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Home My WebLink About8023-zFOF, M lq'O. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnle Of Occupnncy No..Z6.6.8.2. .. .... Date ........... ~eP.t...~.~' ....... , 19..~.~ THIS CERTIFIES that the building located at . .1~/8. El~,Jah. Large. &..1~..eh~rd~ Map No..El.~,Jah. ~$Bloek No ........... Lot No, ~ ...... ltia.~.t:ttuck.. N.,.~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ,T~n~e... 16..., 19.75 pursuant to which Building Permit No. 8023.. dated ........... .J.u~..e.....2.6.., 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 .. l~r:Lv&~e, or~e .£al~l~,ly. ~,~elltr~g ..................................... The certificate is issued to .Inland. Homes..It~o ........ ~Smel, ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ~.lot...1.6...~.9.~. 5...by. P,,. UNDERWRITERS CERTIFICATE No.. Ap.pl~ova~ .by. J., .Kuha~k.i..~/~ .~,/.~.. · ;... HOUSE NUMBER ...... .81~ .... Street ... Elijah. Lane ......................... Building Inspector / FOENI NO. ~ TOWN OF $OUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8023 Z Permission is hereby granted to: ~ ~:~...~L~.~.e.~...:kt~c .......................................... ............ ~:~..t.~.....~....~.: ................................ r at premises located at .~..O..~....2...,.~.~...~.J~.~..~........~.~.~...e...~..s..t...8:~.9.~ ......................................................... .................................................... .~.x..$. ~.~.!..s....~,a.~..,~...~.a..~..e..z....~.o..,a.,a. ....... .~.a...t..t..~ .t.,u.,e.~. ............. pursuant to application dated ......................."T....L~--..e. ....... .1...6. ............ , 19.~..~'...., and approved by the Building Inspector. I~OTEt Setbaek on I~0,000 + lot~ is 5Oft FORM NO. $ TOWN OF $OUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY I nsfructlons 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 approvo~ of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming 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 September 16, 1975 New Building .....X.~ ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Lot 2 Elijah's Dane Estates, Elijah's Dane & Rachael Road, ............................................................................................................................. '~'~t ituck Owner Or Owners Of Property ...I~,f~0,d...~,~,~....%~G, ......................................................................... Subdivision ................................................................ Lot No. ,2. ........ Block No ............. House No.....8.~.5.,.. ................... p . une 26/7 . Permit No 8023Z .. Date Of errantS. ................... /~pphcant .~....~Q~-,~.~...~.~.A ...................... Health Dept. Approval ...5,.-..~..O...-..8...~.....-....c)./..~..G,/,Z.~..Labor Dept. Approval ..... ~i .................................. Underwriters Approval .....~...~..~...~....J~.../.I..~...~ .............. Planning Board Approval yes Request For Temporary Certificate ........................................ Final Certificate .~..e..s. .................................. Fee Submitted $ . .5.. ~. .0. ..0, .......................... Construction on above described building~~2 /~', ./~- ~all .app~abl. e.cod/esand regulations. Applicant ....~ ................... ..;:~ ............................ Sworn to before me this KENNETH W. THURBER_ IlCLA~D HOMES~ INCo Notary Public ..... ~ County (stamp or seal) ~/~/. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 /)o,. September 12, 1975 4pp,,eation.¥o. onfi,e 811"37 N 245582 THIS CERTIFIES THAT Inland Homes, Elijah Lane & Rachael Rd., MaSti:uck, L.I. FIXTURES ~-~NOES ~C~KINOD~CK$~ OVENS DiSH WASHERS ~ EX~AUS~ -- {iMEC~KS ~ BEU UNITflEATE~MULT,-OU(~ FuI~NACE MOTORS ~'u=ure Appliance Feeder/s: 1-2#14, 2-3#8, 4 Park P1 Patchogue, L.I. 11772 ~ ';m~ certificate must not I~e altered in any manner; return to the office of the Board if incorrect. Inspectors may be identihed SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant Zt4L,~NI) ~m ~ Phone ~)o-~gt) 5. Subd!v. I~I. LJ~'$ Address ~ Xl?. ~tl~lm~:~. N.Y. )J.~ 6. Section ~ 2. Property Locatlonl~j.~'~m ~ & ~mm ~ 7. Lot Nu~er 8. Private Well Village ~,-,t.%*,,,,~ Township ~,,,~ 9. Public Water)l~m~ 3. Public Water Company Name Distance to main 4. Lot size: Width ~$feet Length~4~ feet 10. Sewage Disposal System: A.