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Home My WebLink About7809-zTOWN OF SOUTHOLD BU~r)ING DEPARTM~.NT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No..Z.6.8..0.8. ..... Date ...........Dee... ~1~ ....... , 19. ~.~ THIS CERTIFIES that the building located at ...I~/8. Deep. Hole.: lip ...... Street Map No..~2~ ...... Block No ........... Lot No, ~3 .... ltatt:i.talok ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............tpr. ll. 3., 19.7~. pursuant to which Building Permit No..~.80~.. dated ..........A~.l,.!l .... 9..., 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 .~.~.v.a.t..~..o.n.e...r..~..i.~..a..~. !~..~. s ....................................... The certificate is issued to .J.e.~n..P..~$~.o.~& .... v of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · .~els...!1...!97~., .bY. ~,..vi, lie... UNDERWRITERS CERTIFICATE No. ~3~.0~ ..... ;ritzy.. ,29...1~.~ ............. HOUSE NUMBER .... 3 .~31i. ..... Street .. l)~.e.l~. Iip~e. I)~.~¥$ ...................... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERJVilT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7809 Z Permission is hereby granted to: F.r,a~u~s...Ao~e..~o~es..I~c.. A/.C. Jean../Cenclozza ....... .box...1.0~3 ................................................. ~o .~..t..z. ~....~..q~....o.~.e....~.t...z.7... ~..e..z. Lt.~.~ .................................................................................... at premises located at ,!~Q~...~-~ ....... ~..~.~....I~..Q~..~....C.~.{~.~.]~...~.~.tA~.t~.~.~ .............................................. .................................... .~l~...P..~e~...~.o.l.e...P..r.~e ............. Y~t.~. ............................................ pursuant to application dated ...................... ..~.~.~.....~ .............. , 19.~..~..., ond approved by the Building Inspector. Fee $.5.0..;.~. .......... 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 w,th the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property hnes, 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 simdar buddings 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 buddings 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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1.00 New Building ..~..~. ......Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~/.~..i)]~F..~...~Q~F~..~.~E~.-~.~....8..~.~....~.~.:~...$.~..~..~.~.~.F.~.~.~.~.s~TIT[ Owner Or Owners Of Property JEAN ~LENDOZZA Subdivision D~.~.~....,~,.0..[,~....C,.,~...,~..~.....~,.$..~,,~,.~..S, ......... Lot No ......~..,3.... Block No ............. House No ........... .................... 4/9/75 .... BEN mENDOZZA, Pres. ~ Permit No 7809 Z Date Of Permit .................... ^pp,,canr FL~ICE<~..~C)~..~0~S. ½...t.Ne; .......... Health Dept, Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ..................... ..~.~ ............. Fincd Certificate ......................................... // Fee Submitted $ .................................... / ~ nd ~,~mit meeJ'~ Jail applicable codes and regulations. Construction on above described buildin~.~...~, ,,~,.~ ,~.,,~..~,.r~,~ Applicant ................ '[vi~ .................. Sworn to before ' ................ day of ............................................ (stamp or seal) Notary Public .................................... County H.D. Reference No. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM BEN ~ENDOZZA, 1. Applicant 0/0 F~ANCES ROSE HO~ES,I~one744-141~ Subdiv. DEEP HOLE tREe. ST Address BOY. 1092, ROCKY P0!NT~ N.Y. !!~8 6. Section 2. Property location ~/~ D~EP HOLE DRI~~/'7~7' Lot No. S/0 ~ SUF~LK A~NI~ 8. Private well ~,~ Village ~_TT!~3CK Township SOUTHOLD 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Wid~eet Length~feet (Enter on center, lot beloW) 10. Sewage Dispos~ ~ystem: 179.~2 A. [$0~gallon septic tank: Precast ~ Equivalent Block B. ~ching pools: Number~Precast ~, Block ~cial s0o ~ If private well fi] in blanks below: ~' 719.22 '~ --131 ? 88 ' Street DEE~ HO~ OEIV~ Tank capacity 4~Ga] Pump G.P.M.~_S Total well depth__6 Depth to G.W.:~O~ Amount of water in well~ Test Hole Data I Feet I 0 I 2 I 10 I 12 ] 18 The undersigned CERTIFIES: "Construction ~f/ ~uthorized installations wil e in accordance with the Suffolk County Depart~nt o~alth'sfcurrent stand- bards there to." //~_. ~.