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HomeMy WebLinkAbout8029-zFORM X0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy ati831 G. o , 1975" No. ............ Date ................I......... THIS CERTIFIES that the building located at N.f-TFI E WSi A �� .. Street Map No..... y......... Block No... !'1..... Lot No....... f�' ........................ . conforms substantially to the Application for Building Permit heretofore filed in this office dated 519.... pursuant to which Building Permit No.9 CJS. dated ... U 1�.I t: . . ..3.U. . .. ., 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 . P1... 7R! T.t7....0N.`... ..FAMf L� ? `bW e t.l.-t kk6- ......................................... �°I-jl.1S j3N16. (;i.1'�hZE'dt4 l:INaIL. The certificate is issued to ........................................................ (owner, ) of the aforesaid building. c0 'Mr Suffolk County Department of Health Approval . 3ui..�.4.�....��.....�- 5[1 / .............. UNDERWRITERS CERTIFICATE No. 5 HOUSE NUMBER ......: .-5.0.. Street r)4 W (- A �� ............................... ................................................................................. 01 Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. V. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 8029 Z Date ..........................???3 .....3Q............ 19.25. Permission is hereby granted t0iong Creek Fomes �x1..A/C ..... hri$, &, �l�xab�th Finns Southold ............................................................. I.................. ................................................................................ to b'z'.l:'...now one. family- dwe..' i:ng..................................................................................... ................................................................................................................................................................ i £i at premises located at......ot Northwoods ...................................................................................................................... .......................................................... SIO ... Matthew s...Lima..........Cutahngus .............................. ................................................................................................................................................................. pursuant to application dated....................J..=0....30................. 19.7.5.., and approved by the Building Inspector. Fee $. 50. p0........... 1 /-4i�­ .............uling Inspector FORM N0.6 TOWN OF SOUTHOLD Building Deportment 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—(5-9 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 .......k.G New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property 3Jr0 MATHS WS LANL eU , cko uC- y....................................................I.................. Owner Or Owners Of Property ....� k.lS.....� ... i f!Y..... � ( ..C�............. ................................... I..... Subdivision NoRT1+W©gpS.....,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Lot No. ....6..... Block No.... ..... House No...�:'.P Permit No..V.V...�../ � Date Of Permit`�.UN�AO �9�itr'pplicant . 0K... CTZI`E�. (-tOMtS ZNC_ Health Dept. Approval I. �.:O...........................1975'5-So9 Labor Dept. Approval ..... y._.R_: Underwriters Approval . N...z. �.. b 5 D /e' Planning Board Approval .......... Request For Temporary Certificate ........................................ Final Certificate�— .......................................... j °/ Fee Submitted $.................................... Construction on above described building and permiitJ meets all applicable codes and regulations. Applicant.. ? ..ilr r ?......................... ..... ........ I............................ Sworn to before me this ...........I.... day of .