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Home My WebLink About7706-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z66.h.9. ..... Date ............. A~lg.. 2~ ...... ,19..7.% THIS CERTIFIES that the building located at . .~herasa. & .Deep. Hole..Dx. Street Map No. l+2.~t~ ....... Block No...~ ...... Lot No, . .%8~.. Natt&tuok..N,~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Aug...20...1~... pursuant to which Building Permit No...7705Z dated ........... Jan...29 .... , 197~.., 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 .Priv. ate..one, f. amil~..dwe.lllng ....................................... The certificate is issued to .Ben..Mendozz& ..... 0wnex. .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Aug. · .6...1.97'~. · .by. ~, .WLlla ..... UNDERWRITERS CERTIFICATE No. N~.~ ... June. ~.. $~}?~ ................. HOUSE NUMBER .... 3.2.~.~. ..... Street ...D.e.e.p..H.o.1..ej .D.~. ......................... 21)+~ Theresa D~ Building Inspector FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ClERK's OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISESUNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7706 Z Permission is hereby granted t~: Franaaa..Roae..J~omea....A/.C. ~a M~.~LOm .a~ , at premises located at ,~.O..~...~.,.......~.~..~....~-.~.~....C:-.~.~.~ ..~./$,t~e/A .................................... ............................................. ~ e~a..Dx'...& ..D~e~ ..~ota..D~ ....... Ma.t~i.t'~m.~ ................... pursuant to applicotJon dated ................... ~,ltg....~.O. ............. ......, 19~..., ond opproved by the Building Inspector. Fee $.~.~.:.0. g. ........... FORM NO. 6 TOWN OF $OUTHOLD , Building Depmtment 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 with the following; for new buildings or new use: l. Final survey of property with accurate location of o[I buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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, o 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 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 New Building ..~q. ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ../.Iff/.Q..J~]~[P...~Q.T~]~...~I.'V~..~...~[~,-~A..J~[~..~.~[~.~ ................. Owner Or Owners Of Property ...l~..A~...b~..'.~....~..O..~.~..~.O.~.,j.:..~..~g.*. ................ ............................................. Subdivision D.~.~..P.....H...0.~...?..~..E...E..~.....E..S..?..A..~.~.. ......... Lot No............. 5~''' Block No. ............ House No ............. Permit No. 7706 Z DateOf Permit 1/ 9/75 An. ,',,.~ BE~ a%ENDOZZA~ Pres. Health Dept. Approval ............................................ Lmbor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ....................................... ~ .......................................................... BEI~ ~ENDOZZA, Pres~, Frances Rose ~6~es, ~nc. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) lot I$~.1 Dt~ I VE NOTE. · = MONUMENT SUBD! VISION MAP FILED IN THE OFFICE OF 7'NE CLE, I~K OF SUFF'OLK COUNI'Y ON URN. 28,,196§ ,45 MaP NO. yO!U NG &',yOUNG 400 OSTRANOE~ AVENUE, ~IVERHEA0, NEW YORK ALDEN W, YOUNG [.AND SURVEYOR, N.y.G. klC. NO.,12845 SURVEY FOR: BEN MENDOZZA LOT 58 "DEEP HOLE CREEK;I AT MATTiTUC~ Tow. OF S0UTHbUD~ SUFF0~K C0,, ~. y~ SCAL~: I"= 40' ~'AUG. 14~I9~3 HOWARD W, YOUNG L,AND ~URVEYOR SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference J, QB .~167 APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE t. SEWAGE DISPOSAL SYSTEM Applicant t,'RAr~Ct,,¢~ 1~0;;I'; itOi~'~ES~ImC. Phon~44-141~. Subdiv. DEEP HOLE CREEK ESTATES Address ]3ROAD fA'~[~J0X ].O;30~'~0C~2~ ~T. ~1~.'~. 6. Section 2. Property location N/W/C T~SA DRI~ ~O 7. Lot No. b8 DF~P HOLE OBI~ 8. Private well ~S Village i%~ATTTTH~K Township sOU~0LD ~9. Public water ~0 3. Public Water Company name Distanc~e to main 4. Lot size: Width~feet Length~feet (Enter 'on center plot below) 10. Sewage Dispos~yst~m: i~eg, . A. ~0~gallon septic tank: Precas~ ~ Equivalent Block B. ~ching pools: Number Prec~s~ Bloc~k "Special Street T~ ORI~ The undersigned CE,TIFIES: accordance with the Suffolk County Depa~ a If private well fill in blanks below: Tank capacity4p Gals. Pump G.P.M. 5 Gals Total well depth. 