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HomeMy WebLinkAbout8260-zFOltM NO. 4 TOWN OF SOUTttOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..Z680~ ..... Date ............ ,Za~. 21~ ........ , 19..76 THIS CERTIFIES that the building located .at 8~tt~l.~te~ .Ave ........... Street Map No. M..8.Ra~ · · Block No...~ .... Lot No~l~0.l.~....Stil.twate.~ .Ave..C~teho~e conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 0et. · .2~... , 1~.. p~suant to which Building Permit No... 8260Z dated ............ Oat.. 2h ·., 197.~., was issued, ~d conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private..o~e. f~ll~ .dwe. ll~ ........................................ The certificate is issued to ~onaF~. ~alte.~S ....... ~e~ ......................... (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval Dee., .~9.,...~9~.-by .R,. ~illa.... UNDERWRITERS CERTIFICATE No.. N..~0~.~ .... ~.. ~. 1~ ............... HOUSE NUMBER ... 2900 ...... Street . -Still~ate~ .A~ ...................... ·. B~lding Inspeet~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N; Y. BUILDING P. ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8260 Z Permission is hereby granted to: ~..~.J.L.~.L~ ...... j.~.t.~3.~.:~2. ....... ~....~. ...... ...~./~.....L~..o..~:~.¢.~b ......... at premises located at ............... ~...-~'..I...IJ,,...~...~...'~...f~...-~ ......... A.~J~. .................................................. ......................................... . ....................... ~..U...~.C..f..t ...o....~...~.~...~.....~..~.:.~£. .............................. L~'~S Wg- D-o- ~1 /~ ~r~-~ .~..~.c.:lT /,.-;.a:~'~ IZZ~f3. ...... .t.$. ....................... ~ ........................... pursuant to application dated ........................................................ , 1~...~..., and approved by the Building Inspector, /0 Fee .... FORM NO. ~ 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 U"derwriters. 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, pccupancy 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. Certi(icate 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 Jan~e, zy 12, 1976 XXXX New B~i[ding ................ Addition ................ Old or Pre-existi~g Building ................ Vacant [-and .............. Location Of Property .S.~.i...1..1...w.~.~...e..r...,,A.Y..e..t?..u.,e..l.....C.~.,.t.,.c.,h.,~g}}.~ ................................................................ Owner Or Owners Of Property ....!i.~.~.o.~.~..~.~..d...!~.~..~..~.?..~.?. ............................................................................... Subdivision ................................................................ Lot No?~.7..5..O..~ock No ............. House No ............. Permit No. ~..~..~.~.~. ........ Date Of Permit ?-:.0.../..2,.~.../.~..5..Applicant ~.~..~...~.P...~....~.{..~..m. 9..~.~..,~.7..c.., ........................ _ 5-S0-155 12/29/75 Health Dept. /~pprova/ ............................................ Labor Dept. Approval ............... /..:....LLT. .................... Underwriters Approval .............................................. Planning BOard Approval Request Pot Temporory Certificate ........................................ Fin~ Certifi¢ote .......................................... 5.00 Fee Submitted $ .................................... Construction on above described building and permit meets all a?~icabl~Z/ ~g,~J~'~"--~e c/e~a~ti~k Applicant .................................. L. ~ ' ._~ ._. t ...~. ~~ Sworn to before me ............... day of , '7 Notary Public ....... ~.. I? LA'r,:D ]~OMES; 2unht INC. - Kenneth W. Thur~-~er (stomp or seed ~_~/~ ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY - 85 JOHN STREET~ NEW YORK. NEW YORK 10038 ~'""' January 8, 1976 ~PPt'ca'i°"'N"'°"/ile82890¢ N 284055 THIS CERTIFIES THAT only the electrical equipmen! as described bele~ and introduced by the applicant named on the above application number ir~ the premises Leonard Walters, w/s Still Water Avenue, Cutchogue, L.I. Job 237 intheyoliowlnglo*atlo.~ g eas~m*~t 9 t~. ~ 2~ rt, outside S~,~o~ ~:o~ t~ 49,50~; ' a~ fou~ to be in compliance with the requiremen~ of this Board, FIXTURE I I t FIXTURES I lX 28 10 13 DR~ERS FURNACE MOTORS FUTURE APPUA~E FEEOERS EANOES ICOOKING DECKS I OVENS [DISH WASHERS EXHAUST FANS fPECIAtREC?' TIMEC[OCK$ "Eli UNIT HEATERS M~SI~[ET[ DIMMERS SERVICE DISCONNECT '~' 1 ,100. CB " Motor/s: 1- 1/2bp George Zlmllnghaus ~ ParkPLace Patchogue, L.I. ll??2 S E R V C E 2 I ~ ~ 273E OENE~A[ MANAG~,~ D This certificate must not be altered in any manner; return to the office of the Boqrd if incorrect. Inspectors may be identified by.,their credent;als. SUFFOLK COunTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 10. i. Appi';.cant :11q-L~:~11)IiC,,~ :[iqC Phone 298-9096 Address. Bo~c 1~7~ ~'Jc~tti'c~cl~, N,~. 1tg52 2. Property Location Stillwater Avenue V~:lage C'atc~o~e Township_$ou$hold 3. Public Water Company Name nQ 4. uot size: Widthl5$ feet Length. 162 feet Sewage Disposal System: 6. Section 7. Lot Number~9-so-SZ 8. Private Well yes 9. Public Water Distance to main (For Health Services Dept. Us,e) il. A. 900-gallon septic tank: Precast >O~Equivalent Block Ee 2 Special__ in the fol- gallons B. Leaching pools: Number of pools Precast ~ Block If private well, fill low~ng blanks: A. Tank capacity 8o C, TQtal well depth 80 D. ~¢pth to ground water Am6unt of water in well 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 for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. Date Octobo~ 13~ lg?