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Home My WebLink About9468-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Ottice Southold, N. Y. Certificnte Of Occupancy No. Z 9 [7 I Date ~.,U6- I/~ 197~ THIS CERTIFIES that the building located at .7.5.. ~.~ .~.q~..L! .~.~.7....bi~. ! .v!' Street Map No..~..~..~J ...... Block No ........... Lot No,...~..~. ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. E.~..~..2..L, 19.7..8.~pursuant to which Building Permit No..9.~. ~..~. dated SEP7 ~ ~ 7 8 ....................... , 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 The certificate is issued to .~. ~ .~ ~T~..L....~....A.~. ,6?. ~.~.. '.~.....~..U...L.~. ,~.~..c. ......... (owner, l~cc c~- ~) of the aforesaid building. Suffolk County Department of Health Approval ~..~.~.~..~..~.l.~.~..~....W...~f .~...71.~ UNDERWRITERS CERTIFICATE No. ~..~. ?..~.~.~ ?.~... ~...~...3.?.7. .~..~. ?. ............. HOUSE NUMBER ....... 7..~. .... Street . ]~.~. ?..~.q~.~.....~.~..~?..~. .... . .'~.'~! ~.~ ...... Building Inspee~o~ TOWN OF SOUTHOL~ BUILDING DEII)AI~TMENT ~N CLEIU('S OFFICE Sou'rHOLD, N. Y. BUlB)lNG PE~J~AIT (THIS PEI~v~IT MUST BE KEPT ON THE PP.F. MZSES UNTIl. FULL COMPLETION OF THE WORK AUTHORIZED) 9468 Z Permission is hereby granted to: .~:..z.~.e..~.t....~-...~e..Z...2.~.....~..e.~r..o. ...................... .1.~..o.......c.~ .r..o.,!~. n.~...~.o..~' ................................... ?aramus N.J. 02682 Build new one family d~elling H~r~or Lights drive Southold Sept 22 ...... pursuant to application dated ................................ 19~2 ,, and approved by the Building Inspector. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natura~ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses'. 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelting or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~.~ .... :~,~,.,~ U/~.~.'~....~77~.¢~,~./~... ~?..-.. ~,;-.~.<~,~:-~ ,. :~... House No. ~ ~ ~ Street ~" ,, Hamlet Owner ar O~a~r~ af ~mpart~ . ~ .-~ .,,. ,~ ~.~ ~/: . . . '. ~ 4 .:~6 ~:~(> . . ~ ~. ~: . ,.~.~:4¢~ ~: ........... Count,/Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. '~ ''¢:" Date of Permit ;'~ ~¢2¢ ' . ' ..App cant 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 perm,~it meets aJl _ ,. Rev. 10-10-78 FOBM NO. 6 TOWN OF SOUTHOLD Building Department 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 triplicate 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, an6 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 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 aT property showing alt 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-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date / New Building .................... Old or Pre-existing Building ............................ Vacant Land .........~ ............... Location Of Property ....... .... ..................... Owner Or Owners Of Property ........... ..~..~ ................... .~,~...../. ................ ..c~.....,~..,~.~ .............................. Subdivision ./..~(?.?..'(./.~z-/:/.'..r-~...~..C...,.~.,..-~..,..Lot No..~....~...... Black No ............. House No.7.~...~.... PermitNo~...~..~.v~.~Z Date Of Permit~.~ /f~.~.. Applicant .,4~-~r~7- X Health Dept. Approval ,,?¢',,zz,/~,,,~,~,.'~,..,../.?.7.....o~......Labor Dept. Approval ...... ...~...~.../..~...;. .......................... Underwriters Approval .~..?..~....~.../..O...~....-:~...~...~'.'..~...~5...O....Planning Board Approval ....4~...../.?...; ....................... Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ~ ..................... Construction on above described building and permit/~~odes and regulations. Applicant ............... 57 ? ......................................................... Sworn to before me this ~ (.~ ................ day of ............................................ (stamp or seal) Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ p m BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~u.qust I THIS GE~IFIES THAT wo~ e~=mined on 4~ FI. [] 2nd FI. Section Block Lot and ~o~nd to ~e in compliance with the r~luirements o~ this Board. FIXTURE FIXTUSE$ RANGES OVENS DISH WASHBI$ EXHAUST FANS OUTL~'S SWITCHES FLUORESCENT DRYERS FURNACE MOTORS RJTURE TIME CLOCKS MULTI-O~ITULcT DIMMERS SYSTIMS NO. OF I~ET S~RVICE DI$CONNLrC~ I C E OTHER AIq~AUT~: ~!o~or/s:l-3/4hp I-S~oke De~ector 1-10amp. gompacfor 1-10amp. Vacuum Unl* I-Post Light 1~4.5K! Hot Hater Heater S E R V .o. c~c. co.~. *. w. o. 500mcm Edward T. Pafllkk St. HEtyS Dr. South Jamesport, L.I. 11970 Llc,B48 E II This certificate must net be altered in any manner;, return to the office of the Board if may be identified COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MuST NOT BE ALTERIO IN ANY MANHER. ~?~!?~:i':;~THE ~NEW YORK i'BOARD OF.FIRE UNDERWRITERS SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES H. I. EE DIENNIBON EXIECUTIVE: OFFI(=IE BUILDING VETIERAN~ MEMORIAL HIGHWAY HAUPPAUGIE, NIEW YORK I ,7B7 :David Harris, M.D., M.P.H. Commissioner September 20, 1977 Mr. Albert De Lauro c/o The Cove Bay View Road Southold, New York 11971 Re: Application to Construct a Private Sewage Disposal System, n/s Harbor Lights Drive, 800' w/o Brigantine Dr., Bayview, Town of Southold Dear Mr. De Lauro: At the hearing held on August 25, 1977, in the off~ce of the Suffolk County Department of Health Services, H. Lee Dennison Executive Office Building, Veterans Memorial Highway, Hauppauge, New York, you had an opportunity to present your appeal of the department's ruling on the subject application. In accordance with the provisions of subdivision (c), Section 7, Article I of the Suffolk County Sanitary Code, the determination of the Board of Review is as follows: Based on th~ information submitted, that this application be approved, provided the sewage disposal system is installed ~ minimum of BO feet from the surface waters and the well point is driven 10 feet into water. Since the determination of the Board of Review submitted to the Commissioner's office on September 15, 1977, has not been reversed or ~odified by him, it is therefore deemed to be the determination of the Commissioner. Very ~ruly yours, W.~avi ds, P~E. Chief Engineer Bureau of Environmental Health HWD/gph cc Board of Review File ~obert. A. Villa, P.E. ~Ir. Gordon Ahlers, P.E. ' ~Southold Town Building Department ' ~ / / .... ~ ............. ~'"~""'~'"~ ...... I ....... ~'"~ ........................ This a~l~im m~ ~pl~ly f~ in ~ ~wnter ,~.in i~ a~ s~i~ in triplicate ~ ~e Buildi~ In~, with 3 ~ of p~, ~u~ ~ pl~ ~ ~. F~ ~oM~ ~ ~. b. Plot plan ~ing I~ati~of I~ a~ of buildi~ ~ premix, mlation~ip to ~joining premiss or pub c struts o~ or~s, and givi~ a ~ail~ ~r~pti~ ~ I~ ~p~ mu~ ~ d~n ~ the diagram which is ~ of this applicoti~. c. ~e wo~ c~r~ ~ ~ a~licati~ ~ ~ ~ ~ ~fom i~ua~e of Building Permit. d. U~ a~al of ~is ~lic~i~, ~ Buildi~ I~tor will iss~ a Building Pe~it to the applicant. Such permit shall ~ ~pt ~ ~e pmmi~ ~il~le ~ In~l~ ~t ~ ~r~ e. No building ~all ~ ~cupi~ or u~ in ~le or in ~ for any pu~e ~r until a Ce~ificate of ~cu~ncy shall h~e been granted ~ the BuildJ~ In--tar. ~ ~LI~TI~ .~S HERE~Y.~DE ~ the Buildi~ ~d~t for ~e i,ua~ of a Buildi~ Pe~it pu~ant to the ou.amg c~e ~m~nce at t~ T~ of ~ld, ~lk C~n~, N~ Yo~, a~ ~er apphcable ~, O~i~nces or ~ulati~ns, for the c~i~ ~ ~ildl~, ~iti~ or al~mti~s, or for mm~al or ~liti~, as heroin de~ribed. e applicant agr~ to c~ly wi~ all a~llc~le I~, or~na~,, ~ildi~ c~, h~i~ c~e, a~ ~ulati~, a~ to admit out~riz~ in~ ~ p~l~ ~ in ~i~i~ ~ ~ i~i~. 140 Caroline RoaA, Pa uss li.J. 07652 ................ .'.f: .................. ( mss of Ii a ) o/o State whether a~licant is ~r, I~e, ~ent, a~hi~, engineer, general c~tmctor, e~trician, p~umber or bu~l~ Name of owner of premiss . ~b~ b~ .~ ~.%9. ~. ~9 .~9 ....................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No~ ................ .d. ........................... Electrician's License No. C/- Other Trade's License No ............................................... 