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Home My WebLink About6933-zl~Ow~t~' NO. 4 TOWN OF SOUTHOLD BUHDING DEPARTMENT Town Clerk's O~ice $outhold, N. Y. Certificate Of Occupancy No. 7.~937 ...... Date .............14&y..30 ....... , 19 .~t~. THIS CERTIFIES that the building located at .S/8-.I~s.L:I.~. Ro~l ......... Street Map No~aY .Homom.. Block No ........... Lot No.$0... CutchogUq...N.~., ......... conforms substantially to the Application for Building Permit heretofor~ filed in this office dated ..........-0c.t .... ~8 , 19. '7'3 pursuant to which Building permit~ No.. 6933Z. dated ............0~;'' 19" ', 19. '?3' was issued, and conforms to ~a~of the require- ments of the applicable provisions of the law. The occupancy for ~whicht~fis certificate is The certificate is issued to ¢~s~ .~lstlt~e ~i~[t~. (Iolvp ..... ~ .............. · / . (owner, lessee or tei~ant) of the aforesaid building. ," Suffolk County ~epartment of Health Approval 14~r~. · ~0.. 1 ~... ~'. I~-o..¥i~- .1~. · · UNDERWRITERS CERTIFICATE No.. ~ay..,~).. ~.. by ,J,..i[~badk~ ......... HOUSE NUMBER,. ..... ~0 ' ' ' Street. '~ .. Leslie..Read ............... ' ........... BUilding InspectOr TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6933 Z Permission is hereby granted to: C3~se~..E-o~a~r.~.t~n., Co.~p ............... ....... ~....hl ...tl~:~cI~...P. ~th ...................... .............. ~e3.de~ ....... H.~, ................................. to .... ~i~.. ~e~...one...£a_m ~ ~7.-~.~¢alling ................................................................................ at premises located at ..~..0...~...1..,~. ......... ~,~r...~...~B..~.~. ........................................................................... ...................................... ~.J~..J~eslie../lo~d ......... Cutch~e ....................................................... pursuant to application dated ............................. ..0..~.~.....1...8. .......... , 19Z.~...., and Building InsPector. Fee $...~,.~) ......... approved by the Date ................................ , 19 ..... INSTRUCTIONS ~.. a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building 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: ~J c. The wor~ 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, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, (Signature of applicant, ~r name, if a corporation) ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. of duly authorized officer, / If applicant i~ commt~ signature at a~ 2. State existing use and ~cupa~y of premiss and intended use and ~cu~ncy of pr~s~ c~mcti~: a. Exisiting use and occupancy ................................................................................................................................ ' 3. Nature of work (check which epplicable~: New Building ....~'...... ....... 'Addition .................. Alteration .................. Repair .................. Removal' ~ ................ Demolition .................. Other Work (Describe) ........................................ (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, spe~.ify nature and extent o.f each type of use ............................ 7. D mens ons of ex st ng 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 construct on Front ..~...~.~... .... Rear ~?.... . Depth ~ 11. Zone or use district/iin which premises are situated ....... ~.....~....~...= ....................... ~ ............................................/' 12. Does proposed construction violate any zoning law, ordinance or regulation.;> ............................................................ Name of Architect Name of Contractor ..................... .: ............................. Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and i~dicate whether Interior or comer lot. STATE OF NEW YORK, t ¢ ¢ '~ ~ ~/~" ~/' COUN~ OF ................................ ~'~ .................J~G~..... · · ........ · .J.~........... · .... . ' duly and t~t he ' the ' ~. ~; ~.