HomeMy WebLinkAbout8233-zFOItM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's O~ice
Southold, N. Y.
Certificate Of Occupancy
No..~-.~.8.8 ...... Date .............. .~.~.~. ~., 19.
THIS CERTIFIES that the building located at . lB/lB. CR .27. :.@ .A~.V. ah. La. Street
Map No..X~fJfL ....... Block No. :~ .... iLot No, .]1~... Cu~;¢h~® ..... B,X, .....
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .......... Oct...] ..... , 19..?.~ pursuant to which Building Permit No.. 8~.~.~
dated ........... .0et..~ ..... , 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 . .pr.~.v.~.y.e. ~.e...~.a.~..~.~y..~.V.e.]:.~..~n.g ......................................
The certificate is issued to . Atlantie. Homes .o£. SuffoLk..%ne ..... o~el' .........
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .J.~I1..~[. ].~.7.7.. ]~f. R,..V.l~l~a ~ ....
UNDERWRITERS CERTIFICATE No. 1~I2]]~. Ofl'~ ... ~Iay...1.~...~.~7~ ................
HOUSE NUMBER ..... 16.600.. Street... ~lidclle..ROa~; .(CP~7.) .................
/ Building Inspector/
/
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 8233 Z Dote ............................. ~ .......................... , 79 ........
Permission is hereby granted to:
pursuant to application aated ........ ' ~)r /~ ' t , '1 ~....;i and approved by the
Building Inspector.
~o
Fee ....
Buildin~ Inspector
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~_~ BUREAU OF ELECTRICITY
i 85 JOHN STREET, NEW YORK. NEW YORK loo3a
T.,S""t~CERT,E,~sMaT.X-~I2 i976 ~,,~'"~"""'~.~"~'~ ~o~ N 283001
only the electrical equlp.ient as described below and introduced by the applicant named on the able application number in ghe prem;ses
Atlantic Homes, s/w/c Sound Avenue & Alvaks Lane, Cutchogue, L.I.
15
DRYERS
27 19
FURNACE MOTORS
j~ RANGES OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
NO OF FEET
S E
R V I C
.... i LI oo_
OTHER APPARATUS:
4
l-4,5kw Hot water heater
I GFI
Joseph D.Mazzoni
~ 227 Waverly Ave. GENERAl. MANAGER,
I~ Medford, L.. 11763 LIC~ E482
~ Tbs certifca,e must not ben ,ered n any manner; return to the office of the Board if inc6rrect. Inspectors may be identified
TOWN OF' SDUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
Mr. ¸
Cornrff~i~c Works
Suffolk County
Yaphank Ave., Yaphank, N. Y.
Dear Sir:
In accordance with Section 239K of the General Municipal Law of the
consolidated Laws of the State of New York, this is to notify the Commas-
sioner of Public Works of the County of Suffolk that
has applied to the Town of Southold for a permit to construct a building
as shown on the attached plot plan, submitted ih triplicate, dated ................
..... ~e~'""~'""~'"' and titled ...~'-.~..j~..~{iate$ ~J~ ~fe~ 3[~
We shall withhold further action on this application for ten days or as
otherwise provided in the aforementioned Section 239K.
11/17/75: Approved to ~he Town of
Southold, pursuant to
Section 239-K of 'the General ~uni-
cipal Law, as per revised plo% plan.
Single access permitted. Permit
required under Section 136 of the
Highway Law.
~:WSM:ef
cc: Atlantic
Very truly yours,
Building I,nspector
Town of Southol'd,, N, Y,
R.M. Kammerer, ,~onzmissi, oner
W.S, Matsuffaye, Jr., Ch~ef ~Eng[neer
Homes of Suffolk~ Inc.
TOWN IDF -=,OUTHE]LD
OFFIBE OF BUILDING INSPEBTOR
TOWN BLERK'B BFF'II3E
Mr.
Works
Suffolk County
Yaphank Ave., Yaphank, N. ¥.
Dear Sir:
In accordance with Section 239K of the General Municipal Law of the
gonsolldated La,ws of the State of New York, this !s to notify the Commis-
sioner of Public Works of the Cour~ty of Suffolk'that ;, '~t:l~lJc(t .~ilIt~W
has applied to the Town of Southold for a permit }o construct a building
as shown on the attached plot plan, submitted in triFlicote, dated ..... ~.,..~ .....
