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Home My WebLink About7923-zFOUW'~ NO. 4 TOWN OF SOUTHOL~ BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi[icate Of Occupancy No..Z. 697.2 ..... Date ............. April...~.6.., 19..7.6 THIS CERTIFIES that the building located at .S.a.~..~.a.~.~.9 ~.a.y...&. W.a..v~...e.r..e~Ereet Map No~. ~. 1.~q~..r~...E.~.~Block No ........... Lot No, . 38 .... ~t.~;iSu~]C.. N.,X, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... lda~... I3, 19.. 75 pursuant to which Building Permit No..7.923~. dated ......... ~y...i.l~ .... , 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 . .P.~.~.v.a..~.e..o..n.c..f.a..m.~.~y.. ~.~.e.~g .................................. The certificate is issued to . .Clallsen. ~ons.t~uc~;:Lon. Cort~ ... O',~l~el* ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~Ta~.. 2?...19?~..l~y .Ii,..Vlll~.. UNDERWRITERS CERTIFICATE No...N~.~ ~ ..... 8et~t.. ~.. ~.~.7.~ ............ HOUSE NUMBER ... (~. ..... Street . ...~/aves~e s~ [La ....................... Saltaire ~ay FORM NO. 2 TOWN OF SOUTHOLD 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) 7923 Z Date ......................... ~ ......... ~.~ ......... , 19ff.~... Permission is hereby granted to: ..g~ ..~mzt~.uc.t ~m.. ~o~.~ ................ ........... ~.o...... ~..... At..~...~..o.... La.~ ................ .......................... .e...e..Z.~..e..n.. ....................................... to ..buil~... n,w~ ..one..,fa~t'I,~r.. ~v,e ZI:LuI~ ........................... at premises loCated at .,~O.~..~ ......... 8al~;..A~r~..Eata~;~a ......................................................... .......................................... W~...c..r.~.~..t......~,....~.. ~.~.t~.~r.,...w~tr .......... ..M~...t..t,..t.~..u..q~. ................... pursuant to application dated .......................~t.~ ....... .~.~ ............. , 19~...., and approved by the Building Inspector. Fee $~'..~. J.~. ........... Building Inspector FOH~[ NO. ~ TOWN OF $OUTHOLD , B,,ilding Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ! nstructions A~ This application must be filled m typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the fallowing; for new buildings or new use: 1. Final survey of property w~th accurate Iocahon of all buddings, property hnes, streets, and unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage d~sposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and simdar buildings and installations, a certificate of Code comphance 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 buddings 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: l. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 New B~tilding .....~¢....... Addition ................ Old or Pre-ex~sting Buildi g ................ d .............. Lo ot,on of Property ....... ............................... Owner Or Owners Of Property ............................~.....~.....~..~'...~..~..~.. ................. ..~.. ............................................. Subdivision ...."~...~...../.~..../~.....~.~.~.....~......~...~...~., .............. Lot No....~......~... Block No ............. House No ............ Permit No ...~...~..~1~..~.. Date O~,~mit ..~.?../....~.-..Z'..~..~plicant ..~../.~..../~..~.~..~...~...~'...~..(...~.....~m~..~.~.-~...~.... Health Dept. Approval ............................................ Labor Dept. Approval ............................................... Underwriters Approval .......... ...'~...... ........................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~. ........................ Fee Submitted $ ..... .~.~.~....~.. ................. Construction on above described building an~eets all~l~ codes and regulations. Applicant ...... ~~~~.~ ....... ~ .................. Sworn to before me this ~__~,~ ~ ~ ........ .... ....... Nota~ Public ~~ Coun~ ~ ~ I ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number ~--SO APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1, Applicant~m-~x~/~? Phone Address ~.~.~./~i~ .~/~ ~,~ 2. Property Locati'O~ ~~~ ~ ~/~-~ ~ ~ll~ge"~,:j~/~ Township 3. Public Water Compahy Name 4. Lot size: Width ,<~ feet Length ~ feet 10. Sewa~isposal System: ~. ~O0~allon septic tank: Pre~~[qu~valent(~ Block 5. Subdiv..f~~ 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main (For Health Dept. Use) B. Leaching pools: Number of pools ~ Precast 1 ock Special ll. If private well, fill in the following blanks: A. Tank capacity B. C. D. E. ~. gallons Pump G.P.M. ~ Total well depth ~ Depth to ground water~ Amount of water in well /~ The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's 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 HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this pl.ot. APPROVAL DATE ~/F~/-~yF SIGNED ~- .- ~ --~.. _ S-15 Rev. 4/1/73 THE NEW YORK BOARD ',OF FIRE UNDERWritERS' ~ 85 JOHN STREET, NEW YORK. NEW YORK 10Q38, ~ ' ~ , Date ......... ~ ,', '~pplication~Zo~fle O~h~ ~('~-'ll=/ll- tl;-:.i:.~i~U~t~ I~.!