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Home My WebLink About7124-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupnncy No. 'Z~96'~ ..... Date ............... J%ll~ ·. 18-.., lg..~1+ THIS CERTIFIES that the building located at ..-Capt .K:l. dd .DI, ........... Street Map No. -Capt,' lElddB~[I~N° ........... Lot No.. '$63 ..... Ma-tt. ituek .... N.Y, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... t~r-..20 .... , 19. ~1+. pursuant to which Building Permit No..?l ?.1+2;. dated ............ Mal~... ~., 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 .. P~i?aSe · Qne .£a~l. ly. d~elli~g ...................................... The certificate is issued to .. George..Nieholae ..... 0~le~* ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. June...1.3...~97~ .... by. It, .V~.~.'~& UNDERWRITERS CERTIFICATE No.. N..1632~ .... June-S- '1.9~ .................. HOUSE NUMBER ...21,O ....... Street ..... gap't .I~dd .I~ ...................... ~uilding ~nspector ~ FO~M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 712~ Z Permission is hereby granted to: .................................................................. .~.~,~_-~ ........... ~.~...: ..... ,. .................. p...o.t to °.p,cot,on dot.d .... ~..~...~..~,.~......., ~..~., ond op,roved by the Building Inspector. Building Inspector 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 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 Date ~..~...~....~.?. ...... .'I... ~ :...../...~. ~. ~. New Building ...... ...~....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ................................ .4~.../..,~..~',d<'. ....... '.~.../..~.../~....../-~....~....;.../..//./.~..~..../../......~4~..,(. Owner Or Owners Of Property ...~..~.C.~..~...~.~..~...~.....~...~...~.~,~Z~C ....... ../~/./..~..~..49....~.,~...~.. ........................ Subdivision ~....~.~..~../,~...../.,~'../.~?./~.......~..~..(. ........... Lot No../. Z~ Block No ............. House No....~:.....(~...~. Perm t No .?../...~..~.....~-... Date Of Permit ..~./...~...~,~..,?~.Applicant .~.,~...~...'...~......~..~.~..~.~..~...~........./..~...~..~.~'~'.~'...~,~r Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......~.. .................................. Fee Submitted $ ...~...'~;...~...~. ................. Construction on above described building and l~ermit meets all applicable codes and regulations. Applicant ..~i;..~,-~......~.~.~~'~ .......................................... Sworn to before me this Notary"/"~'"'" day OfPublic ..~/~' ' Co~~~ un(~/ ........ ~ ' ....... .......... ~ (stamp or seal, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CE~IFIES THAT o~y t~ ~t~ ~U~nt ~ ~C~ ~ ~ int~ by t~ ~nt ~ ~ t~ a~ ~i~t~ ~m~r ~ t~ ~s of ~ & C Nicholas, 2~0 Capt. Kidd Drive, Matt,tuck, L.I. i.,he.foUo~i.~.~.t~o.; ~ S~,em~.t ~,t~. ~ ~d ~l. outside ~tio~ s~ w~exami~on ~ay 31, 1~7~ ,~/ou~incomplia~ewithth~r~uirementsofth~. TI~ECLOCKs BELL UNIT HEATERS MULTI-OUTLET ~T.]~p~ 3R~NS. ~ SYSTBI4S V I C L., 163 EXHAUST FANS DIMMERS 'Furnaces: Oil 1-1/8bp, 1-1/12bp George Zimlinghaus, q Park Place, Patchogue, L.I. 11772 11 COPY FOR BUILDING :OPY OF ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number ~- Jo -J'$ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 2. Property Location Village /~?~; ~F~ ( ', Township ~q 3. Publi~ Wate~ Compan~ Na~ 4. Lot s3ze: Width ~, feet L~ngth /~,7 feet 10. Sewage~Dt sposal ~ystem: A. ~-~l~'eptic tank: Precast c~ .Equivalent Block B. Leaching pools: Number of pools ( Precast qd~Block Special ll. If private well, fill in the following blanks: ~:A. Ta~ capacit s ;'B, Pu~ G.P.M.//k/ / D. De~%*n to ground water E. Amdubt of water in well 5. Subdiv.;,/~- 6. Section ~ 7. Lot Number / c.~ 8. Private Well 9. Public Water Distance to main (For Health Dept. Use) The underslgt3ed 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 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. APPROVAL DATE '~/~' SIGNED ~------ ~ -- S-15 Rev, 4/1/73 EXUVA'flOt4 I SPECnON REQUIRED TOWN OF SOUTHOLD ~..., .~' .~'j .., _ / ,,~/,.._. .... /.~/-~'~ BUILDING DEPARTMENTr''~c'4'c'~'~'/~ TOWN CLERK'S OFFICE ~-/- ';72' /4/,,~ ~ ,' (/?~, '/' ~,Y /,,~ SOUTHOLD, N.Y. ~ ~' 7/..~.. ,~'-t'.,A,-~: ~ ~-- ' ~ ? ~t~ . Apwo~d ................ % ................ :...., ~....'.... P.,~i~ No. '~'"""'"'~'~"'""'"'"'--'""~"1-~" (,'~-, ~,~, ~ ~)' '~'~'",-'-- Dis~pproYed ~/c ................. ':~ ............. ~ ............................................ ')¢o ~ ~ ~ ..(/ // ................................................................... Y'"'"'"-~' ...... /' ........................ ~ - ~' '/L~-lh~-' [~ K ' (Buffding Ins~tor) ~ ~ ~ r~ APPLICATION FOE BUILDING ~EE~IT .~ D~ta .~.~...~ ...................... , 19.2~... -L~ ~.,~ ~2 . INSTRU~IONS a. This appli~tion must ~ completely filled in by ty~writer or in ink and submi~ed in triplicate to the Building Inspector, with 3 sets of plans, a~urate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot a~d of buildings on premises, relationship to adjoining premiss or public stree~ or areas, giving a detailed description of layout of pro~rty must ~ drawn on diagram which is part of this application. c. The work covered by this application may not ~ commen~d ~fore issuan~ of Building Permit. d. U~n approval of this application, the Building Ins~ctor will issue a Building Permit to the applicant. Such ~rmit shall be kept on the premiss available for ins~ction throughout the work. , e. No building shall ~ occupied or u~d in whole or in part for any pur~ whatever until a Certificate of Occupancy shall have bee~ grant~ by the Building Ins~ctor. 