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Home My WebLink About7827-zTOWN OF $OUTHOLD BUYr.~ING DEPARTm~'T Town Clerk', Of{ice $omhold, N. Y. Certificate Of Occupancy No. Z.?.3.8.~. ..... Date ........... .R..o.y ..... ~.~ ...... ,19..76 THIS CERTIFIES that t~e building located at .~..o.r.a.e...f}.h.o~...9..1, ............ Street ~.~st Map No.0~.e. go..n. .V.l.e. ¥ Block No ........... Lot No..~. ..... ~.~..1;.~.ll .ogl~e ............... conforms substantially to the Application for Building Permit heretofore filed in thi.~ office dated ............ .AP.~!!...1.;719. ?~. pursuant to which Building Permit No. 7.~..~..,. dated ..........Apl';l,],...~.8..., 197~[., was issued, and conforms to all of the require- ments oi the applicable provisions of the law. The occupancy/or which this certificate is issued is..~..!v..a.~.e.. 9.z~...r.e~l.!!~. ¢t.~.~lli~g ....................................... The certificate is issued to ./~0~,~. lt.~lor .......... 0m~er ........................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ...N.oy....17... ~ ~.7.6... b~..~ ~..VJ, ll&. See nots U~~E~n~ERTIFICATE No..N..~.~.6.~.9..~ ..... .H.oy....19... ~. ~7.~. .............. HOUSE NUMBER ..... 6.7.~ ..... Street ....~Iorsa. Shae .Driv~ .................. ...l~0~Aa. P~v&te..woLl..vitI~ .hifb .nitr~-~es ~.-see' health 'Del.?not 'oR .... final .u~vo7 I ~ ~.~ ....... ....... Building ln.qpector ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 7827 Z Permission is hereby granted to: pursuant to application dot, ...... ~..~ ........................ , ,,7~ and opprov" by the Building Inspector. Fee $./~...~..~ Building Inspector FOB~ NO. $ TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: I. 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 af 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 inspect=on 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 ar land use $5.00 3 Copy of certificate of occupancy $1.00 //- / ? - 76 New BuHdin~ ....~... ........ 4kddition ................ Old ac Pre-existing Building .............. ., Voco~ Land .............. ~ Ow,er Or O~ne, Of Pro'pe.~y~.~..~..r..~..~.~. ....... ~..~.., ............................... *. ......................... ; Subdiv,sion ~.r~...TJ..'.~.m......C~.~....Lot ,o. ~.....f'. B,ock ,o...--..:.:.... ,ouse ,o.~....~... Permit No.%~....~...~.... Date Of Permit .~.7/..~....~.....Applicant~(~...~....~..C....~......~..~.. .................... Health Dept. Approval ............................................ Labor Dept. Approval ....... ~ ................................... Underwriters Approval ............................................. Planning Board Approval Request For Temporary Certificate ........................................ Fino] Certificat .......................................... Fee ~bm~tted $ ..~.:..~. ..................... Construction on above described building and/~mit~mee~, a~ regulations. ^~,,,~on, ...... ./...4 ............ ../....../..~XT?;.;] ........................... ................ day ~ ............................................ ~ ~ ~~' ~ COUNTY OF SUFFOLK DEPARTMENT OF HEALTH SERVICES MARY C. McLAUGHLIN. M.D., M.P.H. The attached approval was issued subject to the notation contained below our approval stamp. Would you please type the following condition of approval oH the final C of 0 as this will ensure that any future owner will be made aware of the nitrate problem. "Private well with high nitrates - see Health Department note on final survey". Thank you, · Robert A. Villa, P. E. 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. ApplicantZs4 :;~ ~ ~ . , e* 2. P?perty Location,~/ ,': -_, ,,,, - "' ,, - VillageC,,',-~"~ ,, ~ ~ Township, ~', .~, ~ ,, = ~-. 3. Public Water Company Nam'e '-=-= 4. Lot size: Width,· ,, feet Length~, ~ feet 10. Sewage Disposal System: 5. Subdiv.