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Home My WebLink About5798-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z~1-68 ..... Date .............. kept...20 .... , 19.73. THIS CERTIFIES that the building located at . E/8. l~r.idge. Lane ......... Street Map No.. ~ ........ Block No. :XX .Lot No~ . C~tcho~ , v conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Aorll..6..., 19.72. pursuant to which Building Permit No. ~SZ.. dated ....... A~il .... 6 ..... , 1~.., 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 . Pr.~v~..q~. ~a~x .~vg.~g~g ....................................... The certificate is issued to . .He~. ~a~ ...... ~er .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~ep.t.. ] ~... 19~3.. DY..ii ~. Y.~a.. UNDERWRITERS CERTIFICATE No.. N-'~1kt ~3 .... ~ept. '1'2 '- ~73 .................. ttOUSE N UM BE R...1380 ...... Street .... B~ldge..Lam~ ................................ Building Inspector FORM NO. e, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5798 Z Permission is hereby granted to: at premises located at .........~..~.....J~.~JL~...~ .................................................................. .............................................................. ~l~l~.....ll.~r.. .............................................................. pursuant to application dated ............................ ~JJ~Ju~"-"6 ......., 19...~j, and approved by the Building Inspector. Fee $ .,~...'.~. ........... Building Insp~cto~ THE NEW YORK BOARD OF FIRE UNDERWRITERS CS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date ~epte~ber 12, ]-~7~ Application No. onfile ~II~¢ll9 114123 THIS CERTIFIES THAT only the electrical equipment as described below and introduced bs~ the ~pllcant~rned~n Rhe, ab ~o~. ~pplicotio~ number in the premises of in the follotvlng location; [] Basement was examlned on Sel>t Ol~20e 1' g [] lstFI. [] 2nd FI. OU~-(}~ Section Block ~ 0 '~ "~ and found to be in compliance with the requirements of this Board. Lot FIXTURE FIXTURES RANGES :OOKINGDECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 2~? 41 22 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OT APPARATUS: ~or~ce/-~: ¢)~i, 1-1/~hp, ~,'otors: 1-1bp S E R V I C E A, W.G. NO, OF HI-LEG A, W.G. A.W.G. OF CC. CO~D. OF HI-LEG OF NEUTRAL 1-1/12ho 4/o NO. OF ~EUTRALS Q/9 19R Lake ave. GENERAL MANAGER COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference No~ ~7 -/~7~ / APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said/s~stems is requested,pertinent data herewith: Date 1-Applicant )~ ~v w t_Y ~ , Phon~/~--~6-Sub div Address lq~ k~'~ ~e..M~c~ 7e~ 7-Section 2-Detail~ p~pe~y location ~ ~ ~q~ ~ ~ o~,D N~ R~2~ 8-Lot No. Hamlet C ~%~ ~e To~ 5~ ~ ~%1 9-Private well? ~e~ 3-~blic ~ter supply name ~ Distance to nearest ~in ~-~t Size: Wldt~,~t. Length]~o~ft. (also enter on center plot plan below:) 5-~elling: Single Family ~ T~ Family? / /Cellar? /~'/~lab? ~ ~ Crawl S~ce? /~'~ lO-Pro~s~ syst~: Septic Lank ~ /Precas% ~ /Cesspools ~Shallow ~ols / /Other ~ il-Septic ta~ inside dimensions: Vol~e ~Gals.Length ft. Width ft. Liquid depth ft. / moo Total blocks below inlet: ~1~'o ~2 ~'~3 ~T P~N Street Indi No "Construction of authorized installation! Capacity~Gals. G. P.M. The Undersigned CERTIFIES: accordance with the Suffolk County Health Depart/~.ents' murrent S,t, andards, and amendments thereto, covering Private Se~w~fDis~ Systems. Bulletins, Date ~/.~/) ~, Signed ~./~/Z~///~ ' Owne~,~ or Builder will be in FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date (~0/65 Revis.) S-15 Signed~ ~ jo)of /::% · /, TOWN OF SOUTHOLD ~-,~ ~- ,~ ~ ~, ~ ~'/~ BUILDING DEPARTMENT'/f?/?2~:: ~ /~ ~ ~ TOWN CLERK'S OFFIGE~. ~ ~ ? ~ ~ /~ sou .oL., ,. Exomined ~ ~ 197......~'.. pp cat on No ~.....~.~'~'- Approved ..................... ~.~...~.~ .......... , 19..~... Pemit No....~......,~......~,.....~...~.. 2/~/7~. ~ ~~' D, sopproved' o/c . ..................................................... ...~._.~.~ /~/~~. ~~ APPLICATION FOR BUILDING PERMIT ~/'./~,~~ Dote ...........~..~.~ ........ ~....~ I NSTRUCT(ONS '~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with~e, 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 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 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 Occupancy shall have bee~, 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. Suffo[l~ County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, addttions or alterations, or for removal or demolitionl as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premT~ecessary inspections. ~'~ (Signature of appl{cant, or name, if a corporation) .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder,S,,, ....................... .Q..W.