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Home My WebLink About6743-zFO~M NO. 4 TOWN OF SOUTHOLD BUTLDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . N/.S...S9..tt~t....V.~.e..v..A..vq. ..... Street Map No, .x~:. .......... Block No. ~ ....... Lot No....X~;......~.a..t.t.~.t.u..c.k...~:.Y.: ...... conforms substantially to the Application for Building Permit heretofore filed in t. hi~ office dated ............. Ju~... ~) 19..7~ pursuant to which Building Permit No'6..~.~Z... dated ......... ?T.u..~r ..... .2.0.., 19. ?.~., 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 .P..r~.v.a.t..e...O~lq....f'..mn.$.:l.~..d..1~..]..]:...:~ ....................................... The certificate is issued to .l.a..re . .~... ~ ....... . .C~..e.l*. ...................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health ApprOval ...~?p.t.,, ?.7.., .~.~..~.,, .By..~:..V.~..1.~.,, UNDERWRITERS CERTIFICATE No..~..~ .6~.~..0~. ..... ...J..u~..e..~....~ ~.~. ............ HOUSE NUMBER ..... ~.7.~ .... Street ....S.o..up.d..V..$.~.w..A..v.e ...................... ~OF, M NO. ~ TOWN O~ SOUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6743 Z Permission is hereby granted to: ..... .1~.~o.9......3 2 ..~,v~ ......................................... ................. .r..3,.~.~g ....... 1.1.3~..8. ........................ to ...~.~IJ,1,~ .. i~....g~L ~'~i~Z],~...6~.~ Z],;Img ................................................................................... at premises located at ..~0.~...~ ......... ............................ ]J/,~ .....J~D.g,~l... Y.:I.~.. A~r~ ............ F~a ~.ti.~uck....~.,.Y.., ...................................... pursuant to application dated ........................~lJ~. ....... 2[l ......... , 19.~.~.., and approved by the Building Inspector. Fee ~- ~'...9,0. ............. B~ilding Inspector ' 'I' " THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 THI~ CE~IFIE~ THAT Stephen ~'~nakyan, n/s~d~ :;oundvlew Ave., ab~. 1/2 mi.e/o Salta!re Way, Mattitue~ L.I. ~trz. ~ ~.d n. outside s~t~o, st~ ~t ~==~i~do. May ~!, 1971t and found to be in compllance wi~h the requlrements of this Board. FIXTURE OUTLETS 21 DRYERS rECEPTACLES ~7 SWITCHES 19 RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT UNiT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET E R V I C E OF CC. COND. PER ~ 1 A. W. G: NO. OF HI-LEG OF CC, COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS= *Special receptacles; 1-50amps., 1-30amps. Water heater: Eleo.room heaters: 2-Jt.0kw, 1-2.25kw~ 1-1.7~kw, 3-1. Okw, 1-. 75~ 4otor/s. 1-1bp ~t-1.5kw, !-1.25kw, Tow].e ~ Sons Inc., Lincoln Ave., ~'lastie Beach, 11951 "., / ~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant Address 2. Property Location ~Hlage ~r, ~ , . Township. 3. Public Water' Co~ah~ 4. Lot size: Width feet Length. 5. Subdiv. 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main 10. Sewage Disposal System: (For Health Dept. Use) A. gOO-gallon septic tank: Precast V/~quivalent Block B. Leaching pools: Number of pools / Precast v~ Block Special ll. If private well, fill in the following blanks: A. Tank capacit~ z~ sallons B. Pump G.P.M. ~ 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. Date ~ Signed *~-..~ ......... ~.~ ~ ., FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the aOnPjn~aO~eOrfsuthp~lyHecalanthbeDelP, nasrtt~a~etdthonatt~sadp~oq~a, te and satis~factory Sewage D~ystem BUILDING D~AlrrMINT~Z3D'-~ , ~ *" ~"- ~ SouT.oLo,,N. y.