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Home My WebLink About8558-z - - -"-. -. -. ~ ----.-- _Ko.t TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk'. Office Southold, N. Y. Certificate Of Occupancy No.~'128J. . . . . . . Date...... . .. .. .. . .Oct. .. .7.... ., 19. 7c THIS CERTIFIES that the building located at . RtS. Ol'.egon..l\oOld. . . . . . . .. Street Map No. ..xx....... Block No.xx....... . Lot No. ..;)EX... l-Iatt;i.tuek.............. conforms substantially to the Application for Building Permit heretofore filed in this office dated. .. .. .. .... .Allrd..l. .30 19.?€>. pursuant to which Building Perniit No. 8-55gZ" dated ........... .Hay.. .3. .. ., 19.76., 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 . . Priva te. .SwilumlD1,. .P.ool. .\..rlth. fence. & .acce.ssor;y.s . . . . . . . .. . . . . . . . The certificate is issued to Rober.t. Row.ehl. . . . . Owner. ..... . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R............................... . UNDERWRITERS CERTIFICATE NO.N-~g549!7. . . . . Hay. . 2-6 . . ~ 97e. . . . . . . . . . . . . . . . HOUSE NUMBER. . 307,. . .. ... Street.. . O;r.egon. .Hoad.... . iii1ttituok.......... ...... .......... ........................ .................. ...................... # ~., - . ,,' //' ('./ t. ,~' . {t-.(j}., Y"'~;rli~~' ~io~' . . . . . . . . . roBM KO. I TOWN OF SOUTH OLD 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<<l 8558 Z Date ......................k!aY.............3.............. 19...'19- Permission is hereby granted to: Sk1l:111;y. ..D.1 p.. .p.o.o1.a..l.nC...A./.C. ..Rob t.. .B.awehl ..............Ma.tt.1tuck...................................... ...... ................................................................................. to ....b.uiJ.Q..,nlW..pJ:;1,vate...sw.1lIJm1ug...pooJ...w:1tb...f.elJ.Cing..A..acc.es.sOJ:JA.............. ................................................................................................................................................................ at premises located at ...l~/..3...Gl:e.gon..Ra&.d.................................................................................... .................................................J:1~lt1..1<y~~......... ................................................................................ ................................................................................................................................................................. pursuant taapplicatian dated ........................AJl'l':l:3:.....3e.........., 19"7iJ., and approved by the Building inspector. Fee $...15...QO.......... / .........~.Q....... ...................... . BuilClin ~..".~.,~"-~;...:.....__.~ ~.,~ _.. ~,._~.:..-..L~.~,..;.;::-;..._ _.~.._.._.~.. ,__.__~._.--'--"----'-_'-'--~_. :.~.._,_..._~_~; o),,';w;'.i!f~,~;'j.~~i.,:;i~::~,..; 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 fallawing; far new buildings ar new use: 1. Final survey af praperty with accurate lacatian af all buildings, praperty lines, streets, and unusual natural or topographic features. 2. Final approval af Health Dept. of water supply and sewerage dispasal-(S-9 farm ar equal). 3. Approval af electrical installatian from Baa rd af Fire Underwriters. 4. Cammercial buildings, Industrial buildings, Multiple Residences and similar buildings and installatians, a certificate of Cade campliance fram the Architect ar Engineer respansible far the building. 5. Submit Planning Baard approval af completed site plan requirements where applicable. B. Far existing buildings (prior to April 1957), Non.canfarming uses, ar buildings and "pre-existing" land uses: 1. Accurate survey' of property shawing all praperty lines, streets, buildings and unusual natural ar tapagraphic features. 2. Swarn statement af awner ar previaus awner as to. use, accupancy and canditian af buildings. 3. Date af any hausing cade ar safety inspectian af buildings ar premises, ar ather pertinent in- farmatian required to. prepare a certificate> C. Fees: i 1. Certificate of accupancy $5.00 , 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Capy of certificate of occupancy $1.00 ~d /-1 I!l.. Jit Date ............ ..... :..............,..... ..,...t.::> New Bllilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land ..."'.J...... 1f (j O?f th1f::;;jiJ. 1I.tJl1t..- A t:. Locatian Of Property................. .. [i.l1....... ". .I.. . .)0..,... ... .."'.~....... .t. I '<(,'.: ,.. .,. .-,... Owner Or Owners Of Praperty ... ........t:H..!:>.1..... ... .. .. .If.............................................................. I SUbdi.vision ......~...z:.............................../J......;..:...Lot ~a. .......J!..1:; No. .........::: Hause N'1........... i P.rm,' No.I,{"Y..;,.. Do" Of P"m" ...?!a!,,]~^,P"'''''' . .,... ......"'l..