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Home My WebLink About6552-zNO. 4 TOWN OF $OUTHOLD BU~.DING DEPART~n~IT Town Clerk's $outbol~ N. Y. Certificate Of Occupancy ~o. Z6629 Date THIS CERTIFIES that the building located at .....~..: .l~..r.b.?r...R.o..a~. ...... Street Map NoC].o&~eli. Pfc. Block No .... I~[ .... Lot No, .3B.. ~z~enp~t.. H,~, .......... conforms substantie/ly to the Application for Building Permit heretofore filed in th~s office dated ..............Ma~.....8., 19.. 7][ pursuant to which Building Permit No..6]~. dated ..........~0'...~ ....., 19. ?~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which tMs certificate is ~ued Ls ... P.~.Y&t~. ona .~'e,~3,7. ~,we3.3.~u~ ....................... The certificate is issued to ... ~$..~. F~... F~,t~lla~,~ ...... 0l~ll~ll .......... of the aforesaid building. Suffolk County Department of Health Approval U~ERWmTERS CERTiFiCATE No. ~ (owner, lessee or tenant ) .l~ay...28...197.~...by. ~,..V~3.~ .... ..... ~pr.. 29...19~'. ............... TOWN OF 80UTHOLD BUll.r}I~G DEPART~.NT Towel Clerk% Office $outhol$, N. Y. Certificate Of Occupency No. Z~O Date June .3. ,. ...., 19...~. THIS CERTIFIES that the building located at ...8n11[ .Harbor. I~Qad ...... Street ~aap ~o. ~.:!.~..~.~. ~. ~ock ~o .... .~ .... ~.ot ~o. t~. ..... o..~.~.~..o.~.~.~...~:~: ....... conforms substantiallY to the Application for Building Permit heretofore ~ed in this office / . May. 8 19.73. pursuant to which Building P~it No..6.~. dated ......./. ........... , . dated .........?.~.Ir.. ~8. ...... , 19. ?~., was issued, and conforms to all of the require- ments of the.r applicable provisions of the law. The occupancy for which!this certificate is ~ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..~... UNDERWRITERS CERTIFICATE No..~...1 .~..6~..87 ..... .A.p.r....2.9....1.9..~. ............. HOUSE NtrMBER..3~.~ ......... Street. p.n.u.g..~.a.r.b. 9.r..~..o...d. ..................... Building Tn~oectorI FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6552 Z Permission is hereby granted to: . J[hmU .. &..ge~...~t~m~e~ .................... ......... t.~..~...a9 ....... 6~ ....... ~ ....................... ........... · ~e~&~. ................................................. to ....2~.~..~v..~...lqm~..1-~.. ~t.]:~t.~g .................................................................................. at premises located at ..... T.~t,..~'~. ...... O],&~'~..~O~t~..~e~...[[. ................................................ ......................................... ~g~.~b~r..~&d .............. G~e~nl~O~.t ............................................ pursuant to application dated .......................)J~y .......... J~ ............. , 19..~., and approved by the Building Inspector. Fee $....Je~e2~. ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS SW BUREAU OF ELECTRICITY ~' 85 JOHN STREET. NEW YORK. NEW YORK 10038 · .,s c.~,~,.s~.~. N 156487 o~y t~ ~n~ ~,ment ~ ~cdb~ ~ and ~pt~uc~ bx ~ ap~i~nt ~med on the able .ppl~at~n flum~r in t~ premlses of &'om~zmau~ce~ ~nu~ t~aroor F~., orr ~outh Side O? Shore ~d., 1 Blook s/Dawn Rd., Greenport, L.I. in the following l~ation; ~ B~e.ent ~ 1st FL ~ 2nd Fl. outs lde April 25, 1974 and found to be in compliance with the requirements of this Board. OUTLETS RECEPTACLES SWITCHES VAFO~ 25 38 29 25 DRyERs FURNACE MOTORS ~UTURE APPLIANCE FEEDERS A~T. K.W. OIL H~p. ,GAS H.P. /M~,T. NO. A.W.G. SERVICE DISCONNECT NO. OF S METER 1 150 CBx 1 OTHER APPARATUS: RANGES lO.3 ;PECIAL REC'PT R COOKING DECKS OVENS DISH WASHERS AMT. K. W~] AMT. K.W. UVtT. K.W. I I I I Ill TIME CLOCKS B~LL UNIT HEATERS MULTI-OUTLET SYSTEMS AMT. AMPS. TRA~S. · ' NO. OF FEET V I C EXHAUST FANS DIMMERS WATTS NO. OF CC. COND~ A.W.G, NO, OF HI-LEG A.W.G. NO. OF NEUTRAL$ A.W.G. PER .g OF CC. COND. OF HI-LEG OF NEUTRAL 2/0 1 2/0 *Future App. Feeders: 1-2912, 1-3#10 Water Heaters: 