~'£'c: ~,,~:= ;~ ,'~r~ 6. Section ~'* 7. Lot Number ~ ~ 8. Private Well ?'~ ~ 9. Public Water ~ Distance to main -, 11. A. (9~O~gallon septic tank: Precast ~-.~ Equivalent ~' Block B. Leaching pools: Number of pools Precas~,~,,~ Block__~pecial__ If private well, fill in the fol- lowing blanks: A. Tank capacity, -,!~; .gallons B. Pump G.P.M. -~ C. Total well depth D. Depth to ground water E. Amount of water in well (For Health Services De)t. Use) ,: .... ~ ~ ,'~ ~,~'-~ The undersigned CERTIFIES: "Construction of authorized installations will be in accordanc~ 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. 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 can be installed on this plot. APPROVAL DATE S-15 Rev. 4/1/73 ~: 5 , . =~ONUMENr ~ t-, ~, -, -~ SUBDIVISIONMAP FI~D INTHE / OFTHE~L~RKOFS~FO~ COUNTYON ¢ ~~- YOUNG & YOUNG u.~r.~,z~...T....,o, o. ~o~,.,o. TO SURVEY FOR: · .,. *..~ ,~ · ~,o~..,o. o..~.,o~ KENNETH SCflEUER~Afl g KATH~Efl SCflEUEHMAfl 7209 OF THE NEW YOrK STATE EDUCATION Tltr. [O,",~?rO~· OF WE~ AND CE,~SPOOL~ SHOWS LZ .EIN ARE FROM FIELD OBSERVATIONS ,P. NDI02 F2O;,! D&TA OBTAINED FROM OTHHRS LOT NO. 38, "OREGON VIEW ESTATES" COPIE$ OE THIS GURVEY NAP ~OT BEARING TO RE A VALID TRUE COPY GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY 13 PREPARED, AND ON HIS BEHAI~F TO THE TITLE COMPANY, GOVERNMEi,)TAL AGENCY AND LENDING INSTITUTION LISTED J GUARANTEED TO: AT CU TCHOGUE I $ourttoto TOWN OF SOUTHOLD J ~g~l.l,~rr r/rte euAnA~lrr co. SUFFOLK CO., n.Y._ /~k~) REVISIONS UNAUTHORIZED ALTERATION OR AODITION TO TH~S SURVEY IS A VIOLATION OF SECT[ON 7209 CF THE NEW YORK 5TA~E EDUCATION LAW C~IES OF THIS SURVEY MAP ~T SEARING THE LAND SURVEYOR'S INKED ~EAL OR NOTE' · =MONUMENT $UBDIVISION MAP F1 L~D IN THE OFFICE OF TN£ CLEBK OFSUFFOI. K COUNTY ON AS PII £ NO. YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR SURVEY FOR: ALL $ TRUC T CO/??O/~A T/ON LOT NO. 2B, ~'OF~EGON VIEW ESTATES / C U TC HOG UE ~ UA~ ~ ~ SOUTHO~D SUFFOLK CO., N.Y. BY~ SC^~-E: i, = ,50' I o^'~. AUG.~Z,~974 NOTE' = MO N ~)MEN T UBDIW$1ON MAP FILED IN THE THE Cl EBK OFSUFFOL.K ~OUNTYON ASFI~E NO R£V,$,ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RWERHEAD, NEW YORK ALDEN W. YOUNG HOWAED W. YOUNG SURVEY FOr: ..,..~.v.~ ,~ · v,o~.,o, o~ ~.,o. ALLE TPUCT COPPO~A T/ON NOT TRANSFERABLE TO ~DD'TION~L SCALE: /. ~/ ]DATE: ~//n /= /07~~7 -- TOWN OF SOUTHOLD ?-23,~, ~*,~,~ ~ '~ ¢-~-- ~ "~ TOWN C~RK'S mFl~, ~ 6~ ~ ~ ~ ~UTH~D, N.Y._~ ~ ---~- t/'~, ~. ~ ............................... ~ .... ~~_~_..;~ ~ ~s 2 ~~ ~ ........................ ........... ......... ~ -~/ ~ ~ ~ ~ (Buildi~ Ins~tor) ~ ~ a, Thi~ application must be completely filled in by typewriter or in ink and submitted i~ triplicate to the Building Inspector, v~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule, y~ b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, 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 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 ~iJ~ll have'~be~ granted by the Building Inspector. ~' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Z0n~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for'the construction o~ 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. ~.q.g.~.~...~......~.~...~.~..,....g.~l}..~.~a...l~.~.a .......... (Address of applicant) ~t~te whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ............................................. .s..m~ ~,.~.~. ....................................................................... : ................................................. ~ ........ Name of owner of premises ...[t.°...~.~..a....~...°..~..°...~. .................................................................................................................... If a~l~c~~uly au~ized officer. .... ~.....~..~ .~...¢.....~..; ~.~. ......... ~..~..., ........ -~/ (Name un.title of corporate officer) 1. Location of land on ~hich proposed work will be done. Map No.: ..~...?..~'.,& ..... Street and Numbe~I/...~..][elll~,ee]:to~...D~:[.~l'. .............................................................. ~--~,~?-,~.~i~i~..'.~-~.~-.. pality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......v..l~.g..e,~,~..],l~tX~ ..................................................................................................... one famil dwelli.~.~ .... b. Intended use and occupancy ............ 2 ............................................................................................... Nature of work (check which applicable): New~uilding ......... .............. Addition ..................... Alteration ............... Repair ......................... Removal ......................... D~olition ..~..~,,¢~. ......... Other Work .................................... 4. Estimated Cost ...~..2..8..a.0..0...0.~..0...0. .................... Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .I. ........ Number of dwelling units on each floor ......................................... If garage, number of cars ........I ................................................................................................................................... 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 ....... .~..8..~. ........... Rear ...... .~..8. ................. Depth ....~,.~ ........................ Height ....... .2...0..! .................................... Number of Stories ..................................... ' 9. Size of lot: Front 1 ,~.0 ' Rear ........ .1.~..0..~. ......................... Depth ................................................ Height .................................................... Number of Stories .................................... .. . .......................................... . . .. . 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..... ~ ............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... .~...o. ................................................ 13. Will lot be regraded . Ye~ ........................... Will excess fill be re, moved J=rom premiSes: [C~J~Yes [ ] No 14. Ne me of Owner of premises ...~. J_~'O~C~..,-~'4~,~3'~ ......................... 7~ ............ (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ....... .A.~..]..~.~....I~....o.~....C..o....~.... ................................... ~ ...................................... .7..2..8...-..2...2~.0.. ........... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot· STATE OF COU,T¥ OF .....S._..m?....0...L..K. ............................... ) .......... · ~...3[f~....q.~....~..n.....M..~.~..~...~...~...~..~..o.. .............................................. being duly sworn, de~s and says that he is the appli~nt above named. (Name o/ indivi~l si~ing con~act ) He is the ...... ~0.~ ........................................................................................................................................................................................... , / (~n~ctor, a~t, coyote ofptcer, etc.} i~' of said owner or owners, and is duly authorized ~o ~dorm or have ~dor~d the ~id work and to make and file this application; that all statements ~ntained in this application-are true to t~[~ ~ and ~lief; and that t~ work will ~ ~or~ in the ~n~r set forth in the appli~fion filed therewith. NOTARY PUBLIC, S~te of New Yo~ { ~ ~ a ~ . ~ No. 52-8125850, Suffolk Count{ ~ ~ -~ ~ ~ (S~m~ o/~c~t] ,, ' FEBk '~,,~ i i~OTIFY BUILDING dE?A~TMENT , 765-~660 gAM~O ~pM ~O~ REQUi~ 7'. BEFORE COVERING 3 ~ NAL WHEN JOB COMF~ETEb' '0 -, 3.% 33 --I lq,'-"' ~KLT.c ~ -- MAIN L J B_D, RM.c" 10:-/ O A~RAGE__' / .F Q_~N.DAT I_O.N I REV __J EASTWOOD MONTAUK HWY., HAMPTON BAYS, N.Y. 11946 JOB PURCHASER LOCATIOI EAS_TL O_O.D_.. HOMES :,~LS Y,,t-'