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Home My WebLink About6748-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No..Z. 5.??.6. .... Date ............. .J.o~II...30 ....., 19. THIS CERTIFIES that the building located at . Laul~lwood..&. He.a'che~..PlStreet Map No. I~llr.e. lwO.o.d~ Block No ........... Lot No.. k:~ ..... Lap. r.e. 1....N...Y.., .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~;~ix....~19..73 pursuant to which Building Permit No.. dated ......... J.uly...23 .... , 19.7.3., 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 .Px'i.v. ate..one, fimIZy..dwe~l, ling ....................................... The certificate is issued to .... J.ohn. G~eal~..d.r, ..... 0wnmr ....................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · · $'an. · 30.1971+ ·. by..R .. ~,:i.~!a .... UNDERWRITERS CERTIFICATE No .... N.1.36¢.~2 .... .Jan...7....~.9.7.br ............. HOUSE NUMBER ..... ~.~0 .... Street .... Laur~lwood .~r ....................... Building Inspecto~ T~Mt'N OF SOUTi, IOED IUILI~NB BIFAF, TMINT TOWN CLEIIK'S ~ IOUTHOLB, N~ Y. IUILDINe PElU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6748 Z Permission is hereby granted to: Glenn..Z{e.t.t.l~u..~..,~l'~..Z~c.....A,~.....Jeh~ ..G. rea~y Jr ~.~..i~. .................................................................... ...... · ,laae,~p~, ...... ~.,¥.~ ................................... ,o ~.~.~J...~-~....?.~.e.....f.~Z...d..~.e...z.~ ...................................................................................... at premises located at .,]a~i'-....20.....Z,~1,~'.e,'~lg~la4, ............................................................................. ......................... /~l~,e~..~c~..~..~t~e~...~J.~e. ......... ~.Y~'~Ag~..~;d~.) ............... ........................................ .~.~tlMI,i.....l{.,~.,. ........................................................................................... pursuant to application dated .................... .~T_~)~_.~. ......... .~2.., ........ , 19'/v3...., and approved by the Building Inspector. Fee ~k,..,~, ............ FORM[ NO. 6 TOWN OF SOUTHOLD Building Department 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 ail 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 ..~. ~ ...'~.......~....°... e.. I...~.. ~ ..~.. ..... New Building ........ .~/. ...... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...... ..~'.~ ........... .~,.~...~....~2.~.~...~ ....... .~.....%...~..[::) .......... ~ ....... .~...~...~ ............... Owner Or Owners Of Property ..~..~.~.~....~.........~.....~,..~,..~....~....~ ............................................................... Subdivision ....~....~....~....~..~....~....~..~.~...r~ ................... Lot No. _~...C~...... Block No.....~ ...... House No ............. Permit No....~..!..~..~.... Datce~Of Permit .~.~.....Applicant ..~.~.~.L.~..~....~......~....~.....~.....-~....w~..~.~....~. ,-%0 TrfT'u/ Lab r A f, jr ~, Health Dept. Approval .... ~ ...................... 4. .... 0 Dept. pproval ................. I..... ......................... Underwriters Approval .... .~.........LJ....~...~../......~... ........ Planning Board Approval ............. .~.......~.. ................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ................ Construct,on on above described building ~,n~e[;m_it meets al~J~ab~ ~and~egulations. .................... Sworn to before me this JUDITH T. BOKEN Notary Public, Stale ol¢ New York No, 52~0344963 SufFolk Count× (stamp or seal) . ~, THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,at,~.~ua~'~ ?. l~-~,, App,,c~t,onNo. o,i,e 6881~. N 1 36612 THIS CERTIFIES THAT only the el~ ~ulpment ~ ~scri~ ~el~ ff~ int~ by ~applicant ~me~ o~ th~ ab~e application numar in t~ p.mi.s of Laurel, L.I. in the follo~ing ~ation; ~ Bmement ~ Ist FI. ~ =nd rt. outside Section Block Lot w~exami~don ~H~y ~ ~9~ andfound~obelncompllancewiththerequlrementsofthisBoard. FIXTURE OUTLETS 2O DRYERS FURNACE MOTORS OIL H.P. GAS H. P, SERVICE DISCONNECT I NO. OF 1 20( FUTURE APPUANCE FEEDERS AMT. NO. A, W, G, S RANGES SPECIAL REC'PT. COOKING DECKS OVENS DISHWASHERS I116.~1 ~14.6j ~1 ~. TIMECLOCKS BELLIUNITHEATER!UNITHEATERS MULTI-OUTLET V I C ~'~w ~':~w :~w ~,,,,w .o.o,~c~.co.o. OF^.W.O. X i Lt/oCC' CONO. NO. OF HI-LEG EXHAUST FANS DIMMERS NO OF NEUTRALS A, W. G. OF NEUTRAL 1 4/0 Water heater: 1-~t.5kw Motor/s: 1-!/2bp 1 Post light Elec.room heaters; 1-2.Skw, 2-2.0kw, 3-. 75kw, ~-. 5kw 1 - 1.7 5 kw, 3-1.25kw, 5-1oOkWj Robert A. C, oodalep 525 Orchard St., Wew Suffolk, L.I. 1195~~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPRC~AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval tn construc%~ said systems is requested,pertinent data herewith: Date~._~ 2-Detailed ~pr°per6y lo~o~E~ ~k~ ~ ~~ No. ~-~ Hamlet ~%. 9 Town~_~,~_~r~_~ 9-Private well? 3-Public ~.ter supply-name Distance to nearest main ~ . 4-Lot Size[ Width ft. Length ft. (also enter on cgnter plot plan be±ow.) 5-Dwelling. Single Famlly~,4'Two Family? ~ellar? ~Slab? lO-Proposed system: Septic tank il-Septic tank inside~imensions:.yolume~Gals. Length ft. Width ft. Liquid depth 12-Precast sections: ~umber~Square F' t. Cesspools: Block sizeL incs. D ins. H Total blocks below inlet: PLOT PLAN / ins. Ca~cityw__~als. G.P.M. ~ ~ate 'th Data ~eet 0 2 4 6 8 10 12 ~6 18 Indd The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems": J --Owner or Builder 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 ( 10/65 Revis.) S-15 Signed Exomined TOWN CLERK'S OFFICE SOUTHOLD, N.Y. /-7- 19..