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Home My WebLink About6698-zTO~N OF SOUTHOLD B[~LnING DEPARTMRNT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~ ~/~¥'~ Date ~. /[7~,L. 19~ TInS CERT~nES ~ ~ ~ ~o~ ~ ....... ~? .... ~ ~C. S~ Map ~o ............. nloc~ ~o ...........~t No ................................. confoms subst~ti~y to ~e App~cafion for B~ld~g Permit heretofore ffl~ ~ ~ o~ce dat~ 2 ~ ~Um~ 19~. was issued, ~d co,ores to ~ of the req~ ments of ~e app~cable pro~sio~ of the law. The oecup~ for w~ch t~s ee~ica~ is issu~ ~ ~ 0 F~ ~ F ~ ~ ~ h'( ~ ~ L L ~ ,~ ~ ~e ce~icate is issu~ to ~A ~ ~ 5 ~O'f L ~ N ~ W I~ ~ -- ~ ~ ~ (owner, lessee or ten~t) of ~e Mores~d buil~g. S~olk Co~ty Deponent of He&~ Approv~ .Z~. ~.~ ~. ~ ~ .... ~ .... ~ .~ ~. ~.. UNDER~ITERS CERTIFICA~ No. ~ I~ ~ ~ ~ ~ HOUSE N~BER ~ 7 0 S~eet ~h W ~ ~ ~ V ~ Buildl.g Inspector FOltl~ NO. 6 TOWN OF $OUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form 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. 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 Date ......... ..~.....~...'~...?...!.?.......!....~.... ~.. New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Property .................. ~....~....~,, .. ,~/.. ........ .~....~.. ,[...~..~ ......~ .... ~_,..'~,,,..~,'~ ,,~,, ~....z~., ,0,,, ,'I~..T., ..................... Location Of Owner Or Owners Of Property ....... ..~....A....~.!..[.-'..S. ......... ..~.....~....~.....k....~...h,J. ....... ..~......._J~.../..~-~ ........................... Subdivision .... ..,~...~...,~.....~, ...... ~::~,~..T...~...T....L2.-~ .......... Lot No....?....~.... Block No ............. House No.,.~.....7....O,, Permit No...~...~...?..~....~T_ Date Of Re rmit .~..?....~..~.../~. ~...?;a~pp lica nt ~Y Health Dept. Approval .......... z ................................ ~.aDor Dept. Approwl ................................................ Underwriters Approval ..... ~..~..~L..~..~...Z.Z .......Planning B~rd Approval ......... ~z.(~....: ............... Request For Temporaw Ce~ificate ........................................ Final Ce~ificate .......................................... u Fee S bmitted $ .................................... Construction on above described buildi~rmit meets ~app~l? ~ and regulations. Sworn to before me this .... ..... o. s.,, Nota~ Public~~ ...... ,~County JUDITH T. BOKE FORM 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? 6698 Z Date ........................... ~.'t~T.[~ ....... ~,9 ....... , 19.~..3... Permission is hereby granted to: ,TsBo B...~osy3.e,n. · &. · ¥S.~.~ ................................... ........... .9.L..gmlaey...Av:a ................................... ~o ....~..~..~....s'.~Z..~l[ ......... .(~r:.r.qx~.~...~....~..~o.~3,~..61~8/23) at premises located at ........~l[l~..~t~ ....... ~,l~lJf.~fl..~.e~.~...l~.~,.J[~[~ ........................................... ....................................... ,1;Imm,.~l~m .......... ~eonpnt.~ ................................................................. pursuant to application dated .......................... eT~t~e~.....'~P~ .......... , 19..~f.~., and approved by the Building Inspector. Fee $..tl~*.~ ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS a~T BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 O.t, J~nuary 20, 197~ ~p, lic. tio.;~o.o.f,. 692398 N 140477 THIS CERTIFIES THAT Jim Boylan, Dawn Drive, s/side Shore Rd., Greenport, L.I. in thefollowlng location; [] Basement [] 1st FI. [] 2nd FI. out side Section Block Lot was examined on January 24, 19 ? 4 and found to be in compliance with the requirements of this Board. RXTURE FIXTURES OUTLETS ECEPTACLES SWITCHES INCANDE$CEN1 FLUORESCENT 23 23 DRYERs FURNACE MOTORS FUTURE APPUANCE r~EDERS AMT. K.W. OmlL H.P. GAS H.P. AMT. NO. A.W. SERVICE DISCONNECT ]NO. OF L s E A~T'i 150AN%P' ~C~ ~JI~L~' 1,~2W l~r3WX ~ ~' SW ~.4W "O, O,~E~CC~.COND-1 OT AF~ARATUS: ~urnaces: Oil 2-1/8hp, 2-1/12bp RANGES SPECIAL REC'PJ R COOKING DECKS I OVENS J DISH WASHERS 1 1..~ NO. OF FEET V I C EXHAUST FANS AMT. H.P. DIMMERS AMT. WATTS A. W.O. ~O. OF NEUTRALS A W, G, OF CC, COND. OF NEUTRAL 2/0 ~ 2/0 John P. Engel Jr., Box !156' Miller Place, L.I. 1 ! 