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HomeMy WebLinkAbout2749-zFO,~'~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMI~,NT Town Clerk'~ Office Sour&old, N. Y. Certificete Of Occupency No...Z. 79.2.6. .... Date ............ $.e~.t. ..... 3.0 .... , 197~.. THIS CERTIFIES that the building located at .. E/$. t~a s .~ay .7o.~t · Road Street Map No. Na s~.,. P.t... Block No ........... Lot No, . ~.9 .... .CutchQ g~e .... N...Y q ..... conforms substantially to the Application for Building Permit heretofore fried in this office dated ............. ~.~a~..1 ~.., 19.6~. pursuant to which Building Permit No. dated ............. ~i~.y... ~ ?.., 19~ ~.., 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 . P. ~.v.~;~..qn.~..f. am. ~;Ly..d. ~.e.1.1 ~§...(.f,~Ts.t.. ~L.o.o.~. 4. ~.~ .r.t.i.~]~. ~..d...f~.o. or fini~- The certificate is issued to .Leon .d. Llllian .Brae..to. Lea .&. Lllliar~ .Bran, ..... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ,qept..8 ~. ~ 9.69.. hN. ~. ?~llla ...... UNDERWRITERS CERTIFICATE No. -NS~B.378 ..... Auc..$2...1-970 ................ HOUSE NUMBER ..... 6.725 .... Street ... Eamsau .Point. C~tcho&,ue ............ .... ~L~TE ~. P. ermlt, re~_ui, ed .to. ~omple.te. finishing. 2nd. finer, r~oms ..... ........... '' Building FOg, M NO. 2 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 TH'E WORK AUTHORIZED) N? 27~19 z Permission is hereby gronted to: ..~.o.m~.s...e. ............................. : ....... .................. ......... ~la~,~ au.. ~.o~'t~.t,..~ ....................................... ................ .(lutohogue. ................. : ....... ~ ........ ....... to ....~l.~l,.~.~..~..£~l,~.,.d.~e~4~ ........................................... : ....................................... ot premises located at ...,~.~..~...I~.9~ ........ ~!,~.~.~ ~..~,~.~....0.~..~.., ...,~..,O.~...,..... : .............................. ..... .. .: ... ........................................ l~.~.....~ia,,~a~..~.~.~..~,~ ............ ...................... ~ ................................. Cu~ehOgue ~ l~t~, 19..6~., and approved by the pursuant to opj~licotion doted .... ................................. ~ ....... Z~' .... Building Inspector Inspector (" ' FOE~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Temporeey (summer) Certificate Of Occupancy No.. Z .360~ ·.. Date ........... 0et ..... l~ ...... , 19.69 THIS CERTIFIES that the building located at . .E/~...~.ia~aau. ?~l~t. ROaaStreet Map No. Nassau .Pt. Pl~k ~o ........... Lot No...b.9... fJ. utetlague...I~f,Y., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... l~r. 1 ~ 19. '6~ pursuant to which Building Permit No.. 2.7149Z.. dated ..... Ray.-.1.7 ......... , 19.6~., 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 . .Private. one. ~.ami.Zy .ave0.ting ...................................... The certificate is issued to ...Leon .l~ra~ .... .... Ot~'~lt .................. ] ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...Setat .8..t969...by. R, .ViZZa .... House # 67~ Building InspectSr SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH D ate~ ~-~~/2~:~ Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage dtspos, al facilities for a structure located - (Gi~e deed location) have been inspected by this department and found to be satisfactory. District Engineer 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 DUPLICATE 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, Far existing buildings (prior to April 1957), No,-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 $5.00 ' 3. Copy of certificate of occupancy $1.00 .... New Building ..... ...I,~........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... ~ Z.~ ~ .....~...~...~...~.~..~...6/.........~..O., ./..X..~..~.....'..~....~..~...~.. .......... ~..~...?_~....~/~...~.....~.....~...~.~.... Owner Or Owners Of Property ,L.I/z'O F ~ LII...LII~/~I Subdivision ...~.A~.~..~.. ...... ..'~..../.(+..~. ...................... Lot No....¥.~..... Block No.....~.. ..... House No..~...7...~..~.. ~ 7 ~-~. ~ Date Of Permit ./~..~...~.';~t"/./.?.~..5Applicant ~-£-'-~ ~/ ['~/-~/~ C-- Permit No. Health Dept. Approval ............................................ Labor Dept. Approval .................. ,,~,,/,,',-~,/~,,.: ................. Underwriters Approval ...}~,..~.,,..~..'.,~,,.~,..i,~...,.~.. ............. Planning Board Approval .......... ..)~...~..?..~...s ................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ .................................... Construction on above described building and ,~:~7~it me~_all/q~licable codes and regulations. Applicant ........ ~/'~/..:..~..~.: ,.~....r,...c.~. ~ .~~.......~.~ ......................... Sworn~oxbefore me this ~;f;~ ...... ~day of ..:~.:.I4:.~Z. ..... (stamp or s~o')~:)~/;~' Nota~ Public ~.-..-.~~...~O,n~ ~/~ '~ ~ ~ ~ FIXTURE tECEPTACL~S SWITCHES : F XTURES ~ COOKING DECKS OVENS -- -- '"FURNAC_E MOTORS . _ FUTURE APPUANCE FEEDERS Sr~CC/A, 85 JOHN STREET, NEW'YORK: NEW YO~K ~00~ augus~ ~, t970 ~X~. OF HI-LEG OTHER APPARATUS: ..Water.Heater/d: ~ Motors: 1-1bp., 'fLeD Brac : 278 East 239 Street Bronx,.New York 1047Q.,. :,: ~ AMOUNT - PL~AEE'REMIT BY CHECK OR MONEY ORDER TO THE ORDER OF THE NEW YORK BOARD OF FIRE UNDERWRITERS AS CASH SENT BY MAIL WILL DE A~ TRISK OF SENDER· ' ." Per~ APPLICATION FOR APPROV~T.~ INsTALl.ED PRIVATE SEWAGE DISPEL AND WATER SUPPLY SYSTEM~ Iuspection for appro~l is reqpested, pertinent insta'rlation data herewith. --"- Phone ' 3-Subdiv. l-Section No. 2-Name of Builder .~z~ Phone 5-Lot Number 7-Sewage System installed bv~ Ct/~- ~ ~ ~ 8-(a)Deed loca%io~ of propert~zY°~'' ...... , %~?~u-~esspoo~s-~a)~o.poql?_ ,,(b)Blocks~elow ~et-1) 2) ' 3) - ' ~" Private. the following questions are to be answered:,, -Total 9epth of Well ".,,' ,~:'~'?, ',~ '(b~)Depth to Static Water Level ..... , , ;, U~' The un~ers~sned ,CERTIFIES: 'Above sys~s have been 'c~nstruc~~' compliance with the Suffolk County Health Department's current St~/~/a,l 1 ~n- ~ r -19-Insert sketch of location of Water & Sews Facilities with accuraCe'd~ensions. Based upon the in~a~ion s~a~ed above, satisfactory ~unctionin of the ;i~;~/?~c~ab'ove syst~s can be expected with proper maintenance ~d care. ~' . ~ ' -*~.~ g ' Applications are ~e submitted in duplicate. ReOred information should be typed or legibly printe'4'in ink. Inspectors are not permitted to make inspections of instal, lations until applications have been submitted tq and accepted by this de- par tment. The item number on the application form mhd item number listed below are t~e "~"J'-l.. ~er's n~e'and 'addTess -. if o~er and builder are s~e, so indicate. 2. Builder's name an d address - approvals will be mailed to this address. 6. Building pemic n~ber assigned by the Buildin De artment?~7;LJ~::, ~' ":'~ ~. N~e o~ person or fi~ who actually constructed the sewage dis-osal ( ) F r ~ple. s/s Jones St., 100 e/o Smith St. (b) H~let, (unincorporated in 'to~ship),' for example: Bast Moriches. ,,Viila8e (incorporated area), . ~ple/ ~Northport. (e) To.ship, for ex~ple: Brookhaven, etc. % ..... , Give inside length and width in feet. Liquid depth is ,measured In feet' from ~:4-~,rt~ij.:,~f~F,. each pool.' (c) SCare lentth, w/ich, and heitht of cesspool blocks in inches.' (d) Indicate by check if pretest sections are used. (e) ~ive n~ber of leach- ~(a) Give depth in feet from top of well pipe or casing to well point. :,Depth in feet from top of well pip'rot casing to Water level in well.~ ::Inside diameter of well Casing.' ~ ~ri,: ;' ('i: Name Of .laboratory performing theexaminattonsl Describ!,,method of disinfection, for eXample: quart of l~undry bleack 'of.Water poured into ~ell,and,allowed to stand six hours. ,~,< · ~'":State dare'on whichinstallation'will'~e ready f0r'ins~ectl0n."" "~'""' ............... TOWN CLERK'S OFFIC~20c~ C. ~ L, v ~ :~,~ab'-~*-~'~ ~TH~D, N. Y. ~~ ~ ~ ~ ~omined ..........~ ~.,.....~....,r ...... ...... ......... Approved ........................................ , 19 ........ Pe~it No .............................. ~. / ~. ~ I/~ ~ ........................................................................... ............................................ APPLICATION FOR BUILDING PERMIT ~~ ~ .................... ....... ........ , ~. This application must be completely fill~ in b~ ~write~~ su~m~e~ in d~lic~' ~o the Insp~tor. ~. P]~ plan s~owing I~otion of lot on~ of buil~i~s on premiss, ~lotions~ip to odjoini~ p~mi~s or p~lic ~r~ts or ~reos, and giving o detailed d~cription O~ Ioy~ of pr~ must ~ d~n ~ the diog~m ~ich Is ~ of this ~lic~ion, c. ~e work cover~ ~y this opplicoti~ muy ~ ~ commenced ~fore issuance of ~ui~ing Pe~it. d. Upon ~pravol of t~is application, the Building Ink.tar will i~ue Q Buil~i~ Permit to the ~licont. per. it s~oll be ~ept on t~e premises available for inaction th~gh~t the p~ss of t~ ~ e. No building sbelt be ~cupied or us~ in whole or in ~ ~ for any pu~o~ what.er until o Ce~ifi~e ~ s~ll ~ove been ~ronted ~ tbe Building Ink.tar. 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 Count~, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, ae herein described. The applicant agrees to comply with all applicable laws, 'ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~.~-Q~..~P-.~....~.~!..~...~.....~..~.......?..~..~-*:...~.:......~.~'.....~.... .............. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ...~ss~..2.o~u~.~ ........... Lo~ No: ....~ ............ Street and Number ..~.~....~a.~s&g,..~.~.~c~t......C~A~G~u,e~...N~.~......:.....~...-.....~'i.i ........ ...~. ....... '........~'....... ' '~:)/'--, ~, ~ 7 -~,.~ MunicipalhZY _ ,: .. 2. State existing use and occupancy of premises and intended use and occupancy 6f prOposed 'cbnstr~ction: a. Existing use and occupancy ......... .~'.~,g~'C..]~8-n~ ............................................... ~.......~ ...... ..~ ....... .~ ................. b. Intended use and occupancy ......... .O.~...,C..~..m.~,~.~...~.~rJ~ ................ ............ ;.'....~ .................................... 3. Nature of work (check which applicable): New Building ....~.... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (l~escribe) ...................................... 4. Estimated Cost ..........].~.~Q. QQ...~./.. ............................ Fee ...... .1..9. ...................................................................... (to be paid on filing this application! 5. If dwelling, number of dwelling units ..... or~e ............... 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 ............................ Number of Stories ............................................. . .................................................................. Dimensions of same structur~e with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height ............................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............. 6.Q .......... Rear ........ ~;.O. ............... Depth ....~.0./....~...~ ........... .~ Height ............................ Number of Stories 9. Size of lot: Front ............ ,1D2. ........ Rear ........... ,IQ.O. ......... Depth ....3,].~./...3-%~. ........ 10. Date of Purchase ..............t91~.0 ................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are s~tuated .~, .~.~.D.~ ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... D.Q ........................................ 13. Name of Owner of premises I.~eo~...R~a.c. ..................Address .....C:u,~cb, Q§.u.~ .................. Phone No ..................... Name of Architect " ........ Address Phone No. Name of Contractor ;~.~9..~..~.,....Q~),..t.~ ............. Address ........... ..O..~.~g.h.9~.u...e.. .......... Phone No ..................... PLOT DIAGRAM - Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed and show street names and nd cate whether interior or corner lot. jl~.~.~.o ~r c ~O- ~ ~j~ / 0~! STATE OF NEw YORK, ~ COUNTY OF ..~E~_I~. ............ ~ S.S. 17s 'j~ ? e '"~- ................................. 3.~DZL.RZ'nO .......................................... being duly sworn; deposes and says that he is the applicant (Name of individual signing, application) above named. He is the ............... QWD. eZ'....-...~ll.de~. .................................... (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 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 a~ication filed therewith. Sworn to before~ JJ~l~me this ' .~...~....//. ,-'/ ~,4'/'"~' ' ~ ...~~' Notary Public,~~.c°unty ~ ( g ature of applicant) .................. ...........