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Home My WebLink About6681-zFORM NO. 4 TOWN OF $OUTHOLD BUHDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~6.~2 ...... Date ............Dec...12 ........ , 19. ?3. THIS CERTIFIES that the building located at .. Laeto~ J)x'~ ........... Street Map No.. ;~ ........ Block No.. ~ ...... Lot No...x~x... aouthn].4.. 1~.¥, ....... conforms substantially to the Application for Building Permit heretofore filed in thl, office dated ..........June...1.9.., 197~. pursuant to which Building Permit No.. dated .........~T~n,~.. 20. .... , 19.7.3., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Pr£~ate..one. £amJ,2.y..dweJ.].~ng .................................... The certificate is issued to ...J. errY..~. ¥~.rg:l~t.a. ~,i~.Ca~.era ........ ~e~.~ ......... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .. Dec...12..1.cz'/. 3...bY. ~...V;I.,1.~,&... UNDERWRITERS CERTIFICATE No.. ~. 129.t7.8 .... 1~0.~...26...t97:t ............. HOUSE NUMBER . ...~.l~O~ ...... Street .... l.e~to~ .I)~. ........................... · ......... FOI~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? 6681 Z Permission is hereby granted to: .... ~J~s.t,..~J~t~..D:c~.,e~...~ze.....~L/C..~e~.~y...& Virginia NeC&~era .............. ~}.~.~.~h~d ............................................... to ]~.tl!ld..~e~..~me... f~,~ ~-...d ~:e2.1.~,~ ~ .................................................................................. at premises located at ...~//,~.....,~,~.e.~D~...-~.t'. ...................................................................................... ....................................... ..S..o..~ .t;.b.~.;L~. ......... .1~.,~... .................................................................................. pursuant to application dated ..........................~..?.lZlff ........ ~..0. ........ , 1(~.~...., and approved by 'the Building Inspector. Fee $...~. ~.'.,, ,~, · .......... THE NEW YORK BOARD OF FIRE UNDERWRITERS 8,k BUREAU OF ELECTRICITM ~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 N 129178 THIS CERTIFIES THAT only the electrical equipment as described {wlow and introduced by the applicant named on the above application nu ntber in the pr~rntses of Jerome McCavera, n/side Leeton Dr., 1200' w/o Kenneys Hd., Southold,%. I. inthefotlowinglocation; ~Basement ~ IstFl. ~2nd rt. outside Section Block Lot was examined on r~O Vo~mb er ') ~ ~ 1 ~)7 3 and found to be in compliance with the requirements of this Board. RXTURE OUTLETS IECEPTACLES 38 SWITCHES 2O FIXTURES RANGES OVENS DISH WASHERS EXHAUST FLUORESCENT UNIT HEATERS MULTI-OUTleT SYSTEMS NO. OF F~ET OTHER APPARATUS: %Vat er heater: Elec.room heaters: 1-2.Skw, Motor/s: 1-1/2bp E R V I C NO. OF CC~COhlD. A.W.G. NOOF Hi-I~G A.W.G. NO. OF NEUTRA%$ A.W*G. PER .~ OF CC. COND. OF HI.LEG OF NEUTRAL 1 3/0 1 1/o 2-2. Okw, 2-1.5kwp ~-l. Okw, 3-.75kw, 1-.Skw W.B. Euland, ~~L ~' 'lattit uek, L.I. Per 11 ~ [, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTHReference Health Department Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant~.:~.~ · ~!~-c Phone~~ Subdiv. Address ~-~' ~'~'~] ~ :' ~'~° ' ~m, ~. ~._ ~ ,, _.~ 6. Section 2. PropertyUoca~ilF~q TT-~-. ] ~ Village ~_ .~ , ~ Town~hip ~.~;.~ 3. Public Wa~r'Com~Name 4. Lot size: Width~feet Length~feet 10. Sewage Disposal System: 7. Lot Number 8. Private Well 9. Public Water Distance to main (For Health Dept. Use) A. 900-gallon septic tank: Precast_~Equivalent Block B. Leaching pools: ~ Nuq~r of pools ~- ~:~ ~f..'e c a s_'-~_B 1 ock Special ll,~:'~'_If pr~ate well, fill in the .'~ l~ol 1 (Ll~ng blanks: ~ A. capacity Y-ti gallons ~ B. ~mp G.P.M. b" C. Total well depth D. Depth 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. FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the aOPn~n~aO~e~fs~hp~lyHe~lanth_~beDelP.~sr~etdtho~tt~sadp~oq~a, te and~_ssatisf~ctory Sewage Disp~tem S-15 Rev. 4/1/73 SOUTHOLD, N. Y. Approved 1,...,.,,. Pemit No ........ ., ~-- ..~' . ~(l~uilding Inspector) / ,~,~' ~..~(~ ~ ~ ~ APPLICATIOH FOR BUILDli~IG PER~IT .. , . j 3 sets of Idlm, iocurate plot plan to scale. Fee according to schedule. b. plot Id~n showing location of lot and of buildings on premises, reletionship to adjoining ?emi,re.? or. public streets or m*eas, end ghtil~-~ ~ dasgtlption of Ira/out of IXoparty muK be drawn on diagram which is pa~t of th~s apphcet~on. C. The woek covered by this application may not be commenced before issuance of Building Permit. d. Upon alal~e~al of this applicetJon, the Building Inspector will issue a Building Pern~it to the applicant; Such permit.shell be kept the pmmim ~ldlJblil for inspection throughout the work. J e. No bulldinl shall be occupied or used in whole or in pert for any purpuse whatever until a Ce.rtificate of Occupancy shell have be~n ~'a~ted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Bu~ilding Zone OrdinanCe of the Toem of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Ragulat~ifer the[ eon?ruction buildings, edditlo~s or alterations, or for removal or demolition, as herein described. The applicent agrees re;...?