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Home My WebLink About6498-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy A~gtmt l? No. Z,5~l ...... Date ..........l~[~][~J~ll;$~ ..... , 19.73. THIS CERTIFIES that the building located at .D. ~.~.1r. .R.o.~d. ............... Street Map No. Su~aae.t .Klao~ll~k No. II ........ Lot No..1+?...Nat.tit-~..k.. N~X · ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........April.. 4~, 197.3. pursuant to which Building Permit No.. 61+95Z. dated ............... Apr-il. 2~019.73 ., 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 . ~r..~.v.a.t.e.. p.n.e...f.a.m.~..].y..d.w..e.~.l.~.ng ...................................... The certificate is issued to .fir. egory..&. P. aule.tte...Gouture ........ (h~narz ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~ug...~..1973..by R.. ¥111a ....... UNDERWRITERS CERTIFICATE No.. N. 10.5.~60 .... July... 26... 1973 ............ HOUSE NUMBER . 58.~ ......... Street ... Da&wy. Read ........................... Building Inspect~ FO~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEP.T ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6498 Z Date ...................... &]33~ 1 ....... 20 .......... , 19...~.~. Permission is hereby granted to: .......... .Is3,2. ......... ~lddle ..Cot~t~'...ikmd ...... ............. &aid.eh ......... L,,I.,, ................................. Build new one family dwelling et premises located at ...~.Q~....~.~. ....... ~S.~;..~IOJ,~,~.....II .......................................................... ......................................... ]~.~e~...Roa4 ......... ~tf~.tue~ ............................................................. pursuant to application dated ........................... &j~Zt;~, ....... .1..]...., 19.7..].., and approved by the Building Inspector. Fee $..~..0..?..0. ~'. .......... ' ' Building Inspector ~ORM 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, 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 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 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: 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 8/14/1973 Dote ................................................ New Building.....XX ...... ..... .... Old or Pre-existing Building ............................ Vacant Land ............................ S/S Daisey Rd. Mattituck, N.Y. Locotion Of Property ..................................................................................................................................... Owner Or Owners Of Property ..... ...G~...~.g.~.r.~.....A..,....C...°..14..~l!~...~. ...................................................................... Sunset Knolls 47 Subdivision ................................................................ Lot No ............. Block No ............. House No ............. 6498Z:.4/~.0/7;~. Inland Homes I~lc. Permit No ..................... uare UT Permit .................... App[icant .................................................................. Health Dept. Approval ....3.....S..O.....3:..~.......4./.%.6./.~.3....Labor Dept. Approval ................................................ Underwriters Approv(~5.3:..2:.O...3.....,.7.../.~..0./...7--3.. .............. Plann ng Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~ .......................... Fee Submitted $ ...5,..QO ........................ Construction on above described building and permit meets all applicable codes and regulations. Applicant ....I..n.,1.,.a~,..d.....H...o_m...e..s./Kenneth W. Thurber ..... Sworn to before me this ~~~'~ ~ ~ /~7_} ..... (stamp ........ ~..,~.. day of. or seal) ~ a ;~ ~' / Notary Public .................................... County ~ ) ~C~,~ff, ~?[ THE NEW YORK BOARD OF FIRE UNDERWRITERS ;~ '~l E~UREAU OF ELECTRICITY I~ ~ 85 JOHN STREET. NEW YORK. NEW YORK 100:~8 060 ~ a,~ July 26,1973 ' :, Gregory A. Couture, s/s Daisey Rd. Job ~185- ~cCituck,LI. S~etio. Stoc~ ~7 Gero§e Zimlin§haus 4 Park Pl. Pa~chogue, L.I.11772 This certlficote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified b ~n'eir credentials. SUFFOLK 50UNTY HEALTH DEPART~ENT The sewage disposal and .rater supply 5~ties for this location have been ~s~eeted by this d~artment and found to be satisfactory. . Chief of General Engineering ~v~ D I$y UNAUTHORIZED ALTERATION OR ADDITIOJJ TO THIS 5URVfY IS A VIOLATION OF SECTION 72C9 CF THE NEY1 YCRK STATE TZGEN 135 11846 SUBDIVISION MAP FIA ~O IN ~H~ OFFIC~ OF rtt~ C L Fink OF SUFFOAK COUNr Y' OAI AP~.9 ,19FO ASFIL~ NO~44~* .EV,S,ONS YOUNG & YOUNG NUtYa$,Ie?$ 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK JULY 19,197:5 ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES, INC. LOT NO. 47," SUNSET KNOLLS, S~ AT MATT ITUCK '~ ~ ~~-'~,e~ K SE~EI '~ A ~ eY ' '~ ' ~e ~>'~ SUFFOLK COUNTY DEPARTMENT OF HEALTh H.D.Reference APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested,perti~)data herewith: Date__~ 1-Applicant Greqor.v A, C 0 U T U E ~ Phone739-6708 6-Sub div. SUNSET KNOLL5 Address 7] ~.~,,nn~ ~__ NIANT~£. CONN. 7-Section. 2 2-Detailed property location Daise~ Road 8-Lot No.. 47 Hamlet . M^TTITUCK Town SOUTHOLD 9-Private well7 No 3-Public water supply name £nn~n KiddQ Distance to nearest main 4-Lot Size: Width 115 ft. Len~thl?5 ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~×~ Two Family? ~ /Cellar? /XX/.Slab? / ; Crawl Space? lO-Proposed system: Septic tank · /Precast y /Cesspools ~X/Shallow pools il-Septic tank inside dimensions: Volume 9OQGals. Length ft. Width. ft. Liquid depth ft. 12-Precast sections: / ,Number/ /Square Ft. Ce~s. spo~ls.'_ B19ck sizeI~ incs. Dins. H ins. Total blocks below inlet: ~1 ~2 ~3 .