7 ~ 4 ~ aANAe~ 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.P. Reference No. APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM ~ 7 Address ~ ~ ~ ~'~D~ /i-~ 6. Section 2. Property locatio~ /~ ~ 7. Lot No. ~o~ ~ ?D 8. Private well Village~.~? Township~F~D~O 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Width /~ feet Length /~/ feet (Enter on center plot below) 10. Sewage Disposa~System: A. ~0~ gallon septic tank: Precast~" Equivalent Block B. ~aching pools: Number ?.- Precast~Block Special If private well in blanks below: be in accordance ards thereto." Street fill Tank capacTy Gals. Pump~ T~al well depth__ ]Yepth to G.W. Amount of water in Date ~ell Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The undersigned CERTIFIES: "Construction of authorized installations will with the Suffolk County Department of Health's current stand- 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 r~,,/.~ ~,/~ ? Signed C ~ ~'""'-~----""~. -' S-15 Revised 4/]/72 SOUTHOLD, N.Y. ~ ,,-4. ~ ~'..,.~:.__ /,-- ~" Exomined ............ 19 ........ /~p3 /oy,~ //~ ~.//t,~i}_ ~ o~ /"~ _~0~- ~ ............................. Application No~ ...~..~..~..~ .......... ~p ..~ ........ 1 ............ , ,9 ........ ,,rm,t No .................................. .... ~ ,40~- ,seppr , ...... . .......................................... ~....Z . .....,~ ~ / ~,~ ,~ ~BMIT~ ~ ~ ~ ~ ~ ~ ~ ¢; ~~ , ~ ~, ~...~....~ ............... ....., ~ ...... i_~j__.~is ~cat~st ~~ oK_in ink ~ s~mi~ in triplicate ~ ~ Bu ~i~ ' b. Plot plan showing location of tot and of buildings on premises, re at onsh p to adjoining premises or public streets oF areas, and giving a detailed description of layout ofpraperty must be drawn on the 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 ~nspector 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 pa rt 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 pcmsuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable ~ ~nces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os hembl described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatioos, and to admit authorized inspectors on premises and in buildings for necessary inspections. ~___~.~_-( ......... ; ....... .,.... ; .............................. ; ............ ( ~S~nature or app.cant, or name, if a corporation) - ----~ , (~'i;? ;i;iijii~;;;i ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e ectrician, plufrnber or builder. ,/ .............................. ....... : ............... Y.: ,..................,.~. ~. Name of owner of premises ....................... , _ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer}- Plumber's License No. ~.....OM.~..~.........~..~...~..,~-.~'7'O,~. E~ectrician's License No..~,...W..~....,,,,~,...,.~..~....-~. 't'o4, Other Trade's License No ............................................... I. Location of land on which proposed work will be done. Map No.: ......~.....~....0. ..................... Lot No ..... .7..'...~.. ........... Street and Number .............. .~..~....~.....~M. ....... .~.~.~..~.. ............ ..~.~..~.4~..~_ .r. .... ..,~.....~'.. ..... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .................................................... . ............. b. Intended use and occupancy ...... .~../.~..~...~.....~..~../...~.~. ~...../~..~-'~-~''~ applicable): New Building ...... ~ ...... Addition ~.....3~... .. Alteration .................. 3. Nature of work (check which Repair .................. Removal .................. Demolition .................... Other Work ;', f..../........I/ .......................... ~9 ,~ ,~- cr~ ~ c ~ ~ ~{ (D~cripti~'~ ...... 4. ~timated ~t .~.~ .................... F, L~.~ ............... ... (to be paid on filing this a~lication) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on ~ch flor ............................ If garage, number of ~m ... ~ ............... 6. If busine~, commemial or mix~ ~cu~y, sp~i~ nature and e~ent of ~ch ~pe of use ............................ 7. Dimensions of exi~ing Stru~u~, if any: Front ............................R~r ................................ D~th .................... Height ........................ Nu~r of Stori~ .............................................................................................. ................... Dimensions of same structure wi~ alterations or additions: Front .................................... Rear ............................ ~pth ................................ Height ............................ Numar of Stories ................................ 8. Dimensions of entire n~ construction: Front ....... ~..~ ........ Rear ...~.~.~ ...... D~th .~.~ ..... Height of Stories ...... ............................................................................................................ 9. Size of lot: Fret ........ /~...~ ..................... Rear ..... ~.~.~..." ........... Depth ...~..~ ....... 10. ~e of Pu~hase ........................................................ Nome of Former ~ner ~.~T~.~..~ ....... 1 I. Z~e or u~ district in which promises are situated ...................................................................................... 12. ~s propos~ construction violate any z~ing I~, o~dinance or regulation: ............ ~O ..................................... 13. Will lot be regrad~ ..... ~ ................ Will excess fill ~ remov~ fr~Dremises: ( ) Y~ (~ No 14. Name of ~ner of prem ses ~. ~.~.~ A~re, ~~ ~.. Ph~ Name of Archit~t .~e.e..~/.e~ ............................ A~re, ~....~...~ Ph~ No. ~,T.~ Name of Contractor ...~...~~.~ .......... A~ress ................................ Ph~ No ....................... PLOT DIAG~M ~ate cl~rly and distinctly all buildings, whether existing or pr~ed, a~ indicate all ~t~k dimensions from pr~e~ lines. Give ~r~t and bilk number or description according t0 de~, and sh~ street names and indicate whether interior or corner lot. STATE OF N EW_YORIC .,,,~ t ¢ c COUNTY OF ............................ .~E~'%-~. .................. C~.~. ...... ~ ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract0 above named. He is the ..................... (~..~,~.~ ..................................................................... ~ .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make and file this application; that all statements 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. Sworn to before me this ......... d of ..... ..................... , Notary Public, .....~'~~~. County .... .~.....~.....~..~...~ .................................... (Signature of applicant) TERRI LEE ELAJ( NOTARy PUBLIC, State of New No. 52-6168~95 Oualified in Suffdlk County Commission Expires March FO~ NO. 4 TOWN OF SOUTHOLD BUI~.IHNG DEPARTMI~.NT Town Clerk's O~iee $outhold, N. Y. Certificnte Of Occupnncy No. Z..~.7.77 ..... Date ............Zam~l'~ ....3ii., 19.~t.. THIS CERTIFIES. ~at ~e b~dlog l~a~ at . ,.. ~. D~ ........... St~t Map No. ~eaves. P~Block N~ ~. ZI~.Lot No... 7~ ...... 0reenpor~: .~,~, .... confo~ subst~y W the A~ation for B~d~g Pe~t heretofore ~ ~ office dasd ........... j~ .... 2~ ~19..7~ p~su~t to wMch B~g ~t Ne, ~98Z.. dated ..........J~e.. 29..., 19.~3., was ~u~, ~d ~o~s to ~ of ~ r~ ments of ~e app~cable pr~o~ of ~e law. ~e occ~cy for wMch ~ ce~icate ~ ~sued ~ ...Pr~..~. $~$~ .4W~.~ ..................................... The ~ifica~e is ~u~ ~ .. Jam~ .~o~. & .~e .... ~era ................... (o~, lessee or ~n~t ) of ~e Mores~d b~&ng. S~o~ Co~ty Dep~ment of He~ Approv~ ·..J~ ..~..~ ~ .. b~ ~R,. Y.~.. UND~WRITERS CERT~ICATE No. ~ .................................. HOUSE NU~ER .. ~0 ........ S~eet .. D~. D~i~ ........................... Building /Y/A/z:, ~F iD~O~°E~. -r ~' The sewage disposal and ~,;ater s,!pply facilities for this location ha, re been inspected by this department and found ~ iChief of General~gineering I ~ Service' '7 ,/ (JA.~, ¢ MArGAreT J'cd/~ : ~O'=:t'' "l I I l ~ ~0~i ~LE~ ~0 ~ I I£ (~) APPROVED AS NOTED NOIIF¥ BUILDING DEPARTMENT BE~OR~ COVERING PIPELINE HNAL WHEN 'JOB COMPLETED ~oy~ ~e ~" COL, ~¢~ ~" I0'- I %T~,\R S ~ k~o k ~'o /' / qo" Xflo" X 5~P/..'' ;I (~3 ..... 1'40 I ~Sv~E~ . ~ ' ' ' ', ' N~T(~E~ , ~. ~O~,S~ LOC ~,,0~. I I~' , ~ / B ' k' / ,"' / I'~c~,~,~ L~ / k /' , ~ UN I~ I~'"~l I ~1 '1z --~]' 4' No SCALE '0