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Home My WebLink About8292-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15387 Date March 19, 1987 One family dwelling THIS CERTIFIES that the building ................................................ 1305 Leeward Drive Southold, N.Y. Location of Property ............................................................... House No. Street Hamlet 79 7 2] County Tax Map No. 1000 Section ............ Block ............... Lot ................. S ..... M/o Leeward Acres .... 5599 36 uomvmlon ............................... l~lJea Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated //overaber 12, 1975 8292 Z ........................ pursuant to which Building Permit No ...................... dated.......................N ove mb e r I 2, 1975 ..... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ONE FAMILY DWELLING DONALD SAYRE The certificate is issued to ..................... [o~;n'oi',',rgs,'~'~id~dT~'tl'~ .................... of the aforesaid building. Suffolk County Department of Health Approval 5 S 0- 162 //289731 UNDERWRITERS CERTIFICATE NO ............... : ................................. PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PR~'MIS~is UNTIL FULL COMPLETION OF THE WORK AuI~HORIZED) Permission is h by _ere_. °ran_e_ to: . FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor 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 installa- tions, 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 informa- don required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 ~..~.~ .~.~..~.~. 5.Updated C.O. $ 50.00 Date .... ?. .......... New C on s t z' u c t, i on ......Old or Pre-existing Building ............ Vacant Land ............. Location of Property -~/~,,-- f-(~'~ House No. Street Hamlet Owner or Owners of Property ...... 71 :~ .......... ~.~ ?.. . ,~..~7. ................. County Tex Map No. 000 Section . "? .... 7. / ............. Block ......... Lot.. Subdivision. ~- ~?~:~x~"~"Od//~'f~: .Filed Map No..-.~..~:,~.f..Lot No. Permit No ........... Date of Permit .......... Applicant...~. ¢.~?.~. :~,, .,~......~,~-U~.F. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate .... Final Certificate Fee Submitted $ ............................. Construction on above described building and permit,me,ets all applicabl~c,~des and regulations. App cant . ..~.,~.~.4//,~, Rev. 10-10-78 THE NEW YORK B'OARD OF FIRE UNDERWRITER5 I BUREAU OF ELECTRICITY r- d ~ : B5 JOHN STREET, NEW YORK, NEW YORK 10038 ,,.,,. June 23', ,97~ .~,,,,,,..,,.o,,N,,.o,,z,,,,8,~2~45 N 289731, THIS CERTIFIES THAT Donald Sayre, e/s Leeward Drlve 800~ n/o Topsail Lane, Sou~hold. L.I. ~,, ~/,,,f,,,,,,~i,,gl,,..~o.; ~] ~.;~,...~ ~ /.~'~. ~ ~.d I,'~. outside .s,,,.~,,,, m,,,.~ z.,,, ,,,,..,.~..,i,,,,,~,,. June ]7, 1976 andfo~,tdtobeinco.~pliancewlthtltoreq,~ir,'.tentsqfthi,slh*ard, FIXTURE FIXTURES RANGES soaKING DECKS DISH WASHERS EXHAUST FANS 23 DRYERS AM[ SERVICE DISCONNECT I OTHER APPARATUSt Motor/s: t-3/4hp. ']. I GFI W.B. Ruland 'I Electric,lan ' Lic 242 eEN~At MANAq~ RI Mattltuck, L.I. This certificate must not be altered in dn~ manner; re~urn to the office of the Board if incorrect. Inspectors may be identified rby/,~t~i"r'"creden~ials. [(c~l COUNTY CF SUFFOLk( DEPARTMENT OF HEALTH August 24, 1977 gegarding---SSO-I 62 · The attached App~ov~.l ~As issued sub.~ect to the n~tatfon con,~d .our ~pproval st~.p. ?Yould you please t:rp.e the folIo~:inE_ condition of approval oH the final C of 0 as this will ensure, that ~any future will be made aware of the nitrate proble~.~. "Private well with h~gh nitrates see Health DcpArt~:ent note on fir, al , ~" · - survey , · ~c you, P~bert A. Vi~.la, P. E, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ' ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIE~ THAT oRly the e~tdcal equlpmeRt ~ ~scdb~ be~ ~ iRt~ by t~ applic~t ~m~ on the a~ ~pl~a~n numar in t~ prem~s of Donald Sayre, south west corner Nally Ave. and Kinapp Pl., Greepport, L.I. in the followlng location; ~ B~ement ~ lst FI. ~ 2nd FI. outs/de S~tion Bt~ ~t w~exami~don ~'~ ~ ~ andfoundtobeinrompliancewiththerequlrementsofthisBoard. FIXTURE OUTLETS rECEPTACLES SWITCHES FIXTURES RANGES OVENS EXHAUST FLUORESCENT DRYERS SYSTEMS OTHER APPARATUS: E R V I C OF CC. COND. 2 NO. OF HI-LEG A.W. G, OF HI-LEG NO. OfNEUTRALS OF NEUTRAt B.J. Electric Co. Stlllwater Ave. Cutchogue, New York 11935 GENERAL MANAGER Per l 1 ' COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY l. Appl icant ' ~-~\~ ~ ,~,re~ Phone Address ~0% ~-~gn Pl,~ ~C~ ~. 