1-~.SKW Elec. Room Heaters: 3-2.5KWS 4-2.0KW, 3-1.2.,kW John P. Engel, Jr. ~~ Box 56 Miller Place, New York 1176~ OINHAtMANAO~n/ COPY FOR BUILDING DEPARTMENT. THIS COPY OF gE~iFtCATE MUST NOT BE ALTERED IN ANY MANNE~ FOI~M NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and 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 instaUatJon from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsibte for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and :'pre-existing" land u, ses: 1. Accurate survey of property showing all property lines, streets, buildings 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 in- formation required to prepare a certificate. C. Fees: 1. 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 Date ~... ~'. ~......./..~..~..../...~....~....~... ...... blew Building ................ Addition ................ Old or Pre-existing Building ................ Yacont land .............. location Of Property ................ Owner Or Ownem Of Property ..?~....~..~'..~.~.~_..¢.....~f.~.~........~..../. ,~.~./.~.~..~..~.F.~.~ ............ Subdivision ~.~.~.~.£...~.~ ...... ~.~.~..: .~:- ..................... Lot No...~....~...... Block No ............. House No.~...~..~.. Permit No~'..~..J~...~....2~.. ...... Dote Of Permit .~'..d~../~..~.Applicant .-~-~.~./-------------------~/~..~.... -~.-../..~-- .~..///~. -~'.../~./.-~-.~'~. ....... Health Dept. Approval/~.~..-....~.~..~.~..-.4;.,~: ........... Labor Dept. Approval .......... ..~...:...~...; ........................ Underwriters Approval.~.~.~.~.. ........ ..~,..'Y'./.~...~.~..~. ...... Planning Board Approval ..... ~...'.....~...[ .................... Request For Temporary Certificate ........................................ FinaJ Certificate .......~ ............................. Fee Submitted $ ..... ~...~.~ .................... Construction on above described building and permit meetLall applicable codes and regulations. Applicant . :....~~ .......................................... Sworn to before rr t'~ ...... I Notary Pub~i~ ....~ ~~ounty / (stomp or seal) ~-'~,.~' ~'/~. SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Nu~er 10. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Applicant "~",Y-/~A'Y,/~ ,]. ~l~'"Z~)At/~y~,~l~llone~~. Subdiv Address I~L - ~ ~ & ! ~ ~&[~..~ ~)~l.~. II ~ ~ o. Section Property Location ~" ~' - _C~ ~l~ ~7. Lot Number ............. -- '8. Private Well Village ~yf?~r~:~ ~ 7'- Public Wat%r Com~a6y Name Lot size: Width ././~ feet Sewag~isposal System: Township ~! ?~Ly> 9. Public Water Distance to main Length ~feet (For Health Dept. Use) 11. B. Leaching pools: Nun~ber of pools q~ Precast /~lock Special If private well, fill in the following blanks: A. Tank capacity~ ~allons B. Pump/~ C. TopiCal-well depth D. D~pth to ground water E. Amount of water in well 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 '?A/z Signed ' ' ::::::::::::::::::::: FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Heal th Department that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this p~ot. APPROVAL DATE Ff ?7 S,GNED EXCAVATION INSPECTION REQUIREQ Rev. 4/1/73 ,2 ¢_.~/= ,fro'./" -//~p,¢_¢,°¢' AT' Z'-,4~ z-- M,4~/OA4, /l,<: ~. EA:? 7- FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMINT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, (NGme end title of corporate offlce~/~_/ Builder's Li?nse No ..... J24~a~'.,~ll~_a~[ ................ ~ Plumber's License No....~bCa~..,*'Z/¢~-~,.. ............ Other Trede's License No. 6~e-~¢,.~ ....... 1. Location of land on which propomd work will be done. Map No ............................................ Lot No...~.....~'.'.. ............... Street and Number ..~ ....... ~.~..~t~..~......,~.~.,~'.~.~. ....... ~.,..: ......................... e/e-~...~'~-..~...,~.~...,~-... ....... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ...,,.....~.../.../..~.~..~/.-.........~.....~.~.../-..'~..'..;,..;;k..~....~....~....~..~..../.~ .................. Lrt, If applicant is a corporate, signature of duly authorized officer. .... ........ '.iiiiiiiii ...... 221:1 ~ ......................... L.....:..... .~........7. ....... / ............................. ~ - ~.//_ a. This a~l~ti~ mint ~ ~mple~ly fi~, t,~;...;~: Zr iq i~k end s~ in t~l~ to tM ~uilding b. Plot ~m ~ I~ti~ of I~ ~d of buildi~ on premiss, relationship ~ a~ ~ or ~, ~vi~ a ~ ~n of I~out of ~om~ ~it ~ dr~n on di~ram ~ich is ~ of this a~li~ion. e. TM ~ ~ ~is ~J~tion ~ not ~ mm~n~ ~fore i~uanm of Building Permit. d. U~ ~ ~' ~ll ~l~tion, t~ Building. Im~tor will i~ue a~uildi~ ~rmit to the ap~li~nt. Such ~rmit.sh~l e, ~ ~1~ ~1 ~ ~p~ or u~ in whole or in ~ for any'~ wHate~-untd a ~ifi~of ~m~ ~all ~ ~ ~ ~ InsUre. , ~LI~ IS HEREBY MADE to t~ Building De~K~nt for t~ J~uanm of a Buildi~ Permit pu~u~t to ~ Buildl~ Z~ O~l~ ~ ~ T~ ~ ~ ~ ~n~, N~ Yo~, and ot~r ~J~bJe ~, 0rdin~ or R~l~i~s, for ~ ~ of ~ildi~, ~ ~ ~, or ~ m~al or ~lition, as ~min ~rl~. ~ a~li~nt ~r~s to ~y wl~ all ~inanm, ~il~, ~ ~, ~ ~lations, a~ to ~mit authorized ins~o~ on ~mi~s and in ~ildJ~ f~ ~ In~iom. ~ ¢ ~ ~ (Add~ of a~li~t) ~ ~ ~ll~nt I~ o~, I~, a~nt, amhit~, engin~r, ~neral c~tr~tor, el~rician, plum~r or builder. 3. Nature of work (check which apl~licable): New Building ............. Addition ' Repair ......................... Removal ......................... Demolition ........................ Other Work ................................... ; (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 occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Del~th ................................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ............................................. Height ........................................ ; Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... ~..~....; ....... Rear ....~...~....; ............. Depth ......~....~....; ................ Height ............... ,~...~.. ......................... Number of Stories .........v....~. ................................................................. 9. Size of lot: FrOnt .:~....../../.~2..: ................. Rear ............. ~..~...~.....,~ .......... Depth ......~. ,.~._..~./. ....................... iO. Date of Purchase .,~..:.~..~.-/~...~.-~'... Name of Form~,~) ~wner,~u.......~.~/~..~.-. ............. 11. Zone or use diStrt~ in which premises are situated ..... ~_~ .................................. ~ ...... ~ .................... 12. Does proposedlconstructiop,.~i_olate any zoning law, ordinance or regulation: ...._~ ................................................. 13. Will lot be regraded ~.~'~,~, ........... ~. t~OJ, I .e~cess fill be removed from premise~: [~J~es, ~ [ ] No/3.~,- \ (Phone No.) Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give Street and block number or description according to deed, and show street names and indicate wheth- er interior or corner :lot. I Lot STATE OF NEW YORK, ) COUNTY OF ...... , .~... ,~,...~-...~,, .~..*..~,, ................ ) ........... .~,,,X~,~,,~,.~.,~,....,..~,~,,;.,,~.,,~,~,,.~, .,7~. ,~.._,~,,,~...~%.~,~,,~_. being duly sworn, deposes and says that he is the applicant above named, (Name of individual s~gning contract) 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 and 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. ~ ~_ . TERRI L~E ELAK '~'ork ................... (~....~.....day o,f ...... ~ ~['~ ,.~...~-~ .Y, f -To \ OL LO" Va~'v ~CRL Gr\F h G E, ,'2 'd ?_ '. 0" W/kLL KITC¼E i-3 APPROVED AS NOTED NOTIFY BU(LDING DEPARTMENT A~T 765-2660 9AM TO 4PM FOR REQUIR. ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA. TION OR START FRAMING I %G'-O" b b _L 4~ td 121-0" C) , o~ '3 ,:) [ Li] ...... ,4" F,~ II .\ 'i F LO0~ - I %C/~Lt OPC~ 'T/~I~ Bo&~-P (.O'JEF, 'r ' , L I,,: / LieGE ,(,L ~9 i ts~ FF_L%