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Home My WebLink About6993-zFOIL,Al NO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.z~8?8 ...... Date ..... Na~' .... 2 ....... , 197~+. · THIS CERTIFIES that the building located at . ~el3rz®eo~;t; Day .... Street p~ Map No.]/ermeoo~;t ]~rock No. Lot No. 36 ~ottt;Izo~L(t. l~,~/o ........ conforms substantially to the Application £or Building Permit heretofore filed in this office dated ToY 1~).. , 19 ~.3. pursuant to which Building Permit No.6993Z. · · dated ..... l~oY 26 , 19 73, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .Prl~'at;e ozze. £&r~i3.y dwe;t3, JL~g .................. The certificate is issued to .I4o/~,~{o13ez'~;s ...... .0.~eay .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~,p~'l~! 30 1971+ 10y l~. ~illa UNDERWRITERS CERTIFICATE No. 1~. ] ~+096 ..... Aprl~. ] ~... ] 9~.!~ ............. HOUSE NUMBER . 2beS~. ..... Street ... Y.~nne.~ott...DX' ...................... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT CI-HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETIC~N OF THE WORK AUTHORIZED) · Permission is hereby granted to: ~,.:...~...~: ........ ~.,z-.-~..r..~..:. .............. ................. ~.....~.~o,.~..~-~;,,.= - ~~~ ~ ~ ~'~""~'"~~~' ' ......................... 'Z ............................................ ~,~,~,,,,~,~, .......... ~~~...~~ ......... .~.~...~.. ............ ~muqnt to application dated ~~~...../~...., 1~., and approved by the THE NEW YORK BOARD OF FIRE UNDERWRITERS SN BUREAU OF ELECTRICITY ~- 88 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the abo~e application number in the premises of Raymond !:oberts, n/s Yennecotte T~d., 285' w/o Laurel Ave., Southold, L.I. in the following location; [] Basement [] lst FI. [] 2nd FI. outside Section Block Lot was examined on ./~ri]. lls 19711 and found to be ln cornpllance with the requirernents of this Board. FIXTURE LECEPTACLE I I FIXTURES I ,,,,,. r o,, .NrACE ~O~sTORSH. p. I RJT,,,.~UT~EAPPU:oNCE"~Dw~"~. 1 2 12 SERVICE DISCONNECT INO. OF METER t 200 RANGES SPECIAL REC'PT ICOOKING DECKS OVENS DISH WASHERS AMT. K. W IlA.~T. K.W. ~T. K.W. TIME CLOCKS ~EIA UNIT HEATERS MULTI-OUTLET ~,. ~. ,,A.S. .~ .So;Eo'~.~T I A, W.G. NO. Of: HI.L~G A, W. G, NO. OF NEUTRAL5 OF CC, COND. OF HI-LEG l~/O 1 *Special }{eueptacles: 1-50ampR 1-30sunp dater Heaters: 1-4.5KW Elec. Room Heaters: 1-2.0KW, 4-1.DkWt 1-l.25KW, 2-1.0KW, 1-. 75KW EXHAUST FANS DIMMERS AMT. WATTS ~1/0 Sapanaro & Hlneot Inc. 102 Oak Ave. Shirley, New York 1~ 67 11 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Al ? / ~. ~ '~? 'zo "w'. UNAUTHORIZED A£.r~£ATION OR ADDII'IO TO THIS SURVEy IS A VIOLATION Oy $£C71ON 7209 OF Th~ N~W ?ORK STA~ EDUCATION ~W YE AI lV E ¢ O T'S'~oz~ court ~ii~,~,,rm~ ~e sewage disposal and ~;ater supply ~aoilitfes fo~ %hfs location have been inspec~e~ b~ this department and found ,,4 ~o ~.~ / 'ZT'Z O "v4, Y6h'N E CO T' 7' 4 4/HIIdJTHORIZED ALTERATION OR ADDITION ~ THIS SUEVEY IS A VIOLATION OF ~ECTION 7209 OF THE NEW YORK STATE ~DUCATION LAW, ~COPlES OF THIS SURVEY MAP NOT BEAf~ING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT ~E CONSIDERED TO BE A VALID tRUE COPY IGUAP~,I'TTEES INDICATED HEREON SHALL RUN ONLY TO THE ~ERSON FOR Wt~OM THE S~RVEY ?J SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant F~Vl~t}. ,~ g Phone ~e~.{~¢ 5. Stlbdiv. V~ Address ~X~5 ~ ~c~OC N~ 6. Section 2 Property Location ~/~ · ~ ~lO~ ~ W/O 7. Lot Number ,~U{~ ~V~ ' - 8. Private Well village Township ~OwTN~}~,~ 9. Public Water 3. Public Water Company Name Distance to min 4. Lot size: Width }~ feet Length ~ feet 10. Sewage Disposal System: 900-gallon septic tank: Precast,/ Equivalent Block B. L~:hing pools: ~'i N~er of pools ok ~C~reca~ / Block Special 11. If pr~ate well, fill in the '~ifollo'_-:~g blanks: ,_ A. T capacity gallons B. Pump G.P.M. ~ C. Total well depth D. Depth to ground water E. 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. Dateq~O_____~_~ ,_~q -_ !._~ '~__~_~ Signed ~O % /~.~_~_~, 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 pTot. APPROVAL DATE .//~r~5/- ~ SIGNED _ S-15 Rev, 4/1/73 Disapproved o/c ............................................................................................. (Buildi~] Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~, in ink and submitted in triplicate to the Building Inspector, with 3 sete 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 o~ areas, and giving a detailed description of layout ofpraperty 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 work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of OccuPancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, O~lnances or Regulcttions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein d~cribed. The applicant agrees to comply with all applicable laws, ordin0nces, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for nec .es.