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Home My WebLink About8259-zNO. 4 TOWN OF SOUTHOLD BI. lit.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certific;,te Of Occupancy No.Z.69. 3.6. ...... Date ............. }tar...19 ...... , 19.~.6. THIS CERTIFIES that the building located at . .Deer..Drive ..............Street Map No. Daa~ .Park. Block No ........... Lot No..%7.. · ~4attt.tuek...Il,If., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............0¢.t... 23.., 19. ?~. pursuant to which Building Permit No...82.59Z dated .........0~t;.. 21% ...... , 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 Private..one. family..dveJ, ing ......................................... The certificate is issued to .William. le~n~th .... Owner ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Mai'...16...1976..by. ~.. tlill& .... UNDERWRITERS CERTIFICATE No..Ii2.72.279.. i~ar.. 8.19.~6 ................... HOUSE NUMBER ..... 380 ..... Street .. l~er. D.~ive ............................ FOI~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THtS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8259 Z Permission is hereby granted to: ~.~.L~.~.~ ....... (:!..~.,~.~.,..~...~..~.~ ................ ...,~./~..., .~!!.-, ?...~/?.~. ........ ~.~-:.:..~,. ,~,~. ~. .......... at premises located at .......................................................................................... ........................................................................ ~..A..~.....:~: ~..~...q'. ............................................ ............................... .~..~. .............................................. :~ ............................. ~.0.¥ ...................... pursuant to application dated ................................ ..~...~.,Z.......~...~....., 1~...~....., and approved by the Building Inspector. Fee $.....~. Building Inspector 241 FORM NO. 6 TOWN OF $OUTHOLD , Building Deportment · Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink., and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--($-9 form or equal). 3. Approval of electrical installation from Board of Fire U]nderwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, o 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-ex'sting" land uses: 1. Accurate survey.of property showing oil 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 o certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existi~g dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date March 17, 1976 New Building .~..L.~. .......... Addition ................ O~d or Pre-existing BuiLding ................ Vecont Land .............. Location Of Property N/$ o£ Deer Drive~ l~attituck Owner Or Owners Of Property .:~..~.~..Z..~:,~.,~!...~...e.j,.~,~..[.h. ................ . ................................................................ Deer ,Park 17 . BI ............ Subdivision .... : .......................................................... Lot No ............ ack No. House No ............. Permit No..,~.~..5.?...Z. ....... Date Of Permit .]f..O../...~.~./....7..[?.Applicaflt .................................................................. Health Dept. Approval .H.a.~...c..~.....l...6../...7...6. .................. Labor Dept. Approval ........... .Y...e.S. .............................. Underwriters Approval H..,~.~C..~...,.8../,..7..~...,.N..~..~,2,.,7.7.~...Planning Board Approval Yes Request For Temporory Certificate ........................................ Find Certificate .......................................... · 5.00 Fee Submitted $ .................................... Construction on above described building and permit meets all applic9ble codes and regulations. / Applicont ......................................... ~..~ I~land Homes Sworn to before me this ....... 1.2.... day of .............. ....... Notary Public ......... ,...~~ County Inc.- Kenneth~]W. Thurber (stamp or seal) ~ ~.~ ~, ~ 'r'w i,,E NEW YORK 5OA D OF IRE -- ak BUREAU OF HLECTRICITY 8~ JOHN ST~T. NEW YORK. NEW YO~K 10038 ~'"'" March 8, ~976 Jpplicutio, No. onfile 837734 otdy the elec tr~cal equipment ~ ~zcrlbed belo~ a~ introduced by the aoollcant ~a---J ~ .r- ~ ,. . , . William Keingth, Box 425, Deer D~ive, Mattituck, L.I. OUTLETS :RECEPTACLES, S~TCHES 'iNCAHOf~ENT FIXTURES RANGES COOKING DECKS OVENS ; DRYE2S FURNACE MOTORS ' AM~ KWh! OIL . p. I GAS [ H.p. ~_~100 j CB *F'dture Motor/s: "i .G.F.I. r j J I : 2 ~ I ~ appliance feeder/s: 1-3#8, 1-3#10 1-3/4bp Walter Finger, . BOX 991, Mattituck, L.I. 11952 Llc.18~SE ~*_ ~correct. Inspectors m. ay~Dej~ identifie~ b~t,~ . 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. Appl~cant_/j~j V- ~}~9~/ /~'~/~7~~ Phone .~Z~(~ J'~O ~ 5. Subd~v. /~C Address ~O>q~2Ji~ ,LX~/~ ~,~ ~ (~,~ 6. Section 2. Property Location~~ ~x~)~O~ ~ ~A~ ~ 7. Lot Number ~O~U~ ~A~'~/?~'~ ~'~ 8. Private Well ~llage ,~q~ .... ~c~- ~ToWnsh~p ~o~-~0~ , 9. Public Water' 3. Public Water Company Name ' ] D~stance to main 4. Lot size: Width I~O feet lO. Sewage Disposal System: A. 1,90~ga]lon septic tank. Precast ~/Equivalent Block B. Leaching pools: Number of pools q/ Precast~/[u Block , ,Special 11. If private well, fill in the fol- lowing blanks: A. Tank capacity V ?, gallons B. Pump G.P.M. C. Total well depth D. Depth to ground water E. Amount of water in well Length l~,~~ feet (For Health Services Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' current standards thereto." This application will be valid f~r one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in ~/ffect. / Date /~ O¢~?