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Home My WebLink About6440-zFOEM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N. Y. Certificate Of Occupancy No. Z. ~53 ..... Date ....................... , THIS CERTIFIES that the building located at . .De~r..D. ri.vo ............ Street I,auz'e 1 C~y Map No:-...: .' ....... Block No ........... Lot No..2~~ ..... ~P~P~ .... ~.'~ ~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ f~.s:~...~ 19~.. pursuant to which Building Permit No. dated ........... ~ip..~ql~ .... 2~, 19;Z3., was issued, an~ conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to . ~]:a~..i~q~tP.~. $~P..~. ~ .Ha[~$pp~ ..... ~e~. .... (o~ner, lessee or tenant) o~ the aforesaid building. July 2g ~973..~ H. ~iI_~a Suffolk County Department of Health Approval .................... ~... ~ ...... UNDERWRITERS CERTIFICATE No. ~..~.]: ..... '.~V~ .] ~..].~7~ .............. HOUSE NUMBER .. ~5 ....... Street ..... D.e~; Dr[.~:e ...................... Building inspect~ TOWN OF SOUTHOLD BUILDING DEPART,'~ENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT £ (THIS PERMIT MUST BE KI~PT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? Z Permission is hereby granted to: .ZX~a~..~omes...Iaa ........................................ ...... h,32.....b~a~t~.+ .e~m~y...P,~t ..................... ........... ~oa ....... ~.*~.+.....~.tT.~. ...... '. ............. pursuant to application dated ........................ ,~k~.~...~,.,.:.2~ ....... ., 19..~.~,., an~ approved by the Building inspector. ~ \ Fee $...~.1;~,'~ ~} .......... TOWH OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR CERTIFICATE OF )CCUPANCY Instructions A. This application must be filled in typewriter OFt ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use~: 1. Final survey of property with accurate location of all ~uildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 farm or equal). 3. Approval of electrical installation 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 responsible 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 uses: 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. Certifi¢ste of occupancy SB.00 2. Certificste of occupsncy on pre-existing dwelling or 18nd use $5.00 3. Copy of certificate of occupancy $1.00 Date .....~.~...~ ~.~...Z~ ................. New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ ~ ~ 2~, ~u~el Co~y Estates, ~/S De~maz D~. ~u~e~, N.Y. Location Of Property ..................................................................................................................................... - _ H~rison, JO~n Owner Or ~ners O{ Prope~y ....................... a ....................... A'~ ................................................................. La, el Co~ry Estates Subdivision ................................................................ Lot ~o .......... i.. ~[ock No ............. House ~o ............. 3-2~-73 ~D ~ INC, Permit No.....................6440 Z 0ate el Permit .................... Applicant .................................................................. Meo[th Oept. Approval SO-1321...._.....................................3-19-73 L-bor~ Dept. Approval.....~ ........................................... Underwriters Approval .............................................. Plu~oio9 Booed Approval ........................................ Request ~or Temporo~ Ce~i{icote ........................................ ~i~o1 Certi{icote .......................................... ~ee Submitted $ ....~,0~ ...................... Coustruction on above described bui[din9 end permit meets ell u~p[icobie codes end regulations. Inland H~es ~no,'/,/~nneth W, Th~ber Applicant .......... ( ................ Sworn ,o before me 'a ~ ~~ ......... l...., o, .... .THE NEW YOR!K BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY j~ ak ' 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the electrical eq,~ipme~t ~ described bel~ and int~duc~ by t~ applicant named on th~ abo~ application number i. the premises ~, 5ohn '~. H~ison, ~/side De:mar D~., Lau~e: Country Est., Laurel. L~ ~.,b.I,,..~,,~,,~.~..~ 5"~"'"""~ ~ ~'~' ~ ~"~ ~' outside s-~i--182~-~ FIXTURE ~ECEPTACLES SWITCHES [ FIXTURES v RANG~ ~ ICOOKING DE~KS OVENS ' DISH WASHERS ~u, ~s [. I ~_ ~,~c~o.~sc,.