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Home My WebLink About7583-zFOurn' NO. & TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office $outhold, lq. Y. Certificate Of Occupancy No..Z6~'39 ..... Date ............. l~a~'. 2 ......... , 19.~. THIS CERTIFIES that the building located at . .l,~g .(~r.e.e.k..D.~.:~. ....... Street Map No..~.e..n~..e.e.o.t..t. ~Iock No ........... Lot No..~ ..... ~01zt~Ql~,..N. ,X.. ......... conforms substantially to the Application for Building Permit heretofore filed in thi.~ office dated ........... Se~t.. ~0., 197~.. pursuant to which Building Permit No. ?~'~.. dated ......... QTS...9 ....... , 19 .~.., was issued, and conforms to an of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.r.~. y.a.t.e.. 9.n.e...f.a~..l.l.y..cl.~.q .1.~..~i~ The certificate is issued to ~c~u~. & .~hg~fl.. ~&~, .... .0~'1~ ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....~. 2.197~...lpy..t~..V~,ll& ...... UNDERWRITERS CERTIFICATE No.. N..2~t~7~ .... .bJs~'...~9...¶.97~. ............ HOUSE NUMBER ....... I~.... Street ...~,~ .~3'.e.e.]~..D~'.~,V~. .................... 1~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H~ Y. BI/II. DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7583 Z Permission is hereby granted to: pursuent to epplication dated 19.../.~., end opproved by the Building Inspector. Building Inspector INS ~ KUCTIONS a. This application must ~ ~ly fill~ in ~ ~w~ter ~ in i~ o~ ~i~ in tripl~e ~ ~ Bui~i~ In~, w~ 3 ~ ~ ~, ~u~,~ ~ ~ ~ ~e. F~ ~ to ~. b. Pto~ ~l~ ~i~l~i~ o~.lot ~n~ of bui~i~ ~ premi~,.mlatio~ip t~ ~joini~ premiss or ~lic st~ o~ o~s, ~a gw~ a ~ail~ ~Hph~ ot I~ ~ mu~ ~ drown ~ t~ ~ ~ich is ~ of ~is ~licat~. c. ~e ~ ~r~ ~ ~b ~l~i~ ~ ~ ~ ~ ~fom i~ua~e of ~ildi~ Permit. d..U~al of ~ls ~licati~, ~e Buildi~ I~r will i~ a Buildi~ Pe~it to the ~licont. Such ~rmit ·all ~ ~ ~ ~i~ ~il~le ~r i~ ~ ~ ~. e. No ~ildi~ ~all ~ ~c~i~ or u~ in ~ole or in ~ ~r any pu~e ~r until a Ce~ificate shall h~e ~n gmnt~ ~ ~e Buildi~ I~or. - APPLI~TION IS HEREBY ~DE ~ ~e Buildi~ ~t ~r ~e i,uance of a Bui~i~ Pe~it pu~t ~ ~e~ ~fldj~ Z~ ~i~e ~ t~ T~ of ~o~, ~lk C~, N~ York, a~ ~er ~le ~, O~ ~u,m,~s, ~or ~ c~t~im ~f ~ildi~ ~lti~s or a~temt,~s, or ~or m~l or ~l~, ~ ~;~. _.e ~p~,.~p~ ~ ~ly w,~.all a~,~le.~, ~i~m~, ~ild,~ ~, ~i~ c~, a~ ~, ~m~ am~nz~ m~ ~ p~l~ ~ i~ ~IBI~ ~ ~ J~l~. ...... .... Oo Its= IAI Bust Im4..m, I. L (Address of applicant) 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 corl~-officer) Builder's Lice~e" ~~:':~ ~0 ........... ,. ~;;-.; ........... Plumber's Lice,,.~ No.. .................... ~ ........ Electrician's LicenSe No...~...~.....~7° Other Trade s License No ............. , ................................. Loca~'ion of land on w~ich p ~rc~. work will be ~one..M_ap N.o.: u ...................................... 'Lot No ......................... Street and Number ....................................................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupanCY of proposed construction: '". Exisiting use and occupancy ..t!I~....(~....,.~...~..). ...................................................................................... b. Intended use and occupancy.. ....................................................................................... . . . ....... ..... . .. .... ............ .. . · 3~ '3. Nature of work (check which applicable): New Building. ................. Addition .................. Alteratio~-'~.....::. ........ Repair .................. Removal .................. Demolition .................. Other Work ................................................ _ ~/ (Description) .... (to be paid on filing this application) 5. tf dwelling, number of dwelling units ........ ~ ................. Number of dwelling units on each floor If garage, number of cars ~ ~ ~ ~ ~111,~ ~ ~ IIIl~l~I~, 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 ................................ entire ,,-~, ~,~=truction: Front /l~e~ S~I~J Rear ....~...~.~.. ~.... Depth ~ ~ 8. Dimensions of ~ :~1~ i~r,-um~,r .... ~L~ II~l~,~ _____ .._..~. .............. Height ....................,~e~ o~ 3~orles ..................................................................................................... ~e~i~ 9. Size of at front ........................................................ Kear .......................................... ~xn&m~-.~.... ...................... 1 I. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....l~... ................................................ 13..Wjill lot be reg[aded ....1~... .............. r ...... Will excess fill be ~emoved __. :'. &. '"Nm oArChtect~--r-':~'a''''eo~'"~: ,~P'''''''~'~"'~ ........ ...... rl ...... i L~~~.