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Home My WebLink About5737-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi[icate O[ Occupancy No. JJ..l~gJ~ ..... Date ............... J'~l~T''' '~' '" 19..~ THIS CERTIFIES that the building located at .~J8. Ii'Jim -l~m® ......... Street Map No.jaS~;.,. 8Jll'~' Block No.. mOO '~' · .Lot No..(~. ..... {Jl'®~l~l~Ol'~ .... 11~1[, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Mate~' ' ~'" 19.72 pursuant to which Building Permit No.. ~r~J~ · dated ........... I~ax'~ll .... 9" 19. '72, 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~ivate' mae- family' ~wel~fx~ ...................................... The certificate is issued to . 14m~l, ad. Gem. rod,.an .& .W.i.f.~ ....... 0wl~e.~s ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .14a~y.~O .$972. · .by. t~ .~..~llt ...... UNDERWRITERS CERTIFICATE No .... JJ. ~r~ ...................................... HOUSE NUMBER..~ ~0 ...... Street ......~J~gal¢l~. t~allo .............................. 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) 5737 Z Permission is hereby granted to: ...... ........ 14 $~.1, .. ~,,~m~x'~,. -.It~ ......................... ............. ~eXd~ ........ .!I.,3:o ................................. Bund ~ ~ fa~tl:y d~ll~ at premises located at .......... ~+,;...~.....~I,~;~.~..~JXQZ'~.R..~.I~,..'I: .............................................. pursuant to application dated ................................ J~&:~e~ ....... 8 ...... , 19.~Jj.., and approved by the Building Inspector. Fee $....Jl~,~- ....... EXPIRES--------- THIS APPROVAL APr',_ 1972 EASTERN DISTRICT, R~Ek~AD,N.Y. "~ · ' , ~?P:~C.~_-.£ ~ ~w~S~C~ PR~'ATE SEWAGE DISPOSAL SYSTEMS 6 ~arc.. ' '. 1..~ ........ ~_~ said sys~ems~ is requested,oertinent, data herewith: Date :. ~- ~..~. & ' ' - Phone 6-Sub di~ ~a ..... bane 8-Lot No.~. .....,:__2~a property location E/S~;-"~ ~{c ~ ~' ~ '-.P~..~_:.c water supply name ~ - - - ~, ~ ~ ~ ~stance to neare~.~ ~_ -Lcz 2zz~: Width400 ft, Length 151it, (also enter on center ~-~ ~ ' :ns: Sinsie Family ;X; T~ Family? / /Cellar? ~X/slab? / $.C~:S~ce? / / -~ro~oseC syst~: Septic ~ / /Pre,st / /Cess~ols ~S~I1~ .~ / /Other .-~u'~ic ~ inside dimensions: Vol~e Gals,Length ft, WidthS, ~$,1 ~$~q~d depth .:-?reoas% sections. / /Num~r~Sq~. Cess~ols: Block :c'~al blocks below i~et: ~1 1~2 1~3 ~T ~N C ity~~ '~ Street Mc Cann's Lane The Undersigned CERTIFIES: Indi ~ate NC 'th "Construction of authorized installations, will be in ~ztordance with the Suffolk County Health Departments' current Standards,.Bulletins, =.'n amendmen%s thereto, covering Private Sewage Disposal Systems". 3ate o ~arc~ 1972 Signed Inland ~omes ~n .1. .6~,.~- ~ or Builder ~ hEaLTH DEPARTMENT USE ONLY. Based on the information presented here~h, it is the o[t[niou of the Health Department, that an adequate and satisfactory Sewag~'DisDos~tSyste~, :=.-: oe -.~a~led on this.Plot. Da'~ ~_~ c.-- Signed ~ ' ' EXCAVA110H INSPEC110N P,F. N.74°0~r' IO"E. s.7~°o4'~o"w. 15132 LOT HO5.SMOWN OFFICE N.¥ f ,,,,..0.,,,.o,.~,.,,o,,.,o, PL:OPE ..Su ~.VE',,/b. L~-, FC~ MOUD,.AD ~ NONOP_INE ~ 5UI;L~r~ED _VAN 'FU..YL,~$ _ r".'z, v FOBM NO. 6 TOWN OF SOUTHOLD Building Deportment 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 triplicate 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. For existing buildings (prior to April 1957), Non-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 cede or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. New Building ..... ..~. ............ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...... ..E./..S.....°..~....~..o...G.~.t...s.....~.~..~.~ .............................................................................. Owner Or Owners Of Property Mr. & M~s. Mourad Gourodlan Eastern Shores -- 64 Subdivision ................................................................ Lot No ............. Block No .......1...... House No ............. Permit No....~..~3.~Z...... Dote Of Permit ...,~../.?./.~...Applicont ...~..z~......g~...d....H..°...~..e...~..s......-~....c..*. .................... Health Dept. Approval ..... .~.3.0~'..7.~ ...................... Labor Dept. Approval ................................................ Underwriters Approval ..... .6./..~..~./.~..~. ........................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............... .~ ........................ Fee Submitted $ ..~...QO ........................ Construction on above described building and permit meets all applicable codes and regulations. INT,~ND HOMES INC. ~ Applicant ........... ;~.~ ................... ~......: .............. ~~/.~. Sworn to before me this ~ ~ / ~' 7 z. ................ dayof ............................................ (stamp or seal) ~/~. Notary Public .................................... County FOB~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building~l Inspector. 