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Home My WebLink About6343-zNO. 4 TOWN OF SOUTHOLD BI.TIT.DING DEPAR'~ Town Clerk'-, Office Southold, N. Y. Certificate Of Occupancy No..'~...~. ?. !.e.. Date '~VDi:~'F~e'¢ 't~'~,~' ..... , 19 .... ~IS C~T~S ~at ~e b~i~g locat~ at A~ID N~, C~ ~'~' S~t Map No. ~ ~ ~ ~ BI~ No ........... Nt No.. ~ ~ ~;~'~'"~ ~,~ ~e~ ~-*~,~ '~ .............................. co.om su~t~fi~y to ~e AppHca~on for B~g P~t hereWfore ~ ~ th!. o~ dat~ ...........~ ~../~., l~mu~t ~ wM~ B~di.~ Pe~t No.~3........ V~ ~ dat~ ~ ~, ~ ....................... 1~., was ~su~, ~d co.ores ~ ~ of ~e ~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ................................................................ . ....... ne ~e~i.a~ ,. ~.~ ~ ........................ ~.~ ,~. ~. ~:-'-::' :-'~t"~, ......... of the aforesaid builclin~. Suffolk County Department of Health Approval .~..?.~..! ~.4/.>..7)~.,/...~/..~..f.o.. !.~..~,~ Ui~I~WRI'I~IRS CF~TIt'IC~TE No .......................................... ~ous~, N--LT~ ~ .............. Steer ....................................... Building I~spector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI:~,EMISES UNTIL FO~ COMPLETION OF THE WORK AUTHORIZED) N? 6343- Z Permission is hereby granted to: ~then~..i~po~a ................................................ ...... ~326 .......... ~,..3~t ...................................... .......... ~o~v~ ....... ~a~.....I.L~.t~. .... to .I~s..X~-.ne~-.ene-..~mm~..J:y. ~e ~.~ng- ........................... ~ ........................................................ at premises located at '"'~t,'"~l, ....... OI'~TI~'"I~'"t~"~"~I~'":Z~ ....................................... ............... 7 ............... ~Yde~'"~e~m"t~ .-~..l~or'ch'"Sew"Dr-/~re...'...Or i~n~ ................................ pursuant to application dated ...................... ~'1 ....... q~ .............. , 1~....., and approved by the Building Inspector. Fee $.6~,r~ ........... FORM 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, an6 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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Subdivision No B ock No -- House Hearth Dept. Approval Dept. Appro a, ........ ....................... Request For Temporary Certificate ........................................ Fin~ Certificate Fee Submitted $ ~ ....... .................... Construction on above described building~ ,_i/_~r__ ,/j~and~_permit meets?all applicable codes and regulations. Sworn to before me this ................ day of ............................................ (stamp or seal Notary Public .................................... County ~ SUFFOLK COUHTY DEPARTMENT OF HEALTH APPLICATION,~OR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISP~OSAL SYSTEM /¥~fi Phone -~t~ 5. 2. PropertX losatlon r~,,-~/~/ ;~,d L'~>~ /%../ 7. Lot No. ~ [ f~-' ~/,~ ~,¢ ~- 8. Private well Village ~, , ~ /, · ,.~ ~ownship ~ ~ ./~ -/) 9. Public water 3. Public Water Company name Distance to main i. Lo~ size: Width ~,~> ~feet Length / f~.~ feet (Enter on center plot below) 10. Sewage Dispos~ystem: . -~- A. ~O0/gallon septic tank. Precast ;~quivalent Block B. !~ching pools. Number ' Precast ~Block Special~ The undersigned ' be in accordance ards thereto." Street "Construction of authorized If private well fill in blanks below: Date Tank capacity,C/'~als. Pump G.P.M. ~ Total well depth Depth ~ G.W Amount in Test H,~,~,e ~ Data ~ ! '~;Feet 16 18 CERTIFIES: installations, Will with the Suffolk County Department of Health's current stand- Owner or ~ilde{~ - 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 z' ~ Signed _ S-15 Revised 4/]/72 '0 Z _J ..J Lo+ ~ .,~0'---_TIe ~ ^ v^uD r~u~ copY. .....I~ *,n~s~ mSTnUT~ONS o~ su~s~que, rr ~ye.~'lel~, ~[~w' ~. THE NEW YORK BOARD OF FIRE uNDERWRITERS ~,~ BUREAU OF ELECTRICITY ~" 85 JOHN STREET, NEW YORK, NEw'YORK~lO038 . ~ ~/ · -~ ;~ A..,~.,~.No.o.~,. ~ ~ N ~99083 THIS CE~FIE~ THAT in the fol~ing l~ation; ~ B~e~nt ~ Ist FI. ~ 2nd Fl. O~l~5~rle ~tion Bilk ~erami~on :~O~F~)~ ~ ]~7~ a~foundtobeln~mplia~ewiththerequi~mentsofth~rd. em'tRsS FURNACE MOTORS FUTURE AFPUANCE FEEDERS TIME CLOCKS UNIT HEATERS DIMMERS SYSTEMS heaters: 1-2.5kw, S E R V I C E 11-2.0k~¢, !-l. Skw, 6-1,25kw, 3-1.Okw, ""?'~ieacl_~ L.I. 11901 Per. FOR BUILDING DEP~RTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNI[ER. TOWN OF SOUTHOLD -- / '~ - - .BUILDING DEPARTMENT ,~- ~ TOWN CLERK'S OFFICE, ~/ ~/~-~ ~ - C'z: .... .:...: ............................................ ............. ~1'~/.,. ~/~ APPLI~TION FOR BUILDING PERMIT .~~ ............................. . 3 ~ of plans a~urate plot plan to scale. Fee a~ording to ~hedule. b. Plot plan showing Io~tion of lot and of buildin~ on premises, relationship to adjoining premiss or .