~ , , PLOT DIAGRAM . Locote ~learly and distinctly all buildings, whether existing or proposed, and indicate all set-J:xlck dimensions from property lines. Give streetond block number or description according to deed, and show street names ofld indicate whether interior or corner lot, Lot 'II Lo+ STATE OF NEW~.I__~ S.S .............................................. ;; ............................................... being duly sworn, deposes and soys that he is the applicon! (Name of individual signing contract~ above named. He is the ....................................... ~ ............................................................................................................ (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 st~tem&nts contained in this application are true to the best of his knowledge and belief; and that the work wiU be performed in the manner set forth in the application filed therewith. Swam to before me this ~ / ~ ,' ~ - (SignatuCe'of applicant) (/ JUDITH T, BOKEN~ N~tary Pu~Jic, Slate o{ btere' Yol~ THE NEW YORK BOARD Of FIRE UNDERWRITERS ~---ak BUREAU OF ELECTRICITY 88 JOHN STREET, NEW YORK, NEW YORK 10038 t)°'~-~a~ch 19, 1975 .'tppt~c,,t~on~Vo.o,,f;le 776179 THIS CE~IFIESTHAT N 214 in th, follmvlng tocatlon; ~ Basement ~ $xomined on March 17, 19 7 5 and found to be in compliance with the requirements of this Board. 15 29 17 15 DRYERS FURNACE SERVICE DISCONNECT OTHER APPARATUS: ~Un~.l; heater/s: [- 4.5k~ E[ec.~oom head;er/s: 2-2.0kw, APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS S E- R V NO. OF CC. COND. A. W, O. C DIMMERS SYSTEMS NO. O~: FEE r i E NO. OF HI-LEG 1 ~[I/0 3-1.75kw, 2-1.Skw, 1-1.0kw, 1-.75kw ~.B. Ruland, ~ ~,s __ ~"-~ ~ Jn any monnert return fo the office of the Board if incorrect. Inspectors may~';e [denf~ed by the~nti:Js~ ,~i 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: 1. Final survey of property with accurate location of all buildings, property lines, streets, end 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 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 $5.00 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 .............. Location Of Property ................................. ~ ........ ~ ...... . ......................... : ......... ~../.~.; .......... :"~;':'~':")'"~"~':"" Owner Or Owners Of Property ..~=.c~...C~. ~...~..6....~...,...(..A...q..(.~. ...... .C,...~..~.?..x~.!.....~.~.,.......[..~..i.;.?l.c~-..!.1 ............. Subdivision ?.! .~..~.~..0..~-..(~:.o..~..~......~.~'.).~..~..~.. ................ Lot No..~.-. ....... Block No ............. House No..~.:.~. Permit lxl~r/~'~ ~iC'~ ,O~ Date Of Permit Lc.~. .~ ..~...Applicant .C.1.'.!..~3.~.~£)......~...., ..... Health Dept. Approval ..... ..~...,?.,..~ ................. Labor Dept. Approval ...................... Underwriters Approval ,.~.....~...~....L[..?..,..~..~.. ................ Planning Board Approval ...........~....!,..~... .................. Request For Temporary Certificate ........................................ Final Certificate ......~. ........................... Fee Submitted $ '-~ ~ Construction on above described building and permit meets all applicable codes and regulations. Applicant ,, .~.:.CZ:)...~,f, .<~. :~, £Z,<, ,,,.~. ,,,: ,,,,,~ ~,.¢~ ,~,~.. ........... Sworn to before me this ................ day of ....... NotQry Public ....... ~~~. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant~ J' B~I Phone ~16-~??-2~0 5. Subdiv. A~dress~ , · ¥,~ 6. Section~t~ 2. Property_Location ~m~ ~ D~'~e (~s'~ 2/10 o~ · tulle 8. Private Well Vil 1 age ~ Township $~ 3. Public Water 4. Lot size: WidthX)) feet Length~ feet 10. Sewage Disposal System: A. 900-gallon septic tank: Precast Equivalent Block B. Leaching pools: Number of pools Precast__Block Special__ 9. Public WaterTM Distance to main 1~ (For Health Services Dept. Use) I-ON 11. If private well, fill in, the fol- lowing !anks: i-0~ _ NO, A. Tank capac~y___7~gallons B. Pump G.P.M.~ / C. Total well E. Amount ofpter in ~m The undersigned ~ERTIFIES: "Con~sr.~¢tion of authorized installations will be in accordance with the Suffol~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. Date ~eX~t~emb~x' 27, 1~? Signed ' . ================================ FOR THE DEPARTMENT OF HEALTH SERV-ICES~ 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 /~y/~/~/y/~~ Rev.S-15 4/1/73 I SP£CTiOH IEIIIIIIlB MAYHR JOSEPH 1.. TOWNSENU, JR TRUSTEES HENRY CARl OZZI SAMUEL K^TZ ~reo¢ort, Suffolk Count% % Y. October 8, 1974 To Whom It May Concern: The public water supply of the Village of Greenport, Greenport, New York has a 6" water main installed through Yennecott Park, Southold. Mr. Edmund Bigall, who plans to build a home on Long Creek Drive, Southold, may be connected to our water supply upon proper application to this office. If I may be of further service, please contact me. JIM:ur Very truly yours, James I. Monsell Superintendent of Public Utilities E~ IG/~L L inspected by t?:J;~ d~i,~:~:%~e:,~; a;d found Chief of General Enginoert~¢ APPROVED A,8 I~IOTED NOTIFY BIJILDIN(~ DEPARTMENT ~T f