~ ~/ ~. ~ ~/~ ~-~ ~mi~ ~ -- · ~plicati~ ~ ................................. ....... ....................................................... · . This ~i~J~ muir ~ ~m~etely fill~ in by ~ri~r or in ink ~nd submi~ in tripli~te to t~ Bui~i~lm~or, ~ 3 ~ of ~, ~r~ ~t ~ to ~le. Fee ~di~ to ~le. . ~. ~lot ~ ~i~ .l~ion o~ lot ~nd of ~ildi~ on ~mmi~, r*l~tion~i~ to ~ioinin~ ~r~mi~ or ~blio ~ or ~m~, ~vt~ ~ ~ of Iw~t of ~o~rW mK ~ dr~ ~ di~ram ~i~ is ;~ of this a~imion. ~) C. T~ ~ ~ ~is a~i~tion may ~o~ ~ ~m~ ~m im~ of Buil~ng Pmmit. ~ ~ d. U~ ~ of' ~i~ ~mn,. ~e Bm~mg Ins~or wtll i~ a Buildin~ ~rmit to t~ a~li~t. ~ ~it.~l ~ ke~ ~ h ~ ~1 ~ ~p~ or u~ in w~le or in ~ for any ~r~ ~m~r until a ~if~ ~ ~ ~all we~ A~LI~TI~ IS HEREBY MADE to t~ Buildi~ De~nt for t~ i.uan~ of a Buildi~ ~rmit ~t ~ ~ B~i~ h~ 0~ ~ ~ T~ of ~, ~ff~ ~nW¥ N~ Y~, and o~er appli~ ~, Ordinan~ ~ ~ ~ ~ ~ ~ ~i~, ~ m e~rKi~, o~ for m~val ~ ~litlon, ~ ~rein ~i~. ~ I~i~nt ~ ~ ~ ~~ ~ ~ om~s, ~ ~ ~, ~ ~lat.~s, a~ to ~mit ~thori~d in~o~ ~ ~emim and in ~ ~ ~ I~i~ A~ ~ ~~ ~ ~ ............ ~.~.L...,...~.~ ...... ($igr~u,re of al~licant, ~r,~.. ifa eorpor,fion) /g4~--'03 3~~ ~-e ~~ ...................... ~ ....................................... :..~ ........ ~.. ' (~ of a~m) , / ~ ~ StYe whethe~ .l~JJcant is o~ner, lesme, agent, ~rchitact, engi?r, gerjeral contractor, electrician, plumber or builder. ........... ~~......~...~ ......... ~~:, ....... .~=,-:&...,~.~ ......... , ...................................................... Name of owner of premises ..j....~._~....'.'.'.'.'.'.'.'.~..~....,~....(~., ......~..L~....~.!..C...~....~,..!.~.. .................. : .......................... i ............ iiii... It Bpplicent is a corporsta, sign .a~ure of duly ~J~horiz,ed officer. , / ~ ............. ....... (Name and title of corporate o;r~:) T.:"P' ..... J Builder's License No .......................................................... Plumber's Lice/isa No ......................................................... Electrician's License No ..................................................... Other Tr~le's License No ................................................... 1. Location of land on which propomd ~ork will be done. Map No ............................. /.....,~,~....~Lot NO ....... ..~........, .... , Street and Number .......d.~.~.C-~..'..~..~...'~...~-~. ........ f/4...~..~-~1~;~..'~,.;,.,..,~_~..~.'~,E,_~'~___..~.~.(.~.__ ;~: Municipality 2.State existing use and occupancy of premises and intended u~e and occupancy of proposed construction: a. Existing use and occupancy ................. ..~..~e~..c..~....~.~-/' ................................................. ; ...................................... Intended u. and occupancy ....... .~...;:~. .................... '*"~"'"'~'"'"'~"*'~'"~i'"' ................................................ b. - - 3. Nature of work (check which apolicable): New Building ........ ~ .......... Addition ..................... " Alteration .......... .... Removal Demolition Other Work Repeir ........................................................ 4.. I=stJmated Oost ........ t .............. v .................................. ~ .................................................................................. / I/_t.~' i (to ? peid on filing this application) '~ \ 5. If dwelling, number of dwelling units ...Z..(:.A...'.?