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HomeMy WebLinkAbout11686-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . .Z:12Q36. . . . . . . . Date . . . . . . . . . .November. .2. . . . . . . . . .. 198.3. THIS CERTIFIES that the buildingACCEMORY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 2645. Elijah .Lane . . . . . . . . . . . . .Mattituck . . . . . . . . . . . . . . . . . House No. Street Hamlet County Tax Map No. 1000 Section . . . .1.08. . . . .Block . . . . .Q4. . . . . . . .Lot . . . .7._15. . . . . . . . ... Subdivision .Elijah.Lane .Eatatea . . . . . . .Filed Map No. .6055 . .Lot No. . . .12. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . .Aprj,1 .26. . . . . . . . . 19 .82pursuant to which Building Permit No. . 1A686Z . . . . . . . . . . . . dated . . . . .May. 2.1 . . . . . . . . . . . . . . . . 1982. ,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 . . . . . . . . . . . . . .FOa' -a - coal- b1n-and- -deck. -ad dd•Lion•..to - main- dweI3 irrg : . . . . . . . . . . . . • • • The certificate is issued to WILLL4P1 & JEAN SCHPIITZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner,lessee ar tenant) of the aforesaid building. Suffolk County Department of Health Approval . NA . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . .N/A „ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev. 1/81 FORM NO. 8 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) V11686 Z Date .............................)//fLc.x... Permission is hereb granted to: / rZ ..... ............... ::�...... * ............................:.... :.......—`:.`'.°,.........;.1:.1.� it ef , z ................................................................................ to ........... :./(/ C?, / a,,........n i(l , , �1...........!...... .................. .....r.�... ........ .................................................................................................................................... at premises located at .......... .... / ............. .:..{... n.��.:� r�.� .._.................� ... . . ............ ... . � 1 �` �......................... ...... .. ..............t1.. ......................................................... :n' ^...`.... :......... `r,Y�.......... t�r!...�.r.,�....1'°h5 .....''."... �Z ... County Tax Map No. 1000 Section ...... ........... Block .........1V........... Lot No. .....' pursuant to application dated ..�.a...... .....................::! �9 '.. pp y............. �::!............, 19.4....., and approved b the Building Inspector. / 5 Fee $........................ ............................................................... ............... Building Inspector Rev. 6/30/80 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: 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 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling land use --Pre-Existing C . 0 . $ 1 5 . 00 3. Copy of certificate of occupancy $1.00 Vacant land C . O . $ 5 . 00 Date . . . 10:1Z£3 . . . . . . . . . . . . . . . . New Building . . . . . . . . . Old or Pre-existing Building . . . . . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property EL IJA tf•. SANE. . . ..U.CI, , , , , , , , , , , , , , , , , , , , , House No. Street Hamlet Owner or Owners of Property '.J qp 1. .- CfgN! rL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . . . .03. . . . . . Block . . . q . . . . . . . . . . Lot . .7. .�,5 . . . . . . . . Subdivision{. j?tKf X!N`. . £STi4TT . . . . . . . .Filed Map No. . . . .Lot No. !2 Permit No. I I �b Z Date of Permit . . . 0-f'. .41 Applicant .w.ILL10t-Y1 SCHrnITZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval . . . . . . . . . .. . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . .` . . . . . . . . . . . .Planning Board Approval . . . . . . . . ... . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . .f. . . . . . . . . . . . Fee Submitted $ . .5:0 0 Construction on above described building and permit meets all applicable codes a ulations. Applicant . . .� l C C . . . . . . . . . . . . . . . . . . . . . . Rev.10-10-78 S `C o � 1- .s -- � M All r i a � © I v � c u IEli, � 1� _ Lu cq Ltj w �_ ° rk J l� CL LL -- u s I i I I I c - J VI n C., � c S :t - r / v 7,0 � o a, SDFFOLY COUNTY HEALTH DSPAATL:ENr V APR 5 1974 DAT)r H. D• REF. _�• - Thu sewage disposal and water Supply facilitirs for this location have teen �s inspected by this department and found to be satisfactory. �5 I Chief of Oe a eer rvicea N �P J -4 ~I h It P. ��� / Pt i +L �. ♦ ,p/N,, �`a 10, J � n �' o♦♦moo Z CP 'J v y f.. Irmo LOCArrom OT WLLES AND CESSPOOLS SHOWN HEREIN ARE FROM FLELD OBSERVA17ONE e`L AND/GA PNOM DATA CATAINED FROM OrHVAI �E i� g1 HOFE s' S(1S0jV1S10#M4PRLE01#VrHEOFFJCE 0FrHeCLC-RKTS, FFOLKcoavrYL'IM +t FEB./4,1974 ASS iFIt E W.8065 j► NE-VISIONS YOUNG & YOUNG .. MAR 7,19T4 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK `Il�j., APR 2 'w'771 1974 HOWAND W.YOUNG ALOEN W. YOUNG ,AND SURVEYOR i1'" 1•ROF'Css1ONAL SNUINSER AND t •�tl9] LAND SURVEYOR. N Y.U. LIC. NO. IZD45 SURVEY FOR: qE }E N`y, cf ,ao INLAND HOMES INC. 41t,. ^w I ED " f . d_.,.J•. pr •'—1 -IEL OON LOT NO.121° ELIJAHIS LANE ESTAT ,S O 1 �°o*IN r.,, + a.t. vac •,;r er ea r. -. : ... F•uu n'I o-t v♦•nn:nc' A7 GUA , EEt�{01`7; �( MATTITUCK • ' j� s TOWN OF' SOUTHOLD \dr p t I�P•+ ,♦ t ^:ass. It�„ :: SUFFOLK CO., N. Y. L,,, ♦ ..'