//~/~.~ Date JUL~ 28, 197~ s,gnea~~' / Owner or Builde~ FOR HEALTH DEPARTMENT USE ONLY. Based om the inf~matio~ presented is the opinion of the Health Department, that an adequate and satisfactory Sew Disposal System can be installed on this plot. Date ~/~ ~I S~'g n ~ S-15 Revfsed 4/?/7~ THE NEW YORK BOARD OF FIRE UNDERWRITER5 ak BUREAU OF ELECTRICITY t,.~ July 29. 1975 CERTIFIES THAT t~ el~t~cal ~pmen~ ~ ~rlh~ Frances Rose Homes, w/side Deep Hole Dr., 851.10' s/New Suffolk Ave., ~ttituc~ L.I. Job fo/t.~,,,~/,,, .t,,,.. ~ ~ .... ...t ~EPTACLE$ S~TCH~ ............................ r DRYE~ ~ FUENA~ MOTORS ~TU~ A~iANCE ~DER5 S~)~ ~ PTI TI~E CL~KS <, Be~ ~UN T HEATERS j ~[TI-OUTLET( ~!~ / " ¢~ ~C~4ECT [ NO O¢, S E R V I C I h ~125 ;Pan. ' _~ __. ~_ ...................... *Furnaces Oil !-l/8hp, 1-1/12hp Four Point Elee.inc., ~o West ~--' .... Smlthto~n, L.I. 11787 ,'nay be =dent~(~ed by t~r credent~o{~ foot path ~'.~ _. ~- S. 8~19'20"~. NB?~IB'20"W T~I£ r--OC,~TIoN OF WEr. r.$ AND CE$~POOK~ SHOWN HEREIN ARE FROM FIELD OBSERVATIONS AWD/O/~ FBOM DATA OBTAINED F/~OM OTHE~ NO TE ": MONUMENT SUBDIVISION MAP H£ED IN THE OFF/CE OF THE CLEHK OF SUFFOLK COUNTY ON ,1AN 2~,1965 AS MAP NO. 425~ UNAUTH0fltZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION ?209 OF THE NEW YORK STATE EDUCATION LAW COPIES 0E THL$ SURVEY MAP NOT 8EARING THE LAN0 SURVEYOR'S tNKE~ SEAL 0~ REWS~ONS YOUNG & YOUNG '~f~l~//e~ /F?~- 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK JULY 22,1975 ALDEN W YOUNG HOWARD W, YOUNG SURVEY FOE: BEN MENDOZZA LOT NO. 5~" DEEP HOLE CREEK ESTATES" AT G UAR,a[NTEED TO: MATTI TUCK GUARANTEED TITLE DIVISION OF ~ AMERICAN TITLE INSURANCE CO. TOWN OF SOUTHOLD SAVINGS BANK SOUTHOLD ay SUFFOLK CO., N.Y. . ~.~J/~. ~-z~_ ~AL~. ,,,= ~O' IDA~: ~ ,o,,~,~ l"~¥;J SUFFOLK A VENUE foot_, path NOTE' m = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLEHK OF SUFFOLK COUNTY ON eEWS~ONS YOUNG & YOUNG " 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARI~W. YOUNG SUEVEY FOR: BEN MENDOZZA LOT NO. 5:5 "DEEP HOLE CREEK ES/~ SOUTHOLD -- , · ' ,,' ~ SUFFOLK CO., N.Y. FOEM NO. TOWN OF SOUTHOLD BUILDING DEPA RTMENT ~/'Zrl? ~'' TOWN CLERK'S SOUTHOLD, N. ........ Permk No ................................... Dmapproved a/c ..............................~ ............................................ / t ,-~- ~ t o .................................................................................... ~ ........ ~' ~ ~' '¢'"" /~,. ............................... ................. APPLICATION FOR BUILDING PERMIT '1~ ~ ' APRIL 3, lg75 Date ...................... ~...., 19....~..... INSTRUCTIONS o. Thru opphcohon must be completely filled in by typewnter or in ink and submitted in triplicate to the Buildir Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing Iocahon of lot and of buildings on premises, relahonsh~p to adlommg premises or pubhc streets ( areas, and giwng a detaded descnpt~on of layout of property must be drawn on the diagram which is part of this applicoho, c. The work covered by this application may not be commenced before msuance of Budding Permit. d. Upon approval of this apphcat,on, the Building Inspector wdl issue a Budding Permit to the applicant. Such perm shall be kept on the premmes avmlable for inspection throughout the work. e. No buil&ng shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupant 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 tk Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances t Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary insoections. FRANCES ROSE HONES~ INC. (Address of applicant) State whether applicant is owner, lessee, agent, archdect, engineer, general contractor, electrician, plumber or buJlde BUILDER Name of owner of premises .......... ..d~...~...~...~.t..'~...O...~.~.?.. ............................................................................................... If apphcont ~s a corporate, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ......... ~...~....~....~...