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Home My WebLink About9534-zFORM NO. 4 TOWN OF $0UTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. Z9105 .... Date ......... Ju3.y .... 1~ ........ , lg..78 THIS CERTIFIES that the building located at .12~Q..Caae! 8. Lex~e ....... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . 0c~o~er.. ~.1 ....... , 19.7~ pursuant to which Building Permit No.. dated . November...3 ........ , 19..?7, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Pr:l..v.l[~c®..0ri®. ~e~tly. DwelXfng .................................. The certificate is issued to .. R~I. M~dozza,. Pl,.e8. ,-Er~.ncea Ros~ I-lomb,. ~.. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ........... ?~$ .0~.'[~ ................ UNDERWRITERS CERTIFICATE No ..... . .N~..8c).~.~?. ..... 6/7~ .'~. ................... HOUSE NUMBER .. ~2~O ....... Street ........ .~.a..s.e.~.s....L~..e. .................... .............................................. . .~..t.c.h.o.~..e,..S.~.. y.o.r.k. .......... Building Inspector 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) No. 953 1 Z Date ............................ [~OV ....... .,) ........... , 19.:~.~... Permission is ~ereby granted to: ..,.~:c,,~c ,.~...~tc~el~ ..n.c~s..~z',a ...................... .............. g.u.~.~b,~.m~ ............................................ ~o .. ~.w:~ ,...~.~.~,...~.)x~... £.~ ~,:J,~... d~l~, ~r,~ ................................................................................... YJSC ~e at premises located at ../.: ...... .~.e........~. ............................................. ~t,~u~ ............................................................................................. pursuant to application dated .............. ...Og.~.....,~.l,)t:~l: ................. , 19~7.~..., and approved by the Building Irmpector. Fee $2 .~ .t..l..~. ........... TOWN OF $OIJTHOLD , Building Department Town Clerks Office $outhold, 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: ]. 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 disposals(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 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: ]. Accurate survey.of property showing all property lines, streets, buildings and u~us~l ~.t~_.~,3~ 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-existing dwelling or land use $5,00 3. Copy of certificate of occupancy $1.00 Date .......................: . . . New Building ....~...e..~. ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location of Property ]3ez~ ~e~c[o~.~.~, ~'e~. Owner Or Owners Of Property ...... ~,~.~...~..c...e..s.....~..o..~..e.....~..o...~..~.~..~.....~.c.... ....................................................... Subdivision ~].g...e...e~.....~.,°...]...e.....q.~...e..e..~.....~..~..~.~.e...s.::....Lot No...~.~. ..... Block No ............. House No......8.gS.. Permit No. ~092. Z Dote Of Permit ..3/..LS/.~..?..Applicant Beu Eendozza Health Dept. Approval ............................................ Labor Dept. Approval ....... ..~...~.. ................................. Underwriters Approval .[~J..~J~.?..~.~..,...~/,~,,~/.2.~ ...... Planning Board Approval ..~,/,,~. ............................... Request For Temporary Certificate ............................ i' .......... Fin~ Certificate .... .¥..e..~.. .............................. Fee Submitted $~.!..0..0. ............................ ( /. Construction on above described building and pe~9 tit. meets all ppplica~e codes and regulahons. ^ p,icant... ...... ............... · .............. Sworn to before me this / / , / ................ day of ............................................ (stamp .or seal) Notary Public .................................... County ~ ~_ [~/5,~/g FORH NO. 8 TOWN OF $OUTHOLD Building Department Town Clerics Office Southold, H. ¥. 11971 APIq..IGATION FOR CERTIFICATE OF OCGUPAHGY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: ]. 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-0 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 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-existing" land uses: Acc_.ote ,~r,~ o. ~-op,.ty 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: I. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ..... .~...e.~ ........ Old or Pre-existing Building ............................ Vacant Land ............................ Owner Or Owners Of Property Frances Rose Homes, Ina. Subdivision ......................... .~ ..................................... Lot No ............. Block No ............. House No....]...2.3,.0.. Permit No...3,~,,3..~.....~.... Date Of Permit ~...~..]../~.~..?.7.~pplicant ~'..~.~.(~..~...~.~.~...~C!.D,~.~.,...,~-~.D., ......... ~alth ~pt. Approval ................. ~ .....................Labor ~pt. Approval .......... ~ ................................... Underwritam Approval ~ 38~[~[ 6 7/78 Planning Board Approval Request For Tempora~ Cedificate ........................................ Final Ce~ificate ..... ~.~ .............................. Fee Submitted $ ..~.~.~ ......................... ~ ~ ~h~ ................ ,..~, .................................................. Sworn to before me this // / ................ d~ o~ ............................................ ~s~amp of s~l) Noto~ Public .................................... Coun~ ~//3 h ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS pm BUREAU OF ELECTRICITY ~'- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~dy the dd, ct~r~d equ;pme~t ~ ~ ~ ~ i~t~ by t~ ~t ~ ~,~ ~ ~ ~m~ ~ ~.~ oy ~ _~a~een ~ose ~omesj ~e.~ w/8 C&ses L~e ~q~v n/o-Cedars ~d.~O~. ~D-/~~/ Cuteho~ue~ L.I. ~ ' w~ exami~ on ~ u n ~ ~ , 1978 a~ fou~ ~ be in compliance with the ~uiremeflts of thb B~. fiXTURE I 201 19 FIXTURES OUTLETS ECEPTACLES SWITCHES INCAt4C)ESCEN! FLUC~ESCENT 19 3O DRYERS I FURNACE MOTORS [ FUTURE APPUANC! If~DEt RANGRS ART. K. W, EXHAUST FANS DIMMERS SERVICE DISCONNECT NO. OF S E R V I C E I 12 CB x 1 #Putul'e Applianoe ?eeders:l-2#l~sl-~.fl2~l-3~ 1-C,F,I. 1-Smoke Four Point ElBe. Inc. 350 Lake Ave. Nesconset, L.I. 11767 Lle.307 E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BI ALTERED IN ANY MANNBL THE NEW YORK BOARD OF FIRE UNDERWRITERS ~$ BUREAU OF ELECTRICITY : ~-- 85 JOHN STREET, NEW YORK, NEW YORK.~0038 ,,,.. '~,,:,, ~, ~7~ ..,,,,,,,,,,.,,o.,,,o.o./,,. 93692o N387317 THIS CERTIFIES THAT w ' ' x outside AVe~[ ,~=.o,.;,~do. May 19, 1978 andfoundtobeincomplioncewiththerequirementso/thtsBoard. ~[ RXTURE ECEPTA LE ~ FIXTURES OUTLETS C S SWITCHES I,~CAND~Ep.I FL.ES~ENT RA~ES SERVICE OIS~C)NNECT I NO. OF METER 1 12~ P OTHER APPARATUS: n ¥ I EXHAUST FANS Smoke detector 350 Lake Ave. Neseonset, L.I. 11767 Lie. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY' MANNER. BUILDING DEPARTMENT ~ ~ ~ O~--~ ~ i/ TOWN CLERK'S OFFICE f ~//-~ ~.~-~/O ~ ~ ~UTH~D, N.Y. ~/~/~ ~'~'/ '~ : ~ Applicati~ No. (.~..~.2 .................. ~ Disapproved a/c .............................................................. APPLICATION FOR BUILDING PERMIT D,t~ October 31 1977 INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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. 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 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 wJlJ issue a Building Permit to the applicant. Such permit shaU 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%q 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 alteratiom or.f~gr removal or demolition, as herein described..-,4 The applicant agrees to comply with all applicable laws, ordinances, bt rdi~g code, housing code, and regulations, and to~0 admit authorized inspectors on premises and in buildings for necessar i~spections. Bel~S,J ,~l~?[bl~:' ~[tt~e, ~ o corporat,on) P.0.Box 992, Main Rd., Cu~cho&%te, NY ................................ ............ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~.~.C...~..S.....R...O..S.~..I~.....M~...~.!...~...C..: ....................................................................................... If applicant is a corporate, signature of duly authorized officer. B eZ~ N~,~ ~.tl~ ~e ~Lr. ~9~'~:;°fficer) Builder's License No ..................................................... Plumber's License No. 263 ? Electricion's License No .... .~..0..?.....~. ............................. Other Trade's License No ............................................... ~v/ ,/'-~ /~,.,,,"'" 1 Locat,o, of land on wh,c.h proposed work w, II be done. ap No ................ ~./.~..........~a~ No..~ .......... Street and N~mber W/$/O ¢~ae.'..e ..~m~....e....3:..9..~,~O' N/O ~th.~...~.!....C.u~.o.~.o...~...e...,...~.:.~..,. .