60~ Depth to G.W. 20' Amount of water in well 40 Gals. Test Hole Data Feet t s 2 4 6 8 10 12 16 18 ed installations will ards t~jo)x~ · FOR HEALTH DEPARTMENT USE ONLY. Eased 0n ~the fhf~rm~tion~ p~'sen~d~-h~ith, it is the opi'nion of the H~alth Department, ~that'an~}adequate and satisfactory Sewage Disposal Date System can be installed on this plot; HA I I ~,] ~ ,' \%9 ~ /o7 1o7 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ....... .(.~/. ........ ))......:..! ........ 19.?...~. Permit No...~....~......~...~...~ ...... Disapproved a/c ............ .~.;; ~ .~.~~ (Building inspector) ~, APPLICATION FOR BUILDING PERMIT Application No. > ~ ¢ ~o Date ....................................... INSTRUCTIONS c. 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 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 ofproperty must be drawn 6n 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 o~ 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, buildil~g code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for nec~(~e~"~ ~[O}~[ES,~ Z}~'C~. ~licant, or name, if a corporation) BOX 1033~ ROCKY } OI~, ~L z · 1177~ (Addr0ss o{ opplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. BU:[LOF~ BEN ~ENOOZZA 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. 262P Electrician's License No. ..~. ................................ Other Trade's License No ............................................... Location of and on wh ch proposed work w be done Map No ~...~.. Lot Nlo ag ~/J/~ I~SA ORIV~, A~ID DF~P HOL~, ~RIV~t&TTITU K~ oOUTHOLz; Street and Number .................... ........................................................ ............... Municipality 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 ~-,~..~..I~.X 3. Nature of work (check which applicable): New Building ..X, ............. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) tlS,000, O0 4. Estimated Cast ............................................................ Fee ........................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ..1. .................. Number of dwelling units on each floor ............................ If garage, number of cars '1 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 wffh alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions o,f/~'ntire new construction: 'Front .......... ~...i~.. .................. Rear ...~...~'.. ................ Depth ...~...~...~... .......... Height .....,/.~....-" ...... Number of Stories .... ~... ................................................................................................ 9. Size of lot: Front ............... .l.,3k.o..lO:. ........................ Rear ....... ],~%0,,~q'/.! ................... Depth .~O0,.ilil:.F,/.$ ....... 10. Date of PurchaseD..e..¢...~...1..~.~..9...7.~ ............................... 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: ...t~0 ........................ .j~ ..................... 13. Will lot be regraded ............................ Will ex~,~fJll ~ENDOZZA ~ouo BEN ]4. Name of Owner of premises .................................................... Address ................................ Phon,e No ....................... Name of Architect .............................................................. Address ................................ Phone, No ....................... Name of ContractorFRAii0I!;S ~0SE HOi{ES~IJ,~Oo P,0.BOX 103~ .......................................................... AddressRz0il~y..f,~...¥.i,~..y.~ Phone No..Z~,4..-...1.~..~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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. 130.37' lSk.lO' THER~S A DRIII}~ STATE OF NEW YORK, ~-¢ c COUNTY OF ................................ ........................................ ,l]~.~....i~i;.~Q~,~ ........................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. B~,~ ~E~DOZZA~ Pz~es'~ FRAN¢~S ROSE HO~ES~ INOo He is the .............................. I~UII~T~i.,,...CORR~A~....Oi~ZC~ .................................................................................. (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 ali statements contained in this application are true to the best of his knowledge and belief; and tk, ar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me ........ ............ , // I-1 [ -] '1 ~JiP 7-0 0 1 [ t I ,¸% ~LEV/1T'IoIOof:, ~ITCL~EN