~ being sworn, d~es says ,s apphcant ( ' d'vidual signing applicat~) .............. ~ _ above n~ed He s the ~ ~X~~ ~ (Contractor, obit, co~orote officmr, etc.) of soid o~nmr or ~ner~, ond Js duly outhori~ed ~o perfor~ or hove performed the ~Jd this opplJcotion~ thor ~1~ stote~ents contoJned Jn this opplJcofion ore true to the best of his knowledge ond befief~ ond Sho~ the ~rk will ~ performed Jn the monner ~t fo~h Jn She opplJcofion filed th~rewJ~. Sworn to ~fo~ m~ Noto~ PublJc~ . ........................................................... Coun~~~(SJ~noture of opplJcont) THE NEW YORK BOARD OF FIRE iUNDERWRITERS ak BUREAU OF ELECTRICITY ' : ", ' 85 JOHN STREET, NEW YORK, NEW YORK 10038 "'",une N 162995 THIS CE~IFIES THAT only t~ e~t~ ~u~nt ~ ~scd~ ~ ~ ~nt~ by t~ ~[~nt ~ on t~ o~ ~pJ~a~n numar in t~ p~es of HogaN, s/side Leslie Road, e/o Bay Avenue, Cutchogue, L.I.' ;n t~ foll~ins l~.t;o.; ~ B~ement ~ lzt FL ~ 2nd FL outeide ~t~ s~k ~, w~exami~on ~Sy 30~ 19711 andfou~tobeincomplia~ewiththerequlrement~of~hi.B~rd. DRYERS FURNACE MOTORS FUTURE &FIqJAHCE F~EOERS SPEC~&LREC'PT, COOKING DECKS OVENS DISH WASHERS SERVIC~ DISCONNECT 1 NO. O~ ] S E A~T. &~. ]~IFE ~. 1 ~' 2W ,. 3W3.3W 3 ~ 4W NO. O~C~COND. 1 100 CB x 1 OTHER A~A~ATUS: R V I C OF CC. COND. 2 EXHAUST FANS DIMMERS ~Furnaces: Otl 1-I/Shp, 1-1/12hp Motor/st 1-3/qhp Patrick J. Heaney, 182 East Nontauk IIway, ~ .~/"~ COPY FOR BUILDING'0~ARTMEN~.'THIS COPY OF C,K.r,CATE MUST NOT Bm ALTERED IN SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY I. Applicant Address 2. Property Location ¥illage ~ 3. Public water Company Name 4. Lot size: Width feet Phone lO. Towns h i p Length feet 5. Subdiv. 6. Section ~ 7. Lot Number 8, Private Well 9. Public Water Distance to main Sewa~isposal System: A. ~O0~gallon septic tank: Precast Equivalent B. Leaching pools: Number of pools Precast~OBlock B1 ock Special ll. )f private well, fill in the following blanks: A, Tank capacity B. C. D. E. gallons Pump G.P.M. Total well depth Depth to ground water Amount of water in well (For Health Dept, Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. Date ~, Signed 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 and Water Supply can be installed on this plot. APPROV^L DATE SI NED C S-15 Rev, 4/1/73 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This applicahon must be filled in typewriter OR, ink, and submitted in DUPLICATE to the Building Inspector w~th the following, for new buddings or new use: 1 Final survey of property with accurate Iocahon of all buildings, property lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept. of water supply and sewerage d~sposal--(S-9 form or equal) 3, Approval of electrical installation from Board of Fire Underwriters 4 Commercial buildings, Industrial buildings, Multiple Residences and simdar buildings and ~nstallotions, a cemficate of Code compliance from the Architect or Engineer responsible for the budding. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. B For ex~sting buildings (prior to April 1957), Nomconforming uses, or buildings and "pre-ex~sting" land uses. 1. Accurate survey of property showing all property lines, streets, buddings 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 code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate C. Fees: 1. Certificate of occupancy $5 O0 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1 O0 Date New Building .... ...~..,. ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. / Property ..... . .~.. ~...~../~. :~.:...~..,..~..........~..... ,~. Z~.~...~...~...~..~....~.. ................................................. Location Of Owner Or Owners Of Property .... ..~....~...../~..../.~..~..~....,~...... ,.~,.~,7_/~...~.. ...... I~,~.:.../=,IZZ~ ........................................ Health Dept. Approval ............................................ Labor Dept. Approval ............................................... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~ ....................... Fee Submitted $ ....... ~.~.~ ................. Construction on above described building ~t meets~p~icable codes and regulations. Applicant ..... Z~..~=.~.'~~ .......................................... Sworn to before me this ...... day of .... ..... ..... Notary Public .................................... County (stamp or seal) SUI~'o~ COUNTy REALTH The Sewage disposal a~ ~ate~ supply facilities fo~ this loeatlon have been lnspeo~e~ by this depa:tment Ohlef of erie Services ¢ REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG G CLAUSE~ CONSTRUCTIO~ TOWN OF ~OU~O~ SUFFOLK CO., N.Y. SCALE: /I/= '~O' DATE: -~F FB~CVED(~' AS ' k