~..~. ¥. ....................................................................................................................................................... Name of owner of premises ..... .~..~..~.-..y.. Q.?...%..~. ............................................................................................................. 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.: ...i ....... ~.... Lot No. ~' Street and Number £/S r~,,/~p L.~, /'~o5-,)3~/~o ~/2~., Cu~cl~ /~ ~ ~ Municipality 2. State exi~ing u~ and occupancy of premises and intended use and occupancy of propo~d con,ruction: a. Existing use and occupancy ........ ~.~.~..L~ ....................................................................................... b. Intended use and occupancy ........... ~...~.....~~..~ ......................... ' ..................... Nature of work (check which applicable): New Building ...... ~ .......... Addition .................. =.. Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work (Description) 4. Estimated Cost ............ ...~../.~ ..O.~.O. ................... Fee .............. ...~...~....?.?...~..?.. ...................................................... i .... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~ ......... Number of dwelling units on each floor ....... Z. ............................... If garage, number of cars ................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ..................................... 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 ......................................... Number of Stories ................... ? .................... 8. Dimensions of entire new construction: Front ... ~. ..... Rear ............................ Depth ........................... Height .............. Z...~.......~.. .................... Number of A.. / ...... btorles ................................................................................... 9. Size of lot: Front ............................. Rear ...... . o Depth Height .................................................... Number of Stories ...................................................................................... 10. Date of Purcha, ....!Z ...... ~ ................. Name of Former. Ow~r ...g .......... fi ............ ~,.~ ...................., ....... 12. D~s propo~d construction violate any zoning law, ordinance or regulation: 13. Will lot be re~aded .............................. Will exce~ fill be removed from premiss: [ ] Yes ~ No 14. Name OT u~er OT premiss ....~.l ........ ~. ........ ~...~..~...~..{ .............. =~.~. .......... * ................................................. (Address) (Phone No.) (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposad, and indicate ail sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW Y~ K//, ~ X ) ~ COUNTY OF ....................... ................................................................................... ~in~ dul~ ~om, d~es and ~ that h i~ th~ a~lie~nt abo~ named. ~ s~ing con~actJ He i~ the ...................... ~ ............................................................................................................................................................ (Contractor, a~nt, co.rate officer, of ~aid owner or o~n*r~, and i~ dul~ ~uthori~d to ~rform or ha~ ~rform~d tho ~aid work and to mak~ and fil~ thi~ ~lieation; that all ~t~t~m*nt~ contained in thi~ application ar~ tru~ to t~ b~i~ and b~li~f; and that th~ work will b~ set forth in the application filed therewith. . Not~ Public, Stala of New York ~ ...................... ~...:.._...day of ............. ~c~,~.~x~..30, ~ / /// ~ / / ...... ....................... . ..................................... - (~mre of applicant 49' 4.0' E. - '3ZZ~o$ UJ MAP OF PROPERTY SITUATE AT CUTCNOGUE SCALE. 50'=1" e -~o..~ VAN TUYL ~ SON g = MONU~NT ~o,~ $. 4&' I0' 00" W. - ~..~i D, GIZE&OEIO MAP OF PROPERTY SUE. VEYED · HENleY OMAkl · SCALE .,50'-I" El = MONUMENT SITUATE AT CUTCNOGUE OF $OUTHOL. D TO THIS SURVEY ~S A VIOLATION OF 319.20 Examined ....................... ~'/~}"~'"" 19'72 ~ 6~:/LJ ~ Approved ........................................ , 19 ........ Pemit No ..................................... Disapproved a/c ........ ...~..~ ................................................ FOJ, M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTNOLD, N. Y. Application No ................................. (Building Inspector) APPUCATION FOR BUILDING PERMIT ~Date ~// i 19_72 .... INSTRUCTIONS >-J a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building 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 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 Buili:ling Permit to the applicant. Such permit shall be kept o'n~, 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~ granted by the Building Inspector. . APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit j~ant to the Building 'Zone~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~,.