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Home My WebLink About8557-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .~./~..D, 9..~X~...D. $'~y.e ......... Street Map No.V. eev. ~o~e. C~ ~o ........... ~ot No, .~6 .... ~.~$~.. ~.-~ ..... conforms substantially to the Application for BuildingPemit heretofore filed in this office dated ............~ .... ~., 197~. pursuant to which Building Permit No.. dated ......... ~..3 ....... , 19.~6., was issued, ~d conforms to ~1 of the requir~ ments of the applicable provisions of the law. The occupancy for which this certificate issued is . ~r~Y~. ~. ~a~. ~,~.~n~ ...................................... The, certificate is issued to ~n0~P..~0~..g~q. [P~ .... ~.~ .................... (owner, lessee or ten,t) of ~he aforesaid building. Suffolk County Department of Health Approval 8e~ 8 ~0~6 ~ ~. UNDERWRITERS C~RTIFICATE No. N301 ~8~ 8e~g I 1 ~ovs~ ~u~s~ ... ~O ....... st~t ...~.P~!~ .......................... FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 8557 Z Permission is hereby granted to: Frances Rose Hoae8 Yne .... ~..o.~,..?.~.~ ....... .~?.~..~,~L...."...°.~.k....~...,°.? · .s..~...~S~....o.~s...f.,~.L.Z .~..'..e.!~ ....... lot 26 Dee~ Hole at premises ~ocated at .......................................................................................................................... W~.S Donna Drive Ma~tituck ~u~uon~ to o~,~otio~ doted .................. 2!.a.y. ............ ~. ............... , ~.§...., °nd o~p~o~d ~y t~ Building Inspector. Fee $?..~..*....~{.. ............ ~ ' Build,ng Insp' '~ ector I FO~ NO. G TO~N OF $OUTNOLD ~ guiIdln9 Data.merit To~n Clerks Office $out~o[d. N. ¥o ~]97] 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 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 19,57), 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 ............ B' ' X New qHdmg ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property !?../.~ !.).ozlna Drive 506,09' S/O New Suffolk Ave. ~ Mattituck, NY Owner Or Owners Of Property ~/~aDoes Rose Homes~ Subdivision Deep Hole Creek ~states L,~ ~,, 26 .................................................................................. Block No ............. House No._.5.?..0.... Permit No. 0[5"/ Z Date Of Permit 8/~/'76 Applicant t~anees Rose Romest Inc. Heo,th Dept. Approve, ........ Lobar rapt. Approval ...... ................................... N 301282 -' ' N R Underwriters Approval .............................................. manning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ 5.00 Construction on above described building and permit meets all applicable codes and regulations. Applicant Frances Rose Homes~ Inc. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1. Applicant ~ .... Address /~'O..~ /~a~ 2. P_rop.erty_L~cAtjon , ,/m~ ~-<-~JW~[ ..... Village ~ £! Township 3. Public Water Company Name 4. Lot size: Width /tO feet Length /~:~.~feet Health Services r Reference Numbe APPLICATION FOR APPROVAL TO CONSTRUCT 5. Subdiv. 10. Sewage Disposal System: 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main (For Health Services Dept. Use) 11. A. 900-gallon septic tank: Precast ~quivalent Block B. Leaching pools: Number of pools Precast ~lock Special__ If private well, fill in the fol- lowing blanks: A. Tank capacity.~gallons B. Pump G.P.M. ~"' C. Total well depth ~ ~ D. Depth to ground water ~) E. Amount of water in well Z/O The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' current standards thereto." This application will be valid fQr one year from the date of approval indicated below and may be renewed i~ a current local Building Department Permi/Ois in effect. Date Signed ================================================================================== FOR THE DEPARTMENT OF H~ALTH SERVICES~ USE ONLY. Based on the information presented here- with, it is the opinion!of the Department o'f~Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE '~ ~-~ x '- . Rev. 4/1/73 %Y~"~n~ ~" BUILDING DEPARTMENT ,/o~ TOWN CLERK'S OFFICL~t~ ~ ~U~D, N. Y. ~ o~. Z . ............ Z. EJ. ........... , No ......................... ................................................................................. ................... ........ I~$TRH~IO~$ o. This a~licofion mu~t b~ compl~t~l~ fill~ in by ~p~wril*r o~ in ink ~ ~mi~od Insp~tor, with 3 ~ts of plans, accurate pl~ plan ~ ~ale. Fee acco~ing to ~h~ule. b. Plot plan showing I~ation of lot end of buildings on premises, rel=tionship to adjoining premises or public streets ere=s, and giving a det=il~ description of I~ ofpr~ must be drawn on the diagram which is c. The work c~ered by this e~lication may n~ ~ commenc~ before issuance of Building Permit. d. Upon approval of this application, ~e Building Ins~tor will issue e Building Permit to the applicant. Such permit shell be kept on the premises aveilable for insp~tion thr~ghout the work. e. No building shall be ~cupi~ or u~d in whole or in pert for any pu~ose whoever until a Ce~ificate of ~cu~ncy shall have been grant~ by the Building Insp~tor. APPLICATION IS HEREBY MADE to the Building Department for the issuance of 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~._o~ for removal or demolition, as herei.n described. The applicant agrees to comply with all applicable laws, ordinance~ouil~ng code, housing code, and regulohons, end to admit authorized inspectors on premises end in buildings for necessary ir~spections. ,~nq~u_re,of applicant, ~ame, if a corporation) ~ aend. osza~ Pre%. ~...0....Bcl:c .