ......Lot N .o~X..x...E..a.s.t..M..s.r.~.o..n ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. M..a.r....~.., 19 .?~. pursuant to which Building Permit No...~.~. 3. .OZ. dated ......... ?!a.r....7. ...... , 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 The certificate is issued to .~.9.1'~...E.:..~.o.n.e. ~ ........ 0..w~..e .r ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .S..ep.t....27... ~. ?.7.6....b.y..R.:..V.i.~..1.a... UNDERWRITERS CERTIFICATE No..p.e.n.d.i.n.g ................................... HOUSE NUMBER .... ~..0.0. ...... Street . .E.a.s.t...L.a.n.e. ..... E. :. ?!a.r..19.n' .............. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C:LERK'S O~FICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS P£RMiT MUST B£ KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7110 Z Permission is hereby granted to: ............ ~hn..~.,..,ll. one~ .................................... ......... 6~..... ~..a~l...Ave .................................. .............. ~o~t"~a~Xn~n .......... ~ ................. to ..... B~i.l~ .. ~m~ ..o~e...~em ~..~y.- ~t~e .1.~.~d~ ................................................................................. at premises located at '"'~,'/~"B~8~"L~II~' .............. ~l'd'"OFgl'~,l~J: ............................................... ............................................. r~' ~"~T~"f ~E ........... N~ ................................................................... pursuant to application dated ............................. [/~,~......~ ............ , 19.~.1~..., and approved by the Building Inspector. Fee $'"65; ~'""~:f ~t'lt FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR CERTIFICATE OF OCGUPANCY 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 disposol--(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 "pm-existing" land uses: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual noturot 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: l. 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 DQte New BLlilding ...~... Addition ................ Old ar Pre-existing Building ................ ¥ocont L~ .............. · ocot~on Of Property ../..~.....~£.~...~.~.~-- -- ........ ~.~..~../..~?..~ ....... /U.._..~:~ ......... Owner Or O~ners Of Pro~ ....... ~..~....~..~.~...... '~..~.~.~..~......~.....~.~.~ Subdivision ................................................................ lot No ............. Block. bio ............. House No..~....~.....O Permit No .........,4~....~..... Date Of Permit. ,~. plicant .......... -. ................................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporal/Certificate........................................t'/ Finctl Certificate .......................................... Fee Submitted $ ..... ,~..e. ........................ Construction on above described building and pe, rm~, ~xets all a~p~lica,bl~wcodes and regulations. App, cant .......... .... . ~ // ~ , or ~OTAR '~C , v FU TOWN OF SOUTHOLD C]FFIOE OF BUILDING IN~PEOTOR TOWN OLERK'S OFFIOE SOUTHOLD, N. Y. 119'71 TEL. ~65-~66D February 15, 1977 Mr. John E. Jones 67 Oakland Avenue Port Washington, NY 11050 Re: Building Permit ~7110z. Dear Mr. Jones: In response to your letter of February 10, 1977, please be advised that the temporary Certificate of Occupancy issued on September 30, 1976, was to cover the occupancy of the building constructed under this permit during the period of construction. However, the building permit is still in effect and will be in effect until such time as all the construction is completed. The length of time before this permit expired was 30 months. The Building Inspector, upon your request, would be permitted to make an extension of an additional six months. This permit was dated March 7, 1974, and the 30-month period expired on September 7, 1976. The additional six months that we have given you brings it up to March 7, 1977. It is expected, there- fore, that all construction under this permit number will be completed by this date. In the event that the construction is not completed, the permit then has to be renewed. I sent you this letter to forewarn you of the expiration date so that you could complete the construction and avoid the re- newal of the permit. If the work cannot be completed by March 7, 1977, then renewal will be in order. Very truly yours, Edward Hindermann Building Inspector EH:med TEL. ~65-~660 TOWN OF SOUTHOLD OFFIOE 0F BUILDING INSPEOTOR TnWN I~-LERK'~ nFFIr-E E~OUTHOLD, N. Y. 119'71 February 3, 1977 Mr. John E. Jones 67 Oaklawn Avenue Port Washington, NY 11050 Re: Building Permit #7110Z, dated March 7, 1974 Dear Mr. Jones: This is to inform you that this permit expired on September 7, 1976, and that the additional six- month extension will terminate on March 7, 1977. At this time, renewal of permit will be required unless you can complete all construction by then. Renewal fee is $69.95, payable to the Town of Southold, N.Y. Yours truly, EH:med Edward Hindermann Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number Village ~-~- /~A~_~o~ Township. Sm~-~-~j~ 9. Public Water 3. Public Water Company Name ---- Distance to n~in 4. Lot size: Width /~9o feet Length. /Jo) feet APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Applicant ~/~'~ P~'-,,~-~-'zr3~ Phone ~.) Address 6 ~ ~ ~q~ do~, ~o~ ~(~o~ ~[~oyo6. Section Property Location ~z~ ~o~o ~o o~ o~c~4~o ~q~ 7. Lot Number lO. Sewage Disposal System: A./~gallon septic tank: Precast P/Equivalent Block (For Health Dept. Use) ll. B. Leaching pools: [ Nu~er of pools Precast ~'/B1 ock ~pecial If private well, fill in the following blanks: A. Tank capacitR 8~- 9allons B. Pump G.P.M. [~- C. Total well depth. ~q D. Depth to ground water E. Amount of water in well The undersigned 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 /L~'~/~/ ~ /~? ~ Signed ]~"~ (4'~/~-u-~-o--- opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this pl,ot. APPROVAL DATE 7~/Z~ SIGNED ~ ~ S-15 Rev. 4/1/73 a: This application must ~e completely filled in by typewriter or in ink and submitted in triplicate to the Bu Idina ~nsPeCfor, ~'~ 3 sets of plans, accurate plot plan to scale. F~e accerding to schedul~ -- 'J 'b' Pt' I' ~ ~ ' ' · otl~ an sh~wing location of lot and or'buildings on premises, relationship to a~'ioining premises or pub c streets or areas, and giving a detailed description of layout ofpraperty must be drav~n on th~ diagram which is part of this application. c. The work covered by this application may not be commenced before issu~r~ce of Building Permit. d. Upon approval of this application, the Building Inspector 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 Deportment 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. '' Stot~ whether applicant is~ner, lessee, ...... /p,~.~. (Address of applicant) . agent, a~hitect, engineer, general contractor, electrician, plumber or builder· If opp,licont is a corporate, signc~ure of duly authorized officer. (Ngme and title of corporate officer) ' Electrician's License No ..... ~ ....... .~ ...... Other Trade's License No ............................................... ~/-..0 ~ .~ ~,,9',f,~Z~ J"",.'l ~ Tu~L Street and Number ~ ~ ~ ~/.~ ~o~o~ ~.~ ~ ~,~3' ~o~ o~ ~ ~ Munici~li~ State existing use and ~cu~ncy of premises and intended use and ~cu~ncy of pr~ed construction: a. ~isiting use a~ ~cupancy ....... '...~.C~.~...z...~.~.~.~ ......................................... b. ntend u,e ......... .................................... 3. Nature of work (check which applicable): New Building ......... Addition .................. Alteration Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) ~e'~ o'- ~ o o ~ ~ ..... 4. Estimated Cost ......... .'~......~, ........................................ Fee..~....;[....; ...... L...; ...... ~"l'i' '"'~'17 ....... i"'"'~'""; .................. t o De pa~a on i ~ng ~S app ~ca ion) 5. If dwelling, number of dwelling units ......~....M~....~.. ............ Number of dwelling units on each floor ............................ If garage, number of c~rs ............~.....~....O.. ..................................................................................................................... 6. If business, commercial or miXed occupancy, specify nature and extent of each ~pe 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 ........--Z. ................... Depth .. ~ Height ............ = ............. Number of Stories ....... ~ .................... 8. Dimensions of entire new construction: Front ....~....~.:..O......~.....~.,. ......... Rear ......~.....~.:.o....~....~.,... Depth ......~.....'.....~...~'..~.' Height .../.~.,....~...~.~- Number of Stories .......... ~....~.x~.~. ......................................................................................... : ..... 9. Size of lot: Front ZOO, o ,~'~'. Rear ... /..60, ~.. ~'7', - -, /.~...~. O ~'.7..~. ...................................................................................... uepm .......................... 10.~'~'~.Date of Purchase' e C~', i.~..~, /c~.. . .Name of Former Owner ....~.,'~...~'..~:~ ........... J' ~/'/'°'~/e .................... 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 ........ ..~....O. ............ Will excess fill be removed from premises: C>~ Yes ( ) No 14. Name of Owner of premises ....~...~..../~..~.......~..:...~...~'....~....~. ...... Address~'.~.~.;~.~...~./~.~.,~,~.z... Phone No..~..~...,~.....~...~...?...~ Name of Architect ................~....~'.....'~..~ ....................... Address ................................ Phone No ....................... Name of Contractor .............. ..~...c~.....~....~....x~.. ....................... 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 corner lot. ,/,Al 31 aa/-3oral /00.0 STATE OF NEW ~OR~,/.~ ~,~'_ [ c c ...................................................................................... ~ .......... being duly sworn, d~oses ~ s~ys t~t he is the opplicont (Name Of individ~l signing con~tmcO above name. ' He is the ................................................................................................................................................................................. (Contractor,. agent, c0rpo[ate officer, etc.) of said owner or owners, and is duly authorized to perform or ho~'e performed the said work and to ronke and file this application; that all ,statements coritoined in ,this, application or~ true to the best of his knowledge and belief; end that the work will be performed in the manner set forth in the application 'filed therewith. Swam to b_efo~e me this ~ .. ., .... , ....... ..... ....... . Notary Public~.'~ty ............................ .~...~ .............. .~.~ ...................... c~ /~(Signoture of ~c6nt) ~U~H *. ~o~N // - No. 52-03~9&3 5uttolk Coun~ ~mi~ien Expires ~arch 30, -/ /00. Oo ~.. APPROVED AS NOTED .~ "~ / NOTIFY BUILDING DEPArtmEnT ~T 'w~ 1. BEFORE BACKFILLING FOUNDA- TION OE 5TAET FEAMING ,2, BEFOEE COVEEING PIPELIN~ 3. FINAL WHEN JOB"COMFLETE~ , ., ...................... .......... _ ......... ii:. ,, 9" WA ll£'g CONc/e£Tf_ C£/LtN6 U-OtST PLI4,V ~ Z/k/AY Cr"ol$ r5 N/SE 7-Y 2, "× 8" ~6"0.C. ! .o. el./.W, LAILY T, P,_ COL ~/¢*W' ti~V///,,/\ 7 G.;l'.b, '-_ ~/2 U/VAER. Z~vj 16 'x ,~