~4(J ~ PLOT PLAN · Street DAZSEY ROAD .C 'ad9 _~ W.L. Indi No' Data Feet 0 2 4 6 8 lO 12 14 16 18 The Undersigned CERTIFIES: "Construction of authorized installation, will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date 13 ^p=tZ ~973 Signed ZNL^ND HnMES, ~Co/Ko Thu=be= Owner or Builder FOR HEALTH_DEPA~TMMNT .U.~E .ON. LY.. Based on"the information presen6~d herewith, it is the ~:~n be insballod on ~hJm TOWN OF SOUTHOLD '"'"/~ ~,~'.s'(,-,c~ ~(~,,,~,~)- ~,~,(,/~ ~.. ~V~ t BUILDING DEPARTMENT ? .,c~,.,,=~z~-,Z'--~. TOWN CLERK'S OFFICE SOUTHOLD, N.Y. - Application No ..... .¢(. ......................... Disapproved a/c ............................................................................................ Date ........ .~3.. ,a~,~,~k~ ....................... , 19..Z~ ...... - ' · : "INSTRU IONS a. This applimtion n~ust be completely 'filled in by t~pewriter Or in ~nk end submitted in triplicate to the Building Ins~ctor, ~ ~t$ of ~ans, ~¢uret~ plot plen to amle. Fee a~ording to mhedule. b. P}ot plan showing'~o~ation of lot end of building~ on premiss, r~qetionship t° ~l oining premises or public str~ or are~, er~ giving e detailed description of layout of property must be drawn on diagram which is pert 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 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 pert for any purpose whatever until a Certificate of Occupency 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ell applicable laws, ordinances, building co, de, 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) (Address of applicant) State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or builder. ~ENERAL CONTRACTOR Name of owner of premises G=ega=y A, and Paulette H. C b u T U R E If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......................................................... PlUmber's License No ....................................................... - Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be dOne. Map No ........... ~.~.ll...S.~y.9~( ............... LOt No.: ,..4..'(..~ .............. Street and Number ................. ~D~a~y~d~u~n~9~9~K~n9~9=~j~[~K*~^~^ MUnicipality 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. b. Intended use and occupancy ~ne (1) Family ])ue11~.ng. Nature of work (check which app!icable): New Building ..... ..N.E,~. ........... Addition ..................... Alteration ...... .~. ....... · Repair ........... Removal ......................... Demolition ........................ Other Work ................................... ..... ....... (Description) ' ',,o*=~ ~',,~t $23, O00.O0 4. Estl .......................................................... Fee ............................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .1. .......... Number of dwelling units on each floor ......................................... cars .......... ~; .......................... g. ................................................................................ If garage, number of :: 2 [;ar-i~a=m · . .. 6. If business, commemial or mixed occuoancy, specify nature and extent of ~ach 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 ........................................ 6a.6. - . 8. Dimensions of entire new construction: Front .....6..~.6.". ...........Rear ....... /. ................... uepth ......2..'(.~, ..................... Height .............. 11/!. ............................. Number of Stories 9. Size of lot: Front . .. 11~,s..0,0t ..... Rear 115.00r . De"th .. ~..'(.5.~P.0s ................ 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction Violate any zoning law, ordinance or regulation: .....N..o. .................................................... 13. Will lot be regraded ~.:~ ...................... Will exCess fill be removed from premises: [ ] Yes [ ] No [NLAN]) HOHES, INC. SELDEN, NEId YORK 732=2177 14. Name of OWner of premises ...................................................................................................................................... TN[AND HO,ESs TUft. SEL~d~re~/' ¥'ORK 732_~l~btoine ,o.) Name of Architect ........................................................................................ '~.::'-. ...................................................... (Address) (Phone No.) TN[AN]) HOIflES~ TNC. SEL])EN~ NEll YORK 732-2177 Name of Contractor ....... ~ ....................... ~ ....................... (Address) (phOne No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show strt~et names and indicate whetfl- er interior or corner lot. STATE OF NEW YORK, SUFFOLK ) COUNTY OF ...................................................... ) ll5, O0 ' KENNETH W, THUR~ER, V.P; .: ........................................................................................................ being duly sworn, deposes and says that he is the applicant above named. {Name of individual ~ig~.ing c. ontract}~ , ~ ·, .: He is the ....~.~.~.~....R~..L.....~.?...~.T.R..A...C..T.O.,,R. ......................................................................... ~. ........................................................................................... (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 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. Notary Public ...................................................................... County ....................... ......... :;.~,-- .................... {Signature of applicant) · = MONUM~N~' API~.~,I$?O ASPILE NO~44~ .~WS~ONS . YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES, INC. LOT NO..47," SUNSET KNOLLS, sEC.T/J,.0'~~ AT MATTITUCK sc TOWN OF S0UTHOLO '~:': ," : 40' 1' I I