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HomeMy WebLinkAbout8156-zFOF, M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. 'Z89~'~ ..... Date . .February .... 16 .......... , 19.78. THIS CERTIFIES that the building located at .~11+~[..Minn~haha...B.]..v~I ,.. Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . August; ..... 1-9 ......, 197.~.. pursuant to which Building Pemit No.. 8.1.~6Z. dated . Augus.t ..... 1.9 ....... , 19 .~.5., 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. RIVA~E. OBE. FAMILY..DWELLII~I.G ..................................... The certificate is issued to .. RobeI'/c .Ro~sero ..................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ..... 3.'.~.Q'. ! .~ ~ ..................... UNDERWRITERS CERTIFICATE No ...... N. 3.~J.7.2.6 ............................... HOUSE NUMBER , .. 3.1.t~ ...... Street . .l~lnl~e. hahf~..'.~Ly.d., ..................... ........................................ Sou.tho~ct.,..~. ,.Y... ....................... lrOB~ NO. t TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8156 Z Date ....................... Permission is hereby granted to: · .~.olae a,.t,.. ,Ro&B e.~G ............................................ ...... · ~OG ..../~e ~o;~ ..ll~l, .......................................... ........... ~,V~t,~ ~.. ~ .t~ t~.oz~ ......................... to ....~.~,~..,~.C.~...~..2~,~.~...d~e.l.l.tr~ ....... (~l,r~..£.:l,o~z~..on.:L.y.) ..................................... ot premises located at ...$~/-.~4,~ie}~...}$~.~1 ................................................................................ ................................................... .V~u,+,, h&~.cl..... ~ .'~.:.. ............................................................................ pu~uant to application da~ed ....................... .~.~.~......~.9. ................ , 19.~.~.., and approved by the Building Imoector. FORM NO. 6 TOWN OF SO~THOLD 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 triplicate 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 aT 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 3. Copy of certificate of occupancy $I.00 $5.00 Date ,~ .'f/.~..~ Z ,~..~,, ,.~., ............. New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property Owner Or ~ners Of Prope~y ........ ~,.~Z~:~.,~..~:~.'~../.,~Mz..';.¢a...~.~'~.'~Z~;2 ............................................ Su~,~o, ................................................................ ~ot No...~.... ,~oc~ No. '--.. ,o,,, No.'~/.~5 ,e,~, No....~.L:~.(::~. ~,e? ,e,~, ~].~.~.~.~..A,,,i~,,, ...:<,U,:,:~::...:~;::~<~C~. ......................... Health Dept. Approval ..~ .............. ~ .................... Labor ~pt. Approval ................................................ Underwriters Approval .............................................. ~lannmg B~d Approval ........................................ Request For Temporary Certificate ........................................ Final Certiflcate .......................................... ...¢..~!:~...~r~'~%:'~...,..~..-.~.;... ~ ~ ~ ~; Fee Submitted $ Construction on above described building and permit.D~tjsall appli.~le codes and regulations. Sworn to before me this ................ day of ....-.~.../( ................................ Notary Public .................................... County (stamp or seal) APPLICATION H.D. Reference No._ MOR APPROVAL TO CONSTRUCT A PRIYATE SEWAGE DISPOSAL SYSTEM Applicant Robert Rossero Phone 5. Subdiv. LauqhiRq Waters Address_~_8 L~p~i_~i~o0~tJ~rl~J~Qn_.~o~_JJ~6. Section 7. Lot No. 2. Property location Minnehah~ 8. Private well Yes Village Southold Township SouthoLd_ 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Width 80 feet Length 150 feet (Enter on center plot below) 10. Sewage Disposal System: A. 900 gallon septic tank: Precast _Equivalent Block B. Leaching pools: Number Precast Block___Special ~treet Q Pool Ihe undersigned CERTIFIES: be in accordance with ards thereto." If private well fill in blanks below: ~'Construction the Suffolk County Department of Date ~arch !~__1973 FOR HEALTH DEPARTMENT USE ONLY. Tank capacity4~2__Gals. Pump G.P.M. 5 Total well depth Depth to G.W. Amount of water in well Test Hole Data Feet ~ 0 __~ 2 6 8 ]0 12 14 16 / 18 of authorized installations will Health's current stand- Based on the information presented herewith, it Sewage S-15 Revised 4/]/72 and.found to be i~ comp. tiancq~ith, g~e~requireTr~qnts of rh~Bortrd. ~ ~ RANG~S DISH WASHERS EXHAU-ST~F~N $ Ll~ Rece~taoles: 1-Smoker;,Detector ~iectric, Furnace, ~ Bil~ s Electric must not be ~Jtered m ~ny mannerr retorn to the ofhce TOWN OF SOUT.OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ...... .