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Home My WebLink About5778-zIPOB,M NO. 4 TOWN OF SOUTHOLD BU~.BING DEPARTM~NT Town Clerk's Office $outhold, N. Y. Certificete Of Occup; ncy No.. Z6,33~ ..... Date ............Feh..~0 ........, 19.75 (hayw&te~ ~xt) Be&e~. ~d THIS CERTIFIES that the building located at .l~.t .l/o&4 .Ftahermm ..... ~tf/~t' Map No~.~con~.a./~ayBit~l~No ........... Lot No.. ~ 8. ~. ~ 9. .... g~tc~e.. ~ .~. co~o~ subst~ti~y W ~e AppH?sfion for B~dlng Pemit hereWfore ffl~ ~ ~ office dated ...........F~=.. ~$.., 19~7~ · pmu~t to w~ B~d~ Pe~t No.. ~78~. dat~ .......... ~.. 3.~ ....., 19.~2., was issued, ~d co,om to ~ of ~e r~ men~ of ~e applicable pro~io~ of ~e law. The occup~cy for w~ thi~ ce~ica~ h ~u~ ~ P~iva~e. o~ .f~y. &~ell~ ....................................... ~e ce~ica~ ~ issu~ ~ .. ~lll~. F.~..Jo~t~ ....... ~er. ................. (o~er, lessee or ~n~t) of ~e ~ores~d b~d~g. S~o~ Co~ty Dep~ent of He~ Approv~ Feb.. ~8 .~ ~.. b~ .R,..~1~ .... ~~ITERS C~T~ICA~ No~B336~ ...... ~pt..~.9. · 2S~ .............. HOUSE ~ER .. 1 l.~O ....... S~t..Ni~s · ~h. ~ad ............... ...... FOEM 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) N? 5778 Z Date JJ~J~JJ 31 ]9..'~..... Permission is hereby granted to: to ........ ~tlA..~.e~...mm..~tZ~..aw~l~u~ ............................................................................. at premises located at .......... Tr~)~..~IS..&%~ ......... l~em~:La..~.~...l~O~e~.t~a...(.r.;~sbe~mam Be&eh) ........................ l~l~r~.t e..~c~ ......... ]~l~s~au..~.~;~-~t, ....... Cuteheg~ ....................................... pursuant to application dated ........................... ~E .......~. ......... , 19.~1~.., and approved by the Building Inspector. Fee $. ~. ,rl~ .......... Buildin. g Inspector / THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.. ~.W BUREAU OF ELECTRICITY: -: 85 JOHN STREET, NEW YORK, NEW ~"ORK THIS CE~IFIES THAT William F. Johns~ow,w/end Flshe~an~ Beach ~d.,1000'w/oHa~a~e~s Rd., Cu~oho~,L. I. inthefoll~ing~atio~u~ B~emnt ~ latFI. ~ 2~ ri. outs[de ~,io. e~ ~t ~ ....i~ o. Sept emb e r 16 ,19 7 ~ ..a /o.~ ~ be in co.pliance ~ith the requi~.e, rs of th~ ~rd. RXTU~$ RXTUR~ RANOE$ ~ING ~$ OVENS ~SH WA~E~ EXHAUST FANS ~2 25 1 7.5[ 1 .78 1 1.5 1 30 ,' ~/~ ~L1 ~.~ 1 200 CB x 1 3/0 1 1/0 1-~.F.I. Elee. Room ........ ..... ,_- ................. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAN,'~. SUFFOIX' COUNI~ DEPARTMENT OF HEALTH H.D.Ref. No. APPLICATION FOR APPROVAL OF INSTALLED PRIVATE SEWAGE DISPOSAL AND WATER SUPPLY SYSTEHS Inspection for approval is requested, pertinent installation data herevith. &-Section No, 5-Lot Number ~ 6-Bldg.Permit No. Phone Address 8-(a)Deed location of p~roperty [-~.)T %~' ~JJ ~2D~d;S;~ ,/~ ~d~',~ ~ ~TI~ /~. (b)H~let or Village~,4~",,~ ~o;~.~'Tc~C~ (c)T~n %/~,,THc~ ' 9-Septic tank-gal__L__ft.W ft~Liquid Dep{h ft. lO-Cesspools-(a)No.pools ~ (b)Blocks below inlet-l) 2) 3)__ (c)Block size-L im.~ im.H in. (d)Precast pool '% (f)H ~ ft.~ in; Di~ ~ ft. ;-~ in.(g)Finished grade Co cover I ft. (h)Backfill Material ll-Water Supply: Public Syst~ ; Private Well~l~7 I~i If Private, the roll,lng questions are to be answered: Address M~T~ ~ ~TI~OC~( ~ ([~,~,, ,=,~ ~'/, 13(a)-To~al Depth of We[~ I~ i (b)b~h ~o-S~a~i~ ~a~er Level 15-Name of ~boratory. 16-Method of Disinfection 17-Date ready for inspection The undersigned CERTIFIES: Above syst~s have been constructed and are in compliance with the Suffolk County Health Department's current Standards, Bulletins and ~endments thereto. ~er - ~uilde~ 19-Insert sketch of location of Water & Sewerage Facilities with accurate dimensions. STREET FOR HEA~TH DEPARTMENT USE ONLY Inspected by ~- no~.e ~5//~ ~ Based upon the information star'above, satisfactory 'funckion~ng of the above systems can be expected with proper maintenance and care. Date ~c~ ~ ~ ~nvc Approved , . .... i~l ~ ' r'., TOWN OF SOUT.OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTH~D, N. Y. ~omln~ ............. , · .- 19 ........ ........................................ , 2 .............................. ................................................ ............. ............. x.....v. .................................... ~ .............. j~ ................ ~ ~ "' · (Building Inspector) ~[~ ~~ ~~-',~J~c~v~e 6kA, zo,~.~ APPLICATION FOR BUILDING PERMIT Date ./~...~ .................... -~/ ~../......:., 19~. ........ INSTRUCTioNs a. This epplication must be completely filled in by typewriter or in ink end submitted in triplicate to the Building Inspector, witht~ 3 sets of plans, accurate plot plan to scale. Fee according to Schedule;": b. Plot plan location lot and of buildings on, premises, relationship to adjoining premises or public streets or areas, and~ giving a detailed description of layout of property must be drawn on diagram which is part 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 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 Occupancy shall have been~1~ 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 applicab e 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 all applicable laws, ,~ ordnances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. '"" (~:~nature 'o'; ' 'a' 'i~ '; ;; 'c'; '~ 't', .......... ;'"4 ;'~'~'~'; .... ............ (Address of epplicent) State whether applicant is owner, lessj,e, agent, architect, engineer, general contractor, electrician, plumber or builder. · . . Name of owner of premises /.~/.~ /1: ~ ~** .3'-~,~.~, ~cF,~ ~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on whicl~ proposed work will be done. Map No.: ...~.....~... ....... Lot No ................. ~ ........................ Street end Number ..Z~...~..~.Z...~,~..£....J~..~.., ......................................................... ..~,./.-~..P,~.n.3....~..-~.. ...... / Mudlcipality 2. State existing use and occupancy of premises and intended use and occupancy bf proposed construction: a. Existing use and occupancy ...... ...,~....~...~......'.'.'.'.'.'.'.'.'~=... .......... Z .............................................................................................. b. Intended use and occupancy ....~...~..n~....-~. ........... ~....~'.,,~..g,,.~.~. ......................................... ................. ~ ' 3. Nature of work (check which applicable): New Building ....................... ;/ Addition ..................... Altere~n.:...:. ........ Repair ......................... Removal .................. Demolition ........................ Other Work ............ (Description) (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 ................... z<..~. .................... ~...;:~ ....................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ...~/.P..~'..~.. ..... Rear ........................... Depth ................................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions; Front .......................... Rear ......................................... Depth ............................................. Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ..~....,.'~T... ............ Rear ..... ~...C.. ................ Depth .....9:...~ ...................... Height .......... ~J. ................................. Number of Stories ..../....~7~. ............................................................................ 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district In which premise~ are situated .................... ; ................................................................................ 12. Does proposed oonstructlon violets any zoning law, ordinance or regulation: ............................................................ 13. Wllllotberegreded ......................... : ........ Wlllexce#flllberemovedfrompm. mlses: [ ] Yes [vJX~o · (Addreu) rj {Phone No.) (Addrau) (Phone No.) PLOT DIAGRAM Locate clearly and dl~Inotly ell buildings, whether existing or propomd, end Indicate all set-beak dirnengions from property lin#. Give ~treet and block number or de~rlptlon aooordlng to deed, and ~how street names and Indicate wheth- er Intorlor or corner lot. · I'ATE OF NEW YORK, COUNTY OF ...................................................... .......................................................................................................... being duly 1worn, dl~o#i end Uyl that hi Il the Ippll~lnt ebon1 named. Ha I~ the ................................................................................................................................................................................................................. ~ uld ~ner or wnerl, and II dun iuthorllld to ~fform or hl~ ~rfor~d the laid ~A and ~ make and file ~ll l~l=tlon; ~lt iii i~m~nu aonUlned In thli Igpll~flon I~ true to tM ~lt of hll knowlid~ end ~llef~ end that the ~rk will ~ ~ In ~ ~n~r mt forth In the i~tlon flied t~mwlth, ...... Z ................... ........ ..................................... x. N. N /I//L L t/114 /7,' LJOHN~ TON