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Home My WebLink About8271-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificete Of Occupancy v o ~ast IOCa[eu az ......... : .................. o~ree~ THIS Ct~R~IFIF~S tl~at the building .... Narborview Ay 621}9 ................................. Map No .....' ........ Block No ........... Lot No, 6 I~ttitnok conforms substantially to the Application for Building Permit heretofore filed in this office oct 29 ?ff ........ dated ......................, 19 .... pursuant to which Building Permit No. 8271Z dated .......... .0¢.~. .... 27.., 19..~.~, 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 dwelling The certificate is issued to George & Zaph~.l~i~ C~brieZ 0~ers (owner, lessee or tenant) of the aforesaid building. June 1 1976 by R.Villa Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No, N. ,~.~.71.~.~. ..... ,J.t~. ?.,. ,~.. fi.??.6, ............... HOUSE NUMBER .............. Street .... ~, .r~. ,e.~ ,?.~P3f. ~.a.s.~. .................... ~ ~ ~ Narbo~view Ave Carpets ere by/ owner Building Inspector TOWN OF $OUTHO~D BUILDING DEPARTMENT TO~H CLERK'S OFFICE SOUT~LD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8271 Z Date ...................... Permission is hereby granted to: pursuant to application dated .................. .0..~.~......~. ..................... , 19.~.~.., and approved by the Building Inspector. ' ' Buildin~ Inspector I BOARD: OF FIRE ,UNDERWRITERS ':% W;B,' RUTM ahd ~!:':, '~ .~' ~ - E ectri~ '~n ~,,-I,I,' : ~ , '::!-: ,Matt [t. uck~ ~; I.... ' ' ' :~-,, L ~ c 242 This cefl~ficote must not be.';tt~e~iq 'a~ monner;~ return to'the office of the ~oard if incorrect, inspectors may ~e identified ~y t~c~denti [ TOWN OF SOUTHOLD , Building Department Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Insteuctions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. Final survey of property with accurate location of all buildings, property llnes, streets, and unusual natural or topographic features. 2. F~nol approval af Health Dept. of water supply and sewerage disposol--($-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters, 4. Commercial buildings, Industrial buildings, JV~ultiple Residences and similar buildings and installatlons, 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-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-existlr~j dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ..... ~ ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Owner Or Owners Of Property .,,~ .......................................... :'; ............................. :~..~. ............................. ................................... ~.Lot No....~ ....... Black No ............. House No...Z~.~. .... Subd,v,s,on Permit No...,~,.,~,,.?.,.!..~.~. Date Of Permit !~. ............... App cant ...,,~.,~,?',,~,.~...,~,,.~i!.,,~,.~,,,: .............. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate ..f.~. ................................... Fee Submitted $ .................................... Construction on above described building and~rmit meets all al;~icableJcodes,~}nd Appl,cant ........ ........' .................................. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) 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~E Address ~-~/,-~<,~ ~%1~t2 ~,~ (~0,~ ~, 6. Section 2. Property Lo6a~ion~]o~[~}~[~)~tlk~bt2 JUt 4~~ 7. Lot Num~ ]~L~' ~U~E~x ~S~~ , ' ~ 8. Private Well V~llage ,~,]'~T~Qq Township ~n~F~L~ 9. Public Water 3. Public Water Company Name Distance to main 4. Lot size: Width_l~(~ feet Length /~ feet 10. Sewage Disposal System: (FQr Health Services Dept. Use) A. 90,O,~qallon septic tank: ~recast ? Equivalent Block B. Leaching pools: Nu~r of pools' Precas~B1 ock 11. ! )f private well, fill · )owing~6)anks: A. Tank capacity ~'~/-~x B. Pump G.P.M. Special