>(11 ............ (stamp or sea[) l y30`75' Notary Public ...................... County ; _**a fd y THE NEW YORK;_'BOARD OF FIRE UNDERWRITERS- . dl - SUREAU OF ELECTRICITY .l' 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date October 15, 1975814202 App ion No. an file N250506THIS CERTIFIES THAT - -- _ - only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Chris Finne, s/s Matthews, Lane; #8,4001, e/o Coxts-Lane;,_-, . - -" - Cutchogu in thefol/owing locotiort; Basement C� lst Fh. U, 2nd FI;, OUtSide Section . Block _: Lot was examined on arta oun - - " October tob er 9 j ` 19'7 5 ,% d t6 be in eompliaiice with the requirements of This Board. "FAN$- FIXTURE - OUTLETS ECEPTACLES - '. - _ FIXTURES:- _ RANGES : .. COOKING"DECKS. SWITCHES __. OVENS.. , DISH WASHERS EXHAUST INCANDESCENT 'FLUORESCENY` VAPOR Ah1T. _ K W _AMT. 'K W. - AMT. K W. _ • AMT. K. W. AMT.- KP. 23 33 21 23' DRYERS FURNACE MOTORSFUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCXS 'BELL ,UNITHEATERS TRANS. MULTI,OUTLET SYSTEMS NO. GF FEET - . DIMMERS AMT. K. W. OR GAS H P,' AMT... NO. a 1Y. G. AMT: PMP. - AMT - AMPS AMT H P, A^^TWATTS SERVICE'DISCONNECT '" NO, OF METER EQUIP - _ "- , - - --S '-.' E _ ,- R_ V 1 C E-- -- -- _ AMT. AMP TYPE 1,0' 2W i p' 3W 3 A" 3W 3,e' 4W NO OF, CC. COND PER E . A. W.G. OF CC: CONO.' NO OF HI -LEG- Oi'H "LEG" NO. OF NEUTRAL$ OF NEU RAI 1 200 CB- OTHER APPARATUS: - - W.B. Ruland Electrician Mattituck, L.I. GENERA MA r D PerThis certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their ed dols. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1. Applicant Address 2. Property Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY dailt+7 Phone.`?e'- 0 5. Subdiv.�2it.� .d�b�t�> d vi i i age C'. u7 r,,° - 3. Public Water Corr 4. Lot size: Width 10 Sewage Disposal System: A. 900-gon septic tank: Precast Equivalent Block B. Leaching pools: Numberofi pools Precast_ Block Special ns If private well, fill in the fol- lowing blanks: A. Tank capacity - `k gallons B. Pump G.P.M. C. Total well depth ko ` D. Depth to ground water E. Amount of water in well 140 a. mi ° a< rr, 6. Section OF' $J414t z �;. kvD0.0 J. Lot Number 8. Private Well '0"0 r 7 k14: 1,77 9. Publ i c Water Distance to main :h O feet (For Health Services Dept. Use) 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 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 Signed FOR THE DEPARTMENT OF HEALTH SERVICES' 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 c s alled ovisoz r APPROVAL DATE_ �('Z %.S SIGNED S-15 Rev. 4/1/73 11 ;6C 17 31ti5 U-73 40b7l, MA�HEVVs vF I\ i z. N 8 s4 f� a, Pres f 20, 50 j55oo fo�fUblY O f NOTE „ sr MONUMENT o �q0 W' (j�rl SUBDIVISIONMAPF/LEDINMEOFFICE o OZ OF THE CLERKOF&I FFOLK COUNTY ON �1 5.58 MAYZI, 1970 AS FILENO. 5469. / I REVISIONS YOUNG & i .. .. YOUNFN £y RHEAi rk 400 OSTRANDER AVENUE, RIVE M4t. �W ALDEN W. YOUNG &RY&O PROFESSIONAL ENGINEER AND, LAND SURVEYOR. N.Y.S. LIC. NO. 12845 S, SURVEY FOR; UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION CHRIS L. F/NNE a EUZABETHA. F/ 7209 OF THE NEW YORK STATE EDUCATION N II CF gggg3 LAW LOTNO. B, NORTHWOODS rys._ COPIES OF THIS SURVEY MAP NOT BEARING f, SND SUR`1E�U� THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY AT GUARANTEED TO: CUTCHOGUE 6UARANTEEDTITLE DIV/SIONOF GUARANTEES INDICATED HEREON SHALL RUN AM£RICANTITLEINSURANCECO. ONLY TO THE PERSON FOR WHOM THE TOWN OF SOUTHOLD SURVEY IS PREPARED, AND ON HIS BEHALF V TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED 6Y� HEREON, AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y. LENDING INSTITUTION. GUARANTEES ARE HOT TRANSFERALE ToINSTITUTIONS ORRSUBSEOOENTTIO.IADDIONALR., SCALE: /ll r AOI 1 DATE: APR 30, /975 "o 5-2 .0.F 11 5153 B_79 40671. MATH Evv5 THE LOCATION OF 7VSL7,9 ANO CESSPOOLS SHOWN HFH:L: si'g Y:i' i:�FS%C;SERVATIONS AND/OR FF.Offi BATA OXMIIXED k-R03f OTHERS I\ Z N SANE 1 p E" 1\ or NOTEMONUMENT N' �. Gun SUBOIV/S/ONMAPFILEDINMEOFFICE o � n \\ 5.58 MAY21,1970ASFILEN0.5469. / REVISIONS YOUNG & YOUNG i F fr. 