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Home My WebLink About6997-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Otiice Southold, N. Y. Certificate Of Occupancy No. Z58~?.. Date I4ar . .2(5... , 19..~+ THIS CERTIFIES that the building located at . S/S Bay Shor~. Road .. Street l~tAt-mended Map ~%~%eo i~ay ~st Lot No..88,89~90 · O~oenp~t. ap ~o .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated Nov 20 , 19.73 pursuant to which Building Permit No. 699.7.Z. dated Nov . .21 .. , 19. ?.~, 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 Private .o,ae .f. amil. y dwelling ............................ The certificate is issued to Harold. It., Webber · 0~mer .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pcb. lP 19.7~4 by. R, 7illa .. UNDERWRITERS CERTIFICATE No. lq..lb8267. · .~4ar. Ab...ig?b. ................ HOUSE NUMBER 1030 Street ...... Ba.ysho.r.o · Ro~d ................... .~ .o,~:.~.:. P.e.c.~ i;~.t..f~r..s;c!. J.u.s. te..a..S.c. ~..e.n.c.1..o.s.e.4, .............................. Building Inspector FOR~f NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE P]~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6997 Z Permission is hereby granted to: .......... ~...t:l~ ......... ~.~.~4.~.!~ ........... ............... ~t~l~r, ......................................... at' premises located at ..,~..J~ ~4,~.....~.~J~,.~t,~l~..,1~&~..~;lf.~ ................. ............................... :tl/.~..~.~~..~ .............. ~,.,,n~e.~:~ ................................................... ~)ursuant to application dated ......................... .~...~..~. ....... ~. ........... , 1~.3~ ..... and approved by the Building Inspector. 'Fee ~1'.,.¢~. ............... Building Inspector FOR~ NO. 6 TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s application must be filled in typewriter OR ink, and submitted m DUPLICATE to the Budding Inspector with the following, for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, aha 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, Mulhple Residences and s~milar buildings and ~nstallat~ons, a certificate of Code compliance from the Architect or Engineer responsible for the building 5. Submit Planmng Board approval of completed s~te plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1 Accurate survey of property showing all property hnes, streets, buildings and unusual natural or topographic features. 2 Sworn statement of owner or previous owner as to use, occupancy and condition of buddings 3. Date of any housing code or safety inspect=on of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Budding ...~. ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~.~.'A~f~.~.~)..~.~.c...~.~g.~.~.~..~..ay..~..F~..s.&.~..~.~.~.~.~.~.~9.~.~.'~.~°? Owner Or Owners Of Property .... ~e,3c. o3,d,..~/.eb.e:~ ...................................................................................... 88,,.89 ~ 90 Subdiwsion ..~..s..h..~.o..~..a:..cj.v...e. ............................... Lot No ............. Block No ............. House Iqo,3,O~O.. Permit No ~99.7...Z ..... Date Of Permit ..l:l.,,/.;)~,l~..2'.~pplicant ..~%1;~l...~P-,~f~,l; .................................. Health Dept. Approval ..~,~.~.9./..7..4. ......................... Labor Dept. Approval ................................................ Underwriters Approval .... ,3~.~.~/..7..~ ......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~ ........................ Fee Submitted $ .... ..5,,,DO ...................... Construction on above described building and permit meets all applicable codes and regulations Applicant Sworn to before me this ....... ..... Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS c, ~', BUREAU OF ELECTRICITY ~ JOHN STREET, NEW YORK. NEW 10038 85 YORK THIS CERTIFIES THAT Harold Weber, Kerwin Blvd., Peconic ~ay Est:~te:~, off Rt.25, Greenport~ L.I. Job ~197 was examined on March 11, 1974 and found to be in compliance with the requirements of this Board. FIXTURE ~ECEFTACLESI SWIT HE I FIXTURES I RANGES [COOKING DECKS J OVENS I DISH WASHERS EXHAUST FANS ~,/,-~ I ~--~ I ~'~ [ I II , I I ~ DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL RE'(: PT TIME CLOCKS UNIT HEATERS I MULTI-OUTLET DIMMERS BELL ~ SYSTEMS 1 lO0 CD x I 2 i 4 *'Purnaces: Oil 1-1/8bp, 2-1/12bp George Zlmllnghaus, Il Park Place, Patchogue, L.I. 117'i~2 MANAGER COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. - SUFFOLK COmiTY DEPARTMENT OF HEALTH H.D.Reference No ~ EASTERN DISTRICT, RIVERHEAD, N. Y. APPLICATION FOR APPRO~rAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval t~ construct said systems is requested,pertinent data herewith: Date Phone~-" ~'~-~'6-Sub divPc~:O~:Ic i-Applicant P~o~d Xt, W~ ~'3-''~ ~ Address Ca~ ~,{inioAa ~c',, ~i~uc~ N,Y.' ?-Section 2-Detailed ~roperty locatio~e~yin ~vd,/cuffR$, ~5 to 8-Lot No. ~,~,,~.t~,~ ~mlet ~~Z~ To~ ~nO~ ~Y~[~P~ate well? 3-~blic ~ter sueR1~ name ~z~X~ ~q~ Distance to nearest ~in 4-~t Size: Widt~'~? ft. Lengt~ED ft. (also enter on center plot plan below:) 5-~elling: Single Fazily ~ ~ T~ Family? ~ /Cellar? ~ /~lab? / ; Crawl S~ce? 10-Propos~ system: Septic tank ; /P~eca~Cesspools ~ /Shallow pools il-Septic ta~ inside dimensions: Vol~e ~als.Length ft. Width ft. Liquid depth, I2-Precast sections: ~ ;Number/ /Sq~re Ft. Cesspools: Block sizeL incs.D ins.H Total blocks below inlet: PLOT PLAN Capacity__Gals M. Street IndiCate Nobth Data 'eet 0 2 6 8 10 12 ~6 The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date f~' ~5, ~9~ Signed~ t~ ~~1~ Owner or Builder 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 /( (10/65 Eevis.) J"JAI~OLD ~"~. e CATNE.gJNE D. WEBEI~. AT SUFFOLK COUNTY HEALTH DEPARTMENT VAT~_FE8 1 9 1974 H. z). nE~. ~,..