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Home My WebLink About7555-zF~RM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupnncy No. Z6.~.~.3 ...... Date ............ O*.~ ...... ~ ..... , 19.7.~. THIS CERTIFIES that the building located at ...... D$1~ar. &..Jos.e.~h. ~.~ Street Map No.L~tlrel .Cry. ~otck No ........... Lot No, . 1 ~.... La.urel.,..t~,y., ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Sept...2(~ 19..7.~ pursuant to which Building Pemit No...~.~[~Z. dated .......... 3.el~.~. 2~. .... , 19.7.l[.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.r..~.v.a.t.e...o.b.e...f.~.~.~..ly~ .d.~.l.1..:~.g ...................................... The certificate is issued to I~ll~md..ttome.s .In~.. to. lf~ilella .Deo~ez .... 0~'nz~.s... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval D.e.~. 2 .~ .... I~Y..t~,..V. lll~ ....... UNDERWRITERS CERTIFICATE No..N.J.9. ~.~. 7.0. ...... 8. e.p.t....2.0...~. ~?.~. ............ HOUSE NUMBER . .. 206~. ~IIEIC~ ..... Ilelnm,t~..DI'£~e ..................... : ~0 Joseph I~t ........... ]~il'(~i~ 'g ' ~t~'/' ......... FO~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOI.D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT Or4 THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7555 Z Permission is hereby granted to: ;I;irs,la~..ti. omes...I~e.....2; .................................... ......... ~la.ttStu~k ................................................. to ..hu~cl..~e...ona..f~...~&~Lu~ ................................................................................... at premises located at ...~...~..~.....'l.~.......~..~.~..g~:.~.~.y....E,.~,~:~l,~.~,~ .................................................. ............................................... ~.~.~..~.~.$.~.. ~ ..~, ,o.s.~. ~...s...t. ......... ..~...~,z. ............................... pursuant to application dated ................... ~.~lp.~...,.~.~ ............. ~..., 19..'~'~', and approved by the Building Inspector. Fee $.~.2.~.0~. ........... FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Clerks Office Snu'~hold, 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 disposaI--(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-conforrning uses, or baildings 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 $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date December 2, 1974 New Building .........~.... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property D.e~r..~$.~7~..~.1;....~.~.'~...~..s..'e.p`h...L.~.a:..~.~.~.~.~`.~.~.~ ................................................ Owner Or Owners Of Property INLAND HalveS, ]Z'~Co (K&nella Dearies) Subdivision .... L~t~,l::f~,l-...~.91,t.~.r..~.....~.~.t...a..~...~..s. ....... Lot No..]:..5. ........ Block No ............. House No ............. Permit No .....7..55~Z.... Date Of Permit ..9./.~..~./...7..4...Applicant ...1.~..D...~.O....~...S..~.....I..N..C.... ...................... Health Dept. Approval .... ].~/.2/.74 ........................ Labor Dept. Approval ................................................ Underwriters Approval ...... .]:. .1. ../. .~.. .O. ,/..7. ~ ..................... Planning Board Approval ........................................ Request For Temporary Certificate ....... n.o. ............................ Final Certificate ~e$ Fee Submitted $ ........5.,.Q.Q .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ....I~L~,I[~.~....~..Q~$. ~ ......