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Home My WebLink About6369-zFO~ NO. 4 TOWN OF SOUTHOLD BU~,nING DEPARTMENT Town Clerk's ORiee $outhold, N. Y. Certificate Of Occupency No. g.~.02 ...... Date ........... ~)e~ ... ~.~. ......., 197~. THIS CERTIFIES that the building located at . .~.he~'eea. ~'.$ve ........... Street Map No..~ .HoZe ]~oe~o ........... Lot No..'!S.,,. ~e..~.~.i.t.~..~¥., .t:;...~:.. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 'Peb ..... ~, 19.?~. pursuant to which Building Permit No...6.~.~.~.Z. dated ........... Eeb ..... 16.., lg~.., was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P.~.v~te. one. f~il;f..dwe~J.~Lng ........................................ The certificate is issued to . .Leo..i~oh ....... .0~er .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .D..e.c.:...~ ~...~ ~.7.~...by.. ~:..V.~. ~ .1.a... UNDERWRITERS CERTIFICATE No... I~..~29~',.~: ....... l~a~.. 2.~... ] 9.7.~ ......... HOUSE NUMBER .... ~b~O ...... Street ..... Thor. asa..~)r ......................... t Building Inspector FO~M NO. 2 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? 6369 Z Building Inspector. Fee $....~....'....~....0.. ...... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY P..k r~ 8,5 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT o~ly the electrical equipment as described below and introduced by the appllca~t named on the above application number in the premises o~ Leo RauehE w/side Thereaa Ave., 250' s/o New Suffolk Ave., ~agtlt uck~ was exarnin~d on ~-love~3el" 19, 1973 and foand to be in complJance with the requirements of this Board. lq / 3O16 13 ' j,¥E,.S.,,,. Io,L ,.Tjo,,s.. ,,u2., '""2" FE.'."As. * t 3 8 SERVICE DISCONNECT NO. OF METER 1 100 CB S RANGE TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS '~"~T. AN~FS. TRANS. NO. OF FEET V I C E *Furnaces: Oil 1-1/Shp, Motor/s: !-l/2hp Water heater: 1- ~t.Skw 1-1/12hp 2 EXHAUST FAN! DIMMERS A, W.G. NO, OF NEUTRALS OF HI-LEG OF NEUTRAL Aceumate Ele¢oCooE 827 Middle Country Selden, L.I. 1178~ GiNERAL MANAGER Per 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant Address ~z/~ /o {J ~ ~ ~Lo~?~ 6. Section 2. Property location~/f ~z-~¢~-~ fQ~ ~ 7. Lot No. 5~7M ~ ~,~)C/~ 8. Private well Village /~z+??~S'~ c /CTownship ~ ~ ~/-~ 9. Public water 3. Public Water Company name /~/v;-- Distance to mai~ 4. Lot size: Width // o feet Length /~ ~-- feet (Enter on center plot below) 10. Sewage Dispos~ystem: A. (90~F gallon septic tank: Precast~Equivalent Block ~. ~L~eaching pools: Number ~.-Precas~lock Special If private well fill in blanks below: Tank capacity ~als. Pump G.P.M. ~-~'~ Total well deptha ~ Depth to O.W. ~Amount of water in well ~ O Test Hole ~Data Feet 6 8 10 12 14 16 18 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Departm~ ofnew,He ~th's current stand- ards thereto" ~.~,., / / Date~~ ~..-7.~ Signed ~_~~ ~ ' Own~'r 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 ~/~/~ Signed ~ ~ / ~ S-15 Revised 4/]/72 APPLICATION FOR BUILDING PERMIT ~ '~ Date ...................... , 19. INSTRUCTIONS t~ a. This applicetJon 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. PIct plan showing Iocetion of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, an~ Jiving a detailed description of layout of property must be drawn on diagram which is part of this applicetion. , ¢. The work COvered by this application may not be commenced before issuance of Building Permit. d. Upon a0proval of this epplication, 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 part for any purpose whatever until a Certificate of Occupancy shall have bee~- granted by the Building Inspector. ~ APPLICATION I$ HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone ~Ordinance of the Town of Southold Suffotk County, New York, end other app cab e Laws, Ordnances or Regu at ons, for the construction of ~ '~buildings, additions or alteret OhS, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws ordinances, building COde, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ......... .......................................... (Signature of applicant, or name, if a corporation) ' .......................... ............ ......... ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ applicant is a corporate, signature of duly authorized officer. ~ If /F . 1. Location of land on which nroposed work will be do.~. ~p ~u.. .................... Lot No ............................................. ~ · _~ Street and Number ......~...~...../~ ....... ~.~.~~..~. ...................................................... - Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ,a. Existing use and occupancy ....................... f ........................................................................... ................................. ~ b. ntended use and occupancy ......................................................................................... ~ ..~--~ FOII, M NO. 1 , -- TOWN OF SOUTHOLD BUILDING DEP^RTMENT TOWN CLERK'S OFFICE ~ Examined ..... ~,....~..~.. ............. 197.-~... ...... Approved ........................................ , 19.?...~.. Pemit No ....... ~......~....~...~.... Disc roved a c PP / ........................................................................................... 3~ Nature of work (check which applicable): New Building ........... ..,.~. ..... Addition ..................... Alteration ....... ~. ...... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... {Description) __.........,.,,.,...........,.,.,..,.......,.,,,,., ~ee ~-~~-~----..--~~~~~~~~~-----..----~~~~...-.--..------~~~~~...~-~..-...------~--~-~~~~~~.~~~~~~~-- (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 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 ......................................... Depth ............................................. Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......... ~....O. ......... Rear ....... ..~...O.. .............. Depth .....~.....~...../.. ................. Height ................................................. Number of Stories ........ ../. .............................................................................. 9. Size of lot: Front ....../..~.. .......................... Rear ......... ./. .............................. Depth ....../.~'.. ....................................... Height ................. o................ ................ . . Number of Stories ...................................................................................... 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 regulation: ........ ~ ......................................... 13. Will lot be regraded ...... :..~ ................. Will excess fill be removed from premises: [ ] Yes [~'] No 14. Name of Owner of premises ............................... (Address) (Phone No.) Name of Architect ...... .....~. .............. ~:~ ............ -~. ........... ""i~,~i;~';;i ................................... ii~'~'~l'~'.i ............... Name of Contractor ...~ ........ .~......~ ....................... .~;s/..). .............. ~...il~h~.~'~;:, ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and sho ~,street names and indicate wheth- er interior or corner lot. STATE OF NEW Y,OJ~.., /~ ~' ) COUNTY OF ...~ ............. ) .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ................................................................................................................................................................................................................. {Contractor, agent, cOrporate officer, etc.} of said owner or owners, and is duly authorized tO perform ~l~.~e performed the said work and to make and file this application; that all statements contained in this application are true to the/~t~i~r~ltTO~l~~, __ ~ and belief; and that the work will be performed in the man~er set forth in the application.~ filed therewith. C~°~i~On3~4'o~tes°fNe~oyuon~kpirUr~l.~r - Nota~ ~ u bi i¢ ~ .~'~.......'. ~...re~..~ Co u nW .................................... ~ ..................................................................... ~ - . ($~gnature o£appt~tJ . 17t.~fl ' RHTH~ 1~ ~ /h~u',gAtDO~lYX'/° IL,