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK Mott[NOV.24, 1975 ALDEN W. YOUNG HOWARD W. YOUNG . .. . , ,. PROFESSIONAL-3NG4NEKR AMD- -. ...L.AND-SuR14EYOR.. _ LAND SURVEYOR. N.Y.S. LIC" NO. 12845Br UC. �t0. 4541 SURVEY FOR: s `° UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION ` CHRIS L. F/NNE Q ELIZABETHA. D YV �� 1 y 7209 OF THE NEW YORK STATE EDUCATION LAW I/ tl �G LOTNO. B, NORTHWOODS COPIES OF THIS SURVEY MAP NOT BEARING (yysg Z THE LAND SURVEYORS INKED SEAL OR X JH AT GUAR N E �+ CUTCHOGUE Y V/ ON F GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE AMER� .CE TOWN OF SOUTHOLD SOtltHo K SURVEY IB PREPARED, AND ON HIS BEHALF sua TO THE TITLE COMPANY, GOVERNMENTAL ' AGENCY AND LENDING INSTITUTION LISTED'BY SUFFOLK CO., N.Y. D n#21 &b a' NOT TRANSFERABLE TO ADDITIONAL SCALE; 111 ,. AOS DATE, -APR. 30 1975 N� 5-2 W T ) m „ r> U a �s �„: � m x . h - to- z O C) U U w IF y N U r4 P R (y © U N .0.F 11 5153 B_79 40671. MATH Evv5 THE LOCATION OF 7VSL7,9 ANO CESSPOOLS SHOWN HFH:L: si'g Y:i' i:�FS%C;SERVATIONS AND/OR FF.Offi BATA OXMIIXED k-R03f OTHERS I\ Z N SANE 1 p E" 1\ or NOTEMONUMENT N' �. Gun SUBOIV/S/ONMAPFILEDINMEOFFICE o � OF THE CLERKCFSUFFOLK COUNTY ON \\ 5.58 MAY21,1970ASFILEN0.5469. / REVISIONS YOUNG & YOUNG i F fr. 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK 5°6• `t c� 80 -- IOt 815054,ft" A rep .NB or NOTEMONUMENT w• o Gun SUBOIV/S/ONMAPFILEDINMEOFFICE ao o OZ OF THE CLERKCFSUFFOLK COUNTY ON \\ 5.58 MAY21,1970ASFILEN0.5469. / REVISIONS YOUNG & YOUNG OpUr,K AUG. /, 1975 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK Mott[NOV.24, 1975 ALDEN W. YOUNG HOWARD W. YOUNG . .. . , ,. PROFESSIONAL-3NG4NEKR AMD- -. ...L.AND-SuR14EYOR.. _ LAND SURVEYOR. N.Y.S. LIC" NO. 12845Br UC. �t0. 4541 SURVEY FOR: s `° UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION ` CHRIS L. F/NNE Q ELIZABETHA. D YV �� 1 y 7209 OF THE NEW YORK STATE EDUCATION LAW I/ tl �G LOTNO. B, NORTHWOODS COPIES OF THIS SURVEY MAP NOT BEARING (yysg Z THE LAND SURVEYORS INKED SEAL OR X EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE 0. VALID TRUE COPY AT GUAR N E CUTCHOGUE Y V/ ON F GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE AMER� .CE TOWN OF SOUTHOLD SOtltHo K SURVEY IB PREPARED, AND ON HIS BEHALF sua TO THE TITLE COMPANY, GOVERNMENTAL ' AGENCY AND LENDING INSTITUTION LISTED'BY SUFFOLK CO., N.Y. HEREON, AND TO THE ASSIGNEES OF THE n#21 &b LENDING INSTITUTION GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL SCALE; 111 ,. AOS DATE, -APR. 30 1975 N� 5-2 INSTITUTIONS OR SUBSEQUENT OWNERS. T ) .NB MAV L7 � Foxm NO, i TOWN OF SOUTHOLD BUILDING DEPARTMENT 0/1`+f75 0/,lµ-164, — rmY OK 14;r TOWN CLERK'S OFFICE Art 01( (��-cb e t _i SOUTHOLD, N. Y. 7— Examined ......................©........ 192..t�... Application No..... �. .`............n"I Illf9f7-J e(iIC_0. Approved...................................... 19.....5. Pemit No... ............................... ff L, ........................ n° (,X%1 CA-% t J&a eft Are Disapproved a/c ......... ..................... .......................... V'.141 ............................................................................ (Building Ins pec r) APPLICATION FOR BUILDING PERMIT Date.............................�.C).......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, andR giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance 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. T 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 1 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) (Address of applicant) State whether applicantys owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. i`at;s'�carw".x Name of owner of premises If applican cprporpte, s' nat re of duly authorized officer. �.