~...C...,..... K · W · Thither Sworn to before me this~, /-/ , (stamp or seal) THE NEW YORK BOARD OF FIRE, UNDERWRITERS &W BUREAU OF ELECTRICITY~ ~ 85 JOHN STREET, NEW YORK, NEW.YORK i0038" ~,,t~ November 20~197~ · N 195170 THIS CE~IFIES THAT 16 DRYERS AMT. K.W. FURNACE MOTORS H.P. GAS H.P. SERVK~ DISCONNECT OTHER ~F~ARATU~. . .o. ~w. 0. $ R~ SYS/~S NO. OF EXHAUST FANS D~RS Motorstl-3/~hp , EFutu~® Appllanoe Feeder$:l-3#8,1-2#l~ .- ~Furnaoes:l-1/Shp,2-1/12hp George Ztmilinghaus~ Park Pl. .... ~~ Patohogue.L.I. 11772 eemaaA ~*x~eea COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE THIS CERTIFIES THAT NEW YORK BOARD OF FIRE. UNDERWRITERS BUREAU OF ELECTRICITY. '' ' ' 85 JOHN STREET, NEW YORK, NEW ¥oRK~1oo38 155431 mdy th~ ~ctr/cM squipment as d~scribed below and introduced b~ the applicant nam4d on th~ abo~ application number in the premises of In' :~!'~4 ,~or:es Tuc, e/aide Delmar Drive, 500' n/o Emma Drive, [] ~.~ Fl. outside Section B~h ~0 =nd foun~J to be'in ~mplia~e with the req~i~ment~ of thb ~. ~ O~NS ~AUST F~ TIME CLOCKS UNIT H~ATIRS DIMMERS S E R V I 1 ~/o cOPY FOR SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 5. Subdiv. I~e~ 6. Section 7. Lot Number ~ ~. Private Well Yw 9. Public Water Distance to main' l. Applicant ~ ~, ~. Phone~98-~90 Address P.o, ~ 117e t4~ttlt~, ~ 119~ 2. Property Location Vill~~ ' - Townshi~ 3. Public Water Company Na~ 4. Lot size: Width 125 feet Length 1~ feet 10. Sewage Disposal System: (For Health Dept. Use) Ae Precast X Equivalent B. Leaching pools: Number of pools Precast X Block 900-gallon septic tank: Block Special ll. If private well, fill in the followj~gg blanks: :~A. Tank capacity 42 gallons , B. P~I~o G.P.M. 5 C. Te~al well depth 90 D. D.~epth to ground water ~0 E. .A~ngunt 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. 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 and Water Supply can be installed on this pl,ot. APPROVAL DATE SIGNED ' / r~' '~/'~' S-15 Rev. 4/1/73 ~, N. Y. .................................................................................... ...... . , ............... ,19.~..~ IN~RU~I~S ~ a. ~is a~llc~i~ m~ ~ ~ple~ly fill~ in ~ ~writer or in i~ ~ s~i~ in tripl~ ~ ~ Bui~i~ In~or, wi~ 3 ~ of ~, ~ ~ ~an ~ ~. F~ a~i~ to ~u~. b. PI~ plan ~ I~ionof lat a~ of buildi~s ~ premix, m afion~ip to ~jo ni~ ~i~s ~ ~1~ ~z areas, and givi~ a d~ail~ ~riPti~ of I~ ofp~ must ~ dm~ ~ t~ diagram ~h is ~ of ~ ~hcati~. c. ~e ~ c~ ~ ~ ~lication m~ ~ ~ commenc~ before issuance of Buildi~ P~ff d. U~ appmv~ of ' ' ' ' · is ~li~, ~e ~dd~ I~tor will i~ a Buildi~' Permit ~ ~e ~l~ant. S~h permit shall ~ k~t on the premi~ ~ilable ~r.in~i~ ~ ~ ~rk. e. No buildi~ shall be ~cupi~ or u~ in ~ole or in ~ for any pu~ose whm~r until a ~ific~ of ~cu~ shall h~e ~en gmnt~ ~ the Buildi~ In~or. APPLI~TI~ IS HERE~Y ~DE to the Buildi~ ~ment ~r ~e iss~nce of a Bui~i~ Pe~it pu~m ~ the ~~~t~ ~ ~'~ ~lk ~g~, New York, and ~ec ~lic~le ~, 0~ or ~e a~-Iic~t ~ *~ ~---,- ...,~ -- -~[-~ or~rerm,~% ~[,for m~l o~ ~itl~, ~ ~ln ~. admit~ri~'~,~x ~=~,_,_~],~,~, ~m, na~,, ~,?ng c~, n~ c~, a~ ~mi~, ~ m --"'~ ~ "~,u~a ~ FleHIl~ g~a I~ fil~l~ mr n~e~w I~Ktl~. (Signature of appl Cant, or name, if a corporation) '" P,.Q.~ BOX 117, Matt/tuck NY 11 2 ...................................................... ~ .................... ~.s.: ............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber Or builder. General Contractor Name of owner of premises .....~J~..~J~.~...~I~.~.R .................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No..SZT....P. .............. :. ...... 'i .......... Electrician's License No....2.7..':.']....$. .............................. Other Trade's License No ............................................... o La .q.1 t s . 15 Location of land an which propo~ work will be done. Map N .... ~ .......~...I~,~...