~. ~ ail ~,eable ordinances, building code, homing code, and regulations, and to admit authorized inspectors on premises and in bundmgsfor ~ inlpectmns. ............ (Signature of applicant, or name, if 8 cerporation) (Address of applicant) builder. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Name of owner of premises ....... .~.~..~. Y~..~....~'....~.l.~..~..[i~A):~ ...... ,.,J~., ..,~'... ,.~,,.~,P-.J~ .................................................... If applic~, nt is a corp~orate, signature o_f duly authorized officer. 7-~'~ -~ ~' ~'~,~. ~,~c~' (Name and title of corporate officer) Builder's License No ..................................... , .................... Plumber's License No ......................................................... Electrician's License No ..................................................... ~ Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No .............................................. Lot No ......................... Street and Number ....................... ~'~..e,~/.....~*~-~.~ ........................................................... .~.tV..~/~ ....... /-~'~- ~,~ '7~ ~--~,~'~/~-y"~ ~-b. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~...~J~. ............................................................ ~ .......................................... b. Intended use and occupancy ..... ~.t~-'~,~ ...................................................................................... .~.. ........ .~ ~ ' itl n ' Nature of work (check which applicable): New Building ....................... Add o ..................... Alterat,on......~. ....... Repair ......................... Removal ......................... Demolition ............. .'. ......... Other Work ........ ................. . ~...) ~0 (Description) 4. Estimated Cost ...... ,~.(~. ~ ..~/3~r~. ...................... tee ......... .(. ............. ~ ........................................................... (to be paid on filing this application) 5. If dWelling, number of dwelling units ....~. ........ Number of dwelling un~i~ on each floor .....~.~-.. ............................... f garage, number of cars ...... .~,~ .............................. :~. .................. '. ....................... ~ ........... 6. If business, commercial or mixed occuoancy, specify nature and extent o~ ~ach type of usa ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ............... ~.'..*.~..~:&LL;:;,....,;:;~, ...... :;..~, Number of Stories. · . ....... Dimensions of same structure with alterations or additions: Front ....... ~. ...... ~.: ........ Rear .............................. Depth Height ' ..................................................... ~ ............. ~ ................... Ndmber of Storms ........................................ 8. Dimensions of entire new construction: Front ...,~1~.~.~., ........ Rear ......... ~.~ ............ Depth ........ ..2~...~..'......i ......... Height ...... ~-,~'. ................................... Number of Stor es. . ....,:~.. ........................................................ 9. Size of lot: Front .......... ~...~J~.'. ................... Rear ............. L....=~....~ ................... 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 regulation: ............ ~.~ ......................................... 13. Will lot be retxeded ....... _~;..'~'g...~.. ...... , .......... Will excess fill be removed from p~emi~ses: [ ] Yes j~ No 14. Name of Owner of' premises ..'~'g~'X~.~..~.i~.~t ~I~.......~....C~.~.......~'.~...=..~. ~.,,~j~ .......... ~...~/..~ .~. ).Z,'~... ........ (Address) ~ I~ ~:,~ (Phone No.) Name of Architect ...................................................................................................................................... (Address) (Phone No.) Name of Contractor ~l~u.~,~;L.../~l,x~&.,~,e~, ........ .~:.~i~l~...~'~...~....~m~)~;~ ...... (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 indicat~ wheth- er interior or corner lot. -' STATE OF NEW YORK, ) COUNTY OF ........ .~ ............................................ ) ~ · ~. , ', ~. (Natne o/individual signing contract) .......... being duly, sworn, deposes and says that he is the applicant above named. of ~id owner or o~ers, and is duly authorized tO ~m' Or::haye ~rfor~d t~ said ~ork and to make and file this application; ~at all ;tamments contained in this application are true to t~ ~st o~ hi~ knowled~ ~nd 6~l~ief~a~d that the work will ~ ~dor~ in the ~n~r ~t forth in the ap~ication filed themwith. VI,~'c311VIA I~C CAVE,~__~_ '73 JEIe~. Y _.~._ gX7 £,t) ~J 1 L~ ~ I ,,,-//%