~.L:'~........ Health Dept. Approval ....:~......Labar Dept. Approval ....../ttJ.~........................... . ~" -, UnderWriters Appraval ....... .... .......... .........Plannmg Board Approval........................?.............. . -' ~ Request Far Temparary Certificate ...........~........................ Fina.l Certificate ...... ................................. , Foo """';"'" . .........:5.....:,............... ~ , Constructian an abave describ~:p~:~::n~..~.~.~..~~r~:....p ..... :i: ~. c.........~~~..:~~~I.::~ns. sw(rn to. before me this cS; ~ 76 WIlliAM F BERNARD !~..:zcr 3 ....'(......... day af ....Q.................................. . c !~~<J'll8Fq{E~~RK.,12 ~ I )..tJ 2. j NOTARY PUBLI , ""', r C N. 030267600 Natary Pub IC .................................... ounty . . .'. "0' 'N"V QUALIFIED IN .B':), ":.',:' '7 - .' / Comm EXOlrc,~ .' ,,::\.., 19 ~ 'i ~ k'V/ -' " J ./ _' i #,y' :.c~' _ ? ..??--;;~.~?/.f. i . !.i- . ,~ f.J<L ,:; ; ,;, ~ ; ~, ._ t(J((.17~ ~ V '>;J FOBM NO. 1 7~ cc t- tfitr..( CS TOWN OF sOUTHOLD (J (((eo ~ BUILDING DEPARTMENT . .' MJ TOWN CLERK'S OFFICE 1::. SOUTHOL~ N. Y. r ""'''''"''' ....;1fi!2~1;..._3... 19.21i .. .. A"rko';~ No ~'E:E.!::............... " Approved .................l.~...........2....., 197ti. Permit No. .&2.F..<f...~.. ~':' r Disapproved alc '~:'::':::="T......:~.~:::::t::..:.:.:=---,~i':.~-----( .~ ,.-- c ~_____ . '---- ..-' -- ,-~~_. ~-_._._-- ~~~.,- Yr'0 I V ~ ~ . . Dote ..{.;/'e;:r~c:.~.........:;:...:........., 19.~? \n INSTRUCTIONS . ~ a. This application must be completely filled in by typewriter 0" in ink and submitteq in triplicate to the Building "?I:l Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. . . "', b. Plot pion showing locotion of lot ond of buildings on premises, relationship to odjoining premises or public streets or <;\ oreos, and giving a detailed description of loyout of property must be drown on the diagram which is part of this application. Cl c. The work covered by this application may not be commenced before issuance of Building Permit. (. d. Upon approval of this applicotion, the Building Inspector will issue a Building Permit to the applicant. Such permit sholl be kept on the premises available for inspection throughout the work. e. No building sholl be occupied or used in whole or in part for any purpose whatever until 0 Certificate of Occupancy shall have been granted by the Building Inspector. O' ),j APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the <:, Building Zone Ordinance of th,e Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or C10 Regulations, for the construction of buildings, additions or alterations, or for rem~v r)Or demolition, as herein described, b The applicant agrees to comply with all applicable laws, ordinan ,. Ufldit)9?Od~h o'usin 'code, and regulations,and to admit authorized inspectors on premises and in buildings for es in5l;?t!cti~ / :;I:'-"V7 f)",;z,-,rJ ~o (!;/, ~. ".~ rr . r,' ,,- , / /"<". . .f. . v - . - . ....'(si,g.;~(:L(;pp'iican~.. ~"if";'~;;p;;;ti~~j"""" -; (12. ,. rh. \)J ....'Y!?f......Iq.[.~..../lJ/l.:tJ..J.~T.~.<::jC;;:.=........... .~ (Address of applicant) '',j State whether applicant is owner, lessee, agent, architect, engiheer~ electrician, plumber or builder. '~'~'~~'~"""'~~;'~~"~';~~'i'~~~".'.'.'::(K~bi.~T::::::::::::(B;;:~j:cl;.l:~~:::::::::::::::::::::~:::::::::::::::::::::::::::::::::::::::::::::::: .. ~~.. .~a~~r.~~e~~.i:S~~~..~.~.IVPd.f;;,!f: officer. ~ (Name t~~;'Of corporate af~:~) ~'Q q, .~ Builder's License No. ..~-...~....I...........................~.... __, Plumber's License No. ................................u.............. Electrician's License No. ...............u......................7'.. -, , ~ ao{- Other Trade's License No. .......................u..........u......... 1. Location of land'an whic~r~e.~d wor~~r be hn~. ~ap No.: .....................7};i."j/j...j ,~07~Uc................ Street and Number .....Uqf........9..(L..........rKOJ9...r;.~.............................../../lt:';f:l:7............... ......................... Municipality 2. State existing use and occupancy of PiZises and in~ended use and occupancy of proposed construction: ". ! ~ ~ a, EXlsltmg use and occupancy ......... =........S.................u...;V~............ ...............u..u................u......... b. Intended use and occupancy ..............i.~...7....~...~~"""'j............................................ ";1 r " I ~ It-. '". !j ",1 ! _.;: );L /j 3. N~ture of work (check which applicable): New Buildmg .................. Addition .......7.')..... Alt,ratian ............. Repair ..............~emaval .................. Demolitiar.................... Other Work ....