$ Signed ,, ¥(,.,,.~,~;mw ~ m~7~,),~ =========================================================================== FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presentec here- with, it is the opinion of the Department o'f Health Services that an adequate and sa~is- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATg //~7/~x7 SIGNED ~'- ~., ~' S-15 Rev. 4/1/73 TOWN Or SOUT. OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE APPLICATION FOR BUILDING PERMIT '~ ~ ,~t- ~ ¢~,~ jx.~ INSTRUCTIONS ~ ~ ~ ~ Inspector, with 3 set~ of plo,ns, 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 o~ areas, and giving a detailed description of ~ayout ofproperty must be drawn on the diagram which is part 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 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 CounW, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or afferations, 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 necesso~ inspections. ~ (SiOn~ture o{ applicant, or nome, if a corporation) (Address of applicant) Sta~e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . )...q:9..h.~}..~.~g.J;.'J;eZ/'.~ ............................................................................ if applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......... .J..1..i.Z..~ .................................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ...................... : ................. Lot No ......................... Street and Number Gtill~¢o~ b*v~:~,ue .......................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy 'Va. ce~ b. Intended use and occaponcy % lr~lS/ 3.. Nature ~)f 'wbrl~ (check which applicable): New Building !.~?~..X~... ........ Addition .................. Alteration ...~.~..,' Repair .................. Removal .................. Demolition .................... Other Work ......................... ~ ............................. t~_~~ (Description) 4. Estimated Cost ,,~2:~,;OU.O{) Fee .......................................................................................... (to be paid on filing this application) 5. if dwelling, number of dwelling units ............ .1.. ............. Number 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 c~L~entire new construction: Front~ .....iQ ........................... Rear ....... ,SP ................ Depth .....~...6. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ~.'~! ................................................. Rear ........ ;~.;'i;~ ........................... Depth ...~.'6~ ...................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] 1. Zone ar use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation:,'~ ...................................................... 13. W. ill lot be regraded ..... Ye~.........._........... Will excess fill be removed from premises: ( ) Yes ( :~ No 14. Name of Owner of premises Leon&z'd W&l~-~ Address Phone No, Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ~.....~...i~..D...!.f.?J..~.~.~.....~..L.':.C..: ................. Address ................................ -~'none 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 whether interior or corner tot. \, STATE OF NEW YORK, t e c COUNTY OF ...~qU£~folk ............ }'~'" ................... i{D.b~..~..l-li],.~z, ................................................ being duly sworn, deposes and says that he is the appHcam (Name of individual signing contracf) above named. He is the ....................................... QQ~aD.~Q~ .................................................................................................................. (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 ali statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this Noto~ Public, . .................... ~Uf~O~ .............. Coun~ ....... ,-~~ ................... ~., ....... ~..~ ................ ...... ~ k( ~ ~(Signature of op~licon~ ~ ' ELIZAItEIH ANN NE LLE J %\ REVISIONS TITLE NO. ~86,694 YOUNG & YOUNG SURVEY FOR: LEONARD WALTERS ~ BETTY LOTS 49, 50 ~51 'M S, HA~D, S[CTIO~ TWO" CUTCHOG UE TOWN OF SOUTHOLD 0 NOTE: ~L~.V4TION$ 4R~ ~N¢~O ?'0 AN ASa'~IM~O OATUM. TEST HOLE 0.0 TOP SOIL THE LOCi~TION OF WELLS AND CE$SPO0'/'-S SHOWN HE~E~N ARE F.qOM FIELD OB'~ERVATIONS AHDIOi{ FROM DATA OBTAINED FF, OM OTHEI{S R£VI$1ONS YOUNG & YOU ~e.9~ 400 OSTRANDER AYENUE, R[VERHEA[ ALDEN W. YOUNG HOWARD W. YC SURVEY FOR: LEONARD WALTERS & BETTY L WALTERS LOTS 49, 50 &51 'M S. HAND, SECTION TWO" AT G UARANTEE'.'D TO: CUTOHOGUE COMMONWEALTH TITLE CO. ISOUTHOLD SAVIN'$ :A"K TOWN OFSOUTHOLD ' SUFFOLK CO., N.Y. ~~ ~ ,"=.o ,! APPROVED AS NOTED ~,,,T~: ' °/.t ~'/~/- NOTIFY BUILDING D~PARTMENT AT 765-2660 9AM TO 4PM FOR REQUIR. ~ INSPECTIONS: 1 BEFOR~ BACKRLLING FOUNDA- TION OR START FRAMING 2. ~EFORE COVERING PIP~LJNE 3, ~I~AL WHeN JOB COMPLETED TOWN OF $OUTHOLD Building Inspector's Office Town Clerk Building 5outhold, N.Y. 765-2660 APPROVED AS NOTED NOTIFY BUILDING DEPARTA4ENT AT .... 9'65-2660 9AM TO 4PM FOR BEQU/B. ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA. ....... iii'A_ ]_ )"