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Home My WebLink About8244-zNO. 4 TOWN OF $OUTHOLD BUII.I)II~G DEPARTMRNT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at ~ 88 0 S~ms W~D ~ F~YVltS~eet Map No .... ~..~. ~.~... ~o~ No ..... ~ ..... ~t No...I.~ ............................. conforms substanti~ly to the Application for Building Permit heretofore ffl~ in ~ office dat~ ........... ~.T...i. ~.., 19~ p~suant to which B~d~g Pemit No.~.~.~ dated .......... ~... (~..., 19.~., was issued, ~d co~o~ to ~ of ~e r~ ments of the applicable pro~sions of the law. The occup~cy for which The certificate ~ issued to (owner, of ~e aforesaid b~lding. S~olk County Dep~ment of He~th Approval ....... ~ ............................ UNDERWRITERS CERT~ICATE No. HOUSE NUMBER.. ~.~,~, ~... Street .~.. ~.~..~...~ ~[~.~ ...... Building Tn~geCtor FO~M ~O. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9. 82~4 Z Permission is hereby granted to: ~,~...~:..'::.~..2...tL.~:,.!.~..!~ ....... /.:! f:?..r._.?.......~.!,~:__ at premises located at .................................. ~'.~.~.~...~.7.~..~J/.'/. ........... ~.~..~..):'.~..~,.~,~.!.~.. ...... .~A~.,!.~.?....'.-~.. ...... ........................... .~] c; v T ~..l c l~ B,x lx ~ pursuont to application dated .~..C ."(. ....... I..~~, 19...~. .... and opproved by the Building Inspector. Fee $...ZY..~'.... Building Inspector FOItM 1~/0. 6 TOWH OF SouTHOLD Building Depo~tment Town Clerks Office Southold, hi. Y. 11971 ~PPLICAT~Ohi 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: 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 disposal--(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, 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. Accurate survey*of property showing off property lines, streets, buffdings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os 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, Cc~y of certificate of occupancy $1,00 .~ Date ...../././.?..~',~.... '?.~ ..................... New B~ilding ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....~ ~/...~ ~ ..................................................................................................................... //'O,~-~..~....~.,~...~.?~/~) ~-~. Owner Or Owners Of Property ............... ~.~...~...' .............. ~ ............. ~ .......................................................... . B ock No ............. Subdivision ........................ - ...................................... Lot No. Permit No.....~..'~.....~....~.._. Dote Of Permit/ff/~..?~,.~..Applicant ~,.,.~.~.,..W.',~.~......~..;.....,~..,~..L~;...-~,....~. ....... Health Dept. Approval /I e/~-I ~. Labor Dapt. Approval Underwriters Approval ....... ~...~...?..~..J.l,.~. ................ Planning Board Approval Request For Temporary Certificate h, Final Certificate Fee Submitted $ ............. .~.. ................... described building and pe[r~t meets all apj~ca, bl~ ~ode~ and regulations. Construction on above //////~/~- ~ ~ PP * ........ ......... ............... ............................... Sworn to before me this ,~.-~-~',,~,~./.,~¢~ /~TJ,~' ................ day of ............................................ Notory Public .................................... County (st6mp or seal) '// ~-/7 7 THE NEW YORK BOARD OF FIRE UNDERWRITERS - __ F~ BUREAU OII ELECTRIcrrY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Job -,,,,-,J ......... ~ .... August 15, 1976 21 35 9'7 21 " SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Re£erence EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPRO%~AL TO CONSTRUCT PRIVATE S .E~AGE QISPQSAL SYSTEMS Date Approval to construct said systems is requested,pertinent data herewith: Address ~..~-.~ fF~bin ~)? /~Y~/dm);~ ~ q 7-Sectio~ 2-Detaile~ '~op~rty'iocation ~ ~, ~L~/~ ~- 8-Lot No. /~ . Hamlet . ~5~i~ ' TG~ - ~h~.~ 9-Private well? ~-~bli~ wa~er s~pply n~me Distance to nearest main t g-Lot Smzel Width/~ ft. Leng{h ~ft. (also enter on center plot plan'~ 5-~elling: Single Family I~ T~ Family? ] _/Cellar? ~/plab? ~Crawl S~ce? lO-Pro~sed system: Septic {ank ~/Precast ~ /Cesspool~ ~Shallow pools / /Other il-Septic tank inside dimensions: Vol~e Gals.Length .. ft. Width .ft. Liquid dept~ft. 12-Precast sections: / /Number/ /Squ~re Ft. Cesspools: Block sizeL . .incs.~ins.~ins. Total blocks below inlet: ~1 ~2 ~ PLOT PLAN Street ~ade W.L. Capacity~g~ Gals. --1 G.P.M. Indi No Data Feet ,~' 6 ~ 10-- ~6 18 The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage ~Disposal Systems". ~ )-% Signed FOR ~ALTH DEPART~NT USE ONLY. Based on the info~ation pre~nted here~th, it is the opinion of the Health De~rtment, that an adequate and satisfacto~ Sewage Dis~sal System January 10~ 1977 Re: 5 oO ~e attached approval was issued subject to the notation eontamned below .our approva'L stamo. Woul8 you please type the following condition of approval off the f~:a! C of O as this will ensure that any £uture will be made aware of the nitrate problem. "Private well with high nitrates - see Health Department note on final survey". Th~k you, Robert A. Villa~ P. E. TOWN OF SOUTHOLD ~'//~/~ ~u~.~,~- ~,~ ~((- /'~'~, ~ BUILDING DE~ARTMEHT~~ ~ ~ ~/ ~ ~ ~ ~ ~- ~ TOWN CLERK'S oFFjCE~ ~ ,~ ~_ ~ ~UTHOLD, N. Y. Examined ................ ~/" ....... , 19 ........ ~;;v ~u ~. ., ~ ........ Disapproved a/c ....................... ~ ......................................................... I ~ ~ - ~ ' ~. ~ INSTRUCTIONS a. Th~ application must b~ completely filled in by ~pewriter o~ in ink and submitted in triplicate to the Building Insp~tor, with 3 sets of plans, accurate plat plan to ~ale. Fee accordi~ to schedule. b. Plat plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is pa~ 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 ar used in whole or in part for any purpose whatever until a Ce~ificate of ~cupancy shall have been granted by the Building inspector. APPLICATION IS HEREBY MADE to tine Building Department for tl~e issuance.of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southo d, Suffo k 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for n~essa~ in~ections, ~Df~B~IRD B~B~R i~ . ...................................................... lA. tess of ~ppitcon~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................................................... N~me of owner oT premises .................................................................................................................................................... applicpnt is a corpor~e, signature of duly authorized officer. Builder's License No ..................................................... Plumber's License No ........... ~.~.~.~..~ .................... Electrician's License No ............................................. Other Trade's License No ............................................... ..~... Location of land on which proposed work will be done. ",ap No.: ... ....... ~..,..,~.,~,?.... Lot No ....... Z~. ......... Street and Number ..~.~i..,/~.R/Z.Z.,rL..,~,,,d.~.4/4~,u~...,,i~I.~, ................................................. ..~,.~.~,.~....~..,.~..4~..../~... .... ~ Municipality State existing use and occupancy of premises and in:ended u~e and occupancy of proposed construction: b. intended use ond occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration Repair .................. Removal .................. Demolition .................... Other Work ................................................ ~ c;~ g ~-- (Description) 4. Estimated Cost ............. ,~,.**~.~ ............................... Fee ..... ~.,~.. .............................................................................. (to be paid on filing this application) 5. If clwelling, number of dwelling units ............................ mumber 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 ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front (~"~ / ~ ~ ~ .................................... Rear ....... ~ ............. Depth Height .................... Number of Stories .......... O....A~...,~.~ ................................................................................................. g. Size of lot: Front ........... ~...~.~.. .................................. Rear ..... /...~.,~.. ........................... Depth ...~....~...~.. ................... 10. Dote of Purchase ........................................................Name of Former Owner ....Z,...~'....~..~.~.:.~..../~..'.-~....,..~..~'. ..... 11. Zone or use district in which premises are situated ...................... ~.. ................................................................. 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ............ .~....0.. .................................... 13. Will lot be regraded , ........................... Will excess fill be removed from pr, emises: ( ) Yes (~/) No 14. Name of Owner of premises~.. ........ :r../~/.~...~..~.~...~...../.?.....~,/...~.~..... Address ..~.~..~..9/.I.~.~.t.~..~lt/Phone No.r~'~.~.,~....'./.~.,~.~ Name of Architect .............................................................. Address ................................Phon~ No ....................... Nome of Contracto~,,~'~.~.f..~/.,~.~../../?.~....~J~<~l.~.-..~. ............. Address ~,~..~....x,.:~f?~.~,J...~..~.. Phone PLOT DIAGRAM ~/J ~:'~ ~' ~'~ Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate ali set-back dimensions from property lines. Give street and block namber or description according to deed, and show street names and indicate whether interior or corner Jot. STATE OF NEW YORK, I c c COUNTY OF ................................ .................................. ~..~...~.."...~...~,,.~-]'~* ........................ being duly sworn, deposes and soys that he is the opplJcom (Name of individual signing contractJ) above named. He is the (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 all statements contained in this application are true to 'the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applicotior(filed therewith. Sworn./..-~..t° before me thiSof ........ ......... ......... ................ , .... ----., _ Nota.¥ Public ................ ..~..~..~.,~.. ................ County ........ . .~....~....~...~....~...[ ...~...~ ,.~.........../...'~...T....: ........... (S gnature of app~r, dont) AR'NOLD L. KERT NOTARY PUDL'I'C, Sfa{-o o~ New York 'No. 30.4512287 uaJlfiecJ in 'Nassau Com~3isslon Expires Marc~ 30, 19.,~,,~ NO TE ; mm = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE ~ TH~ ~RK OP ~F~OLK~NTY ON dUN~ 4,1971 AS M~ N~. 5~99 REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: GREENBRIAR HOMES, INC. LO ~ 14, LEEWARD ACRES AT BAYViEW AT TOWN OF BA YVIEW GUARANTEED 'FO: ~o/ ?~ NOTE: · : NIONUMENT SUBDIVISION ~4,~P FI£ED IN THE OF~C~ OP ~H~ ~R~ OF ~FFOL~ ~Y ON dUNE 4,1971 ~ M~ NO. 5599 THE £OCATtOI~ OF WELLs AND CESSPOOLS SHOWN HEI~EI~ ARE FRO,F/FIELD OSSERVATIONS ~NDIOR FROM DATA ORTAIIVED FROM OTHERS REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W, YOUNG HOWARD W. YOUN¢ SURVEY FOR: GRE~NSRI~t~ HOM~S, /NC. LOT NO 14, I EEW,~RD ACRES l~T BAYVIEW AT j GUARANTEED TO: BI~)/~//EW ' USUFE rl~'l.~ INSURANCE ¢OMPAN TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southolcl, N.Y. 765-2660 1 f Y 't