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 ofproperty must be drawn on the 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 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 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 applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Inland Homes, Inc. (Signature of applicant, or name, if a corporation) Selden, New York 1178~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................... ,~ ~. ~ ~ ~.~ .z.....C..o..~ ~.~..~ .q..t..o..~. .................................................................................. Name of owner of Hourad Gourodian premises ................................................................................................................................................ \., If applicant is a corporate, signature of duly authorized officer. -7- / 0 - ~. '~ (~ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: ..... ~..0..2...~. ......................... Lot No ........ .6..~ ........... ~/ Street and Number ................. .E.~..~....o..f......~.g....g.~t~.n..~..~..~a~.....~r.~z~p~.t .................................. ..1 / ~ J~O Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy ................................................................................................................................ Intended use and occupancy 1 Family. Dwelli~E .. 3. Nature of work (check which applicable): New Building ]{ Addition .................. Alteration Repair .................. Removal .................. Demolitior .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ .Z..~..0..0...O. ................................. Fee .~...~4..~ ......................................... (to be paid on firing this applicatio~'i .................. 5. If dwelling, number of dwelling units .......... .3:. ................ Number of dwelling units on each f oar ....... ~ .......... If garage, number of cars ... '1 ].~ X 2,° 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 ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............... .~.~, ................ Rear ........ .~...~ ............... Depth ..... ..2:.~ ............. Height ...... .1..~ ......... Number of Stories ........... .Z. ........................................................................................................ i · t n 100 100.3 1 6 9. S,ze of Io: Fro t ......... Rear .... ~ ............... Depth ..... ~.?..*....?. ............... 10. Date of Purchase ........................................................ Name of Former Owner-~ast;ern.......................Sb. gz'es.............................Dev. Co.zT.~ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation~ 13. Name of Owner of premises ..~o...G.~I~.D. Cl,;[~I.~ ........Address ......~.ClT~..~^.~, ........... Phone No ..................... Name of Architect .,T.~3~.~.~..c[...~..m..e...s.....Z..~...c. .............. Address .......~..e..Z...~..e..~..~.....~..:.~..... ......... Phone No. 7...~..~..~..~..Z...7..?.... Name of Contractor Iralar~d..~omes...lz~c .............. Address .S.e..Z...d...e...~.~ N.Y... ......... Phone No. ?~.~..-...2..Z..7..~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck 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. STATEOF N~I (/.~: ~SS COUN~ OF ..~ ~.~, / / ................. ........ .......... .o.es i,,h. ~ome ~ mflw~auol signing op~ncation) above named· He is the .....................~~ ~ . .. (Contractor, ogent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or how performed the said work and to ~ke and file this application; that oil statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the ~plicoti~. filed therewith. Swam to before me this .................... ......... ....... ' Co~-odian~ ~%Cann Lane, TM ~ Sound Dr. & North Rd. Greenport ~ - ~, ~ 'j ,,lo~ ~1o~ ,ot~; ~ B~se.~ettt f~] lnt£1. ~J 2nd Fl. Outside Section Block Lol ~ ~:~ ,~.;~,dned ott Sure 22, 1972 and fout~d to be lt~ complla.ce with the requirements of this Board. R i FIXTURES RANGES COOKING DECKS OVENS ~DISH WASHERS EXHAUST FANS EOEP 'ACLES SW TCHES ~,cuav , [ ] ~ ' K.W i Ca , H P J ! A.W.G. I A~T. AMT. I ~PS. T"ANS. NC. OF FEET : ~' I WATT5 ~ ~ 'r J I ' S E R V I C 2 j 1 I 4 Appliance Feeder/s: 1-3#8 1-3#6 ~.2urnace/s: 0il, 1-1/Shp 1-1/12hp 1-2#12 George Zlmllnghaus 4 Park Place Patchogue, L.I.11772 T,;~ certi+icate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thei¢ credent;ols S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give de~d location) I / ~ / have been inspected by this department and found to be satisfactory. Chief of General Engineering Services COLONIAL RANCH FLOOR PLAN · FULL CELLAR · FULLY INSULATED · CUSTOM CABINETS · ATTACHED GARAGE · COPPER PLUMBING · CERAMIC TILE BATH · HOT WATER HEAT · CEDAR SHINGLES (FRONT ONLY) · INTERIOR & EXTERIOR PAINTING · 2 CESSPOOLS INLAND ~.~, SE 2-21'/7 473-7349 432 MIDDLE COUNTRY ROAD, SELDEN, N. Y. -4