~a33, .. B= oadwa~.. ,P,~,c ~'~.. ~.o,l~t ,..~T. JZ (Address of applicant) ].].??8 (Name and title of corporate officer) Ben .,,e,nclozza, Pres. Builders License No ..................................................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ ...................................................................................................................................................................... Name of owner of premises .......... ,,~..l~{3.e. ll..~,Q~..~.?.~..,T,~13., ................................................................................. If applicant is a corporate, signature of duly authorized officer. \~ Plumber's License No .... .~.~.~..~.. ................................ Electrician's License No. 3D.7...1~. ................................ Other Trade's License No ............................................... Deep I-lole Creek Estates 1. Location of land on which proposed work will be done. N~ap No.: ...~.~.. ............................ Lot No ....... 2.~ ............. Street and Number ~/~j`)~3~D~1~e~5f~``~g~$/~n~w~S~t~-~j~AV~&~ ............ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ....... ................................... ~''~' X 3. Nature of work (check which applicable): New Building,. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ..................................................... (Description) f 15,000. O0 Fee 4. Estimated Cost ..................................................................................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling unit~ .......... ~ ................ Number of dwelling units on each floor If garage, number of ~rs ................. .~. ......................................................................................................................... ~. If business, commercial or mixed occupancy, speci~ nature and extent of eoc~ ~pe of use 7. Dimensions of existing structures, if any: ~ront ............................ ~eor ................................ Dept~ Height ........................ Number of Stori~ ................................................................................................................. Dimensions of some s,~cture wit~ alterations or additions: Front .................................... ~eor Depth ................................ Height ............................ Number of Stories 8. Dimensions of entire new construction: ~ron, ....~ ....................... Rear ...... ~ ..............Dept~ ...~ ............... Height .....~ ............. Number of Stories ..................................................................................................................... 9. Size of lot: Front ..... ~.~ ........................................... Rear ....~.~ ............................... Depth ...~.~ ...................... 10. Date of Purchase ...~.lO..m.....~-- ' ................. Name of Former ~ner ..~z 11. Zone or use district in,ich 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 promises: ( ) Yes (~) No 14. Name of ~ner of premises .~.~.~...~P.~...~D.~.~.~A~re~.~,....~..~.. Ph~e No.?~m~ ..... _., ?oi t ?78 Name of Architect .............................................................. ~oare~ ................................ Fn~e ~o ....................... Name of Contractor sa~e A~ress sa~e Phone No. . PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~ck dimensions from prope~y lines. Give street and block number or description according to de~, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................................ f~" .... ..~...~.......~.~..,~,.,7_~.?.......~...?..?..,~.~,.. .......................................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contrad0 above named. Builder and cot orate officer. He is the ...................................... ~.. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or this application; that all statements contained in this applicat that the work will be performed in the manner set forth in the No, 52-8125850, Suftotk .performed the said work and to make and file true to the best of his knowledge and belief; and n filed therewith. S ROSE HO ES, It C. SU>-~O~ H Lot 27 NOT£ ,' m = MONUMENT OF T~E CL~RK ~ SUFFOLK COUNT~ ON ' :¥~ 'UN(; & 4dO OST~A~L3~.R AVENUE SURVEY FOR i :{ BEN MENDOZZA :' LOT ~6 TOW. O,'- ~OOTHI SU~FqLK YOUNG RIVERHEAD, NEW YORK vE/vU The sewage disposal ~md w~ter Stlppiy facill~ies for this 1, ooatlou.have nspected ~y this departme~t 1~d o be sati~facto~.._ ~ Servlce~ lot 25 N. 87°/9 ~0"W. , 102. O0 ' Lot 27 · -' MONUMFN T U : STAKE SUBDIVISION MAp FILED IAI rH~ OF THE CLERK ~F SUFFOLK cou~rr ow KIL E NO. LOCATIO~ OF WELLS AND CESspOOLS ~NDIO~ F~OM DATA O~a.,u~ V0UNG & yOUNG ~VERHEAD, NEW YO~K 400 OSTRANDER AVENUE, ALDEN W, YOtjNG PROFI~ S~IONAL [ {~ Gl N E ER. ,Al~ D SURVEY FOR: BEN MENDOZZA LOT 26 DEEP HOLE CRE,EK wr MATT TUCK ESTATES I~ITE ED TO: SA V/NGS BANK i L ~M cap, o~ _J iI- T¥ F IdA L ~OECTI~I~ .... T.~. I' L [JE~; dcm GAP',