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Home My WebLink About7624-zI~O~,M NO. 4, TOWN OF SOUTHOLD BI~.nING DEPARTMENT Town Clerk's O~iee $outhold, N. Y. Certifi te Of Occupancy No. Z~38t ...... Date ............. b~&l' ..... 2~.-.., 19..~ THIS CERTIFIES that the buildin~ located at . ~oa~. Cleeek. ~Dr~.v~ ....... Street Map No.~[enn~cot$, .P~lock No ........... Lot No.. ~. .... /lottthald... 21 ,Y., ....... conforms substantia]/y to the Application for Building Permit heretofore fried in thle office dated ..............i/o~. · ?., 19 .Tt~. pursuant to which Bui]dlng Pernfit No..~.62~Z. dated ............Ney .... 7"', 19'7b~', was issued, and conforms to aU of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~sued is..Pr~,v, ete..one, f. ul~..tw.e, ll~nl ...................................... The certificate is issued to .... David. Hew~; .' ...... 0~ne~. ........................ (owne~, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .l/al,... 11~...1 UNDERWRITERS CERTIFICATE No.]/.211~7.~6.. Mar.. 20. ~7.~ .................. HOUSE NUMBER.. 21,~ ........ Street ... Lo,~l. Ck .D~ve ....................... Building I~spe~r TOWN OF SOUTHOLD ~//.L-~.~ ~ _ --~r, /. ~. ~. ~ BUILDING DEPARTMENT './--~/? -~///-/./-.c~./.d~,,~. ~ TOWN C~RK'S omc~ ~'~/~..<-_..~'.;. ~_ ~ ...~. ~ . -~', ................... -~ ........... , ;~..~> ,'~p~i¢~hon ~o..~....~.;.:....~ ............... .~ ,pro .............. !. ....... i./.. ............ , Permit ............................. ........... ..................__ ............................... ~G'&~-~ ~ - ~e ................................. ~ .............. ,19 ............ Ins~or, wi~h 3 ~ Q~ ~lQ~s, Q~u~e p~ plQn ~o ~ale. Pee G~o~ing ~ 5~h~u~e. ~he wor~ ~e~ed ~y ~i5 Qp~li~Qflo~ ~Qy ~ ~e ~G~e~ be~e ~SS~Q~ of ~i~ing Per~i~. Upon o~ this Qpp[icQtion, ~e Building Ins~ctor will i~ue ~ Building Permit to the opplicent. Such permit shell ~ kept on the premis~ ~=il=ble for insp~tion through~t the work. e. No building shell be ~cupi~ or u~d in whole or in po~ for =ny pu~ose whoever until = Ce~ificote of ~cupQncy shell h=ve ~en gmnt~ by the Building Inspector. APPLI~TION IS HERE~Y ~DE to the Building Department for the ssu=nce of ~ Building Permit pumu=nt to the Building Z~e O~in=nce at the Town of ~utho d, Suffolk County, New York, end other =pplic=ble ~, O~ln=nces or Regul=tions, for the constru~ion of buildings, ndditions or =lter=tions, or for mmowl or demoliti~, os heroin de,rind. The opplicont =grees to comply with ~11 =ppliceble I=ws, ordin=nces, building c~e, h~si~ C~e, ~ ~l=ti~, ~ to odmit =uthorized inspectom on premiss end in buildin~ ~or n~es~ i~tions. Leo Kwasneski (Signature of applicant, or name, if a corporation) SouthoZd ,/)~' 7I (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ~.~.e.~. ............................................................................................................. Name of owner of premises ....~)~,~'.[.d..~.~,.~.l~ ................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. R. McCarvi~l Electrician's License No. D. Tuthill Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. /V~op No.: ~.~.(~..o..t~.~...?.~..~. ......... Lot No....?. .................. Street and Number ..~o.t'~..~.~..~..~..~.~. .............. ~.Q~J.~..Q~i~, ......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ....~Ca.D..~. .............................................................................................................. b. Intended use and occupancy ...... ..o.~..~....~...~.~..~..~.~.....~..¥..e..~...~.~..~.~ ............................................................................ 3: Nature of work (check which applicable): New Building.....~J~; ....... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ............... :~ .............................. . .... (Description) 2 O0 + 4. Estimated Cost ................ $....1.~ ................................ Fee ...~.0.A.~.(~ ............................................................. ; ............. ~1~ (to be paid on filing this application) ol3.e i ..... , ...................... 5. If dwelling, number of dwelling units ............................ Number of dwell ng units on each floor If garage, number of cars ............. .o..~..e. .......................................................................................................................... 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 .......... ~.~. ..................... Rear .......... ..6..6.. ............ Depth ....2..6. ................. Height .................... Number of Stories ....~..~..~ ............................................................................................................ Size of lot: Front ........................................................ Rear .......................................... Depth ................................ Date of Purchase ........................................................ Name of Former Owner ....................................................... Zone or use district in which premises are situated ...n.A.~...~..~.S...~. ............................................................................... Does proposed construction violate any zoning Iow, ordinance or regulation: ...,13~ ................................................ Will lot be regraded ........ ~JJ$~ ............ Will excess fill be removed from premises: ( ) Yes (:~) No Name of Owner of premises .....~..&..¥.~.~.....~...e.~.~ ................... Address ................................ Phone No. ...................... Name of ArChitect .............................................................. Address ................................ Phone No ....................... Name of Contractor T.. Kg/&s.~.es.~.,i _,, Southolcl. .......................................................... ~ooress ................................ 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. lo~ 11. 12~ 13. 14. STATE OF NEW.;YQRI(,. ~ [ c ¢ COUNTY Of ...,~...,t~,,.,z.9,.,J-~,, ............ ~'"'" o K e$.ki be n ...................... ~..~. ....... .~.{~A~ .................................................... g duly sworn, deposes and soys that he is the applicam (Name of individual signing contract) above named. Builder He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fife this application; that all statements contained in this applicotion are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...................... .................. .,...o.,.. .................. Notary Publi~ ............ J~.~.~...o...~;. ~,..~,,~ ........ ,~ ...... County .... .,,~.....'... ~.../.~,E. ~~..7....,.': ..................................... - ~'~/~' ~ ~_ . (Signature o'r appffcant) NMII~J~.~ of New Yom hi, .--'~1~11~11~ ffo~k County,,1 C'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS -~.,~ BUREAU OF ELECTF~tC]TY rJ5JOHN STREET, NEW YORK, NEW YORK 10038 ,,,.; !arch 20, ~7~ ,,,,,,,.,.~,~....,,~ 777~7~ N214776 THIS CEETIFIES THAT '~ ' ' ~;/S ,ong Creek Dr., .~utnlll Rd. & Laurel Ave., David W. H~w~tt, o~thold ~ _~. I. ~..~x..,~.,.do. March 17, 1975 OUTLETS CEPTACLESrL- F"&~O~d;NT- F~U~.E~C~.~ 19 ~ 36 22 ~ 19 ~ and footed to be in cornpllance with the req~drerr~ents tff this Board RANGES~ . ~COOKINGDECK$ OVENS DISHWASHEIIS EXHAUST F DRYERS ~ FURNACE MOTORS J FUTURE APPtlANCE FEEDERS I DIMMEIIS 1 j l/O *Water Heater/s: 1-4.5kw Elec. Room Heater/s: 1-2.5kw~ 1-.75kw, 1-Post Light 1-2.0kw, 1-1.Skw, 3-.Skw 1-1.5kw, 2-1.25kw, 1-t.0kw, Donald E. Tuthlll 3020 Bolsseau Ave. Southold, N.Y. 11971 rhis certificate must not be altered in any manner; return to the office of the Board if incorrect, Insmectors may be identified by SUFFOLK COUNTY DEPARTMENT OF HEALTH Hea~l th Department Reference Nu~er APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applj.~a,t~ 0 /; ~' ~F~'4r~k~J'W~ .Pho~ '/%J"J-( ~ 5. Subdiv. Addr~s ~, ~d,~jsN j~< .' ~, O~//~JE? 6. Section' ~ 2. ~Property Locat~o~ ~ m~ {'~ ~ ~ P ~ ~ E 7. Lot Nu~er y~v~ ~T F ~, , ' 8. Private Well Village _~ ~t+~ & ~ TownshipJ~ ~7~ D g. Public Water 3. Public Water Company Na~ G'~ ~T WmT~ ~e~ DiStance to rain 4.~,,Lot size: Width ,/~ feet Length I ~ ~ feet - ' 10. Sewage Disposal System: ' A. ~ga ilon.~el~tahk:~ ~, ~Precast ~Equivalent Block B. Leaching pools: Number of pools {For ?ealth Dept. Use) 11. If private well, fill in the following blanks: / ~ t~~lO ~. Tank~apacl ns C. To~ well depth ', } ~_~ ', ' ~ ";~' ' "" ~ ~ ~'~ ':' thoffized ~stallatio~s will b~ ih acco~ance The undersigned CERTIFIES: ,"~n~ti~ with the Suffolk County Dep~rt~nt of Health's curr~t standards thereto. This application will be valid for one year f~m the ~ate of approval~ indicted bel~ and ~y be ~n~ed if a cu~ent local Building Depar~nt ~e~it 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 plot. APPROVAL DATE~ SIGNED s-1 EXCAVAtiON DISP ON REi]UaEI Rev. 4/1/73 A ,poRr..Ft-'O~£N RAr:-f~R? ? ' 6 IS',~. O0 - [ .... d,'e¢:,kort ,',,/. Y. K ITCH'~.~ PORC'H: oPEN RAFTEK$' ' LIVING ROOP~, GARA,G E :/ ..2-A31 'i