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Home My WebLink About6697-zFOl~l NO. 4 TOWN OF SOUT~OLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Date ............ ~.;0...1.9 ....... , 19 ?.6.. THIS CERTIFIES that the building located at ...D&lelrl .Drive ............. Street Map No.. C.~0 .~.v.~.~.. PtBlock No ........... Lot No, ~.~. i...(}.?.a.e.~o..~.~...~ .~.~.: ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. .~.~Y...~., 19.73~/ pursuant to which Building Permit No. dated ........... J.t~..e..29 .... , 19..~, was issued, and conforms to all of the require- / ments of the applicable provisions..bf the law. The occupancy for which this certificate is (owner, lessee or tenant) of the aforesaid building. Suffolk County Department q~ Health Approval 8~p~ Building Inspector FOR!VI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERJ~iT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6697 Z Permission is hereby granted to: J~h~..~.~....&..~.£~ ........................ ................. ....... .~.i...~.,...2.3~.~,,~ ............ ,~ ................. .............. ~e~ ..¥.o~r~..-.r-..* ,~,,.~ · ........................... to ~.~il~..~ ..~'~...~'a.~,~l~...~*~ ~.li~ ....... ~,%9~-w~.;~y..;~d...~_t>pe~te.) ..................... ut premises located at ....lo~..~!~......g~-~...[~.O(~O~;J~..~O..~.~.~ .................................................. ..................................... ~&~a3~.. ~zL .~z.e ......... .G~e~o~.th...~,~, ..................................................... pursuant to application dated ................... ~ ...... ~L.~ ...... .,~- ....... ~...., ]9...~., and approved by th~ Building Inspector~ Fee $J~,.~O ............ · Building nspect~r Z~ THE NEW YORK BOARD OF FIRE. UNDERWRITERS ,RW BUREAU OF ELECTRICi*~. ' . ' ~ ' I--- 85 JOHN STREET, NEW YORK, NEW.*~0RK ~.,, s.~temb.r ~,ze?~ ~.....,,o.~o.o.z,~ ;~'71~-3'"": *"'. N 184342 THIS C[;IFl;$ THAT John Ball~Dawn D~ve~O~e~npo~L.I. w~examl~on ~epte~be~ 10~19~ ~fou~tobeincomplia~witht~requi~mentsofth~B~. :. I 2no CB x 1 ~/0 1 2~/n Wate~ H~sters:l-~.5~ ' Eleo. Room - Box 56 COP~( FOR BUILDING DEPARTMINT. THIS COPY OF CER~yE M, UST NOT.? AL!rI~JED IN ANY MAHNER. fl ' -,THE NEW YORK BOARD OF FIRE ,UNDERWRITERS ' ~-- > ' ' :'q Z: ~!.~,L '; ' r 85 JOHN STREET. NEW YORK NEW YORK 10038 ,, ' ' , i ' only the electrical equipment ~s ~scrlbed below a~d ~troduced by t~ applicant na~ the. a~ve.apphcat~on number ;n tfle premises of ~.~..,i.~d~owembe~ 22,~976 ;.- andfo~ndtobeinco;npl~ance~it~th~idqulr*~entsofthlsBoard. OTHER APPARATUS: Elee. room heacerb: 4-2.0, 1-4.5kw. hot water heater JohnBall 250 Dawm Greenport~ L.I. 11944 4/o 1'1.5, 6-1;25, 121.0, 2-~75KW-';:,: This certificate'must not be altered in any mannerz return to the office of the Board if incorrect. Inspectors may b~~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant I i,, i i[ i -~',,~ , .Phone Address. - 2. Property Loc~ti'°n~ ' ' , ~ 'Village. Township 4. Length /~_~ 10. Public Water Company Name Lot size: Width /~ feet Sewage D~posal System: A.//~al~tic tank: Pr~c~s~t~quivalent Block 5. Subdiv. 6. Section 7. Lot Number 8. Private Well, 9. Public Water Distance to main (For Health Dept. Use) ll. B. Leaching pools: Number of pools Precast/~B_lock.__~pecial If private well, fill in the following blanks: A, Tank cap~a~ity. _gallons B. ~ump,.~.Pk,~ . __ //V~ C./// To~al ~ell depth I/. 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 ~tandards 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 informatio~n presented herewith, it is the opinion of the Health Department that an adequate and sa%isfactory Sewage Disposal System and Water Supply can be installed on this pl,ot. ~ APPROVAL DATE , _~ ~77 SIGNED S-15 Rev. 4/1/73 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No ................................................................... Dote .............. ~...~ ....... ~ ........, 19.?.....~... P.~E T^KE .o~,~ thor your o..,,cot,on doted ......... ~..~..~ ....... ~ ......... , ~ forpermit construct ~~ Qt thepremses oceted~. ~ ~' to .................................. ~ ................................... ~ ......... ........... a.~ .................................................. Street ~ Map .~..f~...~& ...... Bilk .....~..~.~ ........ Lot ........... 7.~. ........................ is r~,urned, h~ew,h ~.d d,.~,,roved o. ,he fo,o*.~ ~ro..d. ~ ~ ~ ~~ k ~~ ~'~ ................................................... TOWN OF BUILDING ~UTHOLD, ......'""~.z/.~...~. ........ , ,~.. Examined ~proved ..... ~....~/ ~ .., 19 ~. Pem~ No '~pprov~ ~/c ......... ~.~ ......................... :...~.....~...~ ......................... ~ ....... 7' ........... : ;' ~ .. ~/ ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wit~ 3 sets of plans, accurate plot plan to ecale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, ~eiafionship to adjoining premises or public streets or areas, and 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 Per~it 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 been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, 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 necessar~ inspections. ..... ,.5../....~.2~..~..'..~....w....