~e g v ng a ~ ~ ~scr pt on of ayout of pro~rty mu~ ~ drawn on di~ram which is ~rt of this appl~dn. c The w~ ~vemd by this appli~tion may not ~ ~mmen~d ~fore issuan~ of Building Permit. d. U~n ep~ova of th s application, the Building Ins~ctor will issue a Building Permit to the applicant. Su~ ~rmit.shall the premi~ available for ins~ction throughout the work. e. No bui~i~ s~ll ~ o~pied or u~d in whole or in pa~ for any purpose whatever until a ~rtifi~te of ~n~ shaft have gran~ by the Building Ins~ctor. APPLICATION IS HEREBY MADE to the Building Department for the i~uan~ of a Building Permit pu~uant to the Building Ordinan~ of t~ Town of ~uthold, Suffolk County, New York, and other appli~ble L~, Ordinan~s or Regulations, for t~ ~nstru~ion building, additions or alterations, or for removal or demolition, as herein descried. The appli~nt ~rees to ~mply wt~ all appli~ble ordinan~s, building code, housing ~de, and regulations, and to admit authorized ins~ctors on ~emi~s and in buildin~ for ~ in~io6s, ........................ i~;;~';T;;~.~/-- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~......~..~ .......~. ............................................................................................. ., ........................................................... Name of owner of premises /- ' .... 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 .................................. ; ......... ' ......... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No .............................................. Lot No......~.....~.. ........... ~ Strut a.d .umber ~..~.~......~.~d.~...~.....~.~.~....~.-~-.~.~-.....$.~ .............. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy .................................................................................................................................... Intended use and occupancy .r~...~.~.~.~.....,~...~../~..~. ..................................................................... ~;~Ji~:[3. Nature of work (check'°~'~hich"apl)licable): New Building ...... ~ ...........Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... ..-. (Description) 4. Estimated Cost ....../. ~ ../..?. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... /.. ......... Number of dwelling units on each floor .......... ./. ............................. If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify, naa,tyre_and extent of each type of use ..................................... · . . . 7. D~mens~ons of emst~ng structures, ~f 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 co_~struction: Front ...~..~.,,./.7..~../.:..... Rear .-..~...~...~...~...~.i ....... Depth ....'.J-- ~.'~...O...:~ ............ · . Heght .................. ~....;, ................. - Number of Stones ...... ~,, .............................................. =~ ~ .... , ........... ... 9. S~ze of lot: Front ...................................... Rear ...~..~..X~.. ............................ Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in wMch premises are situated ..................................................................................................... 12. Does l)roposed construction violate any zoning law, ordinance or regulation: ..... !.'./.'.'~.. .............................................. 13. Will lot be re(jraded ._,~¥,C·.~. ...................... Wdl excess flll~be removed from prem~s_: [u~Yes. 14. Name of Owner of premises .~....~/.~-..,/~.~<.¢:.'...~. ....... ~....L.~.,~./...~.......J.~,.~..~.~..~.~..,~ .~../..~.~./-,[/. ...... ~.~.~.;..~.~¥7,) (Address) (Phohe No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ......... ~ ................................................. ; ........................................................... (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 corner lot. STATE OF NEW YORK-~.~/~ _COUNTY OF ............. t~...~ ............ ) '' .................. ~...~..~.~.~.:..~.4.....~,~...~lt~..~...~...~; .......................... being duly sworn, depo,s and says that he is the applicant above named. (Na~ of~ndivid~ Si~ing cOn~act) {Contractor, agent, co~o~te officer, etc. } of said owner or owners, and is duly authorized to ~rform or have ~rformed the said work and to make and file this appli~tion; that all statements contained in this application are true to the best of his knowledge and ~lief; and that the work will be ~Hor~ in the ~n~r ~t forth in the application filed therewith. ~' ~RI LEE E~K aw Yor~: " /- da ' ..................................... ~---~"'"'"~'6,'"" .......................... , ' ' ' ............ ................................ RESIDENCE ,FoRi ~OT~ I~Tf::~_LOCl£~:D \VtT~ ~?UNDATION -.l rl eoF::: /L:uO ~boor2 ,'U x- 4" "2 T'u o r~ [ l'-I Co 2 iL 4L ~/4" RESIDENCE FOR: //~l~ ALIT[4Okl9 %?Oki-LA ,JOSEPH B. BALDINO-ARcH'ITECT PHILADELPHIA, PENNA. DATE