= i- xw �_ .......................................................... (Name and title of co porate officer) y 1. Location of Land on which proposed work will be done. Map No.:.:...........P.f.... Lot No .......................................... Street and Number t /r 'p.wr ° t> r ...........I.......... ........:.................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ........:....�..�:...z.._...`......�..-............�tvx/j ..........,............................................... b. Intended use and occupancy ......................`......................................................................... }(\. (1J ' wJ v In 3. Nature of work (check which applicable): New Building ...... ............... Addition ..................... Alteration............ . q. Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost.. g000 .................... Fee .. . fii�.(I...�....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ..... ...... Number of dwelling units on each floor ......................... I............... Ifgarage, 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 ..................... 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 .....:F .......... Rear ......533 ................ Depth ... .� .... ............. r �. Height...................��.......................... Number roof'Stories ...........5.... �.................................................................. 9. Size of lot: Front ...... c�i t'. �£ .......4 Car Jr�,��.................... Depth .................................................. Height.................................................... Number of Stories...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner............................................................................ 11. Zone or use district in which premises are situated .... e .......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ 0 ........................................... 13. Will lot be regraded ....... .............. ......... Will excess fill be removed from premises: [ ] Yes [�No 14. Name of Owner of premises .......... l5 ,,-../ f j� �nrnr r;'�........................................ ..... ................ ............... (Address) (Phone No.) Nameof Architect..................................................................................................................................................... �J Oddress) (Phone No..)/ Name of Contractor ..... a®VG.,f... t� ?f. .....�!C �.*.-.:...... ..9.4:. 2.2.'rS�.. ............. ............. (Address) (Phone No.) /73 0 �onr6 K e p ". r wt 'rte b �P'''LO DIAGRAM Locate clearly and distinctly all buildings wFie_;�errexisting or proposed, and indicate all set -back dimensions from property lines. Caive street and block number or description according to deed, and show street names atpd indicate wheth- er interior or c rner lot. STATE OF NEW YORK, ) SS t COUNT ............) 1 ..................................... '�� 'YS$,..:..,... ��""� ' .... being duly sworn, deposes and says that he is the applicant above named. me of in ivid l signin(g�" tract) Heis the ....................... .....Zw—c............................... ............................. ............. . (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 aL ,tatements contained in this application are true to t�@IAAWBo1AMstljma*tledge and belief; and that the work will be performed in the manna= set forth in the application filed therewith. NOTARY PUBLIC, State of New York No. 52.8125850, Suffnik County ........'2.0. .......... ... ...term Expires M1rgeh vv'- . . J.....day of ........ �f Notary Public, ... ..... ... ., ounty .................... �!........ ... J.................. (Signature of applicant