The URL can be used to link to this page

Home My WebLink About8245-zl~'OlhM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ............................ St MapNo. ~5~ BlockNo. ~ .LotNo, [ G conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~?.. ~., 19~. pursuant to which Building Pemit Nof~ dated ........... ~.. J. ~., 19~.q~, was issued, and conforms to ~1 of the requ~ ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is h '~k~ ~/~n E ON~ ~x ~, ~ ~td r: LLt a~ mhe certificate is issued to ..~.~ N.~O. (~... P~ ?J.~ ~...Z ~'.~ .................. (owner,! - :--- ' ') of the aforesaid building. su~ol~ county Depar~men~ of Health Approval ~EF ~ ~' S0- 1~7 .... ......................... HOUSE NUMBER ~ ~ ~ O Street ~c~, '~0~ ~o ~ v Bffilding Inspector FOF~M NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8245 Z Permission is hereby granted to: ~'k.,/:~ ~: ~,, '~'L' t,q Tr.. /-¢ c ~'t ~:-..~ .Ti' f.,,./ at premises located at ~ /~/OT~T~ --~A'~ (/'1 ~ ~' ~'~OP* ~ Lo~ ( G LE-~ W~'~ ~d~% ~q'n'~~ ........................................ ~ .......................................................... .; ...................... ~ .................... ~] .............. pursuant to application dated ~ /~ 1~ ~ and approvea by the Building Inspector. Fee $....~....?. .............. Building Inspector FORM NO, $ TOWH OF $OUTNOLD , Building Depmtment Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and st~bmitted in DUPLICATE to the Building inspector with the following; for new buildings or new use: l. 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-0 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 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 formation required to prepare o certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existincj dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date June 14, 1976 X New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~/~ North Ba~riew Rd ,5/~3' .E.../.O Jacobs Lane, Southold Greenbriar Homes Inc. Owner Or Owners Of Property ........................................................ Subdivision Leeward Acres at Bayview ................................................................ Lot No....~-.~...... Block No ............. House No...~..~...8..O... Permit No..~/~.~. ......... Date Of Permit lO/15/r~.~pplicant Gz'eenbriar Homes ~.z].o, Health Dept. Approval ....i.[n~..~.~ ........~..%~..~.J.'.~.Zabor Dept. Approval ................... ~../.....~.. .................. Underwriters Approval ..../~f..~.¢.~...j;~...~..~..o. ............ Planning Board Approval ............ .~.~.:...~.~...: ............. ***** 3res Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ........~..,...o..o. .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant Greenbriar Homes Inc. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.B.Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO, CONSTRUCT ,pRIV,ATE SEWAGE DISPOSAL SYSTEMS Approval tn construct said systems is requested,pertinent data herewith: Date 1-Applicant Gmsenbm Saw. Homes . PhoneBA .SX ~ 566-Sub div [eewamd Acmes Address 854 RQb n Ct, 8a~dw~,, ,N~,Y.. , ?-Section one 2-Detailed p~operty location s~s N. 8a~¥1e'~ ~ 8-Lo~ No. Hamlet ,~ay¥~ew Town $ou~ho|d, , 9-Private well? ,yes 3-Public water supply name Distance to nearest main ,,, 4-Lot Size: Width, O0 ft. Length ~,0,O ft. (als'o enter on center plot plan below: 5-Dwelling: Single Family ~( ; Two Family? ~ /Cellar? /X/.Slab? ~_~Crawl Space? lO-Proposed system: Septic tank ~ /Frecast y /Cesspools' ~_/Shallow pools il-Septic tank inside dimensions: Volum,.e Gals. Length ft. Width, ft. Liquid depth ..... ft. t£-Precast sections: / /Number/ /Square F't. Cesspools~: Block sizeL incs. D__ins. H ,ins. Total blocks below inlet: ~i~2 .... FLOT PLAN -~oo ~ ~ o G~ade ,~0 W.L. ~ ~ ~ Street [~ Data Feet sand 8 .~ ~ ,', ,"1 10 Capacity82 Gals. --1 O.P.M. I0 The Undersigned CERTIFIES: "Construction of authorized installations will be in a~,cordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewa~e~isposal Date," .~' Signed Owner or Builder ~ ' FO~ ~ALTH DEPART~N'T USE 6~'LY. Based on the info~ation presented herewith, it is '~he opinion of the Health De~ment, that an adequate and satis~o~ Sewage Disposal System Date. ,,, Signed > ., THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- ESJOHN STREET, NEW YORK, NEW YORK 10038 ,,a,,, Apri~ ~2, :~976 ,,,,,,,,~.,,o,,~,o.o,f,,e 8365~.9 N 278250 THIS CERTIFIES THAT Mr. W. Adel, No. Bayview Rd., Southold, L.I. 3ob 16 April 8, 1976 ~ ~tr~. [] ~,,a r~. attic & ougside$~e~io- ~o~ rot EXHAUST APPARATUS: Motor/s: 1-3/~hp 1 G.F.C.I. E NO OF CC COND.~ AW'G PEr. '~ OF CC CON i 4 , Southold, L.I..L±~/-~ Per~ 'n any manner; return to the office of the Board if incor¢ect. tow. sou .o' BUILDING DEPARTMENT ......... - ......: ' _ .... ~ INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ir~k and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according tb schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ and giving a detailed description of layout ofproperty rnust be drawn on the diagram which is part of this application. areas, 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 untl a Certificate of Occupancy shall have been granted by the Building inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of'a Building Permit pursuant to the Bu Iding 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildingsfor necessary./, / inspections~ ....