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Home My WebLink About8253-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupancy No. Zfg.6. Q ...... Date ..... April..2, ............. , 19.7.6. THIS CERTIFIES that the building located at .N.. Road. ~:o .Ba.~tiew ...... Street Bayview Woods Estates Map No...5520 ...... Block No ........... Lot No, .21 .............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... October..22, ..... , 1976.. pursuant to which Building Permit No82531~ ... dated .... Oc.tober..22, ...... , lg.6..., 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. rivate. One. FAmily. Dwelling ..................................... The certificate is issued to . Ronald..Ste.v~not ..................................... (owner, ~~t) of the aforesaid building. Suffolk County Department of Health Approval . AP. ril. ,1,0 ,. 1.9.76...RObt....Vil;l,~.. UNDERWRITERS CERTIFICATE No. N2.7.~.~90...l~ar.qh . 15.,. .].97.6. ................ HOUSE NUMBER .5645 ......... Street No~th..Ro~d..go. B&~zvie~ ................ ...................................... ~ou~:h~,. N..Y ....... ./ .............. Building Inspector ]FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8253 Z Permission is hereby granted to: 8outhold ~',ome$ Inc, - Southold :~,. Yo .Z.o~zt ~o3.~i~..: ..... 2: ............................................. to ...... g.~Y:,.~.~gg.~..~...~&~.e...qr-m.f.~gJ.,~...~ll~r.g ........................................................ at premises located u, .................................................................... .~ ....................... ; ................... :. .......... Subdivision: ~ vzew ~oods ~stat~ 1,9 ~ ........................................ ~. ........................................ ., ....... .t,....;~:~ ...................................................... pursuant to application dated ........... Q~.~,O~.~Z'....~ ................... , 19.~.~,., and approved by the Building Inspector. Fee ~..~..*....~.. ............. Building Inspector FOF,~I NOo ~ TOWN OF SOUTHOLD , Building Department 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 oil 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, 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 HIdmg ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Ow,er Or Ow,ers Of Property ..~..~(H.~.~.-..~ ~ i~C, . Subdivision '.~....~..V'~'V¢ ~.op.[7,~ -.~..~.~.~-~ . Lot No ..~...! ...... Block No. ~.... House Permit No. ~-~,~} .......... Date Of Permit ~b::~.~'-.z.~....Applicant ob ~O~l~:~ ~t'J C .~u~..H ....... ~.....~ :~ .~. ........................... Health Dept. PP ............................................L .... Dept. Approval ................................................ Underwriters Approval .~..Z.?.~..~.?.~ ....... :~.Z../...~'..~.?..~.. ...... Planning Board Approval~z.._. ................................ Request For Temporary Certificate ........................................ Find Certificate~-4 .......................................... Fee Submitted $ .ff..,..o..~ ......................... Construction on above described buildir~j-e~d permit~neets all applicable codes ,and regulations.l-' App,ica.t ............. Sworn to before me this /~ lid ................ do~ of ............................................ (stamp o, s~d) . , ~//>*~'~r~ Notary Pub, c .................................... cou. , 6) : - THE NEW YORK 8OARD OF FIRE UNDERWRITERS o,t,. },larch 15, 1976 .4pplication~o.,,t, file 839484 Z ~a ~eveno~, s/w/cur, of~orta 3ayv~ex~ ~oa~ps ~oa~ aou~xold, L.I. tvas examirtqd on March 11, 1976 a)}d fou,*d to bt, in complitmce with tho requiretr*erzts of this Iloard. OUTLETS 16 32 19 16 ' [ I ~ i i l[ OTHER APPARATUS: -- ................... L_ I I Elec. ~oom heater/s: 4-1.Skw, 4--1.0kw, 2-.75kw, 4-.5kw ?4otor/s: 1-1/2hp 1-4.Skqq }Jot water heaters OVENS T~Ts~ ~H~ S'? EXHAUST 2/0 F. l~r. Brudi 1194 ~Vaverly Ave. I!oltsville, L.I. 11742 L I C.~,! 512 D Thi~ cerf,ficoie nlust not be altered in any manner; return to the off[ce of the Board if incorrect Jnspeciors mo5, be identified by tfJeirN,~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number~-~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant~o~,m 14o~,~ i~,~, Phone~l~-~'tq~ Address$1:~¥'~,~,, ~o~o~-~lg~ ~ 2. Property Lo~ation~s~ ~,~ ~.~ ~ Village ~o ~ Township~o~'~'~o~' 3, Public Water Company Name ~ ~o,v ~ 4. Lot size: Width~o feet Length.~oo feet 5. Subdiv.~' ~'5-~, 6. Section ~. 7. Lot Number ~. i -8. Private Well ~ '9. Public Water ~ Distance to main ------ 10. Sewage Disposal System: (For Health Services Dept. Use) 11; A~ 900-~?]lon septic tank: ~recast~ .Equivalent Block B. Leaching pools: ,. Number of pools Precas~'~-,~ Block_ Special If private ~ell, fill in the fol- lo~in~blanks: ^. lank capacity. 