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HomeMy WebLinkAbout7395-zTOWN OF SOUTHOLD BUIIJHNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z~0.1 ....... Date ............... J'Ulm..6 ...... , 19. ~ THIS CERTIFIES that the building located at . lt/$.. ~err~..l~l~ ......... Street Map No. ~ ........ Block No...~ .... Lot No.. ~ .... $O~tl~old,..1~][, ...... conforms substantially~e A~p(~lic~on for Building Permit heretofore filed in this office dated ......... M~I'. ~ ...... , 19.~3. pursuant to which Building Permit No.638~... dated ..... }~.1'.. ~ ........... _T,,~.~F 10 1:~-~?3'n,r~. ., 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 . .1~'.:[..~..re...~.e...f..~.. !~ .dV01.!:L~g.&..~.ar&g~ ............................ The certificate is issued to ...llOhel*~;. l~®l' ..... 0~l' ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval M~. 3 ... ~[ 9~ ..................... UNDERWRITERS CERTIFICATE No. ~.3~1. .8.1 ..... .Al~r.i!...~...~9~. ............. HOUSE NUMBER ...... 3~ .... Street ... T~l'y · .L~ ......... 8~t;l~e~.d ....... Building Inspector FORM NO. · TOWN OF SOUTHOLD BUILBING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . ...8./$..T.e.r. ry..L.~I~s ........ Street Map No.:~ .......... Block No.. X~ ...... Lot No, l~, ...~Mlthol~..],Y, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................ ~.. ,~19 .~.~. pursuant to which Building Pemit No...6~8~-Z. dated I~a~, ~ 19 .?~.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ~r$.~...te.. o~. f~.,.t. 1. ~...~.e~ .LI...ins .&. ~a.~a. g.e ............................. The certificate is issued to . .RO.be..1'~ .D.~ ...... . .(~..e.~' ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.~.. 3...19~... b~..I~,..V.i,~14k ..... UNDERWRITERS CERTIFICATE No..N.~.~.$.8.1 .... .~P.F...~....~9.~. ................ HOUSE NUMBER .... J~ ...... Street..T.e.ry~...L~ ....... 8911t~ol,g[ ........... FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ('I'HIS PERMIT MUST BE KEPT ON TH.E PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7395 Z Permission is hereby granted to: ........... ~.e.~.~...~. ................................................. ....................... ~o,, ~1~3~t. ..................................... ~o ~.~...~.~...~.*....~..~.?..~½.~ ................ .¢.,~..~.oz~..~.e~,.~...63.e~...) .......... at premises located at ..jj/.~..~.jj~..:j~,....~....e~...e.. ........................................................................................ ......................................................... ~.~t~9,1,~, ...... L~.,.~.... ................................................................... pursuant to application dated ................................ .~....U~..~'. ....... .1..O...., 19.,...~..., and approved by the Building Inspector. t Fee $.8~e.~ ........... SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. ;- t",_ I APPLIC&I ION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEH 2. Property location .~ z<,.~,~- ~- 7. Lot No. 8. Private well Village ,rD~,~,,~ Township_./,,:-~,?c~ 9. Public water 4. Lot size: Width /,~- feet Length ,~ feet (Enter on center plot 10. S~wa~e Dispos ~'?~stem: A. ~0?'gallon ~eptic tank: B. ~e~Aching pools: Number_ below) Precast ~"Equivalent Block ,~Precast~g_2cBlock Special Street The be in accordance with ards thereto~f' Date If private well ±iii in blanks below: Tank capacity/? Pump G,/j.M.~,, .-- Tota~ well' dept De~th to G.W. Amount of water well Gals. Test Hole Data Fee~ 0 2 6 8 10 12 14 18 undersigned CERTIFIES: the Suffolk County Department of Health's current "Construction of authorized installations will stand- Signed__ Owner or'Builder · FDR HEALTH DEPARTMENT ~SE ONLY. Based on the information presented ~ the~O 'Health Department, that an adequate and satisfactory System ca~l~ be installed on thSs plot. ':~ Date 'Signed -- herewith, it /72 Sewage (Building inspector) ~' ' ~ ~ ~ ~ ~ Dote ................................................ , .............. a. This a~li~tion must ~ completely filled in by ~r~ in ink and submi~ed in tripli~te to the Building Ins~ctor, ~ 3 sets of ptanl, accurate plot plan to scale. Fee according to schedule. b. Plot plin showing location of lot and of buildings on premises, relationship to adjoining premises or public streetS or areas, and( giving a detailed description of layout of property must be drawn on diagram which is pert of this application. c. The wort< covered by this application may not be commenced before issuance of Building Permit. d. Upon apprOVal of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit,shall be kept 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 Occupancy It~all have granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone ' Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or fqr removal or demolition, as herein described. The applicant agrees to comply with all.abplicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors On Ixemises and in buildings for necessary inspections. (Signature Of applicant, Or name, if a corporation) (Address of applicant) // State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or builder. o~,~u ~<~- ~ ~ ..