in the fol- gallons 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 Coun~ Department of Health Services' current standards thereto." This application will be valid for one year from the date or, approval indicated below and may be renewed if a current local Building Department Permit is in effect. Date c}OC si nedJ: 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 Syste~nd Water Supply can be Installed ?n~thlS plot. APPROVAL DATE~ ,I., "~ ~ SIGNED ~ S-15 Rev. 4/1/73 EXCAYATI I PI CT/Ofl R[QUI O FOB~ NO. !' ' ~ BUILDING DEPARTMENT~ / ~ /_/ _ TOWH CLERK'S omCE ~ /~ ~ ~ ~ ~ ~ ~UTHOLD, ~, 19.~.~ Examined ........ ~....__._. ....... ~ ~,~ ,,~ ~"x~"~ ............... ~,ov,~ ................ '.: .......... '.L ......... , ~..~j. ,~,~ No...~..~.d...~./~ ~ ' ~ ~ .......................... ....... APPLICATION FOR BUILDING PE~IT ~ ~''~ ~ ~ ~ ....................... INSTRUCTIONS ~ &~/~~' ~ a. This application must be completely filled in by ~pewriter o~ in i~k and submitted in triplicate fo Jhe Buildin~ Insp~tor, with 3 set~ of plans, accurate plot plan to ~ale. Fee according tO schedule. b. Plot plan showing location of lot and of buildings on premises, relatlobship to adjoining premises or public streets~ areas, and giving a detailed description of layout ofproper~ must be drawn oh the diagram which is pa~ of this applicationD c. The work covered by this application may not be commenced be{ore issuance of Building Permit. ~J d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perm~l 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 Ce~ificate of ~cupancy~ shall have been granted by the Building Inspector. APPLI ATIO IS EREB MADEt I B I' ~ t f th ' f B I' ~ C N H Y o f~e ui aing uepartmen or e I~uance o a ui aing ~ermit pursuant to Building Zone Ordinance of the Town of SoutHold, Suffolk County, New York, and other applicable Laws, Ordinances orh~ Regulations, for the construmion of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bui'ldiog code, housing c~e, and regulations, and to admit authorized inspectors on premises and i~ buildings for n~essa~ Jn~ections. .................. '....~ ....,.~..~:....: .................................... (Signa~~nt, or name, if a corporation) ..~.:~..~..:.~.. ~..A..~]..L(Lg.~ ........... (Addms~ o{ opplicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder. ............. O..~.~.~.f~ ......................................................................................... ......................................................................... Name of owner of premises ..'.~...~.~..0..~...~..~........~.l~...~.j...~... ....... ..J'?..~..'.~........'..~....,~.....~..(.~.!..~......~..'~../...~...!...~.~. ........................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...................................... 'i .............. Plumber's License No...~.~(..~'.~b..C:.~....~.~b~t~D~:~/.,7~_:4.~ ~f [~r~ Electrician's License No. Other Trade's License No ......................... 1~'""1'1 ............... Mo No '6 ~ 49 Lot 6 1. Location of land on which proposed war wi be done. p ,: ..... ~ ...... : .......... ; ................ No ....... ~ ............... ,. Street and Number ~.~.~...~.~..~.~j~.~.~/~..~./~..~:.¢~i~J.j~...~.~.~..~..~.~..~...~.~j~.~.`~..~!~'~. Municipality 2, State existing use and occupancy of premises and intended use and occupency of proposed construction: o. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ........................................................................................................................ 3. Nature of work (check which applicable): New Building.. ...... g~./..... . Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ..... i~...,.~.~,.~..,O..?... ................................ Fee ...L.~....7.,.t.../..~... ............................