~-/~/~ The sewage disposal and water supply facilities for this location have been inspected b? this department and found Chief of General Engineering Services HAI~OLD INSTRUCTIONS a, This application must-be completely filled in by t~pewriter o~, in ink and submitted in triplicate to the dJJuilding lmpector, with,3 set~ of plato; aCCUrate pk*, plan to scal~ 'Fee acco~ing to schedule. ' . b, PI~T pla~i ~lhglocation~f lot and of buildings on premises, relationship to adjoining premises or publk~ Stteats areas, and giving a detailed ~ription of layout ofpral~erty must be drawn on the diagram which is part of thil agl;dicotion. c. ~ wq, rk covered .bY .~!s application may not be commer~. ,ed before issuance of BuUding Permit. d. U-pan appmvM '~;/:thls! ~pPlJeation, the Building Inspector will igsu~ a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building sftall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate ~hall have been granted by the Building Inspector. ...... · R~or m~l ~ i~I~ II~ h~min d~:ribed. State wh~lr applicant is ow~Nessea, agent, architect, engineer, general cant cto,, electrician, plu~3er or ........................ ' ........................... ...................................................................... ............................. ....................... Nomeo, , ro, pram,,, ..... ........................................... + ................................ ....................... If applic< ~t is a Corporate, signature of ~'--'=:-=-'='~ "~--- ~' , ' ' ................................................ ~ ........................ ;L. ........ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ..... ..5..1.?...-..P.. ............................... 273-~. Electri¢i=n's License No ............................................. Other Trade's License No ............................................... I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No..8...8.~.~.~.~.?..0. ..... Street and Number ...~JR~.~i~.*;:hl;.~..~.~.~.....G..~...e..e..~..~...I'..~....H...:..~..t ........................................................................... Municipality 2. State existing use and occupancy of premise~ and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .......... N...o..~...e. ............................................................................................................ b. Intended use and occupancy ........................ ~ .......... [ ............................................ ~; ......................................... .ature of work (check which applicable): New Building ...~ ......... Addition .................. Alteration ........~. / Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... (Description) 4. Estimated Cost ............................................................ Fee .......................................................................................... (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 ...........o.~..~ ................................ ; ....................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Pear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Numbe~' of Stories ...~ ................... 8. Dimensions of entire new construction: Front ......6..Z...:~ ....................... Rear 6! Depth 3! 14 ' Height .................... Number of Stories ............... .o.~.q. .............................................................................................. 9. Size of lot: Front ..... !. .8. .8. .'. . .8. ~ ..................................... Rear ...... ?..~......6..~ ........................ Depth .....~...3..7..:..8...~. ............ 10.' Date of Purchase ...........: ............................................ Name.of Former Owner ....................................................... 11. Zone or use district in which premises are situated .................................................................................................. 12. Does proposed construction violate any zomng Iow, ordinance or regulation: ....... ~g ............................................ 13. Will lot be regraded ......~.?..~. ................ Wilt excess fill be removed fr_om premises[ (~) Yes ( ) No camp M~n~o-e Rd. ]~. Name o~ Owner o{ remises ~..a~..old We.~,er ......................... p ................................................ Address ~&%'~'J.-I:a~l~ .........Phone ~Uo~.98-85gO Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...,T~I~,.~T~.c~...H~j...~g.t .............. Address ~J~..~.~..~.~[~.~.~'11~1~I~ No. ~.~.~..'.~..~.~.~... PLOT DIAGP~M Locat~¢lea~/-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 indicate whetb~ interior or corner lot. STATE OF. Nk't~Y~ ~- ~ = = / COUN~ ' .... '"'"~ ................... :ff~j,~l~...*...~.~ ........................................ being duly sworn, deposes and says t}mt he is the opplicam (r~ of in~lividualksi~ning contracf) ' ~ -' ' ' 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 soid work and to make and file this application; that all statements contained in:thin, application c~re true to the best of his knowledge and belief; and that the work will be performed in ~e manner set forth in the application filed therewith. '/J Swam to before me this _ ~ ~ // , ................ ........ Notary Public,~~.....~ounty .......... ...~........~Z~.~.~ ~.....~ ............ v (~Signature of a~plicant)~~'---~ ~ T. BOKEN I~. ~2.~963 $offo/k C6unty~,/ " Camm~t Exp~e$ March 30, ]9~.~..~ ,,/lb Api:,ROV;,C, jD AS NOTE~D DATI~:~ FEE: ~7 ,~'~"% BY_ NOTIFY BUILDING DEPAP, TMENT 7~SS-26(=0 9AM TO 4PM lid INSPECTIONS. ~l. BEFORE BACKFILLING FC, UNDA' TION OR START 2_. BEFORE COVEBiNG PiP~LIN~ ~. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CON- STRUCT~ON ERRORS /4:4" _A 0