.'f". tot_ p , DAt PF "Q✓r •��a•''t,...a. SCALE: I t 40 SEPT.28.197.3 73- 99 !G= NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................................- 0�/, 19...Q� �.' —� �j Application No. ......t•.. ..... Approved �.4 19......�.:Permit No. �r 6 Z— Disapproveda/c ........................................... ................................................ .... .................... � ./%G ...... ...... . ........ .. . (Burdrng Inspector) APPLICATION FOR BUILDING PERMIT Date ......:! . ............................ , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildin 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 c areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicotior 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 perm 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 Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulation, and t admit authorized inspectors on premises and in buildings for necessary inspections. ppl i r name, if a corporation)o ons nufa pox5 /(95j, (Address of opplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder dLo-&)L'R ................................................_................................................................................._................................................................ Name of owner of premises ...L�LL(qn �cff,s+ i.Z. �(�-dYti , ....... ....................... ................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. .............. ................................... Plumber's License No. ^..................................... �j�3.� yO �� �(� 'Ap-l2 Electrician's License No. ........—.............................. l( 000 10 fl ' 7• t_5� Other Trade's License No. ...........-.............................. _ 1. Location of land on which proposed work will be done. Map No.: ...A?Tt.�v �................. Lot No. 7:..01r... Street and Number ..... Z,6H� ��/3��f.!�s......�!f f?.i ..................................................eMV/.ZUC;A.......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy S /N6LZ fAM/cy f/Oe+r� b. Intended use and occupancy ...........5:5?6:...... ........................................................................................ t 3. Nature of work (check which applicable): New Building .................. Addition ......`�........ Alteration .............. . Repair .................. Removal .................. Demolition................... Other Work ................................................ .. A (Description) 4. Estimated Cost ...z�/Ov...........................................Fee ......(. ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. ............Number of dwelling units on each floor ......................... Ifgarage, 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 ....:S.S.J............. Rear ...:S:S.r.. ................ Depth ....Z.2.tLn.. Height ......1G............. Number of Stories . .. .....:................................................................................ Dimensions of some structure with alterations or additions: Front .................................... Rear ........................... Depth ................................ Height ...........................7..Number of Stories ................................ �/ 8. Dimensions of entire new construction: Front .........l......��............... Rear.....7...In,........... Depth .....[......I...... r Height .................... Number of Stories .................................................................................................................... 9. Size of lot: Front .............../:5 /.............................. Rear ........f s .o(R..�/............... Depth ...LS(o�.2.q....... 10. Date of Purchase Z-./7.r ................Name of Former Owner ZiF/aE fC(. 11. Zone or use district in which premises are situated ...................f............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...........IW.R................................. .... 13. Will lot be regraded .........AQ........... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premisesL91Y r z....... Address Y[ (T...SYOAW%arw No. Name of Architect .......................:..................................... Address ................................ Phone No. ..................... Name of Contractor ..................... ..................................... Address ................................ Phone No. ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions fron property lines. Give street and block number or description according to deed, and show street names and irx4ir:att whether interior or corner lot. J )„ r 17 - � �- V! `O tom_ I \ STATE OF 1 S.S_ _� ........9 being duly sworn, deposes and says tFe is the npplican (Name of indi ual signing cont above named. S 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 fil. this application; that all statements contained in this application are true to the best of his knowledge and belief; on: that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this �� oG ,-lay of ................. ... 1 I NSOW Public. ............... county ......... .................................. (Signature of plicant) ye te kF fs 6Wwe MirMM