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Home My WebLink About9091-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. certificate Of Occupancy No. ZI0296 Date December 11, 19 80 THIS CERTIFIES that the building ................................................ k//*o~.5.5. .D.e.e.p Hole Drive, Mattituck Location of Property ~/(~s~ . ' .............. ~/e~t' ....................... County Tax Map No. 1000 Section '1 '15 .Block '16 .Lot 2/* Subdivision....D.e.e. lp..H.o.1..e..C?.e..e.k..E.s..'~.a.~.e..SFiled Map No../4.2.~.6....Lot No. ~.0. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~..~r.e.h .......... ,19. ?Tpursuant to which Building Permit No...9.Q9.'1. .Z. ............ dated . . .M.~..rg.h.. 1..5, ............... 19.77, 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 ......... ......... P.~'$y.a. te. 0~1~-. ¥.~. l~,~-Y. D.w~,l.ing ....................................... Ben Mendozza - Frances Rose Homes, Inc. The certificate is issued to ..................... [o~,n'e'r,;'~ .................... of the aforesaid building. Suffolk County Department of Health Approval ..... ~-rSO.-.'l.8~. fl.2./8/.8.Q. I~o.b. er'l;. ~,.. Vi~l,la UNDERWRITERS CERTIFICATE NO. N 497551 ./ Building Inspector Rev 4/79 TO~ OF SO~TtIOL~ 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) N? 9091 Z Permission is hereby granted to: Francies Rose Homes A/C Ben Mendozza ,..%o...x....9..?~ .......... .~f.,~ ~. ~... ,qT~ ?. ~.~ .......... Build new one family dwellinE pursuant to opplication dated ......................... !J8:.~...._.1...~. .............. , 19....~, and approved by the Building Inspector. Fee $ ~1 · ~'0 Building inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: 1. Final survey of property with accurate location of a~l buildings, property lines, streets, and unusua) 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 peoperty 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- tion required to prepare a certificate. Fees: 1. 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 ., .C~,. ~ ..... Old or Pre-existing Building ............ ,Vacant Land ............. Location of Prop~eerty..~..~.. Ho~se No. ~ Str~et~.~ i~. Hamlet Owner or Owners of Property ,~..~:~..~..~O ~O~P~... .... ~..~.~..., ~-~.~.'~-~ ._ ......... .0. County Tax Map No. 1000 Sect'on//~,'. ' 2. . Block ............... Lot .......... Subdivision,~ ~f .~.. ~.J~.~ Map No. ?, ~. $. ,~,. Lot No. ,~:.~ ....... Permit No.~/.~.~. ~ Date of Permit, * . .... Applicant-)~;-¢...~--~,~¢~.. ~.~..~. ¢~.L~.~.: · .. Health Dept. Approva~ ~ ................... Labor Dept. Approvat ........................ Underwriters Approval .'.' .~ ................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ~-~.~. ................. Fee Submitted $.. :-~ . :'. ...................... Construction on above described building an~permit meets all appl~ble code:~.~d regulation~i. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS IBUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003~ FIXTURE FIXTURES OUTLETS SWITCHES F~UO~$~ENT 13 DRYERS [~ 2nd Ft. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES COO-RING DECKS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER APPARATUS~ S E R V I C NO o COND. OF CC COND A. WG OF HI LEG NO, OF NEUTRALS 1 4 11967 GENERAL MANAGER 11. Per_ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. co~¥ ~o~ ~u~o,Ne u~pA~Mmn ~ms coPY o~ ~J~c~,~ ~T No~. ~Ei~ ~ ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROWL ~O.,CON~TRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 2. ProPer~Y Lq~a~idn'~ h~j-p ~ ~m '~62~ ,%/~ 7. Lot Number ~ ~~ ~UL~ '~. - ~ ~ .. ~ 8. Private Well ~',, .:~ ~illage ~'?'FI'~)~'m, Tow~hip ~6~i~{~ 9. Public Water 3. Public ~ter Company Rame ~ ~m~ Distance to main . 4. Lot size. Width ~/0 feet Length I~'~feet 10. Sewage Disposal System: (For Health Services Dept. Use) 11. A. 900-gallon septic tank: Precast · Equivalent Block B. Leaching pools: Number of pools Precast / Block Special.__ If private well, fill in the fol- lowing blanks: A. Tank capacity ,t -~- gallons B. Pump G.P.M. ~ 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 County Department of Health Services' 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 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 System and Water Supply can be installed on this plot. S-15 Rev. 4/1/73 IvOENI NO. 1 TOWN CLERK'S OFFICE ~UTHOLD, N. Y. proved ............. !.! ...... ......... , ,er, it ............................... Disapproved a/c ............................................................................................ INSTRUCTIONS · ' pp. · ' P ' filled Jn 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 o~ buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this application· c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this applicatlon, 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 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 Bu ding Zone Ord nonce of the Town of Southold, Suffolk County, New Y~ork, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or/f~r removal or demolition, as herein described. The applicant agrees to comply with all app cane laws, ord nonces, bui)'~ing code, housing code, and regulations, and to adm t authorized inspectors on premises and m buildings for ~es?ry~nspechon . ~?0 of"opplica;/~,,~ 'name, if o corporation) C~ ~ 'e~.