The URL can be used to link to this page

Home My WebLink About8185-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...Z(~97.~. .... Date ......... .Apri, l... ~. ...... , 197.6.. THIS CERTIFIES that the building located at . itOlXtlil.~J, OW. i~$ ........... Street Map No..~ ......... Block No...~ ...... Lot No, . ~.. 5~h0~5.. ~Y~ .......... coniorms substantially to the Application Eot Building Permit heretolore filed in this office dated ............ Sep~ ..~.., 19.g~. p~suant to which Building Permit No. ..~. ~ dated 8ep~ .8..*~ .&. A~ .~9. ~., was issued, and conforms to all of the requ~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~ate..~e. ~am~ly .dw~ll~ ....................................... The certificate is issued to . .~a~. ~ .Delores .... K~88k ..... ~ers ......... (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of He~th Approval .Ap~'I.1. ~. ,%9~, - .BY. R, .V~la ..... UNDEaWmTEaS CEaT~FICATE No. ~7~S3... ~.. ~.. ~.975 ................. HOUSE NUMBER ..... 90~0 .... Street . ~q~Y~.~W. AE~ ......................... Building Inspector FOl~I NO. ~ TOWN OF SOUTHOLD 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) Ne 8521 Z Date April 21 ]9...2.~.. Permission is hereby granted to: ~,~2.;Li~a ..;f.r .e,.~ .~.~.~ k ..~...~i.$.~.e. ......................... :. .................... ~.o.u.t hold ......................................... to ~.b.~`~f~d~.zm~ad~dLti.~.~(`~:~.~¢~)~.~.xt.~.~.~.~.t.~qg~..~.~.~.:L~.$.n..g ............................................... at premises Iocat,ed at 90.~0 Seined View Ave Southold pursuont to opplicotion dated ...... ~i~..~.~........~..1. ............................. , 19.7...~..., and opproved by the Building Inspector. Building Inspector ~ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 topogral~hic 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 th'e 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 p]Coperty 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 $25.00 -- BUSINESS $50.00 ACCESSORY $]0.00 2. Certific~olr-occupancy on pre-existing dwell ng $ 5.U~daeed C.O. ~ 50.00 Date ....... /.~ .... ~ ............ Mew C on 8 ~ ~ u c ~ i o n...~OId or Pre-existi~g Building .. ~' ....... Vacant Land ............. Owner or Owners of Property .... . ..................................... Subd v s on ............... F led Map No Lot No ......... ..... ............... .... "'t ............................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ...................... ..................... Final Certificate .~'. .................. Request for Temporary Certificate Construction on above described building and...p~rmit meets all applicable cp~es and regulations. ............... Rev. 10-10-78 · FOI~Vl NO. $ TOWN OF SOUTHOLD , B.ilding Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OP, ink, and submitted in DUPLICATE to the Building inspector with the following; for new buildings or new use; ]. Final survey of property with accurate location of all buildings, property lines, streets, and unusual naturol or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposel--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, ~Aultiple Residences and similar buildings and installations, a certificate of Code cornpli~nce 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-exlsting' lend uses: I. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os 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: ]. 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 N .. V' . ~ I "re ex~ t,n Bud 'm --" . Vacant Land -'- ew building ................ AddiHon ................ O d or ~' - 's ' g ' o' g ....~ .......... .. .............. Location Of Property .,~.~..~,~...0.~....(~.~.;.~.~.~.~...t~.~...g..f~.,.~.~..~.....U,J..~..~.~.'~,.'?..~.~.~/~.....~ / Owner Or ~ners Of Prope~y ~.0J.~;~.~.{[J.~.~.~.....~%.~].~.~.~.~ ......................................... ~... Subdw~s~on ............................................................... Lot No ............. Block No ............. House No...,./ ....... Permit No ...........} ....... Date Of Permit ............. Applic~t ...... ~5 .... .~ . [1~ Health Dept. Approval ............................................ Labor ~pt. Approval ................................................ Underwriters Approval .............................................. Planning B~rd Approval ........................................ Request For Tempora~ Ce~ificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building~and permit meets all applicable ,codes Sworn to before me this ................ ....... .......................... Nota~ Public ............ ~ .................. Coun~ N ,~q~ ~meng as deserlbed befo~v and ln~roduced by the applicant na~ned on ~he above a lie ' ' .~.~T ,,,,,,?.o~, ouunav~ew ~venue ~enny Road, Southold, L. . March 29 976 F'XTURE OUTLETS' SWITCHES' 160 ,~ ,, :,, 70 DRYERS ' ';FURNACE FUTURE APPLIANCE FEEDERS ,and found to be in compliance with the requirements of this Board, RANGES OVENS TIME CLOCK! UNIT HEATER<. SYSTEMS 500MOM Panelb~ar'cl;-;s: I-6clr. 15Oamp, 1-26cir~.~50amp I-4oSkw hot water hea?er,- 1-18,0kw & 1-12,0kw elec, C E Fur., 1-10amp FoodBI ende 'Richard Gwydir Vanston. Rd. , Cutchogue, L.I. 11935 '.7. LIC# E2002 D Per_ This certificat~ must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by FOB~E NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8185 Z Building Inspector. Fee $ Z~..~...'.....O~..~. Building Inspector TOV~N OF SOUTItOLD Building Inspector's Office Town Clerk Building $outhold, N. ¥. 765-2660 COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number ~-~S'O APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVA?E SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ~/~)/j~,/'~ )~"~ 17~, Phone ,Address~~ ~ ~,~T¢~ ~V 2. Property [°6a~on ~ m~ ~J ~¢~ ~' G/lO ~~ ~ ~,~ 8. Private Well Village ~auYJ~ ~wnshlp ~~ ~ 9. Pub)lC water 3. Public Water Compan~ Name ~ uistance ~o main 4. Lot size: Width/7~ fee~ Length~ feet 10. ll. Sewage Disposal System: A. O~gallon septic tank: Precast___.Equivalent~ B. Leaching pools: Block Number of pools : Precast ~ Block Special__ If private well, fill in the fol- lowing blanks: A. Tank capacity, ~c~ .gallons B. Pump G.P.M. f Co Total well depth D. Depth to ground water E. Amount of water in well (Fo~ Health Services Dept. Use) 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. Date Signed 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. APPROVAL DATE - SIGNED S-15 Rev, 4/1/73 In,p or)_ ..................................... , 19.....~ .... ~. ~is o~li~oti~ mu~ be ~o~letely fill~ in by ~writer e¢ in ~nk ~ s~ml~ im tripl~m ~ ~ ~ui~i~ Insp~tor, with ~ m~ ef pl~s, o~umte pl~ plan ~ mia. F~ ec~o~ing to ~u~. b. Plot plon sh~in9 I~etion of lot ~nd of buildings ~ premis~, relotlonship to ~joinin9 premiss ore,s, ~nd 9ivi~ e detoi~ de~ription of I~ ofpr~ must be d~wn on the diogmm which is c. Tbe work c~ere~ by this ~li~eti~ moy n~ be comme~ before i~uon~e of Building Pe~it. d. Upon oppr~ol of this oppli~otion, ~e Building Insp~tor will issue ~ Building Permit te the ~1~. ~ ~rmit s~oll be kept on the premises ov~ilo~le ~r