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Home My WebLink About8251-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N. Yo Certificnte Of Occupnncy No...g.6.~.~.? ..... Date ............. 1~.~.1'...3 ........ , 19..7.6 THIS CERTIFIES that the building located, at ....E.o~.t;h..B.a. yF..~.e.w., g.o.a.d. .... Street Map No...L.e..e.w.~.r.~. A~lloek No ........... Lot No..9 ..... $.o.15t..h.o.l.d....E.,.Y., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ .0.C~;...~L8., 19..7.~ pursuant to which Building Permit No... dated ............ Bet.. 20.., 19..7~, 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..l.~'.a.~.e...o.~..f..~l].¥..d.~.o.Z.I.:[Bg ..................................... The certificate is issued to .. All~r.t..J.,..~el~et~ ..... v.~a~r .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Feh... 2~... ~ 92.6.. b~..tl,..V, ille~ .... UNDERWRITERS CERTIFICATE No. ~.1.0~3 .... F~h..~...~10~.~ ................ HOUSE NUMBER .... 7.380 ..... Street ..... l~orl;h. ~ytrt~w. ~oad ............... FORM NO. 2 TOWN OF SOUTHOLD 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) 8251 Z Date ......................................................... 19 ...... Permission is hereby granted at premises located at ~f O/-¢T Fi- ~ ~' t/t E ~.*; ~'~ OAJ~ pursuant to application dated ............................... ~..~ .......... (.~, l~.:.b!.., and approved by the Building Inspector. Building Inspector FORM NO. S TOWN OF SOUTHOLD , Building Deportment 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: 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 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 Date . ,~.,...~, .:......;....~ ....... ~..~.~. ..... New Bqilding ...,,.'~ ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Owner Or ~ners Of Prope~y ...... No mock No ............. Hous. Permit No. ~:~.J...~... Date Of Permit (~¢~?:~:~Xpplicant ..~ ' ~ , ~ , ~/~7 / Heolth Dept. Approwl .................. ...... --~ ~pt. Approwl ...... ,....~ .............. ~ ' ~T/~/ · . ........................ Unde~riters Approval .~..~.,.~..L~../.-~ ................. Planning B~rd Approval ~ ............ Request For Tempora~ Ce~ificate ........................................ Fin~ Certificate ...... ]~ ............................... Fee Submitted S ....~..(~.~ ................... Construction on above described building an~d~permit meets all apg{~cable codes and regulations. ~ ~ ........................ 7~.t..7,.~ ...................... ~ ............................... Sworn to before me this ;>// ..... ..... .................... Nota~ Public ..........~,.L~..,. Coun~ NOTARY PUBL~, State of New Yor~ Ho, 52-812~50, Suffolk County Term ~xpir~ M~rch ~0, THE NEW YORK BOARD OF,;FIRE)UNDERWR1TERS,:!:=:: Mr. A. Stienmetz, North Bayview Rd.,~s/o~Jacobs'Lane~ .=~,'='~=,: :~,~' 33 OTHER APPARATUS ' *Furnaces: Oil t-1/8hp~ l~l/12hp Motor/s: 1 fr.hp : : : . ~-15 amp. G.F.I .['::- ~;:= Southold, L.I. 11971 . SUFFOLK COUNTY DEPARTMENT OF HEALTN H. D. Reference No3~-J'd '- EASTERN DISTRICT, RIVERHEA~,N.Y. APPLICATION FOR A, PPRO~AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is requested,pertinent data herewith: ' 6-Sub div 1-Applicant P ~--'~ ....... ~ ?-Section , 2-Detailed property location ~/~ N~ ~ l 8-Lot No. Hamlet ~W Town ~ 9-Private well? . 3-Public water supply name Distance to nearest main 4-Lot Size: Widtb~ ft. Length~ ft. (also enter on center plot plan below:) 5-Dwelling: Singl.e Family ~X~ Two Family? ! /Cellar? ~/.Slab? / tCrawl Space? lO-~Proposed system, Septic tank .~ /Precast ~/Cesspools / /Shallow pools / /Other ll-oeptic tank tnsi.de ~imensions. Volume~ Gals.Length ft. Width $ ft. Liquid depth~ft. 12-Precast sections. ~JNumber_~/square '~t. Cesspools: Block size~..incs.~ 8 ins. H ~lns. Total blocks below in, et: ~1____~2 #3 .... PLOT PLAN Capa city~ Gals. --1 G. P.M. ,Grade G ,W.L. Data ~eet ~'~, 0 '~> 4 6 '{" 10 ~ 12 14 18 ~ ~o Street Ne~ ~1~ ~ ~ ~ ~ Ind5 ~ate ~ < ~ c~ ...... Nc ,th The Undersigned CERTIF~S: "Construction of authorized installations will be in accordance with the Suffolk Count7 Hoalth De~rtments' current Standards, Bulletins~ and amendments there?;, covering Privat~:~age Dia~s~~' . ~ FOR ~ALTH ~EPART~NT 'USE ONLY. Based on the in~' ~ation ~resented herewith, it is the opinion of the Health De~rtment, that an adequate and satisfacto~ Semge Disposal STstem can be installed on this Plot. Date Signed ( 10/65 Revis.) ~- ' TOWN OF $OUTH~'~' V /~ TOWN CLERK'S OFFICE ,_. /~ ~ SOUTHOLD, N.Y. ~ /'~ Examined ................... ~ .......... , 19 ........ /A~lication ....... ........ ................................ ~g~-APPLICATION FO" BUILDING PERMIT INSTRUCTIONS ~ a. This application must be completely fiJled in by typewriter or 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 or areas, and~ giving a detailed description of layout of property must be drawn on diagram which is part of this application. ~ c. The work covered by this application may not be commenced before issuance of Building PermitJ ~ 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 r, granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building ZoneL~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction o~J~ 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 necessary inspections. . - R~e., ~ ..