..... tBe~....,~!~....dl~...., and titled ..~..~..~&~.,~a
We shall withhold fuffher action on this application f~- ten days or as
othe~ise provided in the aforementioned Section 239K. ~ ~
Ve~ truly yoqrs, ~ ~ ~
Building Inspe~or ~
Town of Southdd, ,N. Y.
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Hea~lth Department
Reference Number
APPLICATION FOR APPROVAL TO CONSTRUCT
A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY
1. Applicant~? /,~.//~
Address~.~ ~ ~z ~:~,"~
2. ProDert~ Location
Village a~ '~ ~-
3. Public W~ter Company~ame
4. Lot size. Width'~,t~ fe~t Length_ tz.,: feet
lO.
Sewage Disposal System:
A. /.9:~gallon septic tank:
Precast ~uivalent Block__
B. Leaching pools:
Number of pools. /
Precast_~oc~pecial
ll. If private well, fill in the
following blanks:
A. Tank ~capacity '-] ~/~ gallons
B. P~p G.P.M. -j
C. T~al well depth
D. De~¢-th to ground water
6. Section
7. Lot Number
8. Private Well
9. Public Water
Distance to main
(For Health Dept. Use)
,E. Amount of water in well ~
The undersigned CERTIFIES: "Construction of authorized installations will be in accordance
with the Suffolk County Department of Health's 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 HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the
opinion of the Health Department that an adequate and satisfactory Sewage Disposal System
and Water Supply can be installed on this p~oto
S-15
Rev. 4/1/73
(~-~36) (st~-~9/Sl68)
Permit No....J~t~.
PERMIT UHDER SECTION 136 of ARTICLE VI of HIGHWAY LAW
WHEI%EAS, a certain highway known as the ~ ~ No.
has been h~lproved and is on the Suffolk County Road System and
ll u ion to
as per sketch or map attached.
NOW, THEREFORE, permission is hereby granted to said
~ ~ 00 ~ ~' to do said work upen the following conditions:
CONDITIONS AND RESTRICTIONS
1, VChen concrete is removed, cut concrete with concrete saw two feet outside the
limits o! the proposal excavation and for the full p~nel width. Vghen the cut is
made in pavement within 10 feet of the panel Joint, the pavement shall be removed
for tull panel width from the cut oR the fay side of the excavation to the panel Joint.
2. Backfill and thoroughly compact fill using POWER TAMPER, placing soils so that
vaxious types of soil are in same relative position as before excavating. Grade to
original surface.
3. Replace pavement, sidewalk or surface s~me as existing; if concrete, replace using
l:lZA:3~/z mix stone mix cor~crete; ii bituminous material, replace using soane type
a~ removed.
4. If concrete curb is removed, replace with simiinr curb 1:1~ :31/2 mix.
5. Edge of Jacking Pits or any other exeavatinn slmll be not less than 5 feet from Edge
of Pavement. No undercutting a~lowed in Pit.
6. Notify the Department gt Ygphfmk 4-~451 when the work is to begin so that an
inspection can ho made of the operation.
This permit shall not be assigned or transferred without the written consent of the Commissioner of Public Works.
The work authorized by this permit shall be performed under the supervision and to the satisfaction of the Com-
missioner of Public Works or his representative.
particular attention is called to the necessity of thoroughly compacting the bar!< fill, which will be required
by the Commissioner of Public Works.
The Commissioner of Public Works shall be given one week's notice by said applicant of the date when it in-
tends to begin the work authorized by this permit, and prompt notice el its completion.
The said applicant hereby agrees to hold the State, County and Town harmless on account of damages of any
kind which may arise during the progress of the work authorized by this permit, or by reason thereof.
Applicant certifies all persons concerned with actual work under this permit are duly covered by Workmen's Com-
pensation Insurance and the State, County and Town shall be held harmless on account thereof.
The Comm/ssioner of public Works reserves the right to at any time revoke or annul this permit should the
said applicant fail to comply with the terms and conditions upon which it is granted.
The applicant agrees to pay all neceS~oamr~ ~ss~onneSreSolfn~d~?.t to supervision and inspection by reason of the
granting of such permit as certified by the C rmss ubhc Works, such payment to be made within ten days
from the rendering of the certified account.
