The URL can be used to link to this page

Home My WebLink About11076-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy THIS CERTIFIES that the building ................................................ Location of Property ....~..O.LT. ~ ........ il ff. ~ !~..~. 7. ~.... ~.P'.~ .~.E. .......... ~ .~.C.C.~.~.I .C~.... House No. Street Hamlet County Tax Map No. 1000 Section ...... 7. ~...Block ....... ! .......Lot ....q. Y:.7. ........ 6fica' "a 5 o.o I ~ Subdivision... PIL C0.~. \ .c.....~..~..c .k. ~..5 ....... Filed Map No ........ Lot No .............. conforms substantially to the Application for Building Permit heretofore fried tn this office dated ...... ~ /' o~ ~. ,195/ ursuanttowhichBmldm /! 0 7 F~ . .Tw.. ' ' . .................. p ' ' ' g Permit No .................... ~Ta./z~ ~.0 6 19 ~/ was issued, and conforms to all of the requirements- dated of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... .~....P. 6:'.~.hT..~ .... d~..~.....C.~.~./L',' 25~/~L, ,~- ...................... The eertificate is issued to DBASE /-. ~J ~'-,I ('~/~C~ L. ~ FO ,~T~.LL 0 ..................... idd,'~;.'~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .... l (.-..~..0..~ ./...-~. ....... 7./..z..o.( .~{ ........ UNDERWRITERS CERTIFICATE NO. IX/ ~ 2L 2 .% 3 ~, N? BUILDING PER. MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ......... ~./~~..~/./.~...:~.~.~..:. ..2:~,~.~......Z.~I .................. : ......... , ', :,~ .......... ___ // ': . / ........ ~ ............................................... ~ .... ..................................................................... ~2.~...G. ........ ~.x~.c~' - ......................... .... . , ........ ~, ~,~ ~,,~ ~, ....... ~.~: ..... ~ ....... ,.~.:.~...Z~,~ZL~ ...... ~..~ ~ ............. : ....... :. .......... ~.~ ........ ~.~ ................. cou~ *~ ~.p Uo. moo so~t~o~ ..... ~-~. ..... ~k ..... ~.~ ......... cot Uo.....G.~.~.:. ~nd 8uildlno Inspector. oo ~ ........ g ............... Rev. 6/30/80 FOEM NO, 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Soutbold, 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 buddings 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 buddings 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 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 $5.00 3. Copy of certificate of occupancy $1.00 Date .... .......... New BLtilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~1, (~ o~ LJ~,.~ .~' L~J~ ~'~--c~e_ ~ r~,~ , Owner Or Owners Of Property ......... ..g...~...~....~.~...%.....~.~ ........ ...C~...~j~..kT.~ ................................ Subdivision ......................................... ~ .................... bar ~o ............. Block No ............. House No ............ .................... .... Permit No. II 0'1 (o -;~ Date Of Permit ...................,~pp,canr ............................................................ Health Dept. Approval .!./....~..?....~./.?. ........................ Labor Dept. Approval ......................... -. ...................... Underwriters Approval .......... ~ 2- .~..~."~ .............................. ~ Planning' Board Approval ........................................ Request For Temporary Certificate ~' FinaJ Certificate Fee Submitted $ ...... ..~.~ .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant . .~.....~. ~ ?..,~...(. ,.(5,/~L~jp C_~ Sworn to before me this ~"~,/C¢,~ ~('~./~_~ ~ ~ ................ day of ............................................ Notary Public .................................... County (stamp or seal) FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hell Southold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 all buildings, property lines, streets, and unusual natural or topographic featu res. 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 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 certi~ficate of occupancy~ $1.00 $5.00 New Building .... × Old or Pre-existing Building Vacant Land Location of Property ............. [¢¢~'~. ~. 8. ,T4e, D¢, ................. ?.e.c.o. zg:~ ¢ .............. House No. Street Ham/et Owner or Owners of Property County Tax Map No. ~000 Section .... ¢.0.7.4 ...... Block .. ¢.0.Q~, ........ Lot .... ~ ...... Subdivision. ~[2..(~J~ o:B¢.0.0~£¢..~;~o,[~$ ...... Filed Map No... 6.6.Q7....Lot No, .6 ........... Permit No. ~!,3,075 .... Date of Permit . 3./.g6/~.~,Applicant . P...C,. ¢P.~;¢~.q ................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certific~.te ..................... Final Certificate ....................... Fee Submitted $ . . 5~......~...~"~ Construction on above described building and ~mit meet~ll a~plicable codes and regu lations~ Applicant ~~~~~--~ I] ~/ ~,~.. ~. ~.'~ .,. ~ Planning Board -10- March 17, 1981 Fishers Island Utilitv Company, Inc. minor subdivision. Mr. Baker has submitted to the board a list of the stockholders of the company with officers and directors. Mr. Wall informed the board that this is not a utility and thus does not come under the rules · of the Public Utilities Commission. ~j-(\/~ On motion made by Mr. Wall, seconded by Mr. Latham, it was ~ RESOLVED to approve sketch map dated February 1981 of the ~ subdivision of Fishers Island Utility Co.~. Inc_. located at Fishers Island subject to the removal of the 15 foot right-of-way to Central Avenue. Vote of the Board: Ayes: Orlowski, Wall, Latham, Mullen ~ ( On motion made by Mr. Latham, seconded by Mr. Wall, it was ;~ ' RESOLVED that the Southold Town Planning Board declare itself · 't lead agency in regard to the State Environmental Quality Review Act ~> for the subdivision of property of Fishers Island Util~ Inc. located at Fishers Island. The Board has made an initmal determination of non-significance. ~ Vote of the Board: Ayes: Orlowski, Wall, Latham, Mullen Peconic Knolls major subdivision. Jack Driscoll, Stan Waimey, Steve Tsontakzs and Mr. Costello, owner of Lot 6, appeared before the board. Mr. Dean, Supt. of Highways, appeared at the meeting later at the request of Mr. Driscoll. George Fisher, Senior Building Inspector, has refused a building permit on Lot 6 until such time as the Planning Board gives approval of access. After much discussion the following action was taken. On motion made by Mr. Mullen, seconded by Mr. Latham, it was \ RESOLVED to direct the building inspector to issue a ~building permit for construction on Lot 6 in the subdivision of Peconic Knolls subject to the following: by Planning Board from the Supt. 1. A letter be received the of Highways indicating that as far as he is concerned he has made an inspection of the property and finds it suitable for access by emergency vehicles. 2. There will be no certificate of occupancy issued until such time as the road is improved with pulvermixing and a coat of sealer all to the satisfaction of the Supt. of Highways and the Planning Board. Vote of the Board: Ayes: Orlowski, Latham, Wall, Mullen July 2, 1981 Jack Driscoll Inc. RealLors County Road 48 Mattituck, New York 11952 Dear Mr. Driscoll: On June 22, 1981 the Flannfnk Board the Bu±ld~g Inspectors of owner of Feconic Knolls to ~esolved to dire. ct Approved Access to enable the receivo Building Permits. ~oard already qr~nted per~ission .letter of March 2t~, t9~1. Now Building Fermits can be Knolls. to Lot number 6 in The the with Zoning and Electrical Fire issued for the lots in ?econic Certificate of Occupancy may be issued upon compliance final approval from the Health Department and Y ours/rul~y, G~orge Ho Fisher Sr. Building Inspector Underwriters. GHF:Jd ~ARY ~LANNEIR OLSEN C~OUNSELLOR AT LAW P 0 BOX 38 ' MAIN ROAD , MATTITUCK, LONG ISLAND, NEW YORK 1t952 PHONE July 7, 1981 Re: Driscoll to Runkel File # 30~7 298-4844 Dear George: I have a copy of you~ letter to Jack Driscoll dated July 2, 1981. Please confirm that a Building Permit and Certificate of Occupancy will be is- sued by the Town on Lot Number 9 upon the completion of the house, which meets the Town requirements, My closing is scheduled to take place on T~esday, July 21,I981, and I would appreciate a response from you before that time. Very truly yours, GFO/clr Southold Town Building Department Main Road Southold, New York 11971 Attention: George Fisher July 10, 1981 