~uo,~sc~,~l ~ ~T. J ~.w.,I ~.j ~.W. j ~~~ ~8~1~ I~8 I_~ t ~1' I II I I ~--~91CE DISCONNECT ND. OF ' S E 'R ~ ' V "' ~ ' ~ OTHER APPARATUS, ' ' ' .... ' *Furnaces: Oil 2-1/Shp, ~l~l/12hp ~ Motors: l- 1/2hp ~ ~ George Zimlinghaus, 4 Park Place, Patchogue, L.I. 11772 This certificate must not be altered in any manner; return to the office of the BOard incorrect, laspectors enoy be identi~ ~;L-by their credentials SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISB3SAL SYSTEMS March 16 1973 Approval to CO~s~rucb said systems {s 'r~q~ested,~erti~ent data herewith: Date _ , i-Applicant ........... Inland Homes, ,Inc' ,,, ,, PhoneY32-~lYY6.Sub div,.Leu=el,~oun't~y,,,,Estats~ Address 43? Middle Country Rd., Selden, ?-Sectio~,.,,z 2-Detailed 'p~'~'~rt~"l'oc~tion W/5 D~'ima~' ~=~ve ' ~ ' 8-Lot No. z ~ Haralet, , L~ursl .... " ' To~ S'6u~9~ ~ .... 9-Private well?, ,,~es ' 3-~blic ~ter supply name Distance to nearest ~in 4-Lot Size: Width 13Oft. Lengt~~o 'ft, (ai'~o enter on center plot plan' below:) 5-~elling: Single Family ~x ] Two Family~ Cellar?,, /x / Slab? ~ ~ Crawl S~ce? / / 10-Proposed system: Septic ~ank /, /Pre~Cesspobls ~Sha~low pools / /Othej / / il-Septic ta~ inside d~mensions: ~ol~Gals.Length ft. Width ft. Liquid depth ft. ~2-Precast sections: ~Number~qua~ Cesspools: Block size~ incs.D ins. H , ins. Total blocks below inl&t: ~1, ,~2 , ~3, ' ' ' ~OT PLAN ~ r? ~ Street Delmar Drive The Undersigned CERTIFIES: ~ 'ade / ,Q W.L. Indi "Construction of authorized installations will be in k_~apa city ~als. ~6 18 accordance with the Suffolk County Health Departments' curPent Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date 3-16-73 Signed INLAND HOMES, ~NC../A. Noonan. j~.. O~ner or 'Builder ~ . FOR I{EALTII DEPARTMENT USE ONLY. Based on the information presented herewith, it %he open, on of tls Ileal. th Do~'lr~,mont, that an adequate and satisfactory Sewage Disposal System ~,~an bo installod on this Plot. (,.0/o5 ~,c-~v.~,~,.,) Nature of work (check which applicable): New Building ....N...e..~. .............Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work (Description) 4. Estimated nn,t $20,000,00 Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .....Z.. .......... Number of dwelling units on each floor ......................................... number of cars ............................................................................................................................................ If garage, 1 Z4 x 20 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 ........................................ 5~,El,, 26~ 8. Dimensions of entire new construction: Front .....5..?.!..8..~! .......... Rear ......... z ................. Depth ................................. · ..'. ............................... Number of Stories ........................................................................................ Neight 18 ' 1 ...................................... 130,00' .- ~- igO,O01 9. .Size of lot: Front 130.00' Rear .......................................... uepzn .................................................. 10. Date of Purchase ..................................... Name of Former Owner .' ........................................................... ; ............... 11. Zone or use district in which premises are si'tuated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ .N..9. ........................................... 13. Will lot be regraded .................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises INLAN]] HOI4ES~ :[NC, e Name of Architect ..................................................................................................................................................... (Address) (Phone No.) INLAN]:] H0t4ES~ INC. SELBEN, N.Y. Name of Contractor .................................................................................................................... ?. . .3. .2. .-. . .2. .Z. ~. 7. ............ (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 accord~ng to deed, and show street names and indicate wheth- er interior or corner lot. STATE OFNEW YORK. ) COUNTY OF ........ KENNETH In/, THU RBER, V · P · being duly sworn, deposes and says that he is the applicant above named. I (Nam< of individual signing contract) (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 al statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann~ set forth in the application filed therewith. (Signature of applicant) APPROVED AS NOTED F~E:~~