Work under this permit to be commenced within thirty days from the date of permit and continued in an
expeditious manner.
The applicant shall su,bmit a detailed plan of structure to be built, with a description of proposed method of
construction.
It is understood that should future changes in the alignment Or grade of .the highway require changes in the
work covered by this application and permit, the applicant shall on reasonable not,ce from the Commissioner of Public
Works make such necessary changes at his own expense within the time so specified in notice.
Traffic shall be maintained by the applicant on this section of the highway while the work is in progress and
until its final completion.
A in the sum of *. to the County asurer Suffolk Connty is
as security that the highway will be restored to its original condition where disturbed at the expense of the
deposited
applicant, as soon as the work has been completed, and the said Commissioner of Public Works is hereby authorized
to expend all or as much of such deposit as may be necessary for that purpose, shcold the said applicant neglect or refuse
to perform the work.
unde~Zsign~d accepts it Subject to conditions described.
Commissioner of Public Works, Suffolk C~UTty
TO AVOID SEIRIOI~S DAMAGE TO VITAL UNDERGROUND FACILITIES, PLEASE CALL LONG ISLAND LIGHT-
ING COMPANY AT JUNIPER 2-9000 OR FOR TELEPHONE FACILrrlES CALL N. Y. TEL. CO. FLORAL PARK
2-OFFICIAL 25 BI,FORE STARTING THE WORK AUTHORIZED BY THIS PERMIT.
PERMIT NO
RES1 DE
EWAY
ADJACENT :TO:
FLEXIBLE T~PE ~VJNO
AS DIRE
TYPES OF PAVEMENT
THEORETICAL CURB LINE
1.BITUMINOUS MACADAM BASE WITH ASPHALT
CONCRETE TOR
2: CINDER OR STO'NE~ SCREENINGS BASE .
CINDER oR STONE SCREENINGS BASE WITH',~
BITUMINOUS SURFACE TREATMENTAND STONE
pORTLAND *CEMENT ·coNCRETE
BE* PERMITTED
oI ~od°¢lit
NOTE
SURVEY FOR:
AT£~NTIC HOMES OF,-.ffUFFOLK, /NC.
°FsouTHOI D I
(Building Inspector)
APPLICATIO~ FOR BUILDING P~RMIT
Date ..... ~...'1,..~ ....
INSTRUCTIONS
This application must be completely filled in by typewriter or in ink and submitted in duplicate to
a.
Building Inspector.
b. Plot plan showing location of lot and of buildings o n premises, reLationship to adjoining premises or public~
streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which
part of this application[
c. The work covered by this application may myt b e commenced before issuance of Building Permit. r~'
d. Upon approval of this application, the Building In spector will issue a Building Permit to the applicant.
Such permit shall be kept on the premises available for inspection throughout the ,progress of the work.
e. No building shall be occupied or used in whole o~ in part for any purpose whatever until a Certificate Of
Occupancy shall have been granted by the Building ~mspect~
APPLICATION IS Hl~wa~y MADE to the Building Department for the issuance of a Building Permit pursuant
to the Building Zone Ordinance of the Town of Sonthold, Suffolk County, New Y~rk, and other applicable Laws,_
Ordinances or Regulations, for the construction .cfi build ings, additions 6r a.l~rations, or for removal or de~n~.~
lition, as heyein described. The applicant agrees to corn ply with all applicable Laws, ordinances, building code,
housing cede, and regulations.
(Signature of applicant, or name if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumbar or
builder ..................................................................................... ~ .....; .......
Name of .owner of premises ................................................................. ; .............
"~ ~I~m~and title of corporate officer)
1. Location of land on which proposed work will b e done. Map NO ................. Lot No ..............
Street and Number ........ ~.O.ff.~..~.~.....-~.0. h.~....~.? .... ?... L (/'~/~ ~; LA dU'r'c&~g)6~, ~c-
Municipalit~
2. State existing use and ~ceupancy of premises an d intended use and occupancy of proposed construction.
a. Existing use and occupancy ........ .~..~..~..~..~.?. ................................................
b. Intended use .and occupancy ...................................................................