Gamy Flanner Olsen, E~q. P. O. Box 38, Main Road, Mattituck~ New York,Il952 Re: Drlscoll - Runkel File ~3017 Dear Mr. Olsen: the Yes, A CePtifi,cate of Occupancy will be issued upon complstion of~the house on Lot 9 which meets the Town requiremen%~'. GHF:Jd George H. Fisher Building Inspector June 29, 1981 Jack Driscoll Inc. Dea~tors County Road 48, Mattituck, New York 1~952 Dear Mr. Driscoll: Or. June 22~ 1981 the Planning Bosrd r~olved ko direct the Bu~ldin? I~spectors of Approved Access to &nab]e the owner of Peconic Woulls to receive Building Permits. The Bo:~Pd s~re~y ~-Dmted p~r~is~ion to lot number 6 in the letter of March 24, lq81~ Now Building Permits can be Peconic Knolls. issued for the lots in Yours t~uly, Deorge H. Fieher Sr. Building Inspector TO HENRY E RAYNOR Jr . Ch.~rman JA~ES WALL BENNETT ORLOWSKI. 3t GEORGE R[TCHIE LATHA~. Jr William F. Mullen, Jr. $outhold, N Y. 11971 TELEPHONE 765- 1935 June 23, 1981 Mr. George Fisher Senior Building Inspector Town Hall Southold, New York 11971 Dear Mr. Fisher: The following action was taken by the Southold Town Planning Board at a regular meeting held June 22, 1981. RESOLVED to direct building inspector of approved access to enable owner of Peconic Knolls to receive building permits. The board already granted permission to lot number 6 in letter of March 24, 1981. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Linda Kilmnins, Secretary June 10, 1981 Gary Flanner Olsen, Esqo P. O. Box 38, Main Road, Mattituck, New York 11952 Re: Waimey and Driscoll.Lot 9 ?econic Knolls Dear Gary: This lot is a buildable lot. I have not received in writing that the streets are improved to the satisfaction of the Planning Board. Mro Henry Raynor, Chairman of the Planning Board, told me the road work is progressing and it will be on their next mee lng (June122) agenda to write me the approval, iThen I c~n issue Building Permits to start conm i I am hol~ing your application for a Vacant Land Certificate o~ Occupancy until I GHi': Jd CC! Mr. Hen~;y Raynor Mr. Jaclk Drtscoll receive this letter. Yours truly, George H. Fisher Sr. Building Inspector JAMES J. FRAYNE Afforney At Law P.O. BOX 1009 74:3 MIDDLE COUNTRY ROAD SELDEN, N. Y. 11784 (516) 698-2121 TO Town of SoBthold Building Department Town~Hall Southold, NY 11971 -Message --]REPLY NOT REQUIRED DATE ~ovember 17, 1981 nSUBJECT ct #6~ Map of Peconic iKnoils ~ en~y's Lane~ Peconic Gentlemen: ~ Enclosed herewith please~find ~lginal an~ copy~f application for copy of Certificate ~f Occupancy on the above premises together with copy of survey and my check to your order in the sum of $5.00 to cover your fee for same. I would appreciate your forwarding me a copy as ebon as possible for my records. ~ JIF/bah [~ /~/ EncY. 3 ~ Very tr~uly y~urs, ~ames J. Frayne SIGNED HENRY E RAYNOR, Jr , Chairman JAMES WALL BENNETT ORLOWSKI, Jr GEORGE RITCHIE LATHAM, Jr William F. Mullen, Jr. Southold, N.Y. 11971 March 24, 1981 TELEPHONE 765 - 1938 Mr. George Fisher, Sr. Building Inspector Town Hall Southold, New York 11971 Dear Mr. Fisher: The following action was taken by the Southold Town Planning Board at a regular meeting held March 17, 1981. RESOLVED to direct the building inspector to issue a building permit for construction on Lot 6 in the subdivision of Peconic Knolls subject to the following: 1. A letter be received by the Planning Board from the Supt. of Highways indicating that as far as he is concerned he has made an inspection of the property and finds it suitable for access by emergency vehicles. 2. There will be no certificate of occupancy issued until such time as the road is improved with pulvermixing and a coat of sealer all to the satisfaction of the Supt. of Highways and the Planning Board. I enclose copy of letter from the Supt. of Highways, as requested. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary Copy to Steve Tsontakis RAYMOND C. DEAN Superintendent March 18, 1981 Tel. 765-3140 734-5211 Southotd To~cn Plar~ning Board Southold, New York 11971 % Gentlemen: Re: Henry's Road Ext. Peconic, N.Y. As per the meeting with the Southold Town Planning Board and the developer of Henry's Road Ext. on March 17, 1981, I found the rough grading of th~s road to be satisfactory and passable at this time for any emergency vehicle. I concurred with the Plannmng Board and the developer that there wmll be no C.0. zssued for any house bumlt on thms road until the road has been regraded and pulver-mxed to Town Specifications with one sealer coat applied. Very truly yours Sup ' t of Hzghway8 lOOlO?! THE NEw YORK~ B~ARD ~,~ ~,~-- ~- r~ , ' :~ lyf ~t: UNDERWRITERS THIS CERTIFIES THAT ; ~ ~ ,116034 81 ~ O ,, ~ ~, ~ ~ was exu.dned on ', S~tion ~l~k ' 5~ 8, 1981 ~.,: '~f~nd;p~c~aocewiththerequirementsofthisB~rd. 15 37 19 i5' DRYERS FURNACE MOTOR:-- SERVICE DISCONNECT UNIT HEATER MUtTI-OUT~T DIMMER SYSTEMS NO. OF FEET t-G.F.C.I. 1-S~me~tect~ 1-4.5Kw, H.W.H. G & S Connractir, Box 215 Southold, N.Y. 11971 cerfifico?e taus! not be olterec~ ~ T i/e,578-g pectors fnO¥ be identified their COUNTY OF SUFFOLK DEPARTMENT OF HEALTH SERVICES DAVID HARRIS, M,D,, The attached approval was issued subject to the notation comtained below our approval st~,.o. Would you please type the foll*,,'f~ug condition of approval on the ~3~a! C of 0 as ~is will ensure that any future ~ner ~W_ll ba made aware of the nitrate problem. · ~- ~ Health Department '~rivate well with ~high ui~zaoeS - see note on ihLual survey. Thank Robert lo Villa, P. E. TGWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No ................................................................. Dote ........................................................ , 19 ....... To ............. ~'""T~ .......... ~'~'i"~O~'~p' ~ ~ ' ................................................... 'TZ'~'~ ...... ................................................................................ F~ Z~ PEtE TAKE NOTICE ~~ti~ doted .................................................... , 19 for~t~u c~E~g~i.~~..,. ~ .......... ~.~ ............ ~t the premises Iocoted ot .................................... ................. ~,.,~,.~ ........................ ~ .......... Street Mop .................................... Bilk ............................................ Lot ................................................ is · '"~"'"r~'r ...... ~*~"s'~ .................... m"'~';x:'~ ...... ~'.': ...... 7'""~'~'i'"¢:~ .... ~2~2 e/~, ~,~ ........................................................ - Fy- ~- ~/~/,~ ................ ~Eii~i~"i~/i~; ............... / INSPECTION RE$6RT No. 15 R~ymond C. Dean: Superintendent Town Highway Department Southold; New Xork DATE: September ~_~3~ 1978 FROM: John w. Davis ' , RE: PECONIC KNOLLS at PECONIC COMMbNTS: No evidence this date of any recent work. Road is rough graded only. Present road material (not full pavement width) is sand, loam and some gravel and has been compacted by grading equipment. Before pulvermixing is done, would recommend 6" to 8" of bank over the full pavement width. Water ponds in front of L6ts I and 2 (previously reparted). A ditch to an 18" CMP stub at catch basin Sra. ~9-00 Rt. does not drain the area. qbe pond area can probably be filled to a level where the ditch will function. Relocation of a drainage ditch (Shown on map dated April 17: 1975) at Lots I and 2 to catch basin at Sta. ~-00 Rt. has not been done. Also, on sam~ map, an existing drainage ditch to be filled and running through Lot 8 to the pond in the psrk area has not been done. The wood sluiceway (Park area pond) has been framed - - no flash boards. Catch basins with curb inlets and integral curb and gutter are in place at Sta.'h Rt. and Lt. O0 Tee CMP culvert at Sra. 6~5 is mare up with two CMP pipes instead of one 18" pipe as called for. 7he out fall end of the pipes is too lows the tops of the pipe are at the bottom of the ditch and the lines are silted. 7his c~fLvert should be reset so the inverts meet the existing draihage ditch. Although the pipe cross section of two 12" pipes is about the sa~e as one 18" pipe, for maintenance the 18" size shottld bg used. Teere-are no headwalls as c~lled for on any of the drainage lines. C.C. Southold Planning Bmrd C.C. Highway Committee C.C.L.M. Tuthill~ P.E. EDWARD d. BAGE PROFESSIONAL ENGINEER INSPECTION REPORT DATE ..... ~3 .v.