~la~k .l~,..~halcl ~N., l ~ ..11971 ........ (Add~? applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................... 9.~.~.r...~.u~-~.~ ................................................................. ;~., .................................................... Name of' owner of premises .....A..Z~.....i~.....J..;...B..?~.[.~ ....................................................................................................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ~. AR1) Aa.~,,~,,,6,? B.,A.~?J.,.]~., '-'"~.~)t No 0. ... Street and Number ...... ~.O.~.~....]~..~..V~...~..~.O...A~.. .................................................................... ..B,~..~..t~....K~,,..-~...S..O...U~...H..O...Z~,. ....... Municipality 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ?, .......................................................................................................................... b. Intended use and occupancy ...,R,,.~_,.[,~,~..,,I~, ,[~,,,~,..,,~g,,,,l~.. ............................................................................................... 3' "Natur~ of work (check which applicable): New Building ...~ .............. Addition ..................... Alterati~)n:;.:..;:.....:; Repair ............. ............ Removal ......................... Demolition ........................ Other Work .............................. ...... 4. Estimated Cost .~.~..0.~..0..0..0. ................................ IDescription) Fee ............... ; ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...1~i~ ........ Number of dWelling units on each floor ......................................... 0N~I 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 .~;....~5.~. .............Rear ..... .~5.~. ................. Depth .2~.~...~..215 .............. Height ........ .3:.2..~. ................................... Number of Stories ..... .0....1}~. .............................................................................. 9. Size of lot: Front 100' . Rear ....~,~(~.~. .............................. Depth ....l~0.0. ........................................ 10, Date of Purchase ,,0~+~cl~a~c...~.7.,5 ............. Name of Former Owner ....~..,,Ii~..A....I~....A..C.~,,~S.....I..~..C..; ...................................... 13. Zone or use district in which premises are situated ....~..,,~. I..~..~...I~.....T~...~,. ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ I~. ................................................ 13. Will lot be regraded --~.Y-]~.. ....................... Will excess fill be removed from premises: [ ] Yes [×] No 14. Name of Owner of premises ....l~]il~]~ ........................................................................................................................... (Address) (Phone No.) Name of Architect ....................................................................................................................................... ... ..... . .. · · · (Address) (Phone No.) Name of Contractor ................................................................................................................................................... (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 street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. ~' O~) r STATE OF NEW YORK,,-~, ~ ) COUNTY OF ....~...,.../.:...~...c...,...'..~ .................. ) ~ .......... ~.~.~..~..:~,:.....J.~...~.~...~ ....... being duly sworn, deposes and says that he is the appli~nt above named. (Name of individ~l si~ing con~act} He is the ................ ~..~...~.~.~..~.~ .................................................................................................................................................. [Contractor, ~t, co~rste o/~cer, etc./ of said owner or owners, and is duly authorized to ~rform or have perfor~d the said work and to make and file this application; that all statements contained in this application are tr~ to t~ best of his knowledge and ~iief; and that the work will be ~rformed in the ~nner set forth in the ap~cation filed therewith. ~ .............. ~..u ......... ~v~x....=~ .......... ~A~.~.&~.~,~ [~ / / /~ SUFFO~ COU~I'Y H2~ALTM D~PAR~ f~i.[~%!o~ fo~, this loca%lon have been t~.~(,'~ed by tl~S d~partment ~]d found TEE ~'OCRTJ'ON OF WEJ, L,¢ ~iND CE$,~POO[E SHOWN HEPIEIN AEE Fl~03¢ 'I¢~,D OBSE~VATION~ AND/OR .FRO.~,f DA~'A C~TAU'L£D FP~OM OTHERS R EVtSION~5 NOTE: ~--~ONUI~EIVT SUBDIVISION MAP FILED IN ~IE OFHCE OF THE CLERK OF ~F~ C~Y ON JUNEL, 19FI AS FILE NO 55~ YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, HEW YORK ALDEN W, YOUNG, SURVEY FOR: ALBERT STEIIVM~TZ ~ I O T IVO 9, " I EEMIARD HOWARD W. YOUNG ~URVEYOR AT BAYVIFM/ TOWN o~ SOUTHOID ~o~ 4"~c~ ~sto~ °0o~, . ....... -~ ! ~f4. R la'VISIONS £ NOTE: I = MONUMENT SUBOIVI$10N MAP F/LED IN THE OFT/CE OF TN~ DL£RK OF SUFFOLK COUNTY ON JUNE4~Ig?I AS ~TLE NO YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUN( SURVEY FOR: 41BERT STEINMETZ ~ lOIS STEINMETZ .ow.o. ~o~.o~TT :~?).1 'i TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N.Y. 765-2660 i APPROVED .~S ~OT~r.p NOTIFY BUILDII~G OEPAtI'TMENT AT 65-~,660 9AM TO 4PM FOI~ 'REQUIR- iNSPECTIONS: 1 BEFORE BACKFILLING FOUNDA- TION OR STAP~T FRAMING ]. BEFORE COVEB. ING pIPELINE ]. ,FINAL WHEN lOB COMPLETED C) '