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Home My WebLink About7533-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~6~.~.8. ...... Date ............ l~lt .....~. ...... , 19. ?~. THIS CERTIFIES that the building located at .. I~.e¥&~ .I)1'~.~ .......... Street Map No~ew~l .AO. Block No ........... Lot No.. ~,.. 8outho~!.. II.~Y .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... g~p~;...%~., 19~l~. pursuant to which Building Permit No. dated ........... I~.a[~;...~[2.., 19 .~.1~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . p~$y&t;,. 0~. 1~!~1~1~'..4~11,~ ..................................... The certificate is issued to ~ltlsopll~ .l~o.~;~ ..... 0~x~l* ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~t~s...~...¶.~t~.. 1~'. tr, .¥~.13.~... UNDERWRITERS CERTIFICATE No. Il..~20~ .... ~,pl*...lt~...~.97~. ............. HOUSE NUMBER .. ~.0~. ........ Street . .I,~I~1. Dx~,~o ......................... Building InspectOr l~u~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT ~rHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7533 Z Permission is hereby granted to: ....... J~s'~pt~..C.t.o.t.t~ ............ : ............................. ......... ~.~ ........................................................... at premises located at ....~0.~,..~ ....... ~e,I~Z~I,..&G~B .................. ; ................................................ Leeward Drive Southold pursuant to application dated ................................ .S..e...p.~ ........ .1..2...., 19...~.~.., and approved by the Building In.%oector. ~OKM NO. S TOWN OF $OUTHOLD 0 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, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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 19,57), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey-of property showing oil property lines, streets, buildings and unusual natural or topographic features. 2. Swam 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 certlfJcate of occupancy $1.00 Date /~ ../~...~..~.?. cS'- New Building ......~... ....... Addition ................ Old or Pm-existing Building ................Yacont Lond .............. Location Of Property ..... ~.?~.~.~..~..~.~..~`~...~.~.~.~.~...~.~:~.~.~.~.~/...~.`~ .............................................. Owners Of Property ..../...o.~.~..~...~....9....~..o...~....~...~...~..........~../.'.E.~.~: .................................................. Owner Or Subdivision ....~...,~....~.~K...~...~....x:?.......~.~...C..~_.,~/,n ................. Lot No.....~:....'~.... Block No ............. House No.:.~.~.~...~..~'~ Permit No..~...~..?....~..:. Date Of Permit ~.'././~/{~.~......Applicant .....~/.~.~..'~-..~.../~........~.~...~..~..~. ................... Health Dept. Approval ............................................ Lobar Dept. Approval ....... ..~/./,C:~. .............................. Underwriters Approval .............................................. Planning Board Approval ....'~../...~. ............................. Request For Temporary Certificate ........................................ Fincd Certificate ...,~ ................................... Fee Submitted $ ....~....u~.... .................... Construction on above described building and permit ~eets all applicable codes and regulations. Applicant ......~1~<~ ...~~.. .................................................... Sworn to before me this /// ........ ~ ..... d~y o( ............... ~..C~.C..~ .............. Notow Pubhc ~/~ C~n~ FOB~ NO. ~ TOWN OF $OUTHOLD BUIIIIING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPOBAR~f Certificnte Of Occupency No.. Z.Z.6..~.2.2.... Date ...............J..ux~.....~.~ .... , lg.. 75 THIS CERTIFIES that the building located at .i[ll.e. Wal~.d..D.%-.I.~. ........... Street Map No..L.9 .e.w.a.~AI..A.ellloek No ........... Lot No.. 2~;. .... ~..ml.t,!lp.l.d.. ~.:~.., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ .8.~.I).~...1~ lg..~l; pursuant to which Building Permit No.. ?.~.33.~. dated ............S.e.p.%...~.~..., lg.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.I'. Sy.a.~.e.. 9.n.e...f.a.m.}.J.¥..d.¥e..1..1..~.g ...................................... The certificate is issued to ...~.08~gh..C~..o.O~;.t#. ....... .Own,~'. ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,l.u~..e....~,~,..~ 9.~. [;...b~...R....~.~..1.l.~. .... UNDERWRITERS C~,aTIF~CAT,. no..~..~.S. 9.~..~.....~.r.~.~...! .6. J.9.?~. ............. HOUSE NUMBER .... 300 ......Street .../~.Wa*'~ D. rl.v.e... ~.o~gl~pJ,d ........... Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU]OF ELECTRICITY r ak 85 JOHN STREET. NEW YORK. NEW YORK 10038 ~t, A ril 16 1 .5 .~pp,cotio,~,~o.o~,;'i~e 778364 '~.,BCE~,~:STHAT' 97 ~=, ~ N 219204 ~y t~ e~ t~ ~uipmea[ ~ ~c~ ~ a~ /nt~uc~ ~ t~ applicant ~ on t~e a~ application numar in t~e prorates ~ ~..~ o~ April4~ 10, 1975 ' · · ' and foumd to be m complmnce with the requirements of this Board, F~XTURE / i I FIXTURES I~ RANGES ICOOKINGDECK$i OVENS IDISHWASHERS EXHAUST FANS 28/ 63 37 28 ii 15.' 1 1.5 2 F * . . ' ' 1 30 SERVICE DISCONNECT INO. OFT ' --'--'' : '* s ' ' E ...... R-' ...... ~' ...... ! .... c ....... E ...... ' 1 15 CB ' x 1 1/0 1 1/0 *Furnaces: Oil 1-1/Shp, 2-1/12hp Motor/s: 1-1hp Robert Harris, Gabriel Hills Rd., Wading River, L.I. 11792 credentials. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their l~Ol~I NO. 6 TOWN OF $OUTHOLD Buiidlng Depor~ment 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: ]. 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, o 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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: ). Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $).00 // ...... ..................... New Building ...... ~ ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...... ~~`~&f~x~2~)x(~/~Z~c~.~/~F~ ............................... Owner Or Owners Of Property ;..-/.O...~./..c:..4~../~ '~' ~..'~,,Scx~' (?~ c-~ j....~.~.~/~!..(?.~..O...~..C~.(~.~: .................... Lot No...~...~ Block No ............. House No ............. Subdivision Permit No...])..~..~'.~..~..~.... Date Of Permit ..~/~./~ .~. App ca.t Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ............. ~ ....................... Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building ar}fl permit meets all applicable codes and regulations. Sworn ,o before me this '-/ // ................ day of ............................................ (stamp or seal) '~/~' ~"~ Notary Public .................................... County FORM NO. 6 TOWN OF SOUTHOLD 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: I. 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: 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 Dote ....... ............. New Building ...~ ........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....... ~.0.. ...... .L.~.~...f..~.ff..x'...~.......~..?...~.!~:~. ....... .,_..(~..~..~?..6...~' ........................................... Owner Or Owners Of Property ~.~.o./~,~=~ ri ~o£,~/'dx (~ r C6/>~,~ Subdivision /~..~ k,,,,~/e~ /gc~.~.5. Lot No..~...... Block No. House No ............. J J PermitNo ..~..~?.~. Date Of Permit ~.././.'Z../.~..~..Applicant - ' ~ ~'~ ¢~' ....................... ....... ..................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate .......... '..~.. .......................... Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit ~mee, ts all applicable codes and regulations. Applicant ...i~~. ............................................................. Sworn to before me this ~,/~,~/~)~ (stamp or seal) ................ day of ............................................ Notary Public .................................... County SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES HealthReference Services Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant J~ ~,co~-~S Phone Address ~£~ F~y~,~ ~ 2. Property Loc~on x~,~,~ . IQl~ Village ~.~ ' Township ~e~. 3. Public Water Company Name ~ 4. Lot size: Width ~ feet Length~o 10. 11. Sewage Disposal System: A. ~W-gallon septic tank: Precast ~quivalent Block B. Leaching pools: Number of pools Precast /~(~Block Special__ If private well, fill in the fol- lowing blanks: A. Tank capacity ~gallons B. Pump G.P.M. Ye' C. Total well depth D. Depth to ground water E. Amount of water in well 5. Subdiv. ~z-~-~ 6. Section 7. Lot Number ~ 8. Private Well ~._~___ 9. Public Water Distance to main feet (For Health Services Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' 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. FOR THE DEPARTMENT OF HEALTH SERVICES' USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~-~/~ ~ SIGNED ~~ ~ ~ S-15 Rev. 4/1/73 INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building~.: Inspector, with 3 set~ of plato, accurate plot plan to male. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoin ng prem see or pub c streets areas, and giving a detailed description of layout ofpmparty must be drawn on the diagram which is part of this ppPlication.