~....~. ...... Lot No ......................... Street and Number .... .~.~;ltil..~,~..I~.i.~.e..~..J.s~.asph,..~.~l~o...a~.el~...~., ....................... /Vmr~cip~ll~ State existing use and occupancy of premises and intended use and occupancy of preposed construction: a. Exisiting use and occupancy None b. Intended use and occupancy ................ ~ ............................................................................................. 3. Nature of work (check which applicable): New Building ......... X ....... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost .~....4~.l~J~t.e~l~. ................................ Fee .......................................................................................... (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 ..~..I. ........................... Rear .....~.?. ................ Depth ....~.~?. ........ Height ..~I~ ...........Number of Stories .....~ ............................................................................................................... 9. Size of lot: Front ..~ ............................................... Rear ..... ~t..~. ...................... Depth ..~ ...................... 10. Date of Purchase' ..;; .................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....1~1~. ..................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~ ............................................ 13. Will 'lot be regrdded ...~..,~.. ........ ~.....~... Will excess iii be removed from premis~s~ ( ) Ye~ - ~3~.) No 14, Nome of Owner of premises ~..~..~.q ......... Address ....... ~ ....... Phar~ Nome of Architect .............................................................. Address ................................ ~ Na~ ...................... Name of Contractor ...~.~...~ .............. Address ............... · ........ ~ ~ ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and JndJcote oil sat-bock'dimensions frar~ property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, [ ¢ c COUNTY OF '. .................... ~ .......... ' ........................ ~t?~t'~'""-q'":~' ............... ;~.being -duly:sWo~n,,,dep~se, and says th~, he is the applican, (Name of individual signing contract) above named. He is the ................................................................................................................................................................................ (Contractor, agent, corporate ~fficer, 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' ere~true to t.he best of his knowledge and belief; and tha~ 'the work will 'be performed in the manner set forth in theapplic~ation filed therewith. Swam to before me this .~~/ ........................ day of ............................................ , 19 ........ . Notary Public, . ................................................... County ................... (Signature of applicant) Lot 16 · z_. jO$1~PPt UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY 18 A VIOLATION OF SECTION 7209 OF THE N~W yORK STATE ~OLICAT~ON LAW NOTE: · -- MONUMENT S UtiDIVISION MAP FI£ ED IN THE OFFICE OF 1'HE CL~N OF SUFFOLK ¢OUNTY ON dUNE P.~, 19 ?O A SMA P NO. 5486. REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES, INC. ~ Gui ~,~TE F~ '~ I'-' ;AT LAURELso '~WOLO ~ '~Na ~i ,,ow. o, so~r~o~o "~"~'~ ~ ~?Z~~' SHOWN HERE~N ARB FBOM FIELD OBSEBVA~O~ AND/OB FBOM DATA OBTAINED FROM OTHB~ · = MONUM~NF SU~DIVISI~ M~FILKO IN TH~ ~NK ~ 19FOA SMAP N~ .REVISIONS YOUNG & YOUNG OCT. Y~ 19r4 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK oc?.18,19r4 SURVEY FOR: LOTNO 15, '~AUREL ~ONTRY E~ 1 IO~ o" 4 /4,4" t- G,I-O"_