(j::.O:,Qt.-...................... ... 4. Estimated Cost~.G.O'Q\..Q.....................,.........Fee ,./ 0..~................................~~.~.s~.~~~.~:~~)............... I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ ..............Numbcr of dwel)ing units on each floor .... ..O......~ . If IJarage, 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 '.'~~='~" '-Rea-r ................................ Depth .................... Height ..............,......... Number of Stor~.......................................................................................,...,....."....... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number. of Stories ................................ 8. Dimensions of entire new construction: Front 1'1................................ Rear\........................... Depth ........................ Height .................,.. Number of Stories .......~..........:.........................,.."...,.,.,.......,......,....,......',.,......................... 9, Size of lot: Front ..............3.ao........................... Rear ........8.0C/................. Depth .....2.2.S.=.... 10,' Date of Purchase .........:.....................lq..?~(..=.Nome of Former Owner ......................................,................. 11, Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13, Will lot be regraded ...~~.:.:...:...lfiAexcess fill be removed from premises:}Q. Yes () No 14. ~<arne of Owner of premises .K.~......................... Address ................................ Phone No. ...................... Nome of Architect .............................................................. Address ................................ Phone No. ...................... Nome of Contractor ............................................................ Address ................................ Phone No. ...................... PLOT DIAGRAM Locate c1eorly and distinctly all buildings. whether existing or proposed, and indicate all set-bock 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. ~-=o___ - - -- ---~._-' - _.- ~ ;Z7r I ~. r <6"' r~<' 2&' . OJ) J "7/' I ."- '" I ~ - ,I 00" O(!-ei (l/\L. - ?OpJ ._ un n'_.___ __0 5TATEOFNEWYORI< '55 COUNTY OF ......Suflalk.........f . ..........................F>:.e.d..,si.e.r.merliug..........................,...,being.duly swam, .def).QseS, .<;m(J says t (Name of individual signing contract') . . above named, He is the ..................,...... ........, ........,.... ..co.n:t.r.a.c tar...... ........ ..... ........ ........ ............... ............ ........ ..............,...,...,......,..... (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 I, knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ..........3r.d....... day of ..............................May......., 19,76.. . '" . N~a::;.i}::~I2,t"" t::,........ ... ",,';;;;;;f;w~)!m El/ZABETfI ANN NEVILLE NOTARY PUBLIC, State of New York ~ 'No. 52.8125850, Suffolk Counth., l Jerm Expires Marcn 30, 19-1-lf" SUFFOLI{ COUNTY HEALTH DEPARTMENT \ DATE-MAR 18 1974 H. D. REF. -it 3Sc)-/// The sewage disposal and water supply fac1ltties for thIs location have been insfl8ctcd by this d7~U~ zI..lZ.. to be satisfactory. . Chief of General Engineering ~....\.- Services 0'11 "i " 1 ,e .' \I~ , ,,0 '- 0 '" '" ." -So ." 0 ." ~ '" .,. - 4-1).' " . "/~ 1.1" '. r< , ~t""'~c. &;0 ~",I'"'" 4~,0' . \ . . . I \ ,1 1~~' / . " ." ,r"-' , ,- (" P IJ9 . \ 0 . \ " t , \~'l \ " TeST BORING \ '" TCI'SO'j.. " l.et,",M " ,,' \ \ 5. 0 .... . .' 0 \ \ '" ~ of!!. S4ND '" ." \ ~. ." 0 -So '" '" \ p.O ,... ." ~O - ...>, ~ '!:. -. ''''.-. "%- ." .0' 0 \ O~ '" 0 \ ".0 W4:Tl!R .... ~ \ ",G - '" -So \ O~ -,-, .- C' \ /' All dislan'ces to Wtltls C1nd ees,pool, are , .-' ." ,I' - . ,-;:;J \ by lo~ation fro,m house owners and fleld -; observations, Since m051 wells and tesI- ~< pools ore nat visible these dimensiOlll ~di. connotbecertjfied, - . \4.1 c'? - SURVEY FOR " ROBERT ROWEHL .. Unoutnarl>:ed olteralion or addti ' ..- .-.r sectiOn 7209 of Ihe New Yo kl s~n 10 ~hls survey is a violation of AT MATT/TUCK c' f h' role E ucohon low ...- oples 0 t IS ~urv..y mop nib I . TOWN OF SOUTHOLD - seal or embossed seal sholl: t bearng Ihe land surveyor"s inked o e conslderlld to be a lId SUFFOLK COUNTY, N. Y Guarontees or c"rtiflcotion~ indicated VO copy. , person for whom the survey' nereon ~hall run anly to the . title company, governmental I~ ~~e:ared, and on h~s behalF to the SCALE 1"= 40' ," hereon, Clod 10 Ih.. Cl.~ignees ; Ih 1'1 a~d lending Inslltulion lisfed JULY 6, /973 or certiFications ore not' Of ~I en lng Institution. GuoraMees ew.r a. M.J' b ransera e to ddJl' J DEC. 6,1973 su w.qu.nt oWner., l;I Icna Institution' or LAND SURVEYOR N.Y.S, LIe NO. 28726 RIVeRHEAO N. Y.