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Home My WebLink About6924-zFOl~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ~(a~S.t.°.l~..H~ad ............. Street Map No.l/aSa.~. p.1;.... Block No ........... Lot No..i77 .... ~h0~... ~ ...... conforms subst~ti~ly to the Application for Building Permit heretofore filed in this office dated .......... ~P~... ~ .... , 19~.. p~suant to which Building Permit No. 6~.. dated .......... 0e~...~. ~.~., 1973.., was issued, ~d conforms to all of the req~r~ ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is . Pr. lva~..~..f~!.1~, d~lll~[ ....................................... The certificate is issued to .. 8~.~9~ .$~r~k~ ..... ~e ....................... (owner, lessee or tenant) of the aforesad building. Suffolk County Department of Health Approval D~0...?..1.~...bY. ~. Y!.!~a ...... UNDERWRITERS CERTIFICATE No. ]]7~...i~g2..~3...i.~?~ .................. HOUSE NUMBER .... 7~P ...... Street . Y.~9~. ~ .......................... '" Building Inspector FOF, M 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? 692 Z Permission is hereby granted to: at premises located at .~JJL,~I~.L;....JIItlBJJ~....JM~II~:-~.....;; ............. t ................................. w/s Vanoton M (old C.o..v..o......]M. ~ .(~Ete~ ..... pursuant to application dated .................... .,J~ll~O.t,.....~. .............. , 19~..., and approved by the Building Inspector. Budding Inspector FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~62~2 ...... Date ............ Dee ..... .~ ..... , lg.?.~. THIS CERTIFIES that the building, located at .. 01d CAB®. B_o_~4 .......... Street Map No. ~ .Pt. Block No ........... Lot No. ~9~ .... ~teho~.. ~,Y, ........ conforms substantially to the AppUcation for B~lding Permit heretofore filed M ~s office dated ......... 8~pt. · ~. .... , 19 ~. p~suant to which Building Pemit No. &9~. Z dated ........... ~et...~.~..., 19.~., was issued, ~d conforms to all of the req~ ments of the applicable provisions of the law. The occupancy for which ~ ce~ificate is issued is . .~t~ate. ~,. family, dwell tng .......................... The certificate is issued to ...81~o~. ~skl ..... ~ ...................... (owner, lessee or ten~t) of the afores~d building. 'S~olk County Dep~tment of Health Approv~ . Doc** .9-. 1~...by. R, .VI~ .... UNDERWRITERS CERTIFICATE No. ]~7~... l~.. ~...~.~ ................ HOUSE NUMBER .. ~ ........ Street .~to~. S~5 ........................... Building Inspeeto~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTR!G[TY ~-- 85 JOHN STREET, NEW YORK, NEW:YORK 10038 N 178475 THIS CERTIFIES THAT only the electrical equipm~ent as deserlbed belme and introduced by the applican~ n~med on the abo~e applleation number in the premise. ~lgmuna Zaz'nOVBky~ V/Blde Yamston Rd.~ 1000* ~/o B~-oadv&tex's Rd. Cut ohogue ~ in the/ollowing location; [~ Seaernent ~ I,t FI. ~ 2,d FI. °utSlde s.:tio, e~,~h was erarnlned on HXTURE OUTLETS Augu. t 19, 197~ 3q ~3 2~ DRYERS RJRNACE MOTORS FIXTURRS and found to be in compliance with the requirements of this Board. RAHGES OVENS DISH WASHERS EXHAUST FANS TIME CL~CKS UNIT HEATERS MULTI-QUTLIT DIMMERS SYSTEMS HO. OF NET SERVICE DISCONNE(:T OTHER APPARATUS: · ~u~ ace s: S E R No, ~,~c~.co~o. ~ cc. co~. c~ H~-~O O~ NeUTP. At 1 1/0 1 1/0 0tl 2-1/Shp, 2-1/12hp W.B. Ru~and, Matt/t uek, L.I. COPY FOR BUILDING COPY OF r NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AddressD~j,.m~A &,.~ f.,,TL£~o~, I,LM~ I;~4 6. Section 2. Propert~ l(4~cati6n ~;~-e~fl~h£Z~ ~;~'r 7. Lot No. '~,,,,.~ ~ ~.,,r~.,~ ~ 8. Private well Villa~e'c,~e,i~]~'-' Township 9. Public water 3. Public Wa~e'r Company name __~ Distance to main Lot size: Width_~feet__.. Length_~feet (Enter on center plot below) 10. Sewage Disposal System. A. 900 gallon septic tank: Preeast ~'Rquivalent Block B. Leaching pools: Number_e~_Preeast ~.-Bloek Speeial~ The Tank ca~cit~Gals. Pump G.~M. ~_~ p Total ,41 Depth ~G.W.~ Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 be in accordance with the Suffolk ards thereto." undersigned CERTIFIES: "Construction of authorized installations will County Department of Health's current stand- Signed information presented Cwith, it FOR HEALTH DEPARTMENT USE ONLY. Based on the is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this plot. S-15 Revised 4/l/72 ,5'¢~/~: SO'= I"' ? awe~r,tpor¢, ,v. ",'. BUILDING DFJ'ARTMINT .~. ........................................ , A~plication No ........................... ~ ..... pr~ ....... : ............................... , 19..Z.:.. Pe~k~ ........................... Di~ro~ a/c ..................... ~'~ .............. ~ ............. ~ ......... ~- ~ Z ' ~ ~. ~-- ~ ........ ~ ......... ~ ..... ~ ~'~' ~ ~: ~ · . ................ . I~ , .... % ~, ~is oDIic~ti~ must ~ complet, ly fill~ in ~ ~ril~r I c. ~e wo~ c~r~ by ~is o~!ication ~ n~' ~ c~ before in~e of Buildi~ Permit. d.. U~ o~ol of ~is o~licat~, ~ 8uildi~ I~tor wilJ ~s~Q ~uildi~ Pe~tt to the Q~Jicant. S~h ~it~ s~oll ~ ~ ~ ~ ~m,~ ~]l~le for in~ ~ ~e work. / ~.-. ~.,, ~o bufldi~ ~11 ~ ~cupi~ or u~ in ~ole or in ~fl ~r any pu~ose whotever unfit Q Ce~ f cote of ~c~v~ mt n~e ~ gmn~ ~ ~e 8ui~ing In--or. ' ~ ~LI~ATI~ ~S HERE~Y.~DE to ~ ~ ~m~t ~or the issuance/of a BUildi~ Pe~it pu~t to QQmlT aumonz~ ~n~o~ on pmm~s a~ ~ ~,m~ ~ ~a~ . ..................... -' .......................... ..................................... ~.~ ........ Store whe~er o~licant is ~ner, Ieee, ~ent, o~h~t~, ~gm~r, generol controctor, el~tricion, plu~ or ~il~r. N.,. of ~,.r of ,~,~se~ ........ ..8~,,.~., ............. 6~.~...~.~.~. .................................... , ................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ......... Z..7....~.....'~......~., ............. ' ' Electrician's License No .... ~.....~...~.....'~.......~.~...' .......... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ....~7... ................................ Lot No ........................ 2. State existing use and occupancy of promises and intended use and occupancy of propc~ construction: a. Exisiting use and occupancy ......... ,...~.~...~-'..~....~...Z ...... ..~...~..~.d .................................................... b. Intended use and occupancy ..................... '...y~.. ................ .~ ................................... Nature of work (cHEck'wfllch ap ble): New Building .................. Addi .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... o ............... '. .......................................................................... 4. Estimated Cost .../'~....:j ................................................. Fee /JO. 0.,~(Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .0...~..~. ......... Number of dwelling units on each floor ...~.~....~m... ........... If garage, number of cars ..... .T..f,~.....O. .............. 6. if business, commercial or mixed occupancy, speci~ nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ..... T. ..................... Rear ................................ Depth .................... Height ........................ Number of Stories ........................... Dimensions o~f same_~st, raet~t~'"~h alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..../.../. ......................... Rear ..../......~. .............. Depth ....~...~....~.. ......... Height ..../.,..o~.....'. .... Number of Stories ...... /...E...?:~T'... ...................................... :~ ......................................................... 9: Size of lot: Front ....... ./.....~2.~..'..~'....0. ............................. Rear ......... ,7....~..!.....~...~i ............... Depth ...~..~.....~. ................ 10. Dote of Purchase ....~1.~i~..'i/...~...,,/..~..,~..~..~'.. ................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..... /~.~..~..i..~....a~...~'A...~. ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... .~....O. .......................................... 13. Will lot be regraded: ...... ~...q .............. Will excess fill be removed from premises: ( ) Yes (/~/~o 14. Name of Owner of premises .~.J[~.q~..e..~...~...~J'...lq.0..l~L.~.~ ..... Address ~.~'.-/..~,.~.u..d./l~l/.e..~J~one No.~.I~..-..~'A/.Z.~....~./*1 Name of Architect ~'.e.~l.~l.~]l'k..~.g.~.'/..?6L.'..~.~.u.~,/I/.~.~l~_/.,Address ......... Z.J~z~l..~. ........ Phone No ....................... Name of Contractor ..~...~-.I,b'.&~.'..~...~..,.,~..~Y...~.~.. ................ Addres~..Tk~£~..~J~.~...~.g./'.phone No~.~...~..-..~.~'..7...O.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property fines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ,./ N/o STATE OF N L%y. ,/,OJ~,~/,~' [,SS COUNTY OF~...4 ' · ............... ~..1~1..~...~,....~..'~.,..~...~...~J~...~..~..~.. ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing cant'rectO above named. He is the ................... ..~....O.....~G.....~'./TX~...C.....~-.~...~... .......... , ..... (Contractor, agent, corporate Officer, etc.) of said owner or owners, and is duly authorized to pert, arm or have p.erformed the said work and to make and file this application; that oil statements contained in this appl~cati0n are true'to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to b~ef~e this / ........... ~..~day~of.....,d,.~ 19.~. JUDITH T. BOKEN (Signature of applic,g~ Nc~G~, Public, State of New York No. 52-0344963 Suffolk County j Commission Expires Mc~rch 30, ~'~/1 AP OF L. ANO N~,~AU ~ 0 APPROVED AS NOTED DATE: ~ ~ /'~" ~ ~ F~E://O,~zF- BYe_' T'= NOTI~ BUILDING DEPARTMENT ~, 7~5-2660 9AM TO 4PM FOR REQUIR. ED INSPECTIONS; 1, BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2, BEFORE COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE ~OR DESIGN OR CON- STRUCTION ERRORS .L A iT' I ~ /PLA /',J .I