~-gallon septic tank: Precast ~Equivalent Block B. Leaching pools: Number of pools 1 Precast ~o Block 11. If private well, fill lowing blanks: A. Tank capacity -~:~ gallons B. Pump G.P.M. j C. D. E. __~pecial__ in the fol- Total well depth ~' Depth to ground water ~-~ Amount of water in well (For Health Services Dept. Use} The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Heal th Services' 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. ~ tlCJ4I~. INCo Date J~e 4, 1975 Signed~ · FOR THE DEPARTMENT OF HEALTH SERVICESm USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE S-15 Rev. 4/1/73 ,5 ' '~¥ .:ou'G "' ¥%% & RE.V~I~IONS JULY21tlg?5 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK AUG. 7, 1975 ALDEN W. YOUNG HOWARO W. YOMNG SURVEY FOE: INLAND HOMES; INC.' LOT 2 "ELiaAH:'s NE ES~ ~oU,THoLD~ TOWN OF SOUTHOLD '~'/:z~ BUILDING DEPA RTMENT,,~/,~ ~ ....... TOWN CLERK'S OFFICE' I~ ................... ~ SOUTHOLD, N.Y. '¢,/1~,/7J- ' ~ ~ ......... , ,J/ .............................................. ..... X* ............................... ................................ ....... ....................... , ..... ~. This *pplicotion must be completely fill~ in by ~pewriter or in ink ~nd ~mittod in triplicote to the BuildlnO ~ Inspector, with 3 ~*t* o{ pl*ns~ ~ccumte plot plan to ~le. Fee occordino to schedule. ~, b. Plot plon showin~ Ioc~tion of lot ond of buildings on premises, re~otionship to ~djoinin~ premisos or public street~ o~ ore~s, ond ~ivin0 o detailed description o{ Ioyout ofpropo~ must be drown on the dioorem which is p~rt of this ~pplic~tion. ~ c. The work covered by this opplicotion moy not be commenced before issu*nce of Buildin~ ~ermit. d. Upon ~pprovol o{ this ~pplic~tlon, the Buildin0 Inspector will issue o Buildino Pormit to the opplicont. Such permi~ ~ sholl be kept on the premises ~voil*ble {or inspection throughout the work. e. ~o buildin~ short be ~cupied or usod in whole or in port {or ony purposo whotever until o Ce~i{icot~ o{ ~cup~ncy~ sholl hove been ~rented by tho Buildin~ 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) BOX 117, ~$~i~u~k~ N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . .g~..nezal .~.o~t~ac tor Nome of ow,er of premises ....~l~d..~S.,...~n~., ..................................................................................................... applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. - Plumber's License No. ,~.~,.7...-.]~. ................................... Electrician's License No. 273-F~ Other Trede's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.:~..~.CrJ...a~...!..s....~.e....~..s.~o¢~lo.....2. ................... Street and Number 1~...~..~...b.~..e.~.t..~....~..~...a..d......a~....d.....~.~.~.~...~1~...!.~...~.e.. ...................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Vacenl: 1 - Fmmily b. Intended use ond occuponcy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ..~.5.~..O..O..O......O...O. .................................... Fee ~...'~......~ .................................................................. (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 c~rs ...~L ........................................................................................................................................ 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 ................................ 8. Dimensions of entire new construction: Front ....... .~..~.. ................. i.~ Reor ......~..~-. .................. Depth ......~ ............... Height ....~..8.. ............ Number of Stories ..~. ................................................................................................................... 9. Size of lot: Front ~..~.~. ................................................. Rear .................. .~...5..O. ................. Depth ....2,..~...~. ...................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... J~.~. .............................................. 13. Will lot be regraded' ..~...e..s. ................... Will excess fill be removed from premises: ( ) Yes (x) No ]4. Name of Owner of premises .[...~..]:.a:..~.~.....~...°..m..e...s.,s.....[..~...c..-. ......... Addres~..°..~....~.]'...7....H...e'..~..~.'.... Phone No..2..9...8..-..?..6..?..6.... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor .~.~..].....a~...~....H..q~....e..s..~.....[..~..c..: ................. Address .~..~.[Z.~...~..~.-Phone No..~..?..8..-..?..6..?.~... 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. STATE OF NE-~/~I~O_ ~, i/ [c ¢ counTY OF ....... ..................... ...... .................... being (~a~'~e of individual signing contracf) above named. He is the ...................................... ~...~.'....~....~i- - ~-- ............................................................................................................. [Co~fg~'tor, 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 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 in the application filed therewith. Sworn to before me thiSday of ~.~..:: 19. 2,~...'~j~ ,~t~,~, ~J___~_~ Notary Public, . ......... ~'4~z .......... County ... -.~~ ....................... IS~gnature of applicant) -0 tJ BUlLriNG DEPARTMENT UP