~. Electrician's License No ...... ~.O...T....E.. ........................... a. Extsiting use and occupancy ..................................................................................................................... b. Intended use and occupancy ....]:.-.~..8~....~..1...~...~..w.e..,1..]:.~...~.g. ............................................................................... Other Trade's L~cense No .............................................. 1. Location of land on which proposed work will be done Map No ....... ~.2...5.6. ..................... Lot No....~..3.. ............... W Street and Number ~/.~.~.~..~.~E~.~.~`.~.~5.~/.`Q~.~W~`b-~.~.I~LA.V~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable) New Building ...~ ............ Addition ............... Alteration Repair .................. Removal .................. Demolihan ................... Other Work ......................................... (Description) 4. Estimated Cost .................. ~.]r~.~...0..0..O..:..0...0. .......Fee ...................................................................... (to be paid on fihng this apphcahon) 5 If dwelling, number of dwelling un,ts ...... ~ .................. Number of dwelling units on each floor ............ If garage, number of cars .......................... ~. ......................................................................................... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ................ 7 D~mensions 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. D,mensions ~f/ent,re new construction' Front .... ~...~. ....................... Rear ..... ~...~. .......... Depth ..... ..~..'.~ .~. Height .... 1.~ ...........Number of Stories . . ' ! ................................................ 17~,52 ~/~ 9 Size of lot: Front ....... ~.O.~..Q;~ .................................. Rear .... .]:..Z.. .0. :. . .0..0..t. ...................... Depth .. 1 ?.~,.gz~...~/.~]... 10 Date of Purchase ...... ..D~.. ?...'],~.,...~..9.?...3. ................. Name of Former Owner ...~...~.'..~.....S..,......~...~..~..~.?Z 1 I. Zone or use district in which premises are situated ............................................................................................. t2 Does proposed construchon violate any zoning law, ordinance or regulahon ....'¢...O.. ........................................... 13 Will lot be regraded ........ ~.~. .............W~ll excess,,f,,il~l,,be removed from premises: (~ Yes (X) No · ^ - JEAN MENDOZZA ~OU°GRANT BLVD. ~N0.BELLMORE-NY SU 1-?00: 14 ~xlame of uwner of premises ................................ t ................. ;~-ct~ess ................................ Phc{ne No ...................... Name of Architect ...................................................... ~.clrd~ej~s0~ ,fCj~ Phone No ...................... Name of Contractor .... ~c~.,~[C~$ ~0~J~..HO~S~,{C., Address ~LOCT~...~.~...~,~J~... Phone No...Z~..".~,.~.~.~ PLOT DIAGRAM Locate clearly and d~shnctly all buildings, whether ex~sting or proposed, and ,ndicate all set-back dimensions fron property hnes. Give street and block number or descr,pt,on according to deed, and show street names and ind,cat- whether interior or corner lot llO. 00' DEEP HOLE DRIVE .l 851.10' STATE OF NEW YORK, [ c COUNTY OF .............................. [~'~' ......................................... ..~.~..~.....~...~.0..~...~..~. ...................... being duly sworn, deposes and says that he ,s the apphcar (Name of mdw~dua[ s~gmng contract') above named. BEN ~ENDOZZA~Pres. FRANCES ROSE HOMES~ INC. He ,s the ........... ~,~I'TLD.I~..Z...g...0..~.?..0..~...~.~....0..~.~....0~....~. ..................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have/~Jrformed the sa~d work and to make and this opplicahon; that all statements contained ~n th~s apphcahon m§ ttue to the best of h~s knowledge and belief, an that the work will be performed re_the manner set forth in the apphc~ ticJn filed therewith Sworn to:b~ore me this ~ ~ t~ / A ........ day of ............... , Notary Publ c, .~- ........ ,~-~,~r,~.,,~,..~..=... .............County ......... ~,~ ~.-..,..~t..r-==: .................... NOTARY PLIbl lC, Stele cf New York No, 52-45]03oB, Suffolk Caramtss~on Expires March 30, *~- -~