//~, ~/J~"n ,,~. ,...~..=.:..: ..................... ; ............ ':1 .... ,...:. .................................. (Signature of applicant, or o~e, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · . GREB R HOMES , Name of owner or premmes ................................................................................................................................................... If applicant is a corporate, signature of duly,~u.~b, orized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ........ ..~...?..~...Z~.-~,. ....................... Electrician's License No ............................................. Other Trade's License No ............................................... C~Z~/m r~ ~r_/b,~-~- Ma No ~ :~ ~ot No /~ 1. Location of land on which proposed¢ ~w°rk will be aone.~.~4~) P ': ................................................... (-(.~M~¢ ¢-~] ........... Street and Number .~....,/~,?,..~;.,f,'~:,~,..., ,~,~,...~..,,~,./. ............ -.-~,-,~,, ............................................... ~ ................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy Of proposed construction: o. Exisiting use and occupancy ..~.>.~..".,~./~..~..' ........................................................................................................ Intended use and occupancy ................................................................................................................................ O 3. Nature of work (check which oppticabie): New Building,. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, .................... Other Work ................................................... ~ ~ ~ 6-- (Description) 4. Estimated Cost ................~....~..~ ........................... Fee ......... Z..6.~...~ ...... ~ ............................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ................... .~....~....~'.. .............................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent af 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 ..............~...4(..~ .............................................................................................. - I f 9. Size of Jot: Front ....... .Z~../,..~....~. ............................... Rear ....... .~...~.'....~...~. ..................... D, epth ...~..~. .................. 10. Date of Purchase .................. ../..~..~...~... ........................ Name of Former~. ,~wner ~...~,..~....~.~....~..-~......,~.~...~..~ ........... 1 1. Zone or use district in which premises are situated ...................... ./.~..~.. ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... ..~....~.. ..................................... 13. Will lot be regraded ............ Will excess fill be removed from,~re ises' ( _~Yes ("~No FI eof Ownero' re .sas 14. ,am pm' ~m~..,~i~..l~lt~, .......... Address ...~'.~..~lt.~./..~/..~..~', Phone No~.?...~./~..~. Name of Architect .............................................................. Address ................................ Phone No ....................... Nome af Contractor ..~[l~i~j~llI{..l~l~-~..i~; ................ Address Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ( c ~ COUNTY OF ................................ f~'~ ............. ~.~,,b~..~'~; ..........................', .................. being.duly sworn, deposes and says that he is the applicam (Name o~ Jnaividua~ signing contracT) above named. He is the ...... ~~ ...................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfarmed 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 tha~ the work will be performed in the manner set fo~h in the applicatio9 filed therewith~ Sworn to before me this / // ~ Z~ day of 0~~ , 19~~ /// ,~ /,/~ ~ ;:;:;";';';::. ........... ::::::::::::::::::::::::::::::: ....... . ....... ...... NOTARY PUBt~IG, S{~*o oF New Yor~ I[ OF HEALTH AD, N,Y, ~ /,5' 40/ NOTE: · = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE A, 1971 AS MAP N~2 5599 SUFFOI~t, COUNTY HE~TH DFL°;~TNE'NT sewage disposal ~rad water supply faaili!,iss fo~' t~.,-~ TNE [OCATrON OF WEt[S AND CESSPO0~ SHOWN HEREIN ABE FROM FIELD OBSERVATIONS ANDIO~ F~OM DATA OBTAINED F~OM OTHERS OC~ a~, /gz~ ~Y 2~, 1976 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUN( SURVEY FOR: Gt?EEIVBRIA R HOkfES, IN C. LOT NO. 16 "LEEWARD ACRES AT BAYV/EW" j GUARANTEED TO: AT BAY VI E kY USZIFE TIFI. E INSURANCE COM*°AN; /? NOI'E; · = MONUMENT SUBDIVISION! M~P FI£ED IN THE OFFICE OF THE CLERK OF SUFFOt tq COUNTY ON dUNE d~ 1971 AS MAP NO, 5599 REVISIONS YOUNG & YOUNG 400 OSTRAHDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. ¥OUN( SIIRVEY FOR: GP~EEIVBRIA R HOMES, /IV C. LOT NO. 16 "LEEWARD ACRES AT BAYVIEW" AT BA.YVIEW TOWN OF GUARANTEED TO: TOWN OF $OUTHOLD Bu[[dir,g /r, sDzctor,s Town Clerk Building Southold, N.Y. 765-2660 I l