~, c. The work covered by this application may nat be commenced before issuance of Building Permit. ' d. beU~ptappraval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc~J shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ssuance of a Bu ding Permit aumuant to the% Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and ather applicable ~-(~nances or~ Regulati..ons, for the construction o.f buildings, additions or alterations, or for removal or demolition, ce heelin described The apphcant agrees to comply v~th all applicable laws, ordinances, building code,.houslng code, and regulatlae~, and to admit authorized inspectors on premises and in buildings for necessary, inspections. - / .... ...................................... , i~latuJ al app icont, ar name, it a corporation) .... ....... ......................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Nome af OWner of premises ...,I~.,~l~,..~..~e~,...~.~,g.~.t~ ................................................................................... If opplicont is a corporate, signature al duly authari:ed officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ....... ~.?...~...'~.~.Z'/~'~....T' Electrician's License No ..... Z,..,M'n~.Z.Z~. ................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: Leeward A¢~'es Lot No. 2~ Street and Number ...[.~.e~'~.~1...~).~;[.I~.1~ ....... ~D.lg,~;hQl.Cl. ....................................................................................... Munk:ipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy vacant b. Intended use and occupancy ....... j:~e...fs~m-~ _'t ~..~.w. elli~L~ ........................................................................... Nature of work (check which applicable): New Building..~ ....... Addition .................. Alteration ................ ~ Repair .................. Removal .................. Demolition .................... Other Work ................................................. .... (Description) Estimated Cost ....................... ~,?.sQO0..~ ................. Fee ...1.2.1..6.5 ......................................................................... (to be paid on filing this application) If dwelling, number of dwelling units ....o~e .................Number of dwelling units on each floor ............................ If garage, number of cars .,...t~'D. ................................................................................................................................. If business, commercial or mixed occul;x3ncy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or odditioos: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .....~.8 ........................... Rear ......)={'~J .................. Depth ...~.1~.-.~. ............. Height .................... Number of Stories ....2. ................................................................................................................. 9. Size of lot: Front .....'~).~[ ............................................ Rear ~ ......... 203 ........................ Depth .....2.Q(~..~....1.9~ ..... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .....".A."...~:Ls~; .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~g~ ................................................. 13. Will lot be regraded ....~.e,~ ................ Will excess fill be removed from premises: ( ) Yes (3[) No 14. Name of Owner of premises ~.O. Se.p~..~..~T. Da~3.~:~e...(~;[.¢O~kddress ..... ~1~1~ ............... Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No. ...................... Name of Contractor ...... .S.~.e. ............................................. 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 whether interior or corner lot. See filed plans STATE OF NEW_YOJ~K~_ [ ¢ c COUNTY OF ....~.~.~...o....J~.. ............ ~-~ .......................... .~D~,,...(~.I,JtD.JI3~I~ ......................................... being duly sworn, deposes and says that he is the applicon! (Nome of individual signing controcf) above named. ~ He is the ...................................... ~)le~e~ .............................................................................................................................. . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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. Swam to before me this ..; .......... L..'I;Z.. dayof .... ._. ........... .,~e~ ................. , 19.~-.LF... j/ /// /~/'~ ~/'~. . ....... ....... ........... ............................ Notary~:~_~_,~,Z~,.e.e.~/~Public, .~- .JJ ~ (,/ (Signature of applicant) MURIEL BRUS~ &61°2 ~-~UAI~,AblTE ,F-J~ TO 't-NI~ 12,S. L~F E ,fl TLE fl,~S.,~., ~ TO_YL~.'- -' I I TON OR START FRAMING 2. BEFORE COVERING PIPEI~INE 3. FINAl. WHEN JOB COMPLETED /, '¸I I t, 1 3 k4 I