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Home My WebLink About7808-zFORM NO. · TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z65)~ ...... Date ............ J.a~ .. 2 ..... , 10.7.6. THIS CERTIFIES that the building located at . W,~S. I~eep. t[ole..D.~, ....... Street Map No. Deep .ttole. (I~Io[~o .......... Lot No..~2 .... Nat.~tuek..N,Y, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Alarm. I,.. 3.. , 19. ~'~. pursuant to which Building Permit No. -7808S. dated ....... April..9.-- , 197.2., was issued, and conforms to all of the req, ire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr;t,¥a.t.e..o..n.c..fa..m!.ly...d.~.e.l. 1..i.rlg .................................... The certificate is issued to Ball .Molxdozz& ..... C~ae~. ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . Dae.. 2~0. ~ 97.~.. b~..lt,~llla ...... UNDERWRITERS CERTIFICATE No. ]~237.90~ .... J~aly. ~!9 .. ~ 9.~.~ ............... HOUSE NUMBER 397~ ....... Street . .l~eep..t~..D.~$.~. ...................... ui ding nspector~ FOILer NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPL~ION OF THE WORK AUTHORIZED) Ne 78O8 Z Permission is hereby granted to: ~mme s...i~ese...Hoz~e*s...~.ne ...... A/.C..J~z~ ~ezulozsa ...~oz..~0.3~. ....................................................... ..... ~k~...Po~t~....]~.~t.~..,..t ~.?.~B ............... to ...~.,J.;L~t ..~e~...f~x~...~;~l~...ct~r.e.~iJ, p..~ ..................................................................................... at premises located at ;~_~...~....,O~e]~..Hole...o~'~e~..~st~t,e~ ................................................ .................................... ~./~...~.~..o. ~...~.0.,1.~ ..P.~;I..~.~ ............. ~a,t.,:¢t .~.~..... ~,. ~.,. .............................. pursuant to application dated ............. ~3~ ....... .~ ..................... , 1~...., and approved by the Building Inspector. Fee ~.Q.~ .~.~.. ............ FORM NO. $ TOWN OF SOUTHOLD Building Depar~inent Town Hall Southold, N.Y. 11971 - 51987 APPLICATION FOR CERTIFICATE OF OCCUPANCYi. Instructions A. This application must be filled in typewriter OR ink, and submitted ia I~ to the Building Inspec- tor 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 installa- tions, 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 appl!cable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pm3perty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 ,~ 2. Certificate of occupancy on pre-existin.q dwelling $15.00 3._Copy o_f ce._rtificat9 9/occupancy ~ $10.00 4.Vacant Land C.O. $5.00 Date .~.rch 4, 1987 New Building . .(~)7~) ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property i~'. ,/~). 397,5. ]2)¢¢p. U01¢. iYe, .l C i uck, . ew .................... Hou~ No. Stye t Ham/et Owner or Owners of Prope~ .. ~Q~. ~. ~.~~ ................................... CounW Tax Map No. 1000 Section . .1.1~ ........... Block .[6 ............ Lot. ,Q29. ........... Hole Creek Estates Subdivision...I-9.t.N.g:. ~.2~..M~.p..o.f.Q¢¢p,/ ....... Filed Map No..4:~5~ ..... Lot No. 52 ........... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. ApprovaJ ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. ~ ................... · 10 00 Fee Submitted $..: .......................... Construction on above described building and permit mee~/"~ appli¢~'~ cgdeF'~nd regulations. Applicant ............ ~ .I,,. ,~,~. {~ .~,~}', ................... By Daniel C. Ross R,~. ~o.,o.?a ~__~¢_~ WLCKHAN, ~CKHAM & BRES~,~, P.C. ~ 3/, V d a ~ Attorneys for applicant Main Road-P.O. Box 1424 ~s~ F~_c~ ~.~_ Mzl._ Mattituck, NY 11952 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 Budding Inspector with the following; for new buddings or new use' I. Final survey of property with accurate location of all buildings, property hnes, streets, aha 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, Mulhple 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 s~te plan requirements where apphcable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-exmsting" 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 ................./~:J'Z-7-5 ................. ~. ........ New Budding ...?J~...~ ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Locat,on Of Property W/S DEEP HOLE DRIVE., 716.O7' S/0 NEW SUFFOLK AVE. ,~ATTITU( Owner Or Owners Of Property .~..~..~.~..~..~.~..~...~..z~..~.~.~t~.~..`~.e.~.~.~.q.~.~'~.~..~..~..~.~~g~? ........... Subdivision ..~..~...~..~...,.~...0..T.~:,..C.~.,..~..~..?..~....r~...~.. ....... Lot No .... .62 .... mock No ............. House 7808 Z 4/9/75 B ' ' ,O. ZZ~ .es. Permit No ..................... Date Of Permit .................... Applicant ~....~.~TD.. ~.:R. ........................... Health Dept. Approval r...~.e.~.....~..~. ........ ..~..:..~...~.:../.!,,7...Labor Dept. Approval .......... ...~...:.(~.. ..... : ................... Underwriters Approval .............................................. Planning Board Approval ....................................... .................. FinaJ Certificate ........................................ Request For Temporary Certificate .................~.. / Fee Submitted $ .................................... [ Construction on above descnbed building aL~I Sworn to before me/~isI~-_ ~ ....... day of Notary Public....~.~.~~..~..'./C_... County licable ,codes and regulations. (stamp or seal) (~.~ 6 ~ THE NEW YOPK BO;kR{~-. OF FIRE UNDERWRITERS P~ances Rose Homes, w/s~de Deep Hole Dr., 716.07' a/New Suffolk Ave. ' ' , ' ', i ' --- {'I - ' ~ ........ ~ [ ~' ........ ~' ............ ~ t ~ ~ ...... ~ --- ~' .......... ~ J ~-~'--I ~ .... ' ' ' ' [ ~ zL~8 L ' ~ ' ' 11_~ ' ' OTH~ ~A~T~. ~Furnaees: Oil 1-1/8hp, 1-1/l~hp Four Point Elec.Inc., 863 West Jericho Tpke. Smithtown, L.I. 11787 not be altered m any manrer, ~eturn to the off, ce of t,~e ~oard if ,ncorrert Im. pec~ors may be ~dert,fed b; t~_'~, credentials /-o1 LOCtlTION OF WELLS ~ND CZsspOO~.g THE D OBSERVATIONS ~HOWN HEREIN ARE FEOM FIEL ---" OTHERS AND/OR FROM DATA OBTAINED F~ NO r~ SUBDIVISION b~AP ~IL£O IN THE OFFIO~ OF ~'H~ P£~RK 0~' SUFFOI K POUNTY ON .£V,$,ONS , YOUNG & YOUNG MAYI§,Ig,-"5 400 OSTRAND£R AV£NU£, RJV£RH£AD, N£W YORK dULY ~g', Ig'/'5 ALD~.'N W. YOUNG HOWARD W. YOUNG SURVEY FOR: BEN MENDOZZA LOT NO 52. DEEP HOLE CREEK ESTATES" AT ............. G UARANIJEED TO: MATTITUC K GUARANTEED TITLE DIVISION OF T'HOLD AMERICAN TITLE INSURANCE CO. TOWN OF SOU SOUTHOL.D SAVINGS BANK SCALE: i.= 40', AUG,IO~Ig?3 5-715 . H.D. Re£erence No. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWACE DISPOSAL SYSTEM JEAN ~F21OOZZA, 1. Applicant O/O F~A~C~$ ROSE HO~ES,I~CRhone?44-1414 Subdiv.OE~P H0~ ~ ESTA~ Address ~ ~0~: R~ PT.. N.Y, I1~8 6. Section 2. Property location ~/S D~P'H~E ~I~ 7/~' "7' 7. Lot No. ~2 ~/0 ~ S~O~ A~ 8. Private ~ell ~ Village ~ITUCK Township S~0~ 9. Public water ~0 3. Public Water Company name Distance to main 4 Lot size: Width~2~-O~eet Lengthier. T% feet (Enter on center plot below) 10. Sewage Dispos~ystem: ~S/~ A. ~ gallon septic tank: Precast X Equivalent Block B. ~eaching pools: Number 1 Precast ~ Block Special__ NJ If private well fil in blanks below: Tank capacity.~2 Gal Total well depth ~Depth to G.W. 20' Amount of water in well 40 gals Test Hole ~Dataq I Feet I 2 15o J z2 r~fd installations wil be in accordance with the Suffolk County Depa %~ent of/~e~h's~ cu~r~ent stand- ards thereto." ~ Jltff/llL/(,/iM'~,~f~, ~// Owner or Builder ' BE, N ME~DOZZA, PRES., FRA~C~S ROS~ HOAXES, I~C. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, i is the opinion of the Health Department, that an adequate and satisfactory Sew Disposal System ~n be installed on this plot. Date S-15 Revfsed 4/'1/7Z Lot .E/ / REVISIONS NO T~ ~-- MONUMENT SUBDIVISION MAP FILED IN THE OF THE CLERK OF SUFFOLK ~ ON YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W. YOUNG SURVEY FOR: BEN MENDOZZA AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK CO., N.Y. ~CALE: l''= 40" 'l ~ATE: FORM NO. I ~ TOWN OF SOUTHOLD .~,~ ~,~ ~-~-~ BUILDING DEPARTMENT ~l~l.~ ~- ~ TOWN CLERK'S OFFIGE~/~ ~ /, ............................................................................................................ APPLICATION FOR BUlLiNG PERMIT , ~ ~RIL 3 . Dele ........................ ~NSTRU~ONS o. This opplic~tion must be completel~ filled in b~ ~pewriter or in ink ond ~ubmittod in triplicot~ to the Buildin~ Inspector, with 3 set* o{ plans, *ccur~t~ plot plan to ~1,. Fee ~ccordino to schedule. b. Plot plan showin~ Iocotion of lot ond of buildings on premise% relationship to od~oinino premises or public ~re~s, ~nd ~ivino ~ detoiled description of Ioyout ofpropor~ must be drown on ~he di~orom which is p~ o{ thi* *pplic~tion. c. The work covered by ~his opplic~tion m*y not be commenced before issuonce o{ Buildino Permit. d. Upon opproval of this opplic~tion, tho Buildin~ Inspector will issue a Bu[Idin~ Permit to the opplic~nt. Such permit sholl be kept on the premises ovoiloble for inspection throughout the work. e. ~o buildino short be occupied or used in whole or in po rt {or ony purpose whatever until o Certi{icot~ o~ Occupancy sholl hove been ~ronted by the Buildin~ Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to thew 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/~7 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. FRANCES ROSE HO~ES, INC. (Sianature of applicant, or name, if a corporation) ...~OZ~. l 0.3,3. ~ ..ROCKY.. P. 0~1f~.~ .. ~ ,.I~L~ .'... 11.7.7.~. ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER BUILDER BEN MENDOZZA Name of owner of premises .................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ~ ~ ~=~ f 307 E Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ...... ~..kS..~. ........................ Lot No....~;~ ................. Street and Number ...W./...B"..D...~..~..P..~.~..~...~.....~..~.~...V~...~...?.~.~..~.~.Z~..~..S.~..~...~..~...~...~.~.~.~...~...` .~..~.~.?..U..0...~... Municipality State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy 1-f~irtl~r d~ol'ltng X 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (escription) 4. Estimated Cost ......... ~..]:..~..~...Og....O.:....Og. ........................... 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 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................... l~j6.~.~..r...~7.6. .... 2 0 ' ' , '"'~ 9. Size of lot: Front .......... ~...sS...,....~. ............................... Rear ....~..~.,..(~ ........................Depth .~'?~,.?8.-.-.N/S ..... 10. Date of Purchase ............ ~EC.~.~I~.~...~.g..'7...3.. .............. Nome of Former Owner .~.~.~..~.....~...~.~.~ ......................... 1 i. Zone or use district in which premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~J.C) .............................................. 13. Will lot be regraded ...~?~ .................. Will exce~s fjII2bO~ be removed from oremises: ~-) Yes '(X')N°-'70Og'SUZ BE .......... GRANT BLVD., N0. BELLCORE NY ] 4. Name of Owner of premises ...... ~j..~.l~.g.~/~.A.. ......................Address ................................Phone No ....................... Name of Architect .............................................................. · o~,.~-,~ .~ ~~5~d~re~h¥'"TU'~"'4 ................. Phone No Nome of Contractor ~'~{,~JC~S..a0~..HI~,~.~Iz~C ....... Address ~OgTK~'..~.~.,..~.~J,.~.Phone No. ~z~_.~._.~.~,'[.~... 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. 716.0~' STATE OF NEW YORK, ~.c COUNTY OF ................................ BEN ~J]NDOY, ZA .................................................................................. ~ .............. being duly sworn, deposes and says that he is the app!icam (Name of individual signing contract) above named. B~,~ I~.ND0ZZA He is the ...........................~...~.~.R....-...B.~..U~.".L.DE...R.....~..Q~P~.~RATE...~.~f~E~..~/~%AN~.~..~.~.~.~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 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 r~anner set forth in the aJ~plica Sworn to I~re me this ~ "I! ......... ..7.. .......... .................. , Notary Public, ..~.v.,~..--~t~,.~, .... ,/: ................ County ............ NOTARY PUBLIC, Slate of New Yo~ No. 52-4510068, Suffolk Counl,/ Commission Expires March 30, J~,~ filed therewith. ,'NDOZZA APPRCVEO A8 ED INSPECTIONS: S. FINA'L WHEN JOB COMFLBT6D NOT RD~PONSlBLE FOR DESIGN OP. CON- 1 T, cv~l~e ~