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Home My WebLink About7200-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi[icate O[ Occupancy NoZ59.~,~ ....... Date ............. ~Q,y .... 9 ..... , 19. ~.. THIS CERTIFIES that the building located at . ~;,a~*s. Road ............... Street Map No... 531.5 ..... Block No .... x~ ..... Lot No. [~ .....E&Z.~..l~.r.~.o.n...~ :.Y.o ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~p:rll.. 23.., 19.7.~. pursuant to which Building Permit No.7~l~O~-... dated ......... ~p~il.. 23..., 19 .?~*., 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 ... Private..one. £alni34r. d~ral llllg ..................................... The certificate is issued to . Leo..Go].Xs~ .......... (h~ner ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval J.U~y...2.. ~9~1~.. by. 1~°..¥iX~ ..... UNDERWRITERS CERTIFICATE No...pend.2ng