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Home My WebLink About6339-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. 2,52~b, ..... Date ............. July. · -~ ...... , 19.73' THIS CERTIFIES that the building located at . 14.i. td - Chex, ry..Wa~r ......... Street Map No. Shora. CrestBlock No ........... Lot No. ~ ..... 01'~enpoz'.t .Dist. 10..(soatllold RoFoD) conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. Jan...16 19.7.3. pursuant to which Building Permit No.. (>.3.39Z. dated ............ Jal~..16..., 19.7.~., 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 .. PrSvate..one. ~m;~3~..c~we,],~,~ng ...................................... The certificate is issued to ...Jo~pl~. Corl~e.~.~..&/C...09t~,. ~ollst;l*tlc.~olt .~O~* (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval J. uly. '3' '197'~} · .by..~,. V.~.tla ....... UNDERWRITERS CERTIFICATE No .... I~..096~91~.. June. '~... 1973 .................. HOUSE NUMBER ............. Street...h/'l ~1.'1..be. ~lpl~..'l ~1 ........................... ( )53ub~ec.t -to. eorreotio, r: .of. w.~ndow- .size..in. bec%~eom-) ...... ............... Buildin'' - g Inspector [ FO~M 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? 6339 Z Date .............. i)'JlJljit~ J'~ ............ 'J~ ........ , 19.~. Permission is hereby granted to: ..... ,l'~s~h...C~rne3.3. ......................................... ............ 8eut, h®~.dr ................................................ to ]~Xt,'t,3,~.. Mv .. ~ae... f~atllr...&~e Ltiag. ..................................................................................... at premises located at .........J~)~...~. ...... ~JJO~'l'*'~Z'el~ ..................................................................... .............................. W$3A..~bee,z,jr...Wa~, ......... 4tr~loo~ ......... t~.4¥v ........................................... pursuant to application dated .......................... ~ ..........~6 ....... , 19..~3., and approved by the Building Inspector. Fee $~.'~. :3 ~. ........... / · BuRdin~lnspectoI' FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office SouthoJd, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructbns A. This application must be filled in typewriter OR ink, and submitted in triplicate 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 farm 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: I. 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 (~ ,-2_ '~ - '*- - ~ N~v Building .................... Old or Pre-existing Building ................ .~ ........ ~ocant Land ....~ ..................... Location Of Properl/~,Zt.~..~...~.=~.~'~..~/~*'" "~'~'"~"~'"' Subdivision ~"/~../.~... ...................... Lot No...~. ......Block No ............. H'<: ouse No...'. ......... Permit No ..................... Dote Of Permit .................... Applicant .................................................................. Health Dept. Approval ...... ~ .............................. Labor Dept. Approval ................................................ Underwriters Approval ...... ~i ............................... Planning Board Approval ................................... . .... Request For Temporary Certificate ........................................ Final Certificate Y Fee Submitted $ ....,~.'~.¢....~....0.. ............... Construction on above described building and permit meets all.,appl~able codes and regulations. Sworn tobefore me this // ~ ~ ~ ~ .... .~. ........ doff '"'"~'~'~"~""~"'~'"~'"""~,XY-~ ' (stamp or~61)/~ Nota~ Publlc~5~. ~oun~ ~ '~mm~s~on Exp,~ ~arch 30, 19 7~ APPLICATION SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No, FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM Subdiv. Address f ., 6. Section 2. Property location ,~_ ~,o ~'J~ ~ ~o7. Lot No. ~' J ! ' 8. Private well Vil ge Township ~/~ 9. Public water 3. Public ~ater Company name Distance to main 4. Lot size: Width M~~ feet Length/~'~ feet (En~r on center plot 10. A. ~a gallon septic tank: Precast'~'~ Equivalent Block Sewage Disposa~stem: l/ B. ching pools: Number_~,~Precast/~Block Special below) Street If private well fill in blanks below: Tank capacity Gals. degth Amount of w~,r in wel~ Data eet 6 8 10 12 14 16 18 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with th~ Suffolk County Department of Health's current stand~ ards thereto." Date Own~or~hilder 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 /f~) Signed~ S-15 Revised 4/1/72 .' -k TOWN OF SOUTHOLD.~,~, ~/-~/~'~-1 ~ ~ BUILDING DEPARTMEN'I~/-~-c~'-~,~/ /u~--~ ~ ~, ~/~ TOWN CLERK'S OFFIC~ ' . -- ,~ / ~ /~ ................ ................ ................ ......... Dimpproved o .................................................................. ~ ~ (~*~ ................................................................... ........... APPLICATI~ FOR BUILDING PE~iT ote .................... ,. Thi~ ~limtion mu~t ~ ~m~l~t~l¢ filled in b~ W~rit~r or in ink ~nd ~ubmitt*d in triplie,t~ to th~ 8uildin~ In~or, wi b. Plot ~l~n ~howinfl Iomtion of lot ~nd of buildin~ on pmmi~, **lation~i¢ to ad~oinin~ ~mim~ or ~ublie ~tr~ or *r~l~, a~ giving a detailed description of layout of pro~rty must ~ drawn on diagram which is part of this appli~tion. ~- c. T~ wo~ covered by this application may not ~ ~mmen~d before issuan~ of Building Permit. ~ d. U~n approval of this application, the Building Ins~ctor will issue a Building Permit to the appli~nt. Such ~rmit.shalt ~ kept ~ the premiss available for ins~ction throughout the work. e. No building shall ~ o~upied or used in whole or in ~rt for any purlin whatever until a ~ificate of ~cu~nw shall have ~ gran~ by the Building Ins~or. APPLICATION IS HEREBY MADE to the Building Department for the issuan~ of a Building Permit pu~uant to the Building Zone Ordinanm of the Town of ~uthold, Suffo[k County, New York, and other appli~ble ~, Ordinanms or Regulations, for t~ ~nstru~ion of building, ~ditions or alterations, or for removal or demolition, as herein descried. The appli~nt agrees to comply with all appli~ble I~. ordinanms, building ~de, housing coda, and regulations, and to admit authorized ins~ctors on premiss and in buildings for nemssaw ins~ctions. Jos Cornell (Signature of applicant, or name, if a corporation) Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder Name of owner of premises ..~.9.~f~]~....C..o.~.]~.~...~ ............................................................................................................. If applicant is a corporate, signature of duly authorized officer. ~,~ (Name and title of corporate officer) ~ Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... ~-J ~[J ~, Other Trade's License No ................................................... ~ 1. Location of land on which proposed work will be done. Map No Ighore Crest Lot No...~'.. ................ ~.. lg d CherryWak ~ Gree~port I~Y. Street and Number ............ ~.~ ................................................................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~..~..(~.~.~ .............................................. .'. ................................................................ b. Intended use and occupancy ...... g~fi...:~R~,;t.~Z..~.'~:~l-~g ..................... ~..~ .............................. i ...... '~)'"~-~**'"~ 3. Nature of work (check which applicable): New Building .......... ~.... Addition ..................... Alteration ............... Repair ...... Removal ............. Demolition ........................ Other Work ................... (Description) 4. Estimated Cost ....................... ~.{~ ,.Q. Q0..--+- ..... Fee ..... ~.L~....~..?...... ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..o..~.~. ......... Number of dwelling units on each floor ......................................... If garage, number of cars .....~..~..o.. ................................................................................................................................. 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 Storms ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ................. Height ..................... Number of Stories ........................... 8. Dimensions of entire new construction: Front ....... .(~0.-..~ ........ Rear ...... 0.0.-.~, ............ Depth ......~..-.~..~,~,q..~... Height ................................................. Number of Stories ..... o.o..~..e. ............................................................................. 9. Size of lot: Front ........ ~r.0,., .................... Rear .......................................... Depth ......... 1.8.~ .................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 1 1..Zone or use district in which premises are situated ............. ~.~..."...~i..s..t;.. ..................................................................... 12. Does pr0posed constrUction violate any zoning law, ordinance or regulation: ...... ~ ................................................ 13. Will lot be regraded ~..~r~s .................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ...~.~,%aph..C.~3z33.e3'1 .................. sto=t;hD, lrl ............................................................ (Address) (Phone No.) Lester Cohen Name of Architect ........................................................................ (Address) (Phone No.} ~ J. Cornell Name of Contractor ................................................................................................................................................... (Address) (Phone No.) property lines. Give stre er interior or corner lot. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and block number or description according to deed, and show street names and indicate wheth- STATE OF NEW ~OP~I~ .. ) COUNTY OF .......~.~:.O....J~... ............................. ) .................................... .~...o..~..~.....C...o..~.~.e...~.~. ..................................... being duly sworn, deposes and says that he is the applicant above named. {Name of individuq, l signing contract/ He is the ................................... l~'~ll~.~,llJ.~i}~ .......................................................................................................................................... {Contractor, agent, corporate officer, etc.} of said owner or owners, and 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. TERRi LEE Et. AK .. 1 6 dav of ~TI~y PUBLIC, State of Ne~oY0f~3, -'~ // ........... ....................... - ........................... ............... .n ,o // /2// ~'% . ,K~ ,.'3 .lluali~ied in Sultoll~.m~--\V // // // / ' Notary ..... ....... ............................. ~' ~' (Signature of applicant) -- I Il- J }~ I LL lOLl" I I T~z~ D I w~ ~ru,,~W.~ T°