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Home My WebLink About8213-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. UPDATED C~RTIFICATE OF OCCUPANCY No Z-26687 Date SEPTEMBER 14, 1999 THIS CERTIFIES that the building DWELLING Location of Property 250 CROWN T.&ND LANE House No. street County Tax Map No. 1000 Section 109 Block 2 Subdivision Filed Map No. Hamlet Lot 12.9 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 23, 1975 pursuant to which Building Permit No. 8213-Z dated SEPTEMBER 26, 1975 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE F&NIL¥ DWELLING & STuuIO WITH DECK ATTACHED AS APPLIED FOR* The certificate is issued to of the aforesaid building. SWANSON & DOROTH~ ABBOTT (owners) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 5-SO~132 - OCT. 21, 1976 UNDERWRITERS CERTIFICATE NO.N-311724 - NOV. 11, 1976 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES CO Z-9443 DATED FEB. 21, 1979. B~ing Inepector Rev. 1/81 FO]~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Ns Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8213 Z Permission is heFeby granted to: ...................... ~..~;~..3.6..9. .......... .e.,~.¢..~.o.~..~ .......... to ..... ~..a~.~e~a~oaB,.&-.aa~.~-~oB..~..e~i~t,~ag,..bu~i~a ................................ at premises located at ....... ,~,~,~,lf/~.,.~e~l[~...~fL..~..~.~...~l~?......]~ ./,~......~....~-.~.a~. ...................... ............................................. ~"~tc~o&u~ ............................................................................................. pursuant to application dated ............... ~.~....~ ..................... , 19.~.~/.., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed cite plan requirements. B. For ex~sting buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinz - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..~.~t..~. ...................... New Construction ........... Old Or Pre-existing BuildingGpD~D ........ Location of Property ...... ~O. ~Q~. ~.7+~I~-~ ....... ~WTC~GU~,. ~ .Y ................... House No. Street Hamlet ~? X SWANSON & DOROTHY I ~DD~ ........... Onwer or Owners of Proper .... % · ~- '' County Tax Map No 1000, Section..~.% ........ Block..~ ............. Lot%~,~ .................. Subdivision .................................... Filed Map ............ Lot ...................... Appli owner Permit No...g2 lZZ ........ Date Of Permit.. 9/~3/75 ...... cant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ......................... Request for: Temporary Certificate ........... Final Certicat~x..~UPDA~IED) FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O{ Occupancy No.. Z 9.4.4 a ..... Date ..... F. ebrktary. 2.1, ........ , 19.~ 9. THIS CERTIFIES that the building located at .Cro.w.n. Land. Lane ......... Street Map No .... .f?.F.~ ~... Block No ........... Lot No .... 1~. ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Sep.tember.. 23.,..., 19.7.5 pursuant to which Building Permit No...8~.1.3..z. dated .... Sep.tembe.r.. 26., .... , 19.7.5., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P.R.I.v..~.T.E..Q~J.E..F.A.~.I;[L.Y.. 9W.~LL!~.G. A .$T!3.DI0 ............................. The certificate is issued to . Pg.r.q .t.hy..%.b.bp.t...a.n.d..J..a.n.e.t..S.w~I%s. Qr~ .................. (owner, of the aforesaid building. Suffolk County Department of Health Approval .5.-$.0.-13.2 ... 1Q/21/.7.6 ............ UNDERWRITERS CERTIFICATE No... ~.3J.~7~.4 .................................. HOUSE NUMBER ..... 2.50 ..... Street...C.~W~..L~.4 .L~a~ County Tax Map NO. . ..... ~ .......... 10 0 0 - 1 0 9- 2 .,- 12.9 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORAllY Certificate Of Occupancy No. ~..~..7~ ? 7 Date ............. 05~.....l~. ..... , 19.7~. THIS CERTIFIES that the building located at .N/8 .ltatn -Read ........... Street Map No..C~ .La~4Block No ........... Lot No .................................. conforms substantially to the Application for Building Permitheretofore filed in this office dated ..............~ept.. ~9..7~ pursuant to which Building Pemit No... ~i~Z dated .......... 8~.N~.. 2.~..., 19.7~., was issued, and conforms to ~ of the requff~ ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is . Private one famil[ dwelling t St~io The certificate is issued to ,. ROrO~hy. Ahb~t~..&. J~et .