/~lumber of dwelhng units'on each floor ......... ;.J'..(..~......~. ;J ........ If garage, number of cars ......................................................................................................................................... ;.. 6. If business, commercial or mixed occuoancy, 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 9f S,tpr es ....................... , ........... 8. Dimenslonsof entire new construction: Front ............. 7..~{. ...... Rear ........ .~.~......~. ...... Depth ......... .~.......7. ............. Height ................................................. Number of Stories .............. /. ........................................................... ff. .......... .9. Size of lot: Front ........./.0..~.,..%;~... ............ Rear ..................... Z.0.../:...~..,..~... Depth .......... n~...~....~..:...~...-~. ................. ~ 10. Date of Purchase ..................................... Name of Forrn~.r O .w. ner .................................................. , ......................... 71. Zone or u. distriat in which premises are situated .......... "~..:.'. ....... ~.~...~... ................. '7 ....................................... 12. Does prolxmd construction violate any zoning law, ordinance or regulation ...............~...~ ..................................... 13. Will lot be mgredad ....................... ._. .......... ___W~ excess fill be cemoved from premises: [ ] Yes [ ] No 14. Name of Owner of premises ......... .~.....5....~....~......'..,~./...~. ........ ~.../...~...~...../~...~....'~.~ ..4~/. ...................................................... (Phone No.) a / · / / (Address) · 7,'~/~ Name of Architect .....ZF.~x'...~,~.~..~ ........ ~ ........... ~ .............. ~ ................................... ~ .......... ?... ........... : ............... · .~ .~Address) ~ ~/. iPhone~i,o.i _ Name of Contractor ........~.~./~.~.~...~.~...~. ....... ..~....'~....~....~.../..~...J....~...4~..:..~..~.......~....Z....~..%~.......~....~..s...~'..?.2....../...~.~J.~ (Address) (Phone N~r//~,~'~" PLOT DIAGRAM (~ ''~J ~ ,~S' Locate clearly and dl~inctly all building~, whether existing or proposed, and indicate all set~ack dimensiom from property lines. Gh~ street and block number or dmcription according to deed, and show street narn~ and indicate wheth- er interior or corner lot. STATE OF NEW YORK... / ~ ) COUNTY OF .......... ./,~/~...::~.. :~./,~'. .............) .......................................... being duly ~rn, de~s and says ~at he ~s the a~h~nt abo~ named. (Na~ ol i~t~ ~si~ ~n~) He is the ................................ ~./~ .............................................................................................................................................. (~n~ct~, a~t, coyote offi~r, etc.) of said owner or owners, ~di is duly authori~d to ~orm or have ~rfor~d t~ said work and to make and file this ap~i~tion; ~at state~n~ ~ntain~ in th~ a~li~tion are true to t~ ~st of his kno~ and ~lief; and that the wo~ will ~ ~ffor~ in ~e ~n~ ~t forth in t~ ap~i~tion filed t~ith. T~.~[ E~K ~ 7 ~ PUBLIC, Stat~[~e~ Y~k ~ · ~ ~'~ ~ ~o~ E~pi~e~ March 30, ~91~ Nota~ Public, ..~....~.~..... ~un~ ......................... ~ ......... ~ ............ souND bONG IS'L/~ND VIEW soUND ~DIO~ F~O~ r r'I [ t .TOt 5T$ ~ l X~_ ST. 1 . PL&'~ /4-''° d, ,- TY U? -rO~(E BAC~{:[[~[~G FCIJNDA. c: 'x ~ ' '" ' 24 ~ .ru~ 8/i975