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy 1-Fa~L['I~, Dwe~Z~n~ 2-Coz' aaz'a~e 3. Nature of work (check which applicable): New Building' X Addition Alteration Repair .................. Removal ..................Demolition .................... Other Work ..................................................... $2.~,000,00 ~ 7g. ~ (Description) 4. Estimated Cost ............................................................ tee .......................................................................... (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 ...... _2. .................................................................................................................................... 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 21' Number of Stories 1 . Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~.~.. ......................... Rear ...... .~.~J ................. Depth 34' Height .................... Number of Stories 1 9. Size of lot: Front 143' Rear 108' Depth 10. Date of Purchase .....lt.0../..2...1.~.~.~. ................................. Name of Former Owner ..~.9.~..~.~..1;.12.~ ......................... 11. Zone or use district in which premises are situated .......................................... ........................................................... i2. Does proposed construction violate any zoning law, ordinance or regulation: .... .~..O.. ............................................... Yes I r f e 13. Will lot be regraded . ..........~, ............... '~/ill exc.e, ss fil b_e emoved ~ob~r,~tises:..( _),Y~ls ~C ) No ~rances ~tose nomes,~nc. .. _ _~ran~ ~.z..v.~ 298-5288 14. Name of Owner of premises .~.I~_..~.~I~.[CZZ&~..P~e~I. ..... Address ~.,J~l~l.~tO.~.~,&..~,[Phone No ....................... Name of Architect .............................................................. Name of Contractor Frances Rose Homes,Inc. Address~'"~X"YY'~"" '~:~ Phone No ............................................................ Address .~llvt~g,~t~t~.~... Phone No. 2..?..8..-..~.2...8..8. .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck 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. SEE FILED ]~LANS STATE OF NEWo¥.Q.~K,~. ~ ¢ c COUNTY OF ....~..~'...+.?...'k.? ............ ]]~t M~"tdo~,~-~.,Preso ,]i'ra4'tces ~ose Homes,Ina.be n~ duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. Builder - Corporate Offioer He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove this application; that all statements contained in this application are thor the work will be performed in the manner set forth in the applicotk 9..~....? -/Swo~o be~ore me this ............ ..... doy of ..... Notary Public,. ................... ~'""'-¢'"~""'""~"~'~k" Cou ty ......... y~..-.~ -- ~/ EL~ZA§ETH ANN NL3VIL ' / NOTARY PUBLI[~, State o! New York~ No. 52-8125850, Suffolk ~e, rm [xpi~s Mar~h 30. ,erformed the said work and to make and file to the best of his knowledge and belief; and therewith. CES ROSE HOMES,INC. BUIM)IN~ DEPARTMEN? .~ ~ .... ,-~ ~u~,o~, ~. ¥. ~ Exam,ned ........ -- __ . .- .................. :.'. ........ ........ , ................................................ APPLICATION FO~ ~UILDI~ P~I~ INTRUSIONS / a. This a~lication must be completely fiil~ in by ~pewriter o~ in ink and submi~ed in triplicate to the Building Inspector, with 3 ~ts of plains, accurate pl~ plan to ~ale. Fee according to sch~ule. b. Plot plan showing [~atJon of lot and of buildings on premiss, relationship to adjoining premises or public streets o~ areas, and givi~ a detail~ description of layo~ ofpr~e~ must be drawn on the diagram which is ~ of this application. c. The work covered by this a~licotion may n~ be commenc~ before issuance of Building Permit. d. Upon approval of this application, the Building Inserat 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 ~cupied or used in whole or in pa~ for any pu~ose whoever until a Ce~ificate of ~cupancy shall have been granted by the Building In~ector. APPLICATION IS HEREBY ~DE to the Building Depa~ment for the issuance of a Building Permit pu~uant to the Bud ng Zone Ordinance of the Town of ~uthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regu at ons, for the constru~ion of buildings, additions or alterations, or ~ ~moval or demolition, as herein descried. The applicant agrees to comply with all appllc~ble laws, ordinances, buil~n~ c~e, housing c~e, and ~ulations, and to admit ~uthoriz~ inspecto~ on p~mises and in buildings for n~e~a~ ~tions. ...... ...................................... (A~dress of affpl~cant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. BUILDER Name of owner of premises ......... ~....