2. PropertY Location TM L~d ~'~¢[~ ' Village ~d~ Township 3. Public Water Company Name 4. Lot~ze: Width~.~feet Length~zo.~qfeet 10~ Sewa~Disposal System: A. ~9~gallon septic tank: Precas~~ ~.Equivalent Block B. Lea~h. ing pools: Number of pools ~ Precast ~Y Block ~pecial Il. If private well, fill in the fol- lowing blanks: A. Tank capacity ~ gallons B. Pump G.P.M. ~5[") ~e~ C. Total well depth (pO D. Depth to ground water E. Amount of water in well 5. Subdiv,j,~.~j[~j 6. Section 7. Lot Number 8. Private Well~ 9. Public Water Distance to main (FOr Health Services Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' ~urrent 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 ~x~C>x)~b~ 5,, \C~]~ Signed ~ ~d~6~U~C~ ~ ===================================================================================== FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based,on the information presented here- with, it is the opinion 6f l~he Department o'f Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. / APPROVAL ATE SIGNED - S-15 Rev. 4/1/73 APPLICATION FOR BUILDING PERMIT ~ ~......~.... ..... 19 .~..~. - ~ Date .............. ~..~...: ............ , ........ INSTRUCTIONS a. This application must be completely filled 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. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or p?bUc st. reets areas, and giving a detailed description of layout ofproperty 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 port 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 t° thel 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 he.rein descri .bed~.__ 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. ................ ........... ...................... (Sig~'~¥~'re of appliconi~"i~"~'corporaflon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ~...c~..~....c%...I....~........¥..~.~.~...e~ ............................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License' No ..................................................... , Plumbers License No ..................... ~ ......... Electrician's License NO ............ ~.%~......-~...... Other Trade s L,cense No ............................................... .~'- .-~' ~'~ ~'~/~ ~reaet:O~nOdf ~undm~rWhich p~d ~o~_rk ~1~ AAa~~/..~..Z.~... Lot No. ::~.%~.,.:..c~., ........... Municipality State existing use and occupency of premises and intended use and occupency of prapl~d construction: a. Exisiting use and occupancy ........... .~..~...~...,~....~-....~....... &~L ~ ...~.: ........................................................................ b. Intended use and occupancy ........ ...~.....~....~.......~ ...~....;./.~........~....~Z...~../../Z./~..: ............. , ............................. 3. Nature of work (check which applicable): New Building,. .... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... -- 4t/ ~ (Description) 4. Estimated Cost ..... ~..~/..~...O...~..~....~....~.. ................ Fee ..... ~... .......................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... /...'. ........... 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 ~pe 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 ~ ~ Rear ......... .~ ~ Depth .....~.... ~ Height ...... / .........Number of Stories ........ J. .............................................................................................. ~-':,~' .... 9. Size of at Front l ~.~. ...................... Rear ....,/.'~..:~.~- Depth ~-~ ~..~..~...../~.. .... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~...O...: ...................................... 13. Will lot be regraded .....(,~.~-~. ............ Will excess fill be removed from premises: ( ) Yes f~(3 /NGo~ 14. Name of Owner of Premise/s ..~..~..~....~C.~...5....~.~ ......... Address .~.:~,~..~,.f.] Phone N~,?' ..... ..'~,~'..2.~... 5~77- Nome 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 whether interior or corner lot., STATE OF NEW Y,~RIf.- , I~ ISS COUNTY Of ...~..'.~...O..~.L~.. ...... f~ .................· .,-...- -....~.-.~ ~.....~ -~'"'~l~n'r~"~f'~'~r~;;[";i~"~'~'~'~'~' ................. being duly sworn, d~oses and says that he is the applican, above name. He is the ~ ~ ~ ~ ~ (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke 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 fo~h in the application filed therewith. Sworn to before ~ this ....... of .......... , . I I EL~AB~H ANN N~ILL~ ~ NOTARY P~LIC, Stltl of NJW ~ 1~ [x~s ~0. ~ Tho se~a~e disposal and~atev supply facllitAss for thl~oca&~n ~ve ~en inspeoted b~ this de~rtme~ ~d f~ / ' 20,' ,