1. Location. of land on which prapasecl work will be done. Map No.: ~lk~f,,ql~..~g~Z ............ Lot No. 43 map 4C~A ........................ Street and Number ......... ~..~.--.~,~e~..~l,~hta..D~d,~,e~og~hold~.Jl~ ....................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....~....,~..c_ ~ b. Intended use and occupancy .............. ~J.z~:~,..ge~la~no~ ................................................................................ 3. Nature of work (check which applicable): New Building' ,:.~..~: .......... Addition .................. Alteration ................ Repair .................. Removal ................. ~ Demolition ....... ~m~;; ....Other Work ..................................................... " ~ ~ '~ (Description) 4. Estimated Cost ...... ~ ................................................ F~ee ................ ? ......................................................................... --~'.;.: .. (to be paid on filing this application) 5. If dwellin~g, number of dwelling units .......... .]'. ................ Number of dwelling units on each floor ..~- ....................... If garage, number of cars ............ ~ ............................................................. ~.i ............................... Z ............. ' .............. ~.. 6. If business, commercial or mixed occupancy, specify nat[~re and extent df each type of use ............................ 7. Dimensions of existing structures, f any Front ............................ Rear ......... u..... ............... : 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 16' Number of Stories ]' ............................................................................................. 9. Size of lot: Front .............. ~.~).0.: .................................. Rear ....~i"~,{~1.*. .......................... Depth 10. Date of Purchase ........ ~.]:....~..e..~....]:~..~.~. ......................... Name of Former Owner ...... ~..e.~.m..n.....~...9.99. ........................... 11. Zone ar use district in which premises ere situated ......... .~..e.~.:i:.~e.~.]: ........................................................ ! ............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~...o.t ............. : .............................. 13. Will lot be regraded . ........................... Will excess fill be removed.from p~mises: ! ~) Yes ,~f nr~nlc~c J~ ~C *~elia De LaUr~ - A4.~..~.140 C~ro].:Lne Rd. P~I~I~ 14, Name of Owner ~ ,. ....................................................................... ... ......... ; ........... ~,,u,,~ ,wu ...................... Name of Architect ....~.o.~.o....~...~.e...~.. ....... : ...................... Aaci~.es~' .8.o...~.~.o.~.~,..~.....~.:..,,....pl.;one No..'~.6.~....[~.~. ..... Name of Contractor ...... .A.:..D..e....~.~.~.?..°....!.°...~s...e..z'....~...?...~...]'..~.e...r)Address ..,"J;; ............ L.....~,.:,, 'phone No. ?..6.~..1..8.~?. ..... PLOT DIAGP,.AM ~ . 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, :a~d' Show street names'and indicate whether interior or corner lot. STATE OF NEW,Y/~,I~/,~.~ COUNTY OF .... ~..~. :..~. ............. (Name of individual above named. (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 Jn 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 th~ application filed therewith. Sworntobeforemethis ~ ~ ~ ........ ~u~ T. ..~...~ ....... being duly sworn, deposes and Says that; he is 'the epplicam ~UFF. GO. HEALTH D~PT. APPIIOVAL AMELIA DELAU~O OABOLIHE ~OAD ~A~us, ~. 0765Z ~ q [ lUFf'. ~. ~llrr. OF HIAl:.'l:H [ ITATIJlINT O!f lllllN1' ~OT ~/,,~,/)/.,~ ~H[ WATEJ! ,UPPLY AND ,[WA(~[ DING[ WILL. CO~FOI~4 TO TH[ ,,. .. .. .~ OWNS.q: mUFF'. C:~, HIJAL.TJ,J DEPT. APPROVAL I H. dr. NC) ..... ~rvice~ ~ ~ ~ P~ ; ~ ,,~ >~. '~ . , · : r ~E~CK V~ TUVL P. C. APPROVED AS NOTED .54~55 C'.n',~- c/C Z',O /5)( 5' J'o/,ygg/?z? 67,. ~. /;7. .~U~ I~ / ?7? /977 t) 5-20 :<3 U AT /VO/V /'/~/0 ~o,,'vc'. ,T Z O' '%lZ ^, *"" '4 or- II , FILL cot,~c, Pz~c~p i vv':o~ _t. . ~(.20 /~ 4977 ~ I