~. r~ ~'.;c...2 P., ~,... 3,.~ ~.7.. TIME ................................................ WEATHER ........................................... RE: Peconic Hnolls COMMENTS: During the month of ~ovember I inmpected thi~ subdivision fou~ times and found the following conditions to exist: The steep,grade at the entrance ~o the subdivision has been re- duced by moving the point of origin of th~ road back in~a the turn-around on Henrv~ Lane. This action conforms to the racom- ~nendstion I made in mV Report 2o The culvert at lot#~ has been installed uns~tisfactorilv. > The pitch of the culvert is too steep. The exit end of the is at the bottom of a raths~ deep hole. This hole is full of wate~ and is a hazard. The inv~t of ~he culvert should coincide with the existiong d~ain~ge ditch. 3~ A pondwhich is not called fo~ an the approved map h~s been cre~ed along the front of Iota #1 and #2. An attempt ,~c drain this pond has been made bV digging a ditch f~omm ~his pond ~o ~he ~catch basin in front of lot#3. The pond ~emains. This pond an~d~In~ e ~i~ch are unacceptable and must be ~e- ~. The roa~ base is baeicallv l~am and is not acceptable fo~ re,mixing. Six inches of bank~un must be'appi~3d bero~$ the :. pulverm~ing operation.' ~' ' EDWARD ,I. BAGE PROFESSIONAL ENGINEER INSPECTION REPORT No...Z3& ..... DATE WEATHER ........................................... COMMENTS: The initial 150 feet of ~aad ente~ing the s~divisicn ha~'a 10% grade, this is too steep. In order to decrease this slops the paint of oriqin of the road should be moved westward into the turn- around at what is nee the end of Henry's Lane. , In a conversation wi~h you it was agreed that if the developer did the g~ading to move this paint of origin ~nto the turn-around the Tstun ltighwa~ Depa~mentiJOuld do the paving of this addltienal section of road= The developer has agreed to do ~he gz'ading ~o move ~he point of origin= : ,RECOMMENDATIONS: NOV 10 1972', EDWARD d. BABE INSPECTION REPORT DATE ~u~ustlS~ 1977 TIME ................................................ WEATHER ................................ COMMENTS: The road has b~en rough ~raded ta the re~ommandatione I made tn my ~eport #204, The d~ainagq culverts reccnnactin~ the mosquito control drainage ditches have not bean instalied but the devaioper said thev ~ill be instailed aa soon as possible. The cona~uction of the drainage pond has begun, When this pond is completed and the drainage culverts installed the.flooding problem should be corrected. Hr, Neison Axion calied me ~o register a complain[ about the elope of the road at the entrance to the subdivision, t referred him to the Toan Planning 8oa~d ~hich approved the profile of the road, RECOMMENDATIONS: EDWARD .I. BABE PROFESSIONAL ENGINEER INSPECTION REPORT TIME ................................................ WEATHER ........................................... COMMENTS: I met with Nr. Steven Tsontakis in regards tocadjusting the grade of tne road. We reviewed the proposed grades and found excessive cuts. The section from Station 3+50 to Station 6+50 was raised to conform more closely to the existing ground elevation. This not only precluded excessive cutting but also left a mosquito control drainage ditch intact. The cut from Station 8+50 to the end of the road was increased so that all of the road now pitches back away from the end of the road. This will preclude water draining from the road onto the land that borders the end of the road. The culvert at Station 6+55 has not been re-installed. This culvert carries a mosquito control drainage ditch under the road, The initial steel drainage pipe was crushed by heavy road equipment and a new pipe ~ will be installed when rough grading has been completed. RECOMMENDATIONS: P D HENRY E, RAYNOR, Jr., Chairman JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RITEHIE LATHAM, Jr William F. Mullen, Jr. Southold, N.Y. 11971 TELEPHONE 765-1938 August 13, 1981 Mr. George Fisher, Building Inspector Town Hall Southold, New York 11971 Dear Mr. Fisher: The following action was taken by the Southold Town Planning Board at their meeting on Fishers Island, August 12, 1981. RESOLVED to approve of the issuance of certificates of oc- cupancy in regard to the subdivision of Peconic Knolls at Peconic. Very truly yours, HENRY E. RAYNOR, JR., CHIARMAN SOUTHOLD TOWN PLANNING BOARD By Linda Kimmins, Secretary FIELD INSPECTION '" COMMENTS ~f ~'~- FOUNDATION FOUNDATION 2. ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, 19 ....... Permit No. //O '.~...~.,-~ Application No. /./...~...7.;~.. ................. DisappToved a/c ............................................................................. .:j ........... · ............ 7 ' ' ................... ................................. '~(~.C Zc,/ /~P/ APPLICATION FOR BUILDING PERMIT ~ Date 2/27 ................ , UL INSTRUCTIONS a. This application must be completely filled in by typewriter orl 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 buddings on premises, rebt~onship to adjoining premises or public streets o~ areas, and gwing a detailed description of layout ofproperty must be drawn on the d~agram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl ,ssue a Budding Permit to the apphcant 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 o 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 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 olterahons, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable taws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Adelphi Land Oo~p. (Signature of applicant, or name, if a corporation) Box 791, Mattituck, N. Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber~r builder. ........................................................................................................................... .I ......................... Name of owner of premises D & C Costello If applicant is a corporate, signature of duly authorized officer. (Name and htle of corporate officer) Builder's License No ...... ~..~.,D. ....................................... Plumber's License No...T~.D. ...................................... TBD Electrician's License No ............................................. Other Trade's License No. TBD S C 500t 1. Location of land on which proposed work will be done. Map No: ....... .P...e.D..o..n..~=g... K..n...o..]:..1..SLot No...~.~ ................. Street and Number ~.H.~.e.~`'~'X~.~.~.L..~...~-.~.e.~.~`~?.~e~.~.~.~.g~`t~..~.:~Y.~: ........................................................................... --~f/o~0 ~ Municipality 2 State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction: Vacant o. Exisiting use and occupancy ............................................................................................................................. b Intended use and occupancy Single Family ~esidenee proper,¢y lines. Give street and block number whether interior or corner lot. Nature of work (che~l~, applicable): New B6ilding X Addition Alteration"i ....... .~. .... Repair .................. Removal '. ................. Demolitian .................... Other Work .................................................... ,4/ __ (Description) 4. Estimated Cost .................... ~ .................................. e ......x ................................................................................. (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 ........................ Numb~er of Stories .............. : ................................................................................................. Dimensions of some structure with alterations or additions; Front ................................... Rear ........................... Depth ................................H'eight ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... ~..' ..................... Rear .....~.~.~ ................. D~th ..~. ................. Height .................... Number of Stories 9 Size of lot: Front [g2 Rear [~ Depth [2~ A~, 10. Dote,of Purchase ~A~ ~8[ Name of Former Owner ~ ~CE ] ~. Zone' or use district in which premises ~re situated Aeslden~lA1 12. Does,proposed construction violate ~ny zoning law~ ordinance or regulation: ...