~']~[}0~d~, .............................................................................................................. If applicant is a corporate, signature o~duly authorized officer. ., (Name and title of corporate officer) Ben aendozza~ Pres [~i[der's License No ..................................................... Plumber's License No ..... .~...6..3. P. .................................. Electrician's License No. ~ .................................. 1/9--/~-- y Other Trade's License No ............................................... DEEP HOLR CRRF, K ESTATES 1. Location of [and on which proposed work will be done. Map No.: .4;~-R6 .............................. Lot No ........ 1~. ............ Street and Number ~/.~..[~I~.~IL.Jl~T-lit~ ......... .7~(I!...,s/.o-.~I~¥...b-'U-F~)LI~...~v-¥..~JLT-~'j~-q~I~ .......... ,~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy .....~,...]~,.~.~,~...ll~re,l~:L138 ....... -].~oaz'...g~L~e· .............................................. 3. Nature of work (check which applicable): New Building-......~. ........... Addition ................. ;,Al~ration ................. Repair .................. Removal .................. Demolitior ..................... Other Work ..................................................... 4. Estimated Cost ..$...],',~.~.~.Q,..(~ ............................... Fee ~' / .~ 1D_ (Description) (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 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 ............ ~a. ................... Rear ..... ,~9 .................. Depth ..... .2._~. .............. Height '18 Number of Stories 1 9. Size of lot: Front .......... ,1,],Q. ...................................... Rear ............. .].10 ..................... Depth ...~8~,, ..................... ]0. Date of Purchase ........................................................ Nome of Former Owner ........................................................ ! ]. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ............. .~...0. ...................................... 13. Will lot be regraded .....%~. ...............Will excess fill be removed from premises: ( ) Yes (X) No 14. Name of Owner of premises ..~...~......~.....]~...0...~. ....................... No. Nome of Architect ..................... '. ........................................ ^aaress ................................ t'none mo. ,~.~,~.-.,,.,~,4.62 Name of ContractorFRAl~ES.-R0~E..liO~ESt.-I.NC~.... Address~,.~).~0~.. ~.... Phone No ....................... · - PLOT DIAGRAM Reeky=l~e~wt~=N~][~ Cutchogue, N.Y. 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. SEE FILED PLANS STATE OF NEW-q~DJ~c,?.b ! S S COUNTY OF ............................... D.~ ~E~DOF-.~A~ ?res....~...~...~..~.Q~$. ~~e ng duly sworn, deposes and says that he is the applicant ~ (Name of individual signing contrac~ above named· He is the ........... ~.~ ....... ~.~...~.~ .................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~CES ~0~ N~S~ INC. ...... ............. dov of , Nota Pubhc .......... ............ .............. : ...... ......... ..................................... , ~ , j ~,; ~ ~ .4 . ~ ~ ~v / ~' / ,~,~m~t~f/a~cant) [LIZAB~N ANN N~ILL~ NOTARY PUBLIC, Stste of Hew Term Ex$ires ~rch 30, lg~ · surF. co. --HEALTH D~T. A,",OVAL ~ H. S. ~O. ~' 49.5 ~. ~q ~ ~AUIHO~IZED ALTerATION OR AOOITIO~ TE~T HOLE SUF?, CO. DEPT. OF HEA R ~ierATF-.MENT OF INTENT I j FOR APPROVAL OF CONSTRUC~N,, ,, ONlY AP~OV~O: ~ ~ ..... i~R~NCES ROSE~O~ES,, INC , J/./~~ .~, ./ lot 3B Path · = MONUMENT CUSDIVI$10N MAP FILED IN TN~ OFFICE OF TNE CL~RK OF ~UFFOLK ~Y ON ~A~ 28, I~ A~ ~ILE NO 4~. REVISIONS AUG. 22,I977 OCT.* 20, 1977 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SURVEY FOR: BEN MENDOZZA LOT 39 "DEEP HOLE CREEK ESTATES" J-~?^.,,,.'r~o TO: ,~r MATT ITUC K, j AMERICAN TITLE INSURANCE CO. TOWN OF SOUTHOLD , 'j S, OUTHOLD SAVINGS BANK i= ~o, o~,~: ocT. ,O, ,~ j~o.~.~o~ ~aeill~i~ f~r t~lS i~cat~oz~ have been , ..... /, ~ = m.~ ~n, ,~.,:~$ -: $~ OF SUFFOLK CO. D~T. 1 ! lq