~.~ .~.........~ ro,ed ................ ...... ..... Disapproved a/c~_ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedu~le. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the 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. 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 Regulati.o, ns, for the const~ction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to ~omply with' all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspecl~ors on premises and in buildings for necessary inspections. (.~.~-~5ignature of applic~, or name, if a corporation) (Address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, generaJ contractor, electrician, plumber or builder. .............. ~.c..~4:.?.~'..~ ................................................................................................................................................................. Name of owner of premises ..............~...~.~:Cr.C...-¢....-/.Z.; ...... J..~.o...~;~.~:£~..~. .............................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................................Lot No ......................... 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 ........ ~. ........ .~...~...{.~..:...~...~.....'.?.~k{..~.~.f..~..,S ................................................................ 3. Nature of work (check which applicable): New Building / Addition .................. Alteration Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... (Description) 4. Estimated Cost ............................................................ Fee ..~..0...'..~!.~....;...,,~..~)..(...~....,'.~.....bf~...O~....~...~.~..~.~. .............. (to be paid on filing this application) I 5, If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of 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 ....~. ........ ~'. .................. Rear 3~ ! ~ Depth ~...q..:. Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front .......... Y..~.....~,..~.. ............................... Rear .......................................... Depth .../.~..~......~ff..-C.. ......... 10. Date of Purchase .....~ff....~...(...~.Y..~. ............................... Nome of Former Owner ....;-Z~,.-.....~.~..;.~..(..~. ....................... 1 1. Zone or use district in which premises are situated .............J~....~....~....¢~. ................................................................. 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ I3. Will lot be regraded .....~...0. ................. Will excess fill be removed from premises; ( ) Yes (~) No 14. Name of Owner of premises .'..~.....~.~..~.LC......'~.5;.~.¢..~..9. ...... Address ~ ~.~...t'.Y. ..... Phone No.- ...... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly end distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions frora 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 NEW YORK, COUNTY OF ..... f ............. /'""~"~-'~'-"-', ............ /' .......... ~; .......... ;"~.'~"4'?"> ........... being duly sworn, deposes and '(~16m'e of'tndividb~al sigrU~g coritro~f) abow,~ named. says that he is the applicant (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 set forth in the application filed therewith. Sworn to before me this Not ,. ......... .... ,:: C .......................... ......... ................. ................................ - ~ ' ,, / (Signgtu~e of applicant) .~.~ .... ~ TOWN OF SOUTHO O ~cc~ ~ ' /o~ ~ PART E ' /~ /- Annroved :L ., 19 ....... Perm,t No. ~.Z. ...................... ~ '~ ' ...................................... L ~ 0~ ~ .................................................................................... ~~ ..... ~/~/ -. ~ APPLICATION FOR BUILDING PERMIT / ~ / ~. ~ . ~ ~ . . . .~ ' 'Date .......... a. ~his application must be completely filled in by typewriter o~ in ink and s~mitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to ~ale. Fee acco~ing to schedule. b.. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproper~ must be drawn on the diagram which is c. The work covered by this application may not be commenced~efore 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 Ce~ificate of ~cupancy shall have been granted by the Building 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, buildir~g code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspect_jo, ns. _~ ~ /~/ __ ~ ~nature of applier ~me, if a corporation) ~o ~ ~ ~ ' (Address of applicant) I ~ ~ ~( ~ ~ Stme whethor ~pplic~nt is owner, lessee, ooent, ~rchitect, en~ineer, ~enerol controctor, electricion, ~lumber or builder. . . o, ..................................... - .............. ..................... '....' If applicant is a corporate, signature of duly authorized officer. ~.~-C'~,~ ¢~/~ ...... ~..~.............~...'...~....~........'.'.~..........~~.....................~....(Name and title of corporate officer) ~ ~u[Idor'~ kicons~ Mo ..................................................... Plumber's License ~o ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ......................... Street and Number .~.~.~.~.~.~f/r/~!~.~.¢~.~`~z~.~.x~.v.~/~~/~ ................................................... Municipolib/ 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 ......... /.....~...~...n.?.L~..~.....:?...~..(-4-¢'~..,""~"..~ .................................................................... 3. Nat6re.of ~ork (check which applicable): New Building,, ................. Addition .................. Alteration ........... Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... (Description) 4. Estimated Cost ........ ..~....~..,...~.~T...~, ................................. Fee ..~...~.~...~..:.~....5..~..~....r~.....~..~i..~.~..T~.~..~r~...D~..~.~.~q..~f~¢..~ (to be paid on filing this applicati~ni "~ ............ If dwelling, number of dwelling units ...... J ..................... Number of dwelling units on each floor ....J ....................... If garage, number of cars ....... ./ ..................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf 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 ..... ~.......~ .................... Rear ..'.~..~..!...~. ............. Depth ...2...~'.~..~. ........ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............... ~.~....~.:.~. ......................... Rear .......................................... Depth :..]...~.~.....~.~. ......... 10. Date of Purchase ...~..m' .~.,.x~...~.....~..~,.2~ ................. Name of Former Owner ...~=.~....~.~./P,/E.L.~. ........................... 11. Zone or use district in which premises are situated ............./~L.i~.~.~..¢- ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ..~....o. ........................................... 13. Will lot be regraded .........A(..O. ............... Will excess fill be removed from premises: ( ) Yes ~X' ) No 14. Name of Owner of premises ....'...~...~.~.~....~.~,~.¢.~..O ..... Address .~. ........................... Phone No. ~.~..J.'...&'..~.~... Name of Architect .............................................................. Address ................................ Phon~ No ....................... N~me of Contractor ............................................................ Address ................................ Phone No ....................... 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 NEW YORK, ~ c c COUNTY OF ..................... l ...... f~'~ r --~ ~.~..~,l~./.~, 1~ ~"-~ being ........... ~-.~.~..j.~.~[]ol..;~~ .............. duly sworn, deposes and says that he is the applicanl abow~ named. He is the ............................................... ;~....;.~..~;..~;~.~7~---.......:......;;:.....,.-7.,; ............................................................... t~on~c~r, ~orpora~e omcer, e~c-~ ~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 set forth in the application filed therewith. Sworn to before me this .... ~..~ ...... day of ...~, ......... ~ ................. , 1~. , ,~ t~a~ run,mc, , ................... ~'"'~'"'1"1~ ..... ~oun~ ~"?"~';~'"'~'"~'~r'r~' ................................ ~ ~ ' ~ ~ ~ I ' / ~ ~mg re or applicant) ~ / No. 52.8125B50, Suffolk u Jl T FRONT ELEVATION I ij- I REAR ELEVATION g RIGHT SIDE ELEVATION LEFT SIDE ELEVATION t~UILDIN~I DEPARTMENT ~6,~2660 ~AM TO ~.PM FOR EDJ INSPECTIONS; 1. BEFORE BACKFILLING FOUND~ TION OR START FRAMING 2. BEFORE COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR 5TRUCTION ERRORS SHEET TOTAL PLAN BED ROOM BED ROO BED RO0 CARPORT FAMILY AREA © PORCH LIVING ROOM SI~K WALL RAN6E NALL KITCHEN CABINET ELEVATIONS REF'G WALL GENERAL NOTES PLOT PLAN R-193 PLAN- 0 0 SHEET TOTAL ,- FOUNDATION PLAN ,4.¸ ,, MAIN WALL SECTION BEARINGPARTITION ~. ALTERNATE CONCRETE S L A B DE TAILS .,,~.~z~.'~,: WALL SECTION JSHEET TOTAL