-WJ/[~-'~' / ~ '~5-' Si gned~~. . ~,~_~.~2· , FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE SI N D S-15 Rev. 4/1/73 ~ , ~ C~.~ ~ TOWN OF SOUTHOLD u-- '~ ' ~ r.~.~-~4 ~ ~O~ TOWN CLERK'S OFFICE ,. -- ,~ ~ r~ ~ ~ SOUT.OLO, a. ..................................................................................... ....................... (~ APPLICATION FOR BUILDING PER~T~ , . ~ ~TX'~ ~ -/~ Date ~ober ~ ,19 ~ '~ ¢;-~ ~ ~/( INSTRUCTIONS ~. This opplicotion must be completely filled in by typewrite~ or in ink and submitted in tdplicot~ to th~ Buildin~ Inspector, with 3 sets o~ plans, occurote plot plon to ~le. Fee occordin~ to schedule. b. Plot plan showin9 location of lot ~nd o~ buildings on premises, r~lotionship to odjoinin~ premises or public streets a~e~s, and ~ivin~ ~ detailed description o~ Ioyout o~property must be drawn on the d~gmm which is p~rt o~ t~is ~pplicotion.~ c. The wor~ covered by this ~pp[icotion m~y not be commenced be~ore issuance o~ BuHd]nO Permit. d. Upon ~pprov~l o~ this ~pplicofion, the Buildin~ Inspector will issue ~ Buildin~ Permit to t~e ~pplicont. Such sh~ll be kept on the premises ov~iloble ~o~ inspection throughout the wo~k. e. No buildin~ sho]l be occupied or used in whole or in port ~or ~ny purpose wh~teve~ until ~ Certificate o~ Occupancy shell h~ve been 9ranted by t~e Buildin~ Inspecton APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the,C. Building 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, buildings for necessary inspections. ...... ................................................. (Signature of applicant, or name, if o corporation) ~x 11'7, }~ttituck, (Address of applicant) Sta~e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,<~neral Con~rac~o~ William Kei~ a~h Nome of owner of premises .................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... 2'73-E Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ................ >. ............................. 1. De~e~ Pazk 32.O~ 17 Location of land on which proposed work ycill be done. Map No.: ........................................ Lot No ......................... Street and Number Dee~ D~zve~ Iv~t~i~uck Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Vacen~ a. ExJsiting use and occupancy ................................................................................................................................ ti . Family b. Intended use and occupancy ................................................................................................................................ 3. * Nlature of work (check which applicable): New Building .~..'~.. ....... Addition .................. AlteraJioB ' Repair .................. Removal .................. Demolition .................... Other Work ~ (Description) 4. Estimated Cost ............................................................ reu .......................................................................................... (to be paid on fJlJn9 this application) 5. If dwelling, number of dwelling units ....... .1. ................... Number of dwelling units on each floor ............................ If garage, number of 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 ..... ~ .......................... l~eor ...... ~ .................. Depth ..~..4. ................. Height ~J Number of Stories '1 '1/~ 9. Size of lot: Front 130 Rear 130 ....................... Depth 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........ l.a..O.. ........................................... 13. Will lot be regraded . ......I~'..~.~ ............. Will excess fill be removed from premises: ( ) Yes (x) No 14. Name of ....... w ............................................................. Address ................................ Phon~ No ....................... N~e ~ Architect .............................................................. Address Phon~ Name of Contractor Ii;LA.~D IICHI~S, I'~C. Address .P..:..O..:...~..O..x..1..1...7. I~otnte~No' 298-96g'6 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram propmCy 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, ~ S S COUNTY OF .~l.~.~.~[k .............. ~' · ........................... P,7~bal?.~..IiJ~.'l~ ......................................... being duly sworn, deposes and soys that he is the applicant (Name of individual 'signing contracf) above named· He is the ............................................ OOZtt~.~,'~O.~. ............................................................................................................. (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 application filed therewith. Sworn to before me, this. " .......... ~,.~'6~.t%.... day of ...... Oe:J;o]:lezl. ..................... , 19...].5 No~tm¥ .Public, . ......................... ~,l,ii'.¢.O.],k, ........ County ....................,%~..~ ......~,..../.~..~.~ ....~ .................... ,~l/j // ,.~._~ ~ /~ ,,-, · . ~.-*~*'-'-,-~ (Siqnature ac[ ogplicant~c~ · No. 52-8125850, Suffnlh Cou y Term Expires March 30, 19~..~ L..o4 L' ,fY TOWN OF SOUTHOLD Buildir ] Inmector's Office Town Clerk Building 5cutho~a. N. Y 765-2660 J ./ 'i .I J