~.a. ryinsi~ctions.~ (~'~. C~A~ ~...~: ...... i~'i~t~'~" o'~f'~l~'~i~n~i"~' name, if a ~rporationJ ........ ...... ........ ........ (Address of applicant) (/77~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... .................... ._. ........... ................................................................................................................................... Name of owner of premises .~.:....I..~..~..~..{'~-.~'.~... .............................................................................................................. If alp, p~Lcant/f~ a cflrporate, signature of duly authorized officer. ......... (Name ajld tit · o corporate ~f cerl / Builder's License No ..................................................... / Plumber's License No ................................................. × Electrician's License No ............................................. Other Trade's License No ............................................... land on whic' proposed wOrk will be done MapNo' c~ ..~ · , LOt No~. .... Street and Numar ...... ~'.~CC~ ....... ~.kU~..:: [~:~:~:~...'~]~;~] ]~ / ' ~~ ~unici~li~ ...... 2. State existing use and ~u~ncy of promises and intend~ use and ~cu~y of p~ co~t~tion: a. ~isiting u~ a~ ~cupon~ .......... ~ ................................................................................... b. Intend~ u~ and ~cu~n~ ......... ~.{.~ ................................................................................................ 3. Nature of work (check which applicable): New Buil~Jing ~..~....~... ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolition...'.... ......... .'.i. Other Work ...................................................... ..... . (Description) 4. Estimated Cost .......................................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... /. .................... Number of dwelling units on eacl~ floor ............................ If garage, number of cars .................... I' ................... : ................................................................................................... 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 .~.t~ ...................... Depth ...'~...~ ....................... Height ..... I.~.. ................. Number of Stories ....... l. ...................... 8. Dimensions of entire new construction: Front .................................... Rear ....... , .................... Depth ........................ He ght .................... Number of Stories .................................. ~ ................................................................. 9. Size of lot: Front ..... !J~...~. ............................................ Rear ................................ ..................... 10. Date of Purchase ........................................................ Nome of Former Owner ...... J'~ ?.~/.~ .m 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~'..~.. ............................................... 13. Will larvae regroded ....... ~_..: ...... ~.. Will excess fill be removed from premises: ( ) Yes (~) No 14. Name of Owner of premises'l~'..~.....~.~......~...~L~.~ .~.~ .................. Address ................................ Phone No .................... .".'. Name of Architect ............................................................ Address~.:~..~...a~./f: ...... Phone No ....................... Name~ of Contractor ~..~J/IJE~J.~:iJ~:...~.'. .......................... Address ..l~l-3TC~/~.~..I/l~c..~,~ Phone No..~.~'.~.Z~.~../..~... PLOT DIAGRAM Locate clearly and distinctly all buildir~gs, whether existing or preposed~ ~nd ind cate a set-back d mensions from property lines. Give street and block number or description occordJngr to deed, and show street names and indicate whether interior or corner lot. COUNTY . S.S ...................................................................................... ~ ...... ,..being duly sworn, deposes and soys that he is the applicam (Nome of individual signing controcf) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate, officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make ~nd file this application; that all statements contained in this application 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 'c~rbefoe~ me this ....~ . ........ ~ (SignJl/ture of applicant) / No. 52-0344968 Suffolk Comrni~ion ~xpire~ Ma~rch ,30,, ' I ri] I1 , I