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Home My WebLink About6744-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z650~. ...... Date ........... ~ap~ .... i2 ...... ,19~. THIS CERTIFIES that the building located at 8ou~d~ .'~ew..Ave ........... Street Map No. Z3~ ........ Block No..313~ ..... Lot NoZZZ.. l~attit:a~k.. J~ o¥, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ,I~...~).., 19~3.. pursuant to which Building Pemit No.6~tl~2~.. dated ............ .J.t~. y... ~., 1973.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private..eme. f~i~..dwell~.n~ .... (appr. oyed, .by. B.d .ApDeals.). ....... The certificate is issued to .. Tea. ry. T~iadam ....... f~ne~. ......................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · ~ept. · ~.... 19.7.%.. b~ .R...V.~Lia.. UNDERWRITERS CERTIFICATE No..9/.1.1~.7Lk..by. J.~ .]~l~backi ................. HOUSE NUMBER ...2~0~ ...... Street .. ~ound..~iew..AYe ....................... ................................................. Building' Inspector FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~FI~.E SOUTHOLD, N.~Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 67~ Z Date ..................... ~.~L~ .......... 2.0 ........... , ] 9..'~.~.. Permission is hereby Granted to: ~Bo_rt~a.~.....~,a~4).J.e....-A/~ ....... ~ez~.~¥...T~.~a~e s .16~o0~ ......... .~g..~vo .......................................... ......... ~s~ .......... ~.~..3~ ............................. to ..~ull~..n~w...oz~..£~.~..~w&ll~n~ ................................................................................... at premises located at ....~o~..t~..~.....~J,Z~.....~.~.~r~..~v...(.a,t.~.~eve~...L,.~..~-.~).l~) ............................ ALf.~....~uncL..~iew..aL~ .............. ~.t.~;uog....~v .................................... pursuant to application dated ..................... ~U~. ......... ~.~) .......... , 19.~.~..., and approved by the Building Inspector. Fee $.1.~.~.~0 ......... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITM E5 JOHN STREET, NEW YORK, NEW YORK 10~3E O,te September ].6, ].974 7338~7' ~ I N 182704 THIS CERTIFIES THAT only t~ e~ equicor ~scdb~ ~ in~ b~.~ aoo~t ~ ~ t~ pppl~at~n flu m~r in the premises of · O~-T~X~OS~ ~ /Sl~e ~o~ ~leW-Ave. ~ ~a~l~0/~ ~.,.. tvas examined on FIXTURE ~ECEPTA LE FIXTURES OUTLETS C S SWITCHES iNCANDESCENT FLUORESCENT MvAL~CF~URy 17~ 51 23 17 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SERVICE DISCONNECT NO. OF X S I E 1 ~ 0 0 CB METER ~o otc cc OTHER APPARATUS: ~otor/s: 1-1bp 8' O" ~rack ligh~ []X2nd FI. 0 ut s ! de Section Block and found to be in compliance v~ith the requirements of this Board. RANGES COOKINO OECKS J OVENS · JDISH WASHERS R V I C A. W, G. NO. OF HF[EG A. W, O. NO. OF NEUTRALS OF CC. COND. Otc HI-LEG 4/0 i Lot EXHAUST FANS DIMMERS 3/0 B.J. Electric Co., Stillwater Ave., CutchoE~e, L.I. Ilq35 OINIIAL MANAGSP~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FO~M NO. 6 TOWN OF SOUTHOLD Building Delm~tment 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 dispasal--(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 formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $§.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building....................~ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .... ...~...D....~....~..~...~..~..~.~..../~S..~..J~.~.~. ............ ~...~...T....¥.(....~..u....~.~. ................... Owner Or Owners Of Property ....... ~ ........................................................................................... Subdivision .......... ~ ................................................ Lot No....~.... Block No...~'~ ...... House No..?~.?.-~.? Permit No. b.~...~..~...~.. Date Of Permit Z/...~9../..7~.Applican, .~c~,......~...~ ............... Heath Dept Approva /~,Z Labor De t A roval .... .~..~/k Underwriters Approval ...?./.'.//./.....~..: ...... ~..~.':Planning Board Approval .... .~...;.....~... ..................... Request For Temporary Certificate ........................................ Final Certificate ..... ..~.... .............................. Fee Submitted $ ......~..~ ........................... Construction on above described building and permit~eets all applicable codes and regulations. , Sworn to before me this ......... o, .,. ,. Notary Public ....... ~/-~.. County // (stomp or Seol) ~Z~l O~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEliAGE DISPOSAL SYSTEM AND A WATER SUPPLY l. Applicant ~r~wt/i~(/~iL, jAR~q Phon~,~,lJ~,l,~ I~ Subdiv. Add,ss 1~4.0~ ~" ~. ~s&,~ ~.~, ~J ;c. Section 2. Property Location ~,~*,J~. v~ ~.~ 4 ~ . 7. Lot Nu~er 8. Private Well Village ,¢~(r~f(~Ct T~nship J~~_ 9. Public Water 3. Public Water ~mpany Na~' Distance to min 4. Lot size: Width feet Length feet 10. Sewage Disposal System: (For Health Dept. Use) A. gOO-gallon septic tank: Precast ~/Equivalent Block B. Leaching pools: Number of pools Precast ~/Block Special ll. If private well, fill in the following blanks: A. Tank capacity J~-~ gallons B. Pump G.P.M. ~ C. Total well dept~ O. 