/.', THS CERTF~ THAT . , ,, ,,- Clausen Const~. Co. n/e/c S~tai~ Dr. i~Wave~c~est~ i Mat~u,d ~ the followlng locatlon; ~ B~ement ~ Ist ~ Septe~e~ 18, 1975 FIXTURE FIXTURES RANGES DISH OUT.TS SWITCHES FL~E~ENT ~2 ~2 DRYERS FURNACE MOTO~ FEEDE~ TIME CL~KS MULTI.OUTL~ - SYSY~S SERVI~ DISCONNEG¥ ,' i' ,- ~ ~-~1-~ F .... il' dl $-tL-II-~IIt Ill Ill ~ .... v iii Pat chogue .. L.I. 11772 THis cerhficote must not be eltered m ~n~ monner, return fo the o~ce IS-Ut 4t1~1tl ~1 I: I :-~11~ t1'-~111 I-- Al= = -- ~lll '-'ill- I,I =,Il z--ill ~ III~ ~he sewage disposal and v/ater supply ' ~Itie$ for this location have been insp6 ct ed.J~t-t~i s ~,epar t merit and to b~ satisf r Ch&~r 0r ~nora~ E~ineerl~ Se~icea Lot R~VI$1ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W, YOUNG HOWARD W. MOIL PROFE$~;IONAI- ENGINEER AND LAND E~URVEYOR §URVE~/0~7 CLAUSEN CONSTt~UCTION COt2P. LOT NO. 38, "SALTAIt2E ESTATES" AT GUARANTEED TO MA TTI TUCK TOWN OF SOUTHOLD SUFFOLK CO, N.Y.~ l.ot 37 SBOWN I~EREIN ARE FROM FIELD OBSERVATIons · ~.~D/OR FR02f DATA OBTAINED FROM OTHERS NO · -' MONUMENT OF rH~ CLERK OF SUFFOLK COU~~ 400 OSTRANDER AVENUE, RIVER~ N~OR'~ LAND IURV~yO". N Y S Lie NO. 12845 ~Y.~ LIC. N~ SURVEY FOR: ~ICHA~D ~ ~ CAROLY~ K LOT NO. 3B, "SAL TAIEE ESTATES AT TOWN OF MA TTi TUCK SOUTHOLD GUARANTEED TO: J /~/ClYilf,'D IV. & C4ROLY/V ~ II~£II,4RO ,II'I.I£ DrL£ ~U.4R4NT££ CO. SUFFOLK CO., N.Y. _.. r-~ ~' _ TOWN OF SOUTHOLD *~ ~ ~ ~ '~"~ TOWN CLERK'S OFFICE Exam ned / . 19 ~../. ~ ~~Abo~Z ......... 7....., ..... ~pr~ed ............................ (....C....., 19.(..~.. Pemit No. ~...~... ........... ~ Disapproved a/c ............................................................................................ ~ APPLICATION FOR BUILDING PERMIT a. Th? .application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, 3 sets ct plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, ~'~d~.. giving a detailed description of layout of property must be drawn on 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 a~proval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept~'n 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 I:~n~ granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zene Ordinance of the Town of Southold, Suffotk 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 a corporation) ...... ............... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ Name of owner of premises ...f~'~..~.,~...~.....~.~...~....~'.~.........~..~...~..j~..... .................................................................... If appli~orporate,~igl~ture of duly authorized officer. ~Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..~.~'...~...~.. Lot No .......... ...~.......~....; ...................... Street and Number ..~....,~.....e~......~....~....~...~'.....~...X~...-. ............................. ,e~..~....~.../.~..°~....~-~-T......~-.....~... ......................... Municipality 2. Sta~ exi~ing u~ and occupancy of premiss and intend~ use and ~cupancy of propo~d con,ruction: Exl~ln u~ and ~cu eno ~~ a. ' 'g p y .............................................................................................................................. b. Inten~d u, and occupancy ......... ~....~/~...~~~~ -- ~' ' Alteration 3. Nature of work (check which applicable): New Building ....................... Addition ..................... ' ............... Repair ....................Remova] .................. Demolition ........................ Other Work .................................... ..... (Description) 4. Estimated ~os~ ......~.~....~ ................................ 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, commemial 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 ....... .,~...--....~... ........ Rear ............................ Depth ......~. ......................... Height .......... ~ .................................. Number of Stories ................................................................. 10. Date of Pumhase Name of Former Owner ....... ..~....-.....r..:..= ............................ 11. Zone or usa district in which premises are situated ............ x~....~.....?. ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~¢~. .............................................. 13. Will lot be regraded .................................... Will excess fill be removed from premisas: [ ] Yes [~No ~j~l~/~l~ (Phone No.) Name of Architect ........................................ ,, ........................................................... ~Jrh'~' i~o:) (Address)- Name of ~on~racmr ..*¢.¢~; ........................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~oack dimensions from lines. Give street and block number or description according to deed, and show ,street names and indicate Wheth- interior or c __----- STATE OF NEW YORK,. COUNTY OF being duly~orn, deposes and says that he is the applicant above named. contract} _ He iS the ........................................................... ~.~ .......................................................... , ~ .................................................... (Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have pe, rfo.rrned 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 an~l belief; and that the work will be performed in the manner set forth in the application filed therewith. ................ : .......... ........ ...... Notary Public ............................. ~~....~.... County ................................................... ..;.......;.......-',. .................................... -- '/ (Signature o$ applicant/ AppP, O:.,/~.O AS DATE: ~ FEE:~B ~ ',' '7-' APPROVED ~$ NOTED , ' . FEE. ~ BY ED NSPECTIONS. - ' 1. BEFORE BACKFILLING , FgUNDA TON OR STAKT FRAMING ', FNAL WHEN JOB COMPLETED