~..~.....~.~.. ~....?...~...~..~,e ~ .............................................................. Name of owner of premises .....~...~...~...~..../:T........~..../..~.....~:~... .................................................................................................... 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 L~cense No ................................................... /~/,~ ~t ~-~ · a,~f 1. Location of land on which proposed work will be done. Map No..~..z..z..:..~......~..~....~....r..'...~.. ......... Lot No ........ ~. .............. Strcetand~,,..~.~. ~"'~,¢ ~ Y ~/,,l- ~ ~ f , ~ r ~,~'~ a.. .... .~..~.: Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ '~ ~ b. Intended use and occupancy ..... ~'~..~....................~...~...'~../~... · ~.. ~...(~....~.~....../' ./...~.~!.,::-. .... ~ ~ ......... : ........ ~ ; .................... Repair ..... Removal .................. Demolition ........................ Other Work .................................... ...... ..................... (Description) 4. Estimated Cost ............................................... Fee /.?.. ...... ..~...!.0..!: ................................................................... (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 occuoancy, specify nature and extent of each Wpe of usa ..................................... 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 ....... ~...~. ............... Depth ....... ~. ....................... ,~,x~ / . Number of Stories Height ...................................................................................................................................... 9. Size of lot: Front ......... ~...~..~. .................... Rear .......... ./..~..?. ......................... Depth ........ ~'.~.~- ................................ 10. Date of Purchasa..~?..x.,l<'. .......... ~.~..~..~,.,.. Name of Former Owner ~...~.~.' ...................................................... 11. Zone or use district in which premisas are situated ..................................................................................................... 12. Does proposad construction violate any zoning law, ordinance or regulation: ............ .~..R .......................................... O, 13. Will lot be re~aded .... .~... .................... Will excess fill be removed from premisas: [ ] Yes [~[* No 14. Name of Owner of premisas ~~~c~z~~~.~x~~=~fZ ....... (Address) (Phone No.) Name of Architect ......... ..~.../.c../.~........~..~..~.,-~.~...~..-... ....................................................................................................... (Address) (Phone No.) Name of Contractor ...... .~,..z~...~'....,~..~ .......... ~.../..../~ .~$z~...~..~.......~..~.=.~...~.. ...... ~...~,~_.~.P..~....~........~....~..vM~.~. ......... (Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposad, and indicate all sat-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 ......... ~.~.~..{~ ................... ) ............. ~..?./~..~'...~....,~].. ........ .~...~..~ ............................................ being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ...,..~..,.t~....~.~..~......~........~...~,..~._.~....~...c.....~...~ ..................................................................................................................................... (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 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 thRr~l~h. .otar .......... c ;). ........ : ......................... ii ~cPF T'- THE NEW YORK BOARD~OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY dp 85 JOHN STREET. NEW YORK. NEW YORK 10038 ,,.,. Ap,.,,~a,,o. No.o.~,,e N 335~8~ TH,S CERT,.~r~9' 1977 85~831 Robert Diet, Terry Lane, off Hobart Rd.. Southold, L. I;~ ~.....~;..a.. April 25, 1977 andyoundtobeincompli.nceu'i,h~herequireme.lsoythlsBoard. OUTLETS ECEPTACLES ¥^.o. DRYERS FURNACE MOTORS FUTURE AP~t. IANCE FEEDERS RANGES : SPECIAl. REC'PT COOKING DECKS OVENS ~ DISHWASHERS TIME CLOCKS BELLs ~UNIT HEATERS MULTI-OUTLETsYsTEMS A~T k~p$ TRAN NO. OF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT NO. O~ S E R V I METE! ,.e'~w ,..'~v'3~,3w ~.e~,w ~c~.co~ .o.c~ H'-LEO 1 150 C B x '1/oi Panelboard/$: 1-6cir." t25amps. C E OF HI.LEG 1 ' 1/6) Robert Diet 41 Manta Ct. 0akdale, N.Y. 11769 This certificate must not be aStered in any manner; return to the office of the Board if incorrect Insoec?ors may be -I Bt.laB W~L.L. J L~V~L. 5TAI~ DST/~I L_. ~I~5c~JNC~LJN IT ~ NO. 4001-A Home SiDiNG P,~,TT'~ ~..N ~ ~0. 4001'A ~ ,,. local ~alion, may require minor changm. V~iFy dimensions on job. I I f i .__ I J- J F ---4 ~ Home. & Gerdeui,~ ~ ~[a~ ~s ~ pmpar~ lo meet top p~ , , hal ~a~ and pmctic~, Ho~ ~ ~ 5 ~c~[ ~atl~J may ~uire minor ch~--' verery dimensions on jo~; . -"~-" ~ ~ B~.,-J.-j.,~_~ HOMES FOR AIJ. AMERIC~ ~ ~TO. 4001-A BE~TER HOMES. F(JR .,~TJ, 'AMERICA I~lonal .~nd~ and pmctic~. HOwever,II ~1~. 6 Veri~ dimensions on lo~.