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Home My WebLink About5658-zNO. 4 TOWN OF SOUTHOLD BUll,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z~823 ..... Date ..........[.~.~ ..... il~.. :.., 19. ~ THIS CERTIFIES that the bulldlng located at 5/5.. 5~und..V3.e,~. A~,e ..... Street Map No..xx ......... Block No. r,x ....... Lot No. x~. · .~outheZ6..~,g. · ·: ........ conforms substantially to the Application for Building Permit heretofore ~edin this office dated ..........Deo. · .~ .... , 19..71 pursuant to which Building Permit No.~6~Z... dated ........... ~ac ..... 7.., 19.71., 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. ri~ate, one, family. ~lwelling ....................................... The certificate is issued to Ro~er.t .Arima.sen.... ~r~er ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .Jar~..7...%97t~...bT. Ro .¥$.~1a .... UNDERWRITERS CERTIFICATE No...~. ~ .~759. · .Jar~.. lt~...19~+. .............. HOUSE NUMBER .... 60~(1 .....Street.. Sound~£ew. A~e ........................ FO]D~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 THE WORK AUTHORIZED) N? 5658 Z Permission is hereby granted to: .... ~e~rl;..,i~.. ~7~.....~:Lw ..t~Ln,e23. to · 2a::JX~ "lle~" Jze'"l'~Lt2~"~l"e'r X~,I~I .................................................................................. at premises located at ........8~"~;~)~J~"~"/~"~,~fil ......................................................................... ................................................. ~ .......... Ii'~ ......................................................................... pursuan,t to opplicotion doted .................................. ~)~.....q~ ........... , 19.~.., ond approved by the Buildin§ Inspector. Fee $'""~'O'~'OJJ ....... FOI~M N'O. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF iOGCUPANCY 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 1. Final survey of property with accurate location of all k~uildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--tS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple R~sidences 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 u~ses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing alt property lines, s~reets, buildings and unusual natura~ ar 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. ..... ......... .._ ; Date ........... New Building ....... ~.~ ......O~d or Pre-existing Building ................ ; ........... Vacant Land ...~ ........................ Location Of Property ....... .~...c~.?..,,/_~. .......... ~:~..)...c;..~.,)(/~,.,..~..,~'.~..~~.. ...... ~..~.~.~. ......... Owner Or Owners Of Property ....~..:'....~. './.~.'/,~./..~¢/.,~-. ............ ~ ............................................................. Subdivision ................................................................ Lot No .......... ~;. Block No ............. House Permit No..~.~..t.~i'.~.~Date Of Permit ]. ..Applicant . ].¢~...~[~).......~.~.........~. :~.~..~/-~ Health Dept. Approval ............................................ Labor Dept. A~pproval Underwriters Approval ........................ ~ ....... Planning Boa~d Approval ........................................ Request For Temporary Certificate ........................................ Find iCertificate .......................................... Fee Submitted $ ............................. Construction on above described building and per~m~:~e~'~a~le ~°~es and regulations. Applicant ........... .< ........ /_~r~...~'.~. .~,¢..rmm--~. ...................................... Sworn ,o before me ~Sis 'I .~" .~. ,,.~.. ~ Z..~ (stamp or seal) ..... .................... Notary Public .................................... County $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Perm*t No. TO WHOM IT MAY CONCERN: The sewage disposal faciliti~es for a structure located (Give deed location) have been/inspected,by this department and f6und to be satisfactory. Chief of General Engineering Services FOB~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT T~N CLERKS OmCE MUTH~D' N. Y. ~pmv~ ........................................ , 19 ........ Disapproved a/c ...... ~~.....~~ ..... .............................................. .................... ~ ~ . ._.. ~ (Building Ins~tor) ~ ~/ APPLICATION FOR BUILDING INSTRUCTIONS ink, and submitted in duplicQte to d~e Buildin/g!~' a, Tiffs application must be completely filled in by typewriter or in I~r. b. Plat:plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or~. areas, a~ Glivlng a detailed description of layout ofproperty muSt be drawn on the diagram which is pa~ af this ~!jq2tion. c. Th~ work covered by this application may not be commenced before issuance of Building Permit, d. Upon approval of this al~plication, the Building inspector will issue a Building Permit to the al~oticent~l:h permit shal be kept on the premises available for inspection throughout the progress of the work. ': - e. NO building shall be occupied or used in whole or in part for any purpose whatever until a Certificate 'of Occupancy~ shall have been grant~l by the Building Inspector. i~dEEI, IC~TION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the lng 7,J~e Ordinance of the Town of Southold, Suffolk County, New ~ork,/efl~ other opplicab,,Iod:~,. Ordinances or P, egulations, for the construction of buildings, additions or alterations, or For/r~mo~al or cl~mol, i~r6n, as~erein described. The appliCan~: agrees to comply with all applicable laws, ordinances, buildir)g'ced~/~housir)~'c9a'e, aj~ r~ulations. ./~'"/Z P~ I// , \ .............. ''~ ........ ~~27" ............... ~0~/~--- meer neral nt t r I State whether al~licant'l'is owner, lessee,/~ge.t, archit.e_c.t, eng' ,ge co rac o, e ectricion, plumber or builder. ........................ · .).'./..~..t.u..V.l~'7~/. ....... e ....... .t~ .............. /~' ........... '/ .......... :'"1~ ............. '~' ......................................... o eo, ........ ......................................... If applicant is a carpal'gte, signature of duly authorized officer. / ~'_ ~ ~ .................. Location of land on which propg,qed work w~ be done. ~A_ap~No.;,, ....................................... Lot No ............ :...,~ ...... Street and Numar .~.t......~.~ ........... [~.~.~.~J~....~. ...... ~......~....~.~ 3. Nature of work (check which applicable): New Building ..... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitian.....~. .......... Other Work (Describe) ........................................ 4. Estimated Cost .........~7~ ......................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ....../.i ............ 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 ........... 7. HeDimensi°~ructureS'ght Number ofif anY:star esFr°nt .-~..~...~~ ............ ....... Rear ...~:;:~. ......... Depth .~ .......... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories 8. Dimensions of entire new construction: Front ....... .~...~.....).~) ............... Rear ......~..~Z.......)..O. ......... Depth Height .J~....~..l .... Number of Stories ......... ....'~... ...................................................................................................... 9. Size of lot: Front ...... 1.~... ........ ~ ...... Rear ........ ~..~..o. ...................... Depth ........ .~,.~...o. ............... 10. Date of Purchase ............... LJ...I....~.] ........... Nan~ of Former Owner . 11. Zone or use district in which premises are situated ........... ~;~..~t~.T.,/~...~.. ..................................... 12. Does praposed construction violate any zo~aJaw, ordinance or reau at on? ........... 13. Name of Owner of premises .~..~. J~...~.'~lr-J~...~/~Sdress/~f~/~/~ Name of Architect ~J~'"""f~J't' ......... '" ................... Address ......... .; ........ :~.:~.....~.....~..,~ Phone No ....... Name of COntractor ....~.,.....~/.~ .~...!..~....1~.. ............. Address .,~.~.l..~.....,~,..~....~..~....!,~..,~, ~.~ No.~...~..~..T..~...~..~..~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from p.r~.erty line?. Give st'ree, t and block number or description according to deed, and show Street names and indicate STATE OF NEWF~jI)RJ~,/ COUNTY aFfray.,/~-- ~__~ ......... ................. · (.l~nel~of J~nn~l~'~'~.l..~i~r~a/V~-ji'L~l~n~...:t ......... being duly sworn, deposes and says t~t he is the appJicont above named. He is the ............................. ~,~A~'~..~.~.-~ ....... i~;;~.~;;~-r;j.;~;;~].L;;;~;,;;~;;..~i;~.~j.;;~;.i ............... of said owner or owners, and is duly authorized to perform or have performed the said work and to make end file this application; that all statements contained Jn this application are true tg.4~e best ~ knowledge and belief; and that the work will be performed in the manner set forth .in the application f,i~d/chere~/~l~. / Sworn to before me this ........ o, .......... , · . · . 850, SUffol/< C0u H.D.Reference No APPLICATION FOR APPRC~AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS ~ t ~/~/ Approval to construct said sy~ems is requested,pertinent data herewith: ua e 1-Applicant/~//~/~ /'~/~/~/~ ~ Phone/3~'/~ ~ 6-Sub div Address ~ _~'/)~/~! ,f/~E. 4~,~/~/~/' ~7~/Z' 7-Section 2-Detailed ,~roperty l~9ocatlon ~.~, 4~/~/4~ %o.u,~ ~,z/,'~ /~g 8-Lot No. Hamlet ~;~"'~r'r~.,c ~L~, ,r~ Town ~//~2~x~z; 9-Private well? 3-Public water supply name ~ Distance to nearest main ~-Lot Size: Width/~ ft. Length/~ ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~ Two Family? ~ /Cellar? / /.Slab? ; ~Crawl Space? lO-Proposed syst~: Septic tank F /Pretest ~/,/Cesspools ~_~Shallow pools il-Septic tank inside dimensions: Volume Gals. Length ft. Width' ft. Liquid depth,.._ft. 12-Precast sections: / /Number~_/Square Ft. Cesspools: Block sizeL tncs.D insoH_._ins. Total blocks below inlet: ~1 ~2 PLOT PLAN Capacit als. ' ~ W.L. ~ " ~ ~ ~ Street Indi e ~ ~ ~ Nc 'th The Undersign~ CERT~S: "Construction of autho~z~tallations ~11 be in acco~ance ~th the Suffolk County H~lth De~ments' ~t Standa~s, Bulletins, ann be ~nsta~ on Date /.'il :/' :' Sign~ - , ' ~:, ( 0/65 EXC TiO IH ECTIO REQUIREB Data ~eet 0 2 6 8 10 12 ~6 18 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Robert R. Anninon, Soundvlew Ave., Kenney's Rd. & Mill Hd. Southold,~. I. w~exami~don JanuaPy 10, 197fl andfoundtobeincompliancewiththerequlrementsofthisBoard. DRYERS FURNACE MOTORS FUTURE APFtlANCE FEEDERS AMT. K.W. O1[ H.P. GAS H.P. AMT. NO. A. W* G* RANGES L 9.6 SPECIAL REC'PT, SERVICE DISCONNECT NO. OF S OTHER APPARATUS: E R EXHAUST FANS DIMMERS COOKING DECKS OVENS I DISH WASHERS AMT. K.W. I AMT' K.W. MT. K.W. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET AMT. AMPS. TRANS* NO. OF FEET ¥ I C OF CC. COND, OF HI*LEG 2/0 NO. OF CC, COND, NO, OF NEUTRALS A.W.G. P~R ,~ O~ NEUTRAL 1 1 4/0 1-1.25kw, 2-1. Okw '-later heater: 1-4.5[cw Elec.room heaters: 2-2.0kw, 5-1.5kw, ?anelboard/s: 1-20cir, 200anp,~. Robert R. Annison, Main ~Oatt, BOx 65, Cutchogue, L.I. 11935 Per ~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.