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ J ............... Number of dwelling units on each floor ....... I .................... If garage, number of cars .........~..~..~) ......................................................................................................................... 6. If business, commercial or mixed occupancy, specif~ 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 ..... ,-.~,.2...:...':T., ................ Rear ...... .Z(.,~....t..~. ........ Depth ....~..~.,:..?. ......... kleight ...... ..~. .......... Number of Stories .............. ~ ..................................... r .............................................................. 9. Size of lot: Front ......... '"' ^ '-"~'L.~.~.,.:.~..~. ........................... Rear ...... "~'-~' ~"..~...../../.:...~...~.. ................. Depth ......~-...~...~.:..P].¢ ....... 10. Dote of Purchase ..... ''-" '-- '"-'"'J~I../'J..~.....~.~.,..L~..I..~.. ................. Name of Former 1 I. 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 .. .... ~,).0. .............. Will excess fill b,e removed from premises: ( ) Yes (V)"No .................. .~..... Phone No .......... 14. Name of ?wner of premises .~.~0~.~)C:.+....'~...~.~Jl~,...~.,J~.J...~ddress ,..~.~/~l~-..~.~' Nome o]' Architect ..~..0.1~..J~.....I~......~....U.~..~..X/ ................. Address ..~..Y~(~.,~.~..~..~..../~..:Y,.. Phone No.'~..~.~..TJ[.~.~.~... Name of Contractor ..~.~.(~..~,J~....~......~...k)....~.g~..~. ................ Address Phone ~o. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn 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 YOAK,, , I c c COUNTY OF (Name of individual signing contract) above named. He is the ....................... ~.' ........................................................................................................ : .................. (Contractor, agent, corporate officer, etc.) ¢~seid owner ~-e~ers, 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 thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ....................... , , . P ti Notary Public, .....~__/~////, , .......... County ..................~e...~.......~J[/~/,.~l~... ............................. NO~TARY pU~I~i~."S~'t"o"~} ~ew York -(Si~f~bture of applicant) No. 52-4522026 - Suffolk Counf¥_.~ ~,~ su o z cou r HEatH JJJN 1976 --- N. 89°2470 The sewage disposal {and wa' qr supply faeilit!r!s for this !locatiod have been __ .~ 200.2~'-~ 7 NOTE: SUBDIVISION MAPFILED IN THE OFFICE OF THE £.LJEt~K OF SUFFOLYf COUNTY ON MA Y I, 1975 AS FILE NO 6249 Chief of General Engineering THE ~C~T~O~ OF ,VIELZg AND CE~gPOOL S e rvi ~ O $ SHO~ HERE~N A~ FE ' ~ =-~J "' , OM FIELD OBSE~VATION~ ?£V!S,ONS ~ ~OUNG:& YOUNG APR. IjlgF6 400 OSTR~N0~ER AVENUe, RIVERHEAD, NEW YORK ALDEN W. YOUNG ; HOWARD W. YOUNG SURVEY FOR: GEORGE GABRIEL ~,, o~ <..~ ~'... ~ -.. ' ~ LOY'.O. "**LET Tow. oF ~OUTHOt~:D ~ ', ' r UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY 18 A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEy MAp NOT BEARING THE LAND SURVEYOR'S INKED 3KAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY GUARANTEE~ i¢;DICATED HEREON SHALL RUN ONLy TO THE PERSON FOR WHOM THE $JRVEy IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, ~OqERNMENTAL AGENCY AND lENDiNG INSTITUTION LtSTE~ HEREON~ AND TO THE ASSIGNEES OF THE LENDING INST~TUTION GUARANTEES ARE REVISIONS N. 89 °24 '10 200.2~' -- ' f,~Z: NOTE' ~UBDIV/SION MAP F1/ED IN THE O~FIC£ OF THE CLERK ~c SUFFOLI~ COUNTY ON MA Y I, 19 ?§ A S FI/E NO 6 249 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG % HOWARD '~t', YOUNG SURVEY FOR: GEORGE GA BRIEL LOT NO. 6 , "INLET EA S T EST~ TES " ^T ?dA T TI TUCK TOWN or SO~THOLD SUFFOLK CO., N, ¥. SCALE: APPROVED AS NO~ED · NOIlFy BUILDING DEPA ~' 765 26~0 9A RTMI:NT , , - M TO 4PM /;OR REQNll, ED .1 i 'I L-_ LF-WATiO ~ -M ,I L_ Dt~P, AM i'¸ IL