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 appl~ant, or name, if a corporation) (Address of applicant) State~vhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder: Name of owner of premises ....C~....~......~..~.~. ...... ,~.~.:~..~., .~x~.g~...~. .................................................................................. if applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work witl be done. Map No.: .....L....~...~..~. lot No .......... .~.....~....?... ...................... Street and Number .....~...~.,~.....~-.,.,.,.~.a .~......./.t{....~..~'./~. ...... .,~...~.; ............... ,~2~...~...~...2:.a..~......~....~..~.~. ..................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... b. Intended use and occupancy .......... ~....~..~..~x.../..,~ .,~....~....~..../..~...~'..!...~-; ......................................... -3. ' Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ....... Repair ......................... Removal ......................... Demolition ........................ Other Work ..................... (Description) 4. Estima d cost .................... ............................................................ (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 ........¢~..,(ff..,e~.. .................... , ........... , ...................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ..................................... 7. Dimensions of existing structures, if any: Fron~...~.~....~...... 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 ....(o,~..~...."~....~.. Rear ..~...s~.. ................ Depth .C~.....'~..;..~. ................. Hmght Number of Stories ~'-'~'~- 9. Size of lot: Front ............. .,~...~..../. .............. Rear ................. ..~'.....~.../. .............. Depth ....... ../'~../. .............................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purcha~f--~..~..~..~;:~.ffName of Former Owner ....~-~-...~...~2~..,~........z~....~)~...~...~. "~"....c~...:. ....... 11. Zone or usa district in which premises are situated ....... ;~.~: ................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~...~...~.. ............................................... 13. Will lot be regraded ___ ; .~...~....~. ................. Will excess fill be removed from premises: [ ] Yes [4 No 14. Name of Owner of pmmi~t~ .................................................. ~.. ............... 7. ............................ ~... .......... ~ ...... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ../../~.~.Z~.~..ZZ....~,~...d~.. ......... ././..?.~...~,~.4~./~.~.~....-~... ............... ~....~...Z..~../..~'....~...~.... ( Ad d r · s s )~/-~,~,,~,~ ,~.~/~ (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK~ u FFo J,-- ~ ) SS COUNTY OF ...................................................... ) ........ ~¢~.~..,~..........x~.:~.,e.~.,i;.~..'J...~.v..~. .............................. being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract} He is the ....... .ff~..~%:~..~.~..~...,~.~...~.,~..~'. ............................................................................................................................................................ (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 are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. .............................. ....................... W~~! ~l.Gca ao_, lb.-~-Z?,, '" z~'Et' ................................. W ....................................................................................................... (StgnatureofapplicantJ lot 157 "~.85°00'$0"g: CAPT 11N KIDD DRIVE- NOTE=' e=MONUMENT SUBDIVISION MAP FILED IN THE OFFICE ' OF THE CLERK OF SUFFOLK COUNTY ON JAN. 19,1949 AS FILE NO. 1672 J~,~J TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W* YOUNG HOWARD W. YOUNG SURVEY FOR: GEORGE NICHOLAS 8, COSTAS NICHOLAS LOT NO. 16 3 "CAPTAIN KIDD ESTATES" AT GUARANTEED TO: MATTITUCK TOWN OF SOUTHOLD SUFFOLK CO., N.Y. aY/~/:TT.4FF/..,~,~ ~,j~. SCALE: I =40'} DATE:MAR. Id,', 974 741'-14f NOTE;' S. ~$o00'$0 ' CAPTAIN Lot 157 MONUMENT SUBDI¥1SION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JAN. 19,1949 AS FILE NO. "8.8~°00'$0"~. '0.00' -.. I Lot 163 ® , Iv'OG~OO'JO"W. 90 OC KIDD 2he sewage disposal and water supply faeilities for this location have been inspected bF thts__~rtm~ut ~nd~nd Chief of ~eneral Engineering Services THE r-OC,~T[ON OF WEt, If; ~ND C£$$P00~ SHOWN HEREIN ABE FROM FIELD OB3ERVATION~ ~.,NDIOI~ ERO/'d DATA OBTAINED FBOId OTHERS REVISIONS YOUNG & YOUNG~ JUNE 10,'974 400 OSTRANDER AVENUE, RIVERHEAFIF, N.,~,t~8~'~ ALDEN W. YOUNG SURVEY FOR: GEORGE NICHOLAS a COSTAS NI~;H~I / AT GUARANTEED TO: MATTITUCK TOWN OF SOUTHOLD SUFFOLK CO,, N.Y. DFUV E LAW. - .......... ~- ....... APPROVED A ~, ¢ ..... J, , - ~ ED INSPECTIONS. .. ,r?L U/VI::/ND, ~£~.4 F'~ E L E-I, ~ T/O A/ ?.CCT/ON t~ U/L_ DERS FO EL/~DA.. TION. PLA IV