~¢' ~,'~e:acto z z~, ~ r e~.E en ~ ... ?. :..o.. J. a b.a K (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ~en ~'~endozz~ Name of owner of premises ............ -, .............................................................................................. If applicant is a corporate, signature of duly authorized officer. B e~ a~ ~r~ ~e~ of~ :~oroer~t~e,~ ~L a e.n.-c°fficer) Builder's License No ..................................................... Plumber's License No .......... ~...~. ........................... Electrician's License No ..... .~.9.?...-J~ ........................... Other Trade's License No ............................................... Deep ]~foJLe 1. Location of land on which proposed work will be done. Mop No.: ...~.p.~..~.:c.e.e~...z,~.-ha.z, el~ot No ..... ~O ............... Street and Number /!~ ~.)ee-o ?~Io]e I)~clve~ LF~6' ,~$./.0 ~Jaw F-hLf.~oltc A.V.e,.,~'~at..b.=l. uu-.c.k~lxT~. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ............... ]:. P.~..~niZ~ D~4~.eZ]-.$L~ .................. 3. Nature of work (check which applicable): New Building~ .....:~ .......... Addition ...~...~ ...... Repair .................. Removal .................. Demolition .................... Other Work ..................................................._ ¢-15,000'00 F ,.~./ ~'d (Description) 4. EstimQted Cost .......... :.; ................................................ ee .......................................................................................... (to be paid on filing this ~pplicotion) 5. If dwelling, number of dwelling units ........ .~. ................. Number of dwelling units on each floor ............................ if g~r~ge, number of cars ............................................................................................................................................. ~. I¢ business, commercio] or m~xed occupancy, specify neture ~nd extent of e~c~ type of use ............................ 7. Dimensions of existing structures, if ony: Front ............................ Reor ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of s~me structure with Qlteretions or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions o~ entire new construction: Fron~ ........ ~.~ ...... , ................ Rear ..,.D.~ ................... Depth ...... ~.~ ............. Height ......... ~. ...... Number of Stories ......... ~ ........................................................................................................... 9. Size of lot: Front ....................... ~.D ..........................Rear ..........Z~Q ......................... Depth ....... ~2.Q .................. 10. Date of Purchase ........................................................Nome of Former Owner ........................................................ i h Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~.0. .......................................... 3. Will lot be regraded ...... ~'.9.~ ............... Will excess fill be removed~p~ (~? (~) No 14. Name of Owner of premises ....~:~..~',~.~9.~.~.~ ...................Address ~[~.~.~E9~.~.t~.~. Phone No....................,..73~-6662 Name of Architect .............................................................. Address '"6..0 ............................ ~ox 992 Phone No ....................... Name of Contractor ..~'.~'.~%q~.~...~'.~q.%%..1~[9/~ff~,z,.,~,9.~. Address ..~t~i~..]3.~.., ........... Phone No ........ q~ff ...... PLOT DIAGRAM Cutchosue NY Locate dearly 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. FILED PLANS STATE OF NEW '~R~, ~ ~ F¢ S COUNTY OF ...... 'R .z.t.% .Z.'.9..z... ~}'.e.~'.~.~..e..q.~...~.].~.~.~.~F~.e.~.~.~t.?.~.Ai~j~.~.~....}.[~]~.~.'~.N~eing duly sworn, deposes and says that he is the applicom (Name of individual signing contract) above named. He is the ....... ~,~,~r.~g~it}~.~:~..Q~.~.~.~.%~ ............................................................................................................. (Contractor, agent, corporate officer, etc.) of s~id 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 ere tg~e to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the applicati~f?d therewith. Swam to before me this PRAN~J~'5 ROS.~E llO~,~..~:S, INC. ...... ....... o, ......... ...................... ....... Co.. ........ ................................. ~ ~LtZAB~ti ANN ~[~IEL~ NOTARY PUBUC, State of New york No. 52-8t25~50, Suffolk /VE / VEIVU Lot G~ lot G8 Lot 49 ~ Lot 50 Area = 21,999 sqft .ezow Lot 61 NO TE: SUDDIVISION MAP FILED IN THE OFFICE OF THE' CLERK OF ~UFFOL~ COUNTY ON JAN, ~8, 19~6 AS Pl~ NO. 4266 L:ISTED OF THE ARE YOUNG ~ YOUNG OSTRAND~R'AVENUE, RIVERHEAD, NEW YORK 4qO YO~N~- v HOWARD W. YOUNG ALDEN w. SURVEY FOR;~ :: '~ ~"~e ~ ~ , .,~, ~ ~ 832 Lot 6~ Lot 4~ ~r ~-. OF TI~ Cl£R o ~ o~< co lot 51 UNAUTHORIZI~D AL~TERATION OR ADDITION TO THiS SURVEY'IS A VIOLATION OF SECTION R£WS,OaS YOUNG & YOUN~~y OCT: 10~ 1980 400 OSTRANDE~ AVENUE, iRIVERHEAD, NE~P"YEtR'~¢~ OCT 21,1980 ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: F~A~CES ~OSE H~S, IN~. LOT NOSO "DEEP HOLE CREEK ESTATES" ~ERIG~N F/TLC INSURANCE ~0. TOW. OF SOUTHOLD'~ 4-- -1' I ~ - I t ; E BROADWAY ' ROCKY P01NT~ N. Y, 11775 3-1~'2 ,,,.q-/~/ ~ q