imsp~tion tHro~H~t tNe e. ~ building sbell be ~cupi~ ~r u~ in whole or in ~ for ~ny pu~ose wH~er until ~ ~lfi~o~ of ~u~ncy sh~ll h~ve bee~ gmnte~ ~ the Building In~tor. APPL CAT ON S HEREBY ~DE to the Building Depadmont ~or ~e issuo~e ~f ~ ~uil~ Bud ng Z~e Ordinon~e of tNe ~ of ~old, ~ffolk doun~ New York, ond o~er oppli~le ~egul~tions, ~r the constru~ion of buildings, ~itions or oltereti~s, or for mm~ol' or demliti~, ~ ~in d~ri~. THe oppli~ont o9rees to ~omply with ~11 oppli~o~le I~, I ~, h~sl~ ~e, ndmit ~uthoriz~ in~tom on premiss ond in ~ull~ln~ ~r ordirenc~s, bulldi..ng co~, I State Whether applicant is owner, lessee, agent, architect, engineer, general contractor, eleCtrician, plumber or builder. ,' Nome of owner of ~, .......................................................................... , ....................................................... (Name and corporate officer) Builder's License Other Trade's License No ................................................ 1. Location of land on which proposed work will be done. Mqp~..~... · · . · .~;,.,~ __N°"~~' ' Lot No ......................... Street and Number ......................... ~.~t~'al~.d~lF~,al.:~ll~.i'iii'ii'iii'iiiiiiiiiiiiii'.~;~l~M~aW~4~i~ ........ 21'\ State existing use and occupancy of premises and intended use and occupancy of proposed cdnstruction: a. Exisiting use and occupancy ....~....~.J~"~4~..~( .................................................................................. b. Intend~duseondoccupancy.O~-~J~.'....-.,ll'~""'"'~'~ll.~'.~7...~/':~?~l~'~, ....................................... 3. Nature of work (check which applicable): New Building.. ................." Addition .................. Alteration ................ Repair .................. Remov~J .................. Demolitior ..................... Other Work ..................................................... Jm~.~...~...~..~....~(....~.. (Description) 4. Estimated Cost ........................ ..(-~.. ................ Fee (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 ~'"~1,(/~ ' 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ....................... ~u~mi~r,l~ of Stories ........ ~;~,~,e ........... <~,~, 4' 8. Depth Dimensions o ire new construchon Front ~ , Rear ~' .)ns~o~f~e~/.,.~.... ' : ............. ... ....................................................................... ....... Number of Stories .......~....~...x~.. ............ ~/j~. ~ ~ .......................... ..~....~.-T.,.yl.i~~, ~, Height Sze of at' Front . /~;/--'~ R ~-- - -.,-, 7; ..... 9. _ ............. ~ij~j~ _ .7.~i-~ ..................... ear ....~. ......................... ~,.~.~.ept~l~w.~,,~ .............. 10. Date of Purchase ........................................................ Name,~o~mer Owner ...; ............................... ~.. .............. 11. Zone or use district in which premises are situated ................................................ .;~::~ ......................................... 12. Does proposed construc~p~)v~iol.ate any zoning law, ordinance or regulation: ........... i 13. Will lot be regraded ..........~r:...~e~.~_..~jbe removed from premises: ( ) Yes (-) No 14. Name of Owner of premises .................................................... Address ................................ Phone 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-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. STATE OF NEW YORK, ~S S ~mame or inaiviaum signing contrail above nam~. (Contractor, 6gent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thru the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this Ne. S2.8125850. Suffolk County ~nauthorlzed alteration or addition to this survey is a vioJatioa of sechon 7209 of tbs. ?,'%' Yo~k ~tete Education Lew. ' ' ' , .... surveyor's inked ~ ' ~ ~ ' ~L,~c¥ ~d copy. SURVEY FOR WILLIAM KREITSEK AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUI~T¥~ N.~. GU~IRANTEED TO: AMERICAN TITLE INSURANCE CO WILLIAM KREITSEK CL4Y' ¢ / ~/~t.5/ 7 × SURVEY FOR WILLIAM KREITSEK AT SOUTHOLD TOWN OF $OUTHOLD SUFFOLK COUNTY, NDV_ I?. DESIGN #1252 (~ HOME PLANNERS, INC.. DETROIT TERRACE MASTER BED RM, 154xl3S CL, 90'-0" 66'-0" PLAY TERRACE 24'-0" TOOLS STOR, STOR, BATH BATH FAMILY RM, 21Bx 12S BEAMED iI , RAISED KIT, 12°x 130 DN, OPT, BSMT STAIRS GARAGE 23Bx 234 BED RM, BED RM, l lSx 154 134x II6 ENTRY RM, 19ex 136 DINING RM, IoBx 156 1985 SQ, FT, Selected for House Beautiful's Special Publications BU / NS ILDIN6 MANUAL HOUSES & PLA VACATION HOMES u IA 7;4" i //:$/¢,, F / 0 0 ~ APPROVED AS NOTED NOTIFY BUILDING DB'PARTMBNT AT tr7-~765-2660 9AM TO 4PM FOR REQUIR~ ED INSPECTIONS: TION OR START FRAMING d ..4 '1 ,! HOME PLANNERS, INC. .,AN .o. 163].0 GRAND RIVER AVE., DETROIT 27, .ICHIGAN I 2 5 2 SHEET I IRVING £. PALMQUIST-ARCHIT£CT x, RICHARD B. POLLMAN-D£s~N£R L 5L4" J I I F ,~ 0 ,,'V T E £ Z' l/ A T / 0 N .~c ~ ~ ~ a."=~'-o" L T k HOME PLANNERS,' INC. PU,. No. SHEET 2 IRVING E. PALMQUIST-ARC.]T£CT or 5 RICHARD B. POLLMAN-D£Sm.£R ga: UAI £2( ¢ A I/ A T£ O 34:4" UUEX'c, .31:9" 90'-0" "l UME)CCA VA ¢/~o$s- $£cT/ox/ $Ca ~-~ .' l" = l:O" .~,..~ ~'........-...;y~,.. ~,'9.'~-;'',~. ....... '-'",,"~:"~ 16310 GRAND RIVER AVL · DETROIT 27, MICHIGAN 2 ~ 0 U A,/ Z:)'~4 T' / 0 /v' ~'% *U. ~.~ IRVING E. PALMQUIST-ARCH,TECT o, 5 ~ L ~ ~ 4"=/:0.. ..'k~-.~:~'~ RICHARD B. POLLMAN-D~SmN~R es'- 7" % ~lt~ A~v / PRELIMINARY CHECKED APPROVED DAT£ o"~"~'~"~1 a n n e rs, inc. DESIGN NO. 1252 ITEM COLUMN NO. I QUANTITY & UNIT MEAS. MATERIAL (TYPE and/er SIZE) UNIT TOTAL LINE COST COST 2 4 ITEM COLUMN NO. ~' QUANTITY & UNIT MEAS. MATERIAL (TYPE and/er SIZE) UNIT COST TOTAL COST ~alh 6 20 Pea. 2 Poi. 18 1~2 a~ Pu · 9 C~mk TS~e ~e 14 Flatfarw 3O 32 33 37 38 39 xSx~ x8 8xSxl~ 8 x 12n # Se~d " 46 Lintel 8" l~.m. ~ Z'~,r, aee 'A~dz,l~e z 12" Stee~ Sssh St, eel 52 53 54 55 57 62 63 64 65 66 67 69 7O L~Jtt~. 72 73 83 64 Cream% 210 2P~g, 2 16~o 100 Lira. 1 2 2~x lO"x lfP-O~ Jaimt 10.X12,.0# :Lmx 10" Janet ~ aeldeee Lmx 10"~ 16'.0" · 2uxlZgx 12'.0e Je~ Wall Zez 8#x 80.0e Staldl Bm 6~x 1~'.0" 8"x ~O'.O" r F~md · Os~m~t W~sd~.. ~k ]~ld 86 87 LINE ITEM QUANTITY & MATERIAL UNIT TOTAL NO. COLUMN NO. ~ UNIT MEAS. (TYPE and/er SIZE) COST COST s ~eht~ . B~ek~ 6 ~~ . P . P x ~' Casing s ~_'. 6' "3 F ~ - T~ ~ Co.em 1 ~ ~ Ltn.~, N~d ~ ~ 1~ 8"x 8~-0 s4 ~ ~ ~ ~ x ~" ~ Sh~ ~ ~ ~ 16" x ~ Z~TZON 4S 12~ s3 ~2 L~. ~1 55 2~ t.4..~, ~ ~ ~ ~.~. ~/8" ~ 76 ~.~. O~-=~ C~e ~e ~r 6z ) P~. Pa~ es 2 ~.. ~ & ~ ~ , e4 6 Pea. T~ ~ '~ ~ Mfl~ 67 760 ~,Ft, ~ - 7o 1~ ~.~. 2" x 7[ ~ ~n~. 1" x 2" 72 ~ ~n.~. 1" x ~ " " 75 ~ ~ ~ - ~ 1~ B~. ~ - ~9 80 L~, ~ ~ s2 I~O~ T~ a4 1 ~ 3'-6~ 6'.8~ -- es 1 ~r ~z 6'.8~ DATE NOTE: ome anners, inc. MI:I 2 ,; LINE ITEM QUANTITY & MATERIAL UNIT TOTAL LINE ITEM QUANTITY & MATERIAL UNIT TOTAL NO, COLUMN NO, ~ UNIT MEAS. (TYPE and/or SIZE) :OST COST NO, COLUMN NO. 5 UNIT MEAS, (TYPE and/or SIZE) COST COST e ? ~ 2,.6~ 6'.8"x 1.318" " e 1 24 1~ ~M 2'.6"x ~'~" " 24 15 Pai~ 3" x 3" Butte 67 1 ~e 9'-6"x ~"x 12" S~ Ca~% ~ M~ ~ 67 ~ ~h~ A Mm4 1 hms ~"x ~"x 2~" S~ ~ 7o S2 1 O~ ~2"x ~ 12" ~ah.lf ..E~IMJNA.Y = PR~LIMINA.Y-- -- NOTE " · ~lanne~, ' inc. ......................... ML-2 2