~.~P)~,[~atio, ns, f._or.,~e~nstruction of · buildll~gs additions or alterations, or for removal or demolition, as herein described. The apPlicantxs~re.e~.o/~..o..mply w~tf~all/llpplicable laws. ordinances, building code, housing code, and regulations, and to admit authorized inspectors on pre mis~ an~/b(Jildings f~/s~ary inspections. ......... 7....¢ (Address of aplSlicant) State whether applicantx~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ ..................................... ................ ..................................................................................................... Name of owner of premises .......... (,/;-.,~.....~,......,,'~:.L~,, ................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on w,hich proposed work will be done. Map No.: ..................................................... Lo, No ............. Street and Number ...~.Z~....~..~..~...~..~.~....~...~.;/./..~..~..~...?.~._..,~x~.......~....z....~.~j....~.~.~..~ ~/"/'r')"//v'/m'-~'//~,..,, .............. ...~ ................... Municipality 2. State existing use and. occupancy of premise~and intend_e~ use and occupancy of proposed construction: a. Existing use and occupancy .............../1~/..~,..C...~....~..~7- ........ r~ ....................................... ~ ........................................... ~[ b. Intended use and occupancy ........ ..~..~./(/...~...~.. ............. :..~....~...C..~.....~:.. ..................................................................... I,~ ! : Nature of work (check which applicable): New Building ....................... Addition ..................... AlteratiOn .............. ~' /-~ ) /~-~ ,~1~ ] ~-. ~ {Description) 4. Estimated Cost .........,~.....~..~Y..~d. ...... ,; ....Fee .,., ...... ,.4~...~..z~..~ .................................................................... /' / (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 ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ..................................... 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 ........................ za (~) ,~ 7 ............. Number of Stories ........................................ 8. Dimensions of enti~e new construction: Front ....~..,.~./~. ...... Rear ............................ Depth ................................. Height ... ~. ....................... ? ...... Number of Stories ................. .~ ................ ; ........... ,'....y .................. ............ _ .... 9. Size of lot: Front .......;..°~ .~...~..r ............... Rear ........ ..~.. ~..d. ................... ,.... uep~J3, ....~ .... ~ ......... ~ ^ · .......... ..10;~::. Date of Purchasa ......... ~ ....... ~ ...........Name of Former. Owner/i ..j~..~-...~.,4./ ...................... , ..................... .~ ......... Zone or usa district in Which premises ara situated ........ .z~, ....................................................................................... 11. ~2. Does proposad construction violate any zoning law, ordinance or regulation: ........ ..U...../~.....~.. ..................................... 13. Will lot be regraded ........................... -~ ...... Will excess fill be removed fron3 premisas; [ ] Yes' [ ] No ..... ....... 14. mama at owner or premlsaS ............ ~...y.l..~ .................................... ~. ...........~, ........... '. ~ ............ /,/ (Add,ss) (Ph6~le No.) Name of Architect ................................ / / (A~lress) (Ph~e No.) Name of Contractor ............................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposad, and indicate all sat-back dimensions fro_~m ~ property lines. Give street and block number or description according to deed, and show street names and indicat~-~__~.~' er interior or corner lot. (Name of individual signing contract] duly sworn, deposes and says that he is the applicant above named. He is the ................... O....u~..~......°..{~.. ................................................................................................................................................................... (Contractor, agent, corporate officer, etc.] of said owner or owners, end 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 be~d~ ~hi~ ~[ledge and belief; and that the work will be performed in the manner sat forth in the application filed therewith. Notary Public, State of New Yo[~ "~'""t~;''''day No. 52-0344963 Ik Cour~f ....... '" .... .... v