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 FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Oepartment that an adequate and satisfactory Sewage Ois~osql System andWaterSupplycan bei~stalledonthis plot. ~ .~j EXCAVATION, INSPECTION REQUIRED Rev. 4/1/73 __ ............. , .............. INSTRUCTIONS a. This tp~i~lion mint ~ ~m~ly ,fil~ in by ~wrl~r or ~n ink and submi~ in ~n~~ ~,~wt 3 ~ of ~, ~m ~t ~m to s~le. F~ ~ to ~le. -:. ~ ~o~~_l~t~ of lot. and of ~ildi~ ~ pmmim, relatio~i, to ~joini~ ~. h e M ~ ~1 I~i~t~n ay not ~ ~ ~ i,u~ of Buildi~ hrmit. d. U~ ~ ~' ~b ~i~ion, ~ Building. I~ wi i,~ a Building ~rmit h ~mim ~ ~ ~i~ t~o~ut ~ wo~. ' e. No ~i~ ~1 ~ ~ or u~ in w~le or in ~K for any ~r~, ~a~Nr until ~ by ~ ~ Incr. · ~LI~T~ IS HEREBY MADE to t~ Building ~nt for t~ i~n~ of a Buildi~ ~it O~i~n~ ~ ~ T~ ~ ~ld, ~ ~nW, ~ Y~, a~ o~r a~li~ ~in~ms, ~i~ ~, ~d~ ~, ~ ~lati~s, a~ to ~mit a~riz~ in~o~ on S~te ~r ~nt is o~, Ira, a~nt,.amhi~ ~, ~neml c~t~, el~i~, plum~r or buil~, ............ ....... .... .................................................................... N~ ~f ~ ~f ~r~i~ ...... Z. ~,~ ........ ,~.,.~.,~,~ .......................................................... ........... ...... Pl~r'~ Li~n~ No ......................................................... ~br Tr~'~ Li~ No ................................................... l, L~lti~n of li~ on ~i~ ~o~ ~orl ~iJl ~ do~, ~i~ N~,,,~ .............................. ¢, ,** .&~t ~ ....... ~ .......... 2. S"' *xi.i~ U. and ~u~ncy of ,remi=/~ i~nd~, and ~u.~y of a. Exi~i~ u~ and ~u~ncy .................. ~.~ ......... ............. ' .......................................................................... b.In.n~and=u~y .. ~ .~,'~' ~ ..................... ~ ................ ,...~ ....... ~, .......................................... 3. Nature of work (check which applicable): New Building~.~..~= ............ Addition ..................... Alteration .............. ; Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) ¥ / ~ ~ ~ (to be paid on filing tn~$ epphcatmn)/ ~/' \ 5. 1' dwelling, number of dwelling units ..... ./~'.~..-~.) Number of dwelling units on each floor ..........~.[~,,~Z .............. If garage, number of cars ............................................... , ............................................................................................ 6. If business, commercial or mixed~qccuoency, 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 .... , ....................................... He!ght ............................ .~..~ ...... Number of Stories .......................... ,Z. ......... O. Dimensi;ns of ent?e new construction. Front ........... .~..~...... Re~ ................. Depth ........ . .~.....~.... ............. 9. Size of lot: Front ........ ~'.~....~..:..q.~.. ........... Rear .......... /.~..~..:.P..?....~. ............. De th ........ .~...~....~.,..o....~. 10. Date of Purchase.. .................................... Name of For ~me, r,O,~'ner ......... =;~ .............................................................. 11. cone or use cIiS~rlcx in WhiCh premises are s~mumo ....................................... : ............ , ..... 12. Does proposed construction vmlate any zoning law, ord nanca or regulat on ........ ~ ..................................... 13. Will lotberegradecl ................ ~ ......... Will ~j~ flll b~ removed from premises: [ ] Yes. [ ] No 14. Name of Owner of premises. ............ , '~'~'"';'~', ...... /"'"~'~""~'"'-~'~'"":', (Address) .......................................................... . (Phone No.) iName or ~r~r ................ (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 according to deed, and show street names and indicate wheth- er interior or cerner lot. STATE OF NEW YORK,~ ~ ~ ~] ~ r~ COUNTY OF ............. ~,~,~ ! ........................................... ~ing duly sworn, d~po~s end ~¥s thet h* i* t~ ~limnt ~bo~ ( Na~ o f individ~ si~ing con~ct ) H~ ~* th* .................................................................................................................................................... ~ ~n~etor, a~t, co--ate o[fi~r, etc. J ~t~t~n~ eontain*d in thi~ ~lieat~n ~r~ tru~ to't~ ~t of hi~ kno~d~ and ~li~l ~nd that lh~ work will ~ ~t forth in the application filed therewith. . " ' --'~RI ~ E~ ) NOT~ .PUB,LIC, ~ ~ New Yprk .......................... ........ .......... ................. Notary Public, .~....,~.~ .......... ~unW' . ................................... ,~ ......... ~~ .................. bONG ON~ TO THE PER~ON FOR WHOM THE TO THE TITLE COMPANY=$OVERNMENTAL AGENCY ANO LENDING iNSTITUT~ON LISTED REVISIONS soUND ~OWN HEREIN ARE ~DIOR FROM DATA OBTAINED FROM OTHERS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG SURVEY FOR: TERRY S. TRIADES 8~FRANCES TR IA~ AT MATT TUCK ,TOWN o~- SOUTHOLD SUFFOLK CO., N.Y. sY/T-//Aj SCALE: I" = 60' IDATE: FEB. 7, 1974 HOWARD W. YOUNG APPRC~ED AS NOTED DATE: -- NOTIFY BUILDING DEPARTMENT AT 765-2660 9AM TO 4PM FOR REQUIR- L~ iNSPECTiONS: 1 B~FORE BACKFILLING FOUNDA- TION OR START FRAMING k.~T~ u~-l' 'r V~ ha, !"I 4',¸ ,4*' i,, III 4 .o II .¸%