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Home My WebLink About6496-zFOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z'~956' · Date ......... June..9+ ....., 19. ~h THIS CERTIFIES that the building located at · ~herasa Drive ....... Street Map ND. Deep .}late. C~oec~ I~.t~. ..... Lot No...I.7 ~IattLtttck . I] ,~., ...... conforms substantisdly to the Application for Building Permit heretofore filed in this office dated ...... 'Al~ri'l · 16, 19 '75 pursuant to which Building Permit No. 61+96Z. dated .... April ]9, 19 . ~.~ was issued, and conforms to all of the require- ments o£ the applicable provisions of the law. The occupancy for which this certificate is issued is .Private. one lY_~_mi-ly dwe.l.l-L;tg .................................. The certificate is issued to .Grovor & &~he~esa ~hompzo~t ... O~ners ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Jmue 1.1 . ] 971+ by &~, .V. illa. UNDERWRITERS CERTIFICATE No..~..~ 368~0 . .Jan...~ . .1.9~1~ ................. HOUSE NUMBER . .1+~O .... Street . .The~'ese .igri-ve ........................ .... '~'"- "u~B l'~i~ng inspect' '-"o~'"'t .... l~'O~ 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? 6496 Z Date ....................... ,/~:I~L ....... .~.~ ......... 19~.3 .... Permission is hereby granted to: · - ~'o~'e~-. &.. ~h~e~...~ol~p Boz~ ................. ..................... ~a~.~..~ric~x ............................. .................................................................................. at premises located at ..~,d~t...[~.~ ..... ~S&..D~ ....... ~.Do~)..~[o,~O...Ck...I~ ........................... ............................................... ~tt~_.~.... ~.:~ ...... '. ...................................................................... pursuant to application dated ........................ /q~'~t~L.....1.6 .......... ,, 19.~..~ .... and approved by the Building Inspector. Fee $~ .............. FO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. T~MPOR~I~ Certificate Of Occup; ncy No..Z. ~.7.~.9 ..... Date ..............J.a~ .... ~0. .... , 19. ~.. THIs CERTIFIES that the building located at.. ....~eS& ,I~J~.v~ ....... Street Bst Map No,D..eq.p..H.o.~..e..C~lock No ........... Lot No.: l?. .... ...l~.t.t.~,. ) .~...~. ? .... conforms substantially to the Application for Building Perm/t heretofore filed i~ this office dated ...........Ap, l~, .~....~..6, 19.'..~.~ pursuant to which Building Permit No. 6~6Z.. dated ...........Ap.r.~..~ .... ~.~., 19.~.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one family The certificate is issued to .G.~..o?.e.1,..~...T~..e.r..e.s.a...?0..a~..~ .~. ............. ...(~...r.s. ..... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant ) : .......... UNDERWRITERS CERTIFICATE No.P.~rl~J~ .......... .......................... HOUSE NUMBER.. ~0 ........ Street .. ~.~$..D.~' ............................ THE NEW YORK BOARD OF FIRE UNDERWRITERS J~1, BUREAU OF ELECTRICITM ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 T.,s 136830 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of G:ovet Zho~pSOnR Zhetesa D;. s/o ~ Bu~£o1,k Ave. Hatt~cUCkEL. L inthefollowlnglocatlon; ~ Basement E~ lstFI. [] 2nd FI. OUtSLd~I ~ctio. Bl~k Lot ~s.~;~do. December 27, 1,973 andfoundtobelnoompllancewlththerequire.entsofthisBoard. FIXTURE FIXTURES RANGES ~)VENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER APPARATUS: 1,o3/&hp--- E R V I C NO. O~ERCC. COND.A.W.G. OF CC. COND. NO. OF HI-LEG OF HI-LEG Zl:uman H, Cook Champ1,tn PI. Gzeenpor tE ¢ ."'~,IAL MANA~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ..Scale = 4d'.,. /" /,IJ/,.J;%,~NT,;&I; To TI.IF ~lilCA~(I TITI,~. SECTION 12C9 OF THE NEW YORK STATE EDUCATION LAW. T~'Z LA~%D SURVEYOR'S INKED SEAL OR AT j7' '0 3 0.P, UNAUTHORIZED ALTEI~Ai'I~)N OR ADDISON TO THIS SURVEY IS A VIOLATION OF $£CTION 72C9 OF /HE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOE ~ARING O,,~'.Z7, /??x. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant~ ..... ~. +~,,,,n ~./~o~oso~ Phone~,.o{j~. 2. Property locati~n~.r ~.~ '~.~ D.,~' 7. Lot No. 8. Private well Vtllage~]~,~ Townshtp~,,~/~ 9. Public water 3. Public Water Company. name mu~e Distance to main 4. Lot size: Width~d feet Length /~m / feet (Enter on center plot 10. Sewage Disposal System: A. 900 gallon septic tank: Precast ~ Equivalent Block B. Leaching pools: Number ~ Pretest Block Special below) If private well fill in blanks below: Tank capacity ~Gals. Pump G.P.M. ~ Total well depth__ Depth to G.W. Amount of water in well Test Hole Data Feet 0 2 6 8 10 12 14 16 18 The undersigned ERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards thereto." EuiIder 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 1'~ ~/f ~ '"~ Signed S-15 Revised 4/~/72 =m,ned ....... --,,.,, ,o Approved ................. ~.~. ........ ~.L. ......... , 19..?...~. Pemit ,o.~...~.....~.~...~ ......... .'~ Disapproved' o/c ................................................. · · ..... ~Sl~t;~'i ....... APPLICATION FOR IUILDIN(~' I~RMIT Date ............... .~.~.Z../..~.. .................. , 1~...~..~.... ~; INSTRUCTIONS ,.This application must be completely filled in by tvpewriter or in ink and submitted in triplicate to the Building Inspector, with~ 3 se, of pllnl, ac~urlte plot plan to .cale. Fee according to schedule. . . b. Plot plan showing location o~f lot end of buildings on premises, relationship to adjoining premises or public streets or areas, 'and~ giving a detailed dmmription of laveut of propertv must be drawn on diagram ~ is pert of this apptioafion. e. The work aovemd by this el:l~ication m,y not be commenced before issuance of Building Permit. d. Upoe.~qlloval of~l~ eppl~ion, the Building Inspector will issue a I~AlJlding Permit to the applicant. Eueh permit shall be kept on the Pmml.# Iv¢lleb~, f~ Irmpe~len throughout the work. ' · e. No bulldlnB ;.1~t_, I be e_,~__,~ecl or used in whom or in pert for any purpo~'whatever until a Certificate of Ocoupency shall have beenr grlflted by the I~u~ldT~g In~beotor. APPLICATION I S HEREBY MADE to the Buildin~ Depertrnent for the iuuenca of ~ Building Permit pursuant to the Building Zone Ordlnenee of ~ T~wn of Southold, Suffolk County, New York, end other ~ieab~ Laws, Ordinance; or Rewlatiom, for. the construction of building, mJditiom ~ elteratlom, or for rembvel or demolition, es herein describe#. The applicant ~rees to comply with ell applicable ordinance,, building ood., housing code, and regulations, and to admit authorized inspectors on peemises and in buildings for necassary inr~coction~. (Sig~taiture'o~ ~Pp~licant, or nlm~Jf a 4X)rporetion) (Address of .l~pljr. ent) //~ State whether applicant is owner, lessee, agent, architect, englrfeer, general contractor, electrician, plumber or builder. ................ .~..~.~.~....~ ......................................................... :.'. ......... ~ ....................... ~ ............... ~ .............. : ................. tf ~ppJic~ ~a corporate, signature of duly authorized ~ffic~_r. (Name end title of' corporate officer) 1. Location of land on which prppmed work will be done. Map No.: //,,,n~- (,, Lot No ............ ~.. .............................. ................... :i _~, ~ ' 7~ '7'~ Street and Number ~ ..~...~......~. ....... ~.~.~.~.../...~.~...~..~...~ ...... ~...~...~,.Z~.r...~.....~.:....: ...................... ff ,,~ 0 ~icipatiW 2. S~ate existing use and occupancy of premises and intended use and occupancy of proposed construction: a.- Exbt~l um~nd oeoupanoy ............. ~ .......................................................... , .......................................... ;1.~ ]J..l_,g. ^....~ I~ ~,~o: b. Intended use end occupancy ....... .......... ,...~x....~.~,.,-xw.z~r~...~/..T~'.......~...t~.....~...~.:.....-~:~_ ......... Nature of work iohe~k whichappliceble): New Building .................. Addition ..................... Alteration ............... Repair ......................... Removal ...................... ;.. Demolition ............ ,4 ......... Other Work .............. ~. .................... (Oe~rlption) Estimated Cost ........... /..~.~.¢..¢.....~ ................. Fee ...... ,..~.;,~ ................................................................................ (to be paid on filing this applicat,[~l]~ 5. If dv~lling, number of dwelling units ...... Z ....... Numberodwef Iling units on each floor ....... '~....;.~..,0...d....f~...-~......,_;~ If garage, number of=ers 6. If business, commemiel or mixed occupancy, ~eci~ nature end extent of each type of u!e .......................... ; .......... 7. Dimensions of existing ~mctures, if any: Front .......% ............ Rear ......... ;..'....; .......... Depth ........... ~ ....................... Height ................................... ; ....................... Number of Stories ............ ; ................................................................ Dimensions of same structure with alteretiom or additions: Front ..... ~ .............. Rear ......... ..~-......~..~ ................... Depth ................ ~ .......... ; ........... Height ........................................ Number of Stories ....... .~...'....~.. ..................... 8. Dimensions of entire new constructmn: Front ........ le...~: ....... Meer .......................... ,,~,u. ................................. Height ................................................. Number of Stories ......................................................................................... · 9. Size of lot: Front ............ ././¢. ................... Rear ............. ./../~..~ ................ Depth ......... /.i¢'~..../. ............................ Height .......................... ; ......................... Number of Stories ............... Z ................................................................... ~ -¢ 2- ~ ~ ..... 10: Date of Pumhme ....././.:..~.. ...... ..~.. ............. Name of Former Owner ..~.~".~/~......,~., ........~ ....... ~.'~. .............. 11. Zone or um district in which premises ere situated ........................................................................................ t~ ......... ;. 12. Does propoesd con~tructionu~,violate any zoning law, ordinance or regulation: ........................................ : .................. 13. Will lot be m~rad~d ~._.....i~i~';.,q.,. J/ill excess fill be remo,~d from premi.ee: [ ] Yes No , ~,. ¢~,~,~,, ~e:~-./e.e~,,... ........... .Y..~ZC.~..~..~ ......... 14. Neme of Owner of premiere 2~.ff..~.~_.~..., ......................................................... (Addm.) (Phen~ No.) Name of ArchJ~t ...................................................................... ;.:.;.:.....~..~. ................................ ~}I;:_"_"2~;_"~ ............... .. ,.m. of Co ,=r .............. ..... PLOT DIAGRAM Locate dearly end ~t~ln~fly all bui!~nge, whether existing or pmpoesd, and. Indicate ell sat4~ack dlmenMon~ from propor~ Iine~t~lVii~li'mlt'ar~t bilk rfumber 'bt de~r!ption accordir~ to deed, m~d ~how street names end indicate whel~ erinterlor °remner I°t' ~C.~ e,~-~4~---~',~,~) ~ ~ J' ~"i "19/ ~.~'' u.)1~'3J ' Lo-~ IL. STATE OF NEW YORK, _ ' ) COUNW OF.....%:.~..~.~:.~..%X..% .................. I SS .............. ; ..... '~: .......... bPing ~uly s,WO, rn, depo~l~ I~'ld laYS that be il the allPltelnt abo~e namll~ '' : H, is me....: ............... :C~.~.~'~ .................................................................. _., ........................................................................................... ( Conf~tor, nent, con~ ~ ~ ) . ~ ~ of .aid owner or ~r., ~ ~ duly ~l~thorlz~l to p~form or beve Ilerforn/d the ~ld ~ ~ to rn~e ~d nflhl ~ ~; ~ ~ ~ f~h In ~ ~tl~ ~ ~ith. ~ ~' .................... y ot .................. ~.~:~2~ ........ No~ ~ubh~ .~.~.~.. ~n~ ...... [~....~..~ ........................... APPROVED AS NOTED NOTIFY-BUILDING DEPARTMENT ~L A~