4Z .gallons B. Pump G.P.M. C. Total well depth D. Depth to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Heal th Services' 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 THE DEPARTMENT OF HEALTH SERVICES' USE ONLY. Based on the information presented here- with, it is ~he opinion of the Department of 'Health Services that an adeq]j~t~nd satis- factory Sewage Disposal System and Water Supply ca--installed on th~plg~t/. S-15 Rev. 4/1/73 18-157~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plat 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 ofpraperty must be drawn on the diagram which is part of this application. c. The work covered by this application may nat 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 of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, Now York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os 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 bulldlngs for necessary inspections. State whet~er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises SOda.C> .~.o~-~' If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License N .o2-. ........... Plumber's License No. ~ ~.'..~...~..~.~. in' Lin ......................................... Electric o s ce se No..~ Other Trade s I-icen~ No ............................................... 1. Location of land on which proposed work will be dcLne. Map No.: ~...~....~....o. ........................... Lot No...~...\~ ................. Street and Number ..~,~...~.?..~..~...~....~...~..~..~....~...~. .................................................... ; .................. ; ........................... Municipality 2. 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 ...~.....'~....~.....~...~....~.~...~-...~....~ ........................................................................................ ~3.~ I~ature of work (check which applicable): New Building ......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ....'~. ................................................................................................................................ (to be paid on filing this application) 5. If dwelling, number Of dwelling units .....~.. ..................... Number of dwelling units on each floor .O..~--,~......~'...L;..:......~.. If garage, number of cars ~'...o. ................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each t~pe of use ~ ............... 7. Dimensions of existing structures, if any: Front ............~.......~r ................................ Depth .................... Height ........................ Number of Stories ...................... ~ .............................................................................. Dimensions of same structure with alterations or additions: Front ............ ~ ............ Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ ' " : ' . .... '.4" --~4' ~ " 8. Dimensions of entire new construction: Front ..~'....~. ........................... Rear .~...~. ..................... Depth ~....'7.......~. .......... Height .~ ..............Number of Stories .~....~.....~.. ........................... ~ ........................................ )'9~'~'"~ ............ Size of lot: Front ./....~.~'~: .~)... ........................................ Rear ...~.~....~.. ............................. Depth ......~.. ...................... Date of Purchase .......... :.:.:., ....................................... Name of Former Owner~..:...~...~..)..~...O...L:..~.. ............................... Zone or use district in which premises ore situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ....~..~. ............................................ Will lot be regraded~.~. ....................... Will excess fill be removed from premises: ( ) Yes ~'(',d) No Name of Owner of premises ..~...?....'~.9....L?...~.9..~..f-...~...~.~..C.:. ...... Address .~....0.?...-1..~..O..~..D. .......... Phone No.-I.~.~:...~.?..~...~... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor u " " Address Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bcx:k 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. '10~ 11. 12. 13. 14. STATE OF NEW YORK, ~S.S COUNTY OF ....~ ........... ................................................................ being duly sworn, deposes and says that he is the applicam ~~JJl~ng contract) 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 tha~ the work will be performed in the manner set forth in the application filed therewith. ................. day of .... ': ........................................ ; ';;7 ............................. NOTARY pUBLIC, State of New No. 52.8125850. Suffolk Term Expires M~lr~h 30, BUILDER'S NO. TITLE NUMBER The se,~age disposal and water supPlY facilities this location have been inspected b~°t~his dep~.rtment and found KE'NNETH C. FRINK LIC£NiE(~ LAND SURVEYOR ROCKY POINT, L.I., N. Y. SURVEY Of LOT ~/ JOB NO. MAP OF ~ YV/~' ~7 ~100~$ ~'.5'T,,~TE$ LOCATED IN ~AYV/~ ~OWN oF SO~O~O . ~U~O~ ~0-~ N ~ SCALE I IN. TITLE NUMBER BUILDER'S NO, /V ~ ?° ~o / / SURVEY OF LOT 2/ MAP OF cC3z~ wv/£ ¼/ PLOT PLAN LOCATION , FINAL, JOB ':~" C FRINK KENNETH . L_~cEMsED LANO SdRvE¥OR ROGKY ~OINTi L.I., N. Y. ::- ,APPROVED Ag NOTE*'' "' '~1' NOTIFY BUILDING 'DEPAI;~E'NT AT ~ NOT RESPO~I~/E ~6~ DESIGN OR CON- ALL STRUCI'URAL LUMBER )SPANS r CONP£Y .AND L,I~ML' ': : CODLr. : ,,7.,