~ / ~ ~ ~ ..................................... ..., PemJt No.....~......../u.........~..~...~ Approved Disapproved a/c ~ .......................................................... f , ..., (Building/nspec~or) APPLICATION FOR BUILDING PERMIT ........... '., r te ...... 19.'1 ..... a Th,. apphcat,on must.., pi rely .,hed ,nb 'NSwrTitRerUoC~'r ',nONins. iub',tled ,n'il, ,.cate to tbe Bu, d o sets of plans, accurate plot plan to scale. Fee according to schedule. . b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or af~ and~ giving a detailed description of layout of pro.rty must . drawn on diagram which is pert of this application. c. The work covered by this application may not. commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kej~t on the premises available for inspection throughout the work· e. No building shall . occupied or used in whole or in part for any purpose whatever until a Certificate of Occupency 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 t. 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 ai3plicable laws, ordinances, building code, housing code, and regulations, and to admit authori zed inspectors on Ixemises and in buildings for nece~ary inspections. (Signature of applicant, or name, if a corporation) (Address of applicantl ~ t q q"~ State whether applicant is owner, I.essee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................. ................................................................................................................. Name of If applicant is~corporate, signature qf duly ~authorized officer. ~ amc and title or corporate orricert 1. Location of land on which proposed work will be done. Map No.: ............ .~...~.'~..C{...~.... ................. Lot No...~...(~.... Street and Number .~lll~l~i,J~,i}...~"~~....~. , ~./'~' '....~.~h~....~ Municipality 2. State existing use and occupancy of premises and iritended use and occupancy of proposed construction: a. Existing use and occupancy ........................................... ,, ............................ ;~} ..................................................... b. Intended use and occupancy ...... 3. Nature of work (check which applicable): New Building .......... ~.... Addition .....................Alteration ......... ...... Repair ............ ~b~ ......... Removal ......................... Demolition ........................ Other Work ..................... ~ .............. 'PI~, - ~0 ~ ~ I Description) 4. Estimated Cost .....~.~L.,...~.¢3.C3. .................Fee ...... .C~...-~ .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... [ ..... 'i, Number of dwelling units on each floor ......................................... if garage, number of cars .........~ .............................................................................................................................. 6, If business, commercial or mixed occupancy, 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 of Stories ........................................ ' ........... 8. Dimensions of entire new construction: Front ........ .~...~.~. ...... Rear ........ .~..C~.. .......... Depth ................. Height ............ --' ' ~...~....O...*. ................ Number of Stories ....... ! ................................................................................. 9. Size of lot: Front ........ .~....t~.~ .................. Rear . . ~ ..~..~.. ...................... Depth .......~.....(~..~. ............................. 10. Date of Purchase ..~~.~.t.~.~..~,~ Name-- _(O of Former Owner,:....._...:-...:,;..,~j - l J-- ....... ~._.~.~....._. ........................ 11. Zone or use district in Which premises are situated ...... ~:;~...~..~.~¢~,,V~ ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ .'f. .................... [ ............................. 13. Will lot be regraded __ : ~ ............... Will exce_~ll be re_moved from premises: [ ] Yes [ ~o 14, Name of Owner of premise~ ....... ~...,~....~ .................................. ' . L~ (A(~ss) (Phone No.) Name of Architect ................................................... ; ......................................................................... ~ -..-..~ .......... : .... a~) ~, ~ ~ ' {'~ (Address) {Phone fao.! Name of Contractor ,,~.....T......:)~.~.~L6--C~T--,~..~ ............................................................. (Address) (Phone No.) PLOT DrAGRAM ~'~ (o-C- ~ ~o~ I~ocate 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 corner lot. COUNTY OF~'. ..................... ) .......................................................................................................... being duly sworn~ deposes and says that he is the applicant above nanmd. (Name of individual signing contract) He is the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have perfofmed the said work and to make and file this application; that all statements contained in this application ere true to the best of h~)~Wlle~eK~d. . be el; and that the work will he performed in the menner set forth in the ap~i~tion filed therewith. Neha~ I~ubllc, Store of New ----- III ............................. ~-::.....day of ...~ ............. ~.m.,iel~.Morch ~Ox~,jg.~_~ .......... M t~ l::) O? JOHN ~ G~.E,~L.Y,_ J~. ALICE G12__EALV ' 7'0 ~/~ O~~ ~OU~'HO~O ~c.c~/~ : ~0'=1" T'o v/tV ©~' ,,,,!, Y. I I APPROVED AS NOTED "/V/~ ~/~"-..,~_._c~_.0.._... ~ NOI-IF¥ BUILDING DEPARTMENT AT '~-' GLEN~~'r x, .... .FIRST