~ ................................................. 13. Will lot be regradedl ....... ~Q...~ ............Will excess fill be removed from premises: ( ) Yes (~) No 14 Name of Owner of premises C~¢ello Address Phone No. Name of Architect ............................................................. Address ................................Phone No ....................... 3ox 791 Name of Contractor A~eZ[)hl ~ Co~p. Address ...~¢,~[[.~e.E~ Phone No, 298-~599 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exl:fing or proposed, and indicate all set-~ck dimensions from or descriphon according to deed, and show street names and indicate See Attached Site Plan STATE OF NEW I Ss COUNTY OF ...........~..z. .............. ~' · Steve G. Tsontakis ................................................................................................. I~eing ,d,uly swprn; depases a~d says that he is the applicam (Name of individual signing contract) above named. He is the 2 ........ .OO~YA0&OY. ...... : ..................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duik 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 2.~ , f Feb ru~y ,~ 81 ....................... aa o, . .......~. ...... ~ ................. (,..,., ly ... (S~On~turo o{ opplic~nt) L/NDA F. KOWALSKI ~OTARy PUlL,O. SL/o al ~ew No, 52.452477~ j j Commmslon Expires March 30~ High Nitrate~ - Water not to be used for preparation Of baby ~ormula or consumption by infants under 6 mos. of age. ~actlitt~a ~r thi~ lo~a~lon have HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT M NEAR[ST WATER iaAINl-[tal _ W SOURCE OF WATAR ~l~T[ PUBUC ~ S~F CO TAX M~P ~T I000 SE C TION ~ BLOCK ~ LOT~4~7: OTHER THAN THOSE SHOWN HEREON ~ ~'1t~ LOC~TIO~ OF WELL(W), SEPTIC TANK(ST)a CESSPOOLS(CP) SHOWN HEREOR SURVEY FOR DANIEL d. COSTELLO ~ CAROL A. COSTELLO LOT 6, "MAP OF PECONIC KNOLLS" AT PECONIC TOWN OF SOUTHOLD SU_FFOLK COUNTY, NEW YORK JUNE 5,1981 MAR 2~ 198i DATE FE~ 24,1981 SCALE I"=§0' NO. 81-61 GUARANTEED TO' FIRST AMERICAN TITLE INSURANCE CO. OF~I.Y. RIVERHEAD SAVINGS BANK DANIEL d. 8~ CAROL A. COSTELLO YOUNG a YOUNG ALDEN W YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S LICENSE NO 12845 HOWARD WYOUNG~ LAND SURVEYOR NYS LICENSE NO 45893 RIVE YORK ~7 AX 10 Z3 [XCAVAlIO# INSlTefl REQUIRED SUFFOLK COUNTY D~ARTMENT FOR APPROVAL OF CONSTRUCTION ONLY SUE DIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON UEPT. 29~ IUT7 AS FILE NO. 6607 N ~ LOCATION OF WEI. L(W),SEPTIC TANK(ST)D CESSPOOLS(CPI SHOWN HEREON &R~ FROM FIELD OU~RVATIONS AND OR DATA OETAfHEO FNOM OTHERS TOY POST E0494 SURVEY FOR DANIEL d. COSTELLO 8~ CAROL A, COSTELLO LOT 6, "MAP OF PECONIC KNOLLS" AT PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE FEB. 24, 1981 SCALE I": SO' NO. 81-61 H COPIES (~ THIS SURVEY NOT BEARING THE LARO I RIVERHEAD SAVINGS BANK PURPOSE AND ARE NOT TO BE USED TO ESTABLISH I ~ X~~/ ] ~ VENUE 70UNG YOUNG & : ~ J HOWARD W. YOUNG, LAND SURVEYOR ~ ~ ~ NYS LICENSE N045893 FIRST AMERICAN TITLE INSURANCE CO. OF N.Y. · / v SURLY FOR DANIEL J, COSTELLO ~ CAROL A, COSTELLO LOT 6, "MAP OF P/CONIC KNOLLS" MAR 27, 1981 AT PECONIC OA~E FEB. 24, 1~81 ~WN OF SOUTHOLD SCALE 1%50' SUFFOLK COUNTY, NEW YORK ~0, 81-61 ~ U~UTaOaIZEO ALr[eat~O~ Oe AOO~T~O~ suev[Y · ~ wo~t~o~ ~ s[c~o~ N~W ~O~K S~ATE EDUCATION LAW FIRST AMERICANTITLE IN~A~E C~OFN,Y. ~COe~ES ~ tins SU~VE~ ~OT ~Aeee suev[~'s ~aKEO SEAL OR E~eOSSEO SE~L Sa~LL OANIEL d.~ CAROL A. COSTELLO HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUCT AND ~ HmS ~E.A~F m THE TITLE C~P~Y tTHE~ ARE ~ ~ELLI~I WITHIN I00 FEET Of THIS PROPERTY INSTITUTI~ GUARANTEES ARE ~T T~SFERABLE TO ADDTONAL INSTITUTES OR SUBSEQUENT WILL C~FORN TO THE STAN~RD5 OF THE SUFF~K COUNTY DEPARTMENT TO EXiSTIN6 STRUC~RES ARE FOR A SPECIFIC T~[ ~ '0 R AVENUE COUNTY ON IEPT. ~8, I~T~ AS FILE NO.G~OT ~ I AND ~NO SURVEYOR N Y.S UCENSE NO. 12845 ~ ~ I HOWARD W. YOUNG, LAND SUeVEYOR ' ~ L~T~W~L(W),SEPTIC TANK(ST)SCESS~OLS(CP) SH~N HERE~ . ~ m~ N Y S. LICENSE NO 4.5893 ~E FR~ FIE~ OBSE~ATtONS ~0 OR ORTA OeT~fl~O FROM OTHER S NY8 ?E:~ 42817 i -9 II STEVE 'i'S,OH f'~-,,,''IS