~on....9~s ....... (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval . P~d~.g. .... :... ................. UNDERWRITERS CERTIFICATE No.. pending .................................. HOUSE NUMBER .,. 2~0 ....... Street ...Cro~.~.~e... 2ute~e ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 o,,,,, November' I~, 1976 ~.~,..,~.,~...~,.8273~1 N 311724 ~lS ~E~IFIE~ THAT J~et Swanson, Main Rd., n/s West Cutchogue,Cutchogue, L.I. ~.~..do. Nov~ber 8, 1976 ~"df°"ndt°bein~m~ia~th~the~qa~re'e"~ofthls~rd' RX~Ut; ~ ~ fiXTURES · [ R~G~ )C~KmNG ~KS ~ 0~S [DISH WASHERS [ EX~T FA~ OTHER APPARATUS: Panelboards: 1-11cir 125amp, Motors: 1-1/3hp. *Multi-outlet systems No. of Feet-_2q'-0" Plugstrip, 3q Receptacle 116'-0" Lite Track, 22-Lights - B.J. Electric Co._ Stlllwater Ave. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 disposcl-(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 applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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-existing dwelling or land usc 3. Copy of certificate of occupancy $1.00 $5.00 Date Feb. 5, 1979 New Building ............. Old or Pre-existing Building ....~(. ....... Vacant Land ............. Location of ProperW . .2.5. .0..C.~.o..wp..~.a..~.d..~..ag.e ............. C.g .t.c~.o.g?.e.,..N..e.w..~..o..r~..];. [..9.3,5. House No. StreetHam/et Owner or Owners of Property . . . .D.o.~.q ,t.~y..Z..,..A.b.b.o. ~.t.,...~.ap.e.t:. ?....S.¥.a.qs.o. ~ ............... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Map No ............... Lot No...l..9 .......... Permit No..877.3, ..Z... Date of Permit 9./7.6./.7.5..Applicant . ~.a.l~.e..~..S.w.a..~.s.o.~ ................. Health Dept. Approval '.°/.~./~. ~....~..~.~. ?.~.-./. ?.~_abor Dept Approval ........................ Underwriters Approval..~/ '.~. ~ t 7 ~ .~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .. ~ .................. Fee Submitted $ ......... t~ .~.~.. ...... . .~..* f.~ . . Construction on above described building and pj~rm~~?~ll codes and regulations. Applicant .... ~ .~. ~ . .~(~...~ ................... Rev. 10-10-78 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference APPLICATION FOR APPROVAL TO cONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 10. Applicant Phone Address ,,.3 .Abk<~tt. J.cl,Swanson Property L'oo~t ~9 ~.~l:~~i~~] Village , Township Public Wat~t~hqy~ Name ~,.~uk~ul~ Lot size: Width feet Length .~ feet Sewage Disposal System: 5. Subdiv. 6. Section 7. Lot Number 8. Private Well±~ 9. Public Water Distance to main (Fo? Health Services Dept. Use) 11. A. 900-gallon septic tank: ,/ Precast Equivalent Block Bo Leaching pools: Number of pools Precast Block Special__ If private well, fill in the fol- lowing blanks: A. Tank capacity, fallons B. Pump G.P.M. C. Total well depth D. Depth to ground water E. Amount of water in well 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 6f 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 /' ~ . SIGNED S-15 Rev. 4/1/73 a. This application must be completely filled in by typewriter Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee b. Plot plan showing location of lot and of buildin areas, and giving a detailed description of layout ofprpperty m* c. The work covered by this application may nat d. Upon approval of this application, the Building shall be kept on the premises available for e. No building shall be occupied or used in whole ~ shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Zone Ordinance of the Town of Regulations, for the construction of The applicant agrees to comply with all admit authorized inspectors INSTRUCTIONS in ink and submitted in triplicate to the Building schedule. relationship to adjoining premises or public streets o~ drawn on the diagram which is port of this application. issuance of Building Permit. will issue a Building Permit to the applicant. Such permit the work. part for any purpose whatever until a Certificate of Occupancy Department for the issuance of a Building Permit pursuant to the Suffolk County, New York, and other applicable Laws, Ordinances or additions or alterations, or for removal or demolition, as herein described. laws, ordinances, building code, housing code, and regulations, and to in buildings fo~ry inspections. (SignaCure of applicant, or J~ame, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owners Name of owner of premises ...L.'