3. Nature of work (check which applicable): New Building ...~. .... Addition ........ Alteration ........
Repair ......... RMnoval ........ Demoliti, on ........ ~/th.e~] Work (Describe) ......................
4. Estimated Cost ..~....c~. ,~..~..~'..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 ..........................................................................
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 ........................................................
Dimension.s of same structure with alterations or additions: Front .............. Rear ...............
Depth ................ . Height ................ Number of S~ries .....................
8. Dimensions of entire new construction: Front .....~..." ......... Rear . ~.s~.,? ..... Depth .
Height............Rs Number of Stories ~ ...............
9. Size of ~ot: Front ...~. ........ Rear . .~..'.' ...... Depth ...~]~.s ........
10. Date of Purchase .... ...~.... ~ ............... Name of Former Owner .............................
11. Zone or use district in which premises are situated ....................................................
13. Name of Owner,of premises . ~[JMII~.~ .... A, ddress ~ ~ ~
Name of Architect ............................. ~ddress ...................... Phone No ............
Name of Contractor~g~ll~'~.~ki~ ............ Address ...................... Phone No ............
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give s~reet ancl block number or de script$0n according to deed, and show' street names and
indicate whether interior or corner
STATE 0F I~RK, )S.S.
COUNTY OF~.~ ....... )
~ ~ .... being duly sworn, deposes and says that he is the appli-
(Name of in,dividuai sigpini: application)
cant above named. He is the .~...~...?~.. .................................... ........
(Gontractor, agent, (~rporate officer, etc.)
of said owner or ~owners, and is dilly authorized t,o perf.~rm or have performed the said v~ork and to make and
file this application; that all statements contained in th is application ave true to the best of his knowledge and
belief; .and that the work will be perimmaed in the mann er set fort~ in the application filed therewith.
Sworn to before me this
................ day of .................... 19....
N~tary Public, .................... County
(Signture of applicant)
of
R£VlS~ONS YOUNG & YOUNG
--~ ~,~'~.~'~'~: 400 OSTRANDER AVENUE+ RIVERHEAD, NEW YORK
CZ'?:/~ /.~.,2'_-~ ALDEN W. YOUNG HOWARD W. YOUNG
SURVEY FOR:
ATLANTIC HOI4ES OF SUFFOLK, INC.
AT CU TCHO GUE ~
· OWN O~SOUTHO£D ~~. ,/.~:.,~
Of
oo¢
54'
o~,~l ~ =.MONUMENT
· ~ T~E LOCAT~Oi~ OF V/ELLS AND ~.~ ,P .. ~
~HOWN HEREIN ARE F~OM F~ELD O~SE;~ ~ ATiON$
~ ~D/OR FBOM D~TA OBT~N~D F~O~ OT~E~
YOUNG & YOUNG
400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
ALDEN W. YOUNG HOWARD W. YOUNG
SURVEY FOR: FFO~~
ATLANTIC HOM~S OF SU
G UAR~T~ ro:~
AT ' CUTCHOGUE
TOWN or SOUTH OLD -
suFFOLK CO.~ -N.Y. -
DATE: - I NO~ ..... b
TO BE A VALID TRUE COP'~
GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE mERSON FOE WHOM THE
SURVEY iS PREPAR[D, AND ON HIS BEHALF
TO THE TITLE COMPANY~ GOVERNMENTAL
A&ENC¥ AND LENDING JN:~TITUTiON LtSTED
HEREON~ AND TO ~FHE ASSIGNEES OF THE
LAW
o ~,,Jl ~' -- MONUMENT
R£VlS~ONS YOUNG & YOUNG
--" .... ' "-" 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
.£v~sto.s YOUNG & YOUN
SURVEY FOR: t ~ ~ / 'j
AT CUTCHOG~E SourHoLo SAVIN~
L
iI
INCLUDES
REGRADING
DRIVEWAY
CON~r RUCTION,
N OTi F't~.B~ii ED~NG'-ID~A RTM ~ N'~' AT ,
765-2660 9~M,'FO 4PM FOR REQUIP~r
ED IN~PECTIONS: :
1. ~QRE BACKFILLING FOUNDA-
~TION'~OR STAR~ FRAMING' ,'~ ' ' "', ·
2.%BEFORE ]COVERING PIPEL N~
3'. FINAL
~T, RESPONSIBLE