~ .y.....q (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~';~; ............ ~;";;;';~ ........... i~i'~ .................. i ......... Z ..................... i .............. i'i'iiii"i ...................... i .... 'o,o;~;; ,;;~iii. .~...: ...... ~ ...... ~ .............................................................. If appliCant is a corporate, signaeure of duly authorized officer. Street and Number~.~..,~C..~.~.......~J...g..(~../...?...F.c~.. ........................................ ~....~..~ ..................................................... //~' Municipality 2. State exi~ing u~ and o~upancy of premiss and intended use and o~upancy of propo~d construction: a. Existing use and occupancy .............. ~ ................... ~ .......... ~ ........ ~ ...... .~ ............................................................ Inten~d u~ and ~upancy .~~..~~....~~ ................................................... b. '~.~ 3. Nature of work (check which applicable): New Building ..,,....~ ........ Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... 4. EstimatedCost~..~..O..6..~.:...O...0. Fee ~t~' ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ...... ~. ........ Number of dwelling units on each flogr ......................................... If garage, number of cars ...... ~;~..~......' ........................................................................ ~ ...... ..,.' ........................................ 6. If business.' conlmercial or mixed occu~ancv, specify nature and extent of each tvpe 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 ............ , ........................ ~... Nurr~ber of Stories .....~ ............... ;; ...... :, ......... 8. Dimensions of entire new construction= II=rent :..~.~..; ..........Rear ~.....~.../7../. ............ De, pt'h ....~....~.. ............ Height...~..~. ..... Number of Stories ./ . ..... :..:..:= ,,, .............. ",-- ' ............... ; ................. "r ............. :... ~ -. ..... ; ..................... 9. Size of lot½ F~ro,nt ..,~......, ........................ Rear .....~.~. .............................. -;~oth ..,~..7.. ...... ..~./.~.. ............... Date of Purchase ,/.:~[3 '.T/.:.~...~. ..~ZJ. ................. Name of Former Owner ..~t~..~..~........~...~..F~.~ ........... :......;: .... 10. . . . ............... '- 11. Zone or usa district m which premmes are situated .,, ................................................................................................ 12. Does oropmed construction violate any zoning law,'ord nance or reg~tior~.../~....o. ............... L.a.,~ ........ '..;: ................ 13. Will lot be regreded ~.°,. ...... r", ......... ~..~Vill.excessfillberemov~df_~ =remiss: [ ] .Yps .~. NO 14. Name of Owner of pre~ni~s .~U',~ '_,~.[~.~/~....~.......~'/...~...~..,,~....~.. ~....~1'~.',~..~.~.:..(~.~.. ..... .~...~...-.~..-~..~..o...., ~..., 0. ~ Z ~ p/~' (Address) .. ~.~ ./* - / (.Phone Ne.) Name of Archit~l; ...'.'~.~../~..~......~:'.~..~¢,L..~..~ .............. ~..C:~.....~I;/~'......../'~..~.~..~.~.~..~......~J..~..:-~.~.~T...~./.~. ......... -~ ,/. [ v~ I~ ,. (Addressl ~. .. , ~No.) Name of Contractor ...~..~.~.....~.~...p,...F...~. ..................... ~,L..~.~/~,~__/._=_$:~, ~;~s')" '"""''"'"'"'" ~'" "" ---'"'-' {Phone i~o.) · ~, · ,;~ ~ · . .~, PLOT DIAGRAM :. Locate clearly and distinctly all building~ ~w~. ether e~,[,~lng.or proposed, and indicate all set- ,b~,, k dimensions from -, -~ property Ilnes~G.i~r street and block number or ~Tt~ription a~-~cord~ng to deed, and Show street names and indicate wheth-- '~ er interior or corher lot. . STATE OF NEW YORK~ _ ' ) COUNTY OF . ..~ .V...~: .~..~ .~..~..~. .................. ) ............. :......~..C~.,'~.. ,~.....~....;......~.<~:~,~, '.~ ................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individu~l signing contract] He is the ..................... ~.~..'~X-'~..~,~.....: ......................................................... ~......~ ............................................................................................... (Contra~or, agent, corporate officer, etc. of said owner or owners, and is duly authorized to perform or have perforn~d the said work and to make and file this application; that all statements contained in this application are true to the besl of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ~.~ - .<---... ,~> ~ in Suffolk Coumy .· / / // / / I / N . -. . . _ ~ __ 'C.. ~ r~,~,,, .s,~, ~0, ~S ~ [ /.~f/ /d:/( ag/ otary r'uohc ...................... ...'~,&~,9~,~..., County . ................ ~.-~Z..~ ....... /~....~.~..L.~.......~_ ................................... o.' LAN E. b MAP Ol= ~ I ONAUTJIORIZED ALTERATION OR ADDI¥10~J ro T S SU~.VEY IS A VIOLATION OF S£CT ON ?209 OF THE NEW YORK STAT~ C PIES OF THIS .URYEY MAP NOT BEARINJJ E E LA,~ D SU~V[¥Oi~'5 INK_D SIAL OR AT" ~AS 7' lt,/IAj~/O AJ, A/, V. ~CO/¢; 4O' =/" .... Li-Zq 'To W/"-,, LL- i _n-~] -I'I -1'I£lTl 1, L.~Z~ L_..f .I _2.1 j::~, j FA, NA~ L1' L\x/~'~ c~ 'F-,o o fA, APPII~VED AS NOTED' 16S.1660 9AM TO 4PM FOR REQUIR- J×rT. F--.oOv,,, X . %c/'k~.¢__,. VA" = \~- o" ~LO0~, b- .......... ¥ f ~C ~LLOP~. b I',JO % qk't L_ e_ I Ii I