.O...r. othy I · Abbott.,. Janet: To Swanson If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License ~No ........ ~..~.....l~...t.?J...1...1....+......~..~....g:~. E Mattituck Plumbing and Heating Plumber's License No ................................................. Electrician's License No. P..........J..:....~l.?..~.~.r..~..c....~.?any Other Trode's License No..!~..a..s..9.P...T~..t::....c..~.P...a..e...~. ...... 1. Location of land on which proposed work will be done. Map No.: .....~.2~.9. .......................... Lot No....Icj ................ Street and Number 3~.~;['...;{.~,~...2.% .................................. C.u~:.c~e..ga~w..Xox~..,L].~3,.% .............................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Unoccupied barn o. Exisiting use and occupancy ............... ' .................................................................................................................. b. Intended use and occupancy ..... .,A..,r..t:.....~.~,?..~.,;j:.~ .................................................................................................. 3. Nature of Work (check which applicable): New Building.. ................. Addition ...~X .........Alteration ................ Repair .................. Removal .................. Demolition ..................... Other Work ..T~J~.~jlJLO~.~;~. ....... 4. Estimated Cost ................. .,~ ........................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..,rlo. t..a..d~l,~ll~ber of dwelling units on each floor ............................ If garage, number of ~ ........ D.~ .............................................................................................................................. 6. If business, commercial or mixed ~cupancy, specJ~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ...~e ................... Rear .....~8e ..................... Depth ~2~ ............. Height ...... ~ ................. Nu~er of Stori~ ....~ .......................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ...................... ~ ....... .~ Height ....2~. ................. Number of Stories ........ ~ ..................... 8. Dimensions of entire new construction: Front .................................... Rear...2~ .................... Depth ........................ Height ...~.~. .......... Number of Stories ........ ~ ......................................................................... .................................. 11. Zone or use.district Jn which premises are situated ...... ~~ .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: N~ ................................................... 13. Will lot be regrad~ ......... ~ .............. Will excess fill be removed fr~ promises: ( ) Yes ( ) No Name of C~tractor ..g.~ ..................................... ; ..... A~ress ................................ Phone No ....................... Locate clearly and distinct~ all buildings, whether existing or'proposed, and indicate all ~t~ck dimensions fro~ prope~ lines. Giv, street an~ ~k number or description according to de~, and show street names and indicate whether interior or corner lot. t~ STATE OF N~ ~ ~ ~SS COUNTY OF ......... ~~fl .............................. ~~..: .................. being d~ deposes and soys t~t h~ is th~ applicam (Nam~ of individual signing~ above nom~. SHe is .................... ............................................................................................................................................ (Contractor, agent, corporate officer, ~tc.) of said owner or owners, and is duly authorized to perform or hav~ performed the said work and to ~ke and fil~ this a~lication; that all statements contained in this applicotion ar~ t~e to t~e best of his kno~ledg~ and belief; and that t~ ~ork will bep~rform~d in the manner s~t fo~ in the application filed therewith. Swam to b~for~ m~ this ' ~ - ~ ~ (Signature of applicant) LEFFERTS PAINE EDSON NOTARY PUBLIC, State of New York No. 524077685 - Suffolk County Commission Ex~resMa~h30, 197~ , ,/ L O-r" l,~ _i~)O~, OT'HY /. .~B,~OTT ~U-l C '7"ow~v o~,, ./o4.v4 ~OLK O01~TY p~lT[~ D~PA~TM~NT · LOT 1~ Lo-r I~ . ~?.~/'40''W' _ t0.4.'/4 // ~cJ?CIdO~Um facilitY, es for this looatlon ha~e been Chief of General Engineeri~. Se~iceS :e Ti 1 :u,tchogue CELLAR PLAN LOFT PLAN 1/4"= 1' 15 sept 75 /~architect