The URL can be used to link to this page

Home My WebLink About6569-zFOl~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.~5.802 ....... Date ............. F. et) .... 22 ..... , 19.7.%. (Ha~a~er Rd Ext) THIS CERTIFIES that the building located at ~ishe~a_ns .Bewgh Re% .... Street Map No. Pe¢oni¢. Ba~B~o ........ Lot No...8 .... C~/tchoglle... N..~, .... conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... gay ..... ] ] , 19 7.3. pursuant to which Building Permit No. 6~6.9Z dated ...... May ... :1.%., 19 73, 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 .P~iva~..~. f.~mll~..dwe, lling ............................. The certificate is issued to ~K~nr~eth Bx*owe,~ ...... G~e~. ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No. HOUSE NUMBER . ~9~ ·. . Street .... Fishel-mans. Be~¢h. P~t.. ~l~ate).. ZL.. ... Building Inspector~ ·/~.eb 20 197~+.. by R. Villa .... Oct . 2.. ~ 9.7.3 .............. ~FOR~ NO. 2 TO~N OF SOfT'OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 6569 "/~'~)~Z' ~-;-~ Date ........................... ..~.~. ...... .~...~ .......... , 19~,,'~... hereby granted to: Permission is ............. g.~.~b~o.~e ............................................ to.~...~..1.ci.....n..e.~...o.~..~...~..~J,ly...~e;Ll~& .................................................................................. at premises located at ...~.~..~...~.....~..~.O~i~...]D.~J~r...~;~.~Jl~.~Jl...~ ......................................... .................... ~a~ua..hemc~..Bo~...( ~t )...or...t~ay~a.tar~..r.o~d..~temt lo~ ..... ................................ .~ .t.~..h..o. ~.,.~.. .......... ~.,.~..,. ...................................................................................... pursuant to ap,pi!cation dated .................... ~1)~. .......... ~..1 .............. , 19.~_~.., and approved by the Building Inspector. Fee $....L~...t...O~.......' ...... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, ti. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled ~n typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the follow~ng, for new buildings or new use' Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograph,c features 2. Fina{ approval of Health Dept. of water supply and sewerage d~sposo{--(S-9 form or equal) 3. Approval of electrical installation from Board of Fire Underwriters. 4 Commercial buildings, Industrial buildings, Malt,pie Res,dances and similar buddings and installations, a cert,f,cate of Code compliance from the Architect or Engineer respons,ble for the budding. 5. Submit Planning Board approval of completed site plan requirements where applicable. B For ex,sting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses 1. Accurate survey of property showing all property hnes, streets, bu,ldings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of build,rigs. 3 Date of any haas,rig code or safety inspect{on of budd,ngs or premises, or other pertinent in- formation required to prepare a cert,ficate 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 oo, ................... New Buil&ng ...... t.../.~ ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. · oc o,,on of Property ..... ~...~ Owner Or Owners Of Property ..... ~.././~..,....r..~...r..~..~...~...~...C~ Subdivision ~.~.f~.~. ~.. ~.'.~.~.~..~.~.~..~..~t.ot~ No ~ ... Block No ............ House No ............ Permit No ~.~Z.. Date Of Perm~t~Z;~,.:~pp,,cant ~~..~.~. ...................... .~.<- ~_~/~> / Health Dept. Approval .~......~......;.:/.~' ...................... Labor Dept. Approval ............................................... Underwr,ters Approval ./~.].../.~/.~'~:)Z~...~.. ................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ..~ ............................... Fee Submitted $ .... .~.~.~.~. .................. Sworn to before me this ...... ~.~ ~o, o, ...K...~...L~..Z.~ ............. Notary Public .................................... County Construction on above described building and.pe/mit meets all appllgable codes and~regulations. Applicant .................................. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICIT~ '- ~0S JOHN STREET, NEW YORK, NEW YORK 10038 85 "a'October 2. 1973 A.p.co,,o. No.o./,~ N 118009 THIS CE~IFIES THAT Ke~eth Brower, Cut cho[ue ~ L.I. ~exami~on ~~ ~ ~ andfou~incompl~ancewitht~r~ui~mentsofth~B~rd. RXTU~ I RXTURES RA~ C~I~ D~KS O~N$ DI~ W~E~ EXHAUST FANS DRY~RS -I mR'NACE ~Tb~S I ~TU~ A~E ~' ~ALR~'" TIMEC~KS J mL ~ M~m D~ERS 1 200 W.~. Ruland Mattituck, L.I. J~ 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH EASTERN DISTRICT, RIVERHEAD,N.Y. APFLICATION FOR APPROVAL TO CONSTRUCT ?R .1VATE S~EWAGE DISPOSAL SYSTEMS Date Approval to construct said systems is requested,pertinent data herewith: Address ~ ~") ~ l~F~t~) ' .~.~_.~}/~ection. , / ! .. 2-Detailed'~6~er~~ ~'/~;T/~ C7//~ ' ' ""~'Lot No .. .... Hamlet ~, ~. ~..~ ~ .... ~'~-~Y~/~..i z~..~' 9-Private well? ~ .- 3-Public 'w~t~e~'p~/i~&~ ~ ~ ~O~ce to nearest main 4-Lot Stze~ Width-z~- ft. 'L&~gt~.~_ ft. (als~ ~-n{~ on center plot pla~~//3~, ~-Dwelling. Sin~g_l.e~m~ily ~. ~f~Tw~gg~ily? ! ,,! Cellar? ~ Slab? ~ ~ lO-Proposed system. Septic t-~nk ~Precast~_~sspools ~/Shallow pools ~ /Ot~~ il-Septic tank tnsi.de c~tmensions: 'Volume. m__._Ga~fs. Length. ft. Width .... ft. Liquid. depth £t i2-Precast sections. ~Number/~'~qqua~. Cesspools. Block size~ incs. D ins. H ins Total blocks below in~e~: ~1 7~2 ~3.. ' ' PLOT PLAN "Construction of authorized installations wmill The Undersigned CERTIFIES: accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date Z-~,//~O... Signed ~~~ ~Cf~.j~ / Owner or Builder Data Feet_ .1., - , _ ,, be in FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health De~rtment, that an adequate and satisfactory Sewage Disposal System can be installed on this 'Plot. Date ,C"/'r(;"/? '~ Signed (10165 Revis.) $-~ Approved ........................................ , FOBM NO. 1 TOWN OF SOUTHOLD - BUILDING DE~RTMENT TOWN cLERK's OPFICE $OUTHOLD, N. Y. Disapproved a/c ............................................................................................ (Buildin~ InspectOr) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS t~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wi 3 sets 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 or areas, an~ giving a detailed description of layout of property must be drawn on 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 o the premises available for inspection throughout 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 bee~ granted by the Building Inspector. ~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a B[Jilding Permit pursuant to the Building Zone. ~ance o~ the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction ,~l~!?~lngs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspactionL~ (Signature'ofapPlicant, or name, ifa corporation) (Address of applicant) State whether applicant is owner, le~ agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~,~1~,~..~~ .................................................................................................. If applicant is a corporate, signature of duly authorized officer. (~qame and title of corporate/officer) 1. Location of land on which proposed work will be done. Map No.: ..................................................... Lot No ............ Street and Number 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~...~.~ ......................................................................................................... use and occupancy ..~.~..~ ............................................................................................... b. Intended Nature of work (check which applicable): New Building ..... ~.... ........... Addition ..................... Alteration .......... L... ~; Repair ......................... Removal ....................... .. Demolition ............ ' ............ Other Work .................................... 4.Estima d Cost ..... .............. ,. F--..., ...... ......... ,, ........................................... ......... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... /. ........ . Number of dwelling units on each libor ......................................... , . .- \ : ............. :... If garage, number of cars ............................................................................................. .~, .............. .~ ........ 6. If business, commercial or mixed occupancy; spe~if~/na~ture~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: Fr_om~..~ ................. Rear ......................................... Depth ............................................. Height ...... ; ................. '~ ................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ ~ .......... Rear ....,,~...~.~..... Depth ..... n~,.~. .................. . / Height .................. .~. ........................... Number of Stories ....... /. ................................................................................ 9. Size of lot: Front .............. ~...~-...'~....~. ......... Rear ............. ..~..~....~ ................. Depth .....~..~...../. ............................ 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or reguletion: ...,...~..~ ............................................... 13. Will lot be regreded ~ ...................... Will excess fill be removed from premises: [.] Yes.. _ [v~'No 14. Name of. Owner of premises ......~..E~5'L.~>.~.~'~c .~.)~ ....... ~.~. ~. ~~...U,~.Z~ ~)~ ....~.. · · .'~. ,~.¢~g~29'S (AddreSs) (Phone No.) Name of Architect ...........~ ....... ,....., ........................................................................................................................... ~r~//~ ~, ~ ~1.~~ ~. - ,~ ,~ Z.. ~...~....~.~.~f.~.A"~.-- -- _ (Address) ~..,~'...~.....~.4~./..~.* · . (Phone No.) Name of CO nt racto r..,-~,~,~..-.~-~ ...~. ...... .................. ................ , .... (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 whe~li,~ er interior or corner lot. STATE OF NEW YOR~,. /,,~ /j, ) COUNTY OF ...... ~./SL ........... ) A~ ~"'~ ~/~'~~ bein duly sworn der scs and sa s that he Is the a I,cant above named .................. r~,~,~'"'~'~: ' . . . ............................ g , po y ' pp ' . · , am~ofindividualsign~co~n~trac~t~_~ Ha is the ................................................. ~..~r.......o~_.~ ........... } ...................................................................................................... {Contractor, agent, corporate of J~cer, 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 state~rnents 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. /..L.]/'.day of //~V/' _/~'RR, ~E EL~K.~i~~. .............. ..~...~II~..BLiC. State otue. e;..,~...' :~___~'_ _~~ C_tL3' ........... ~X.,E..~2.~,,,9, . :.~... .... ~/ ~ ~ /~ . .~/~) . '~---"'~, - ~ f.~ I~ll. itied in Sultolk Count'/ 19"7 '" '= '~~~ 'P! !'esl~S n tY O' ';" ........................... (~t/~/'e ~[ ~'J~J~'a~ ,) ..................... Notary Public, ~ AtA y Ia/A T'E I~ J ~;.o FEB 20 1974 .. D. REF. g:_~.qS7'.~'/? DATE The sewage disposR1 End water supply facilities for this location have been inspected by this depar%men% and found Chief of General Engineering Services · ,5'tale: 3~ TM ~$.o v~ ~ .t~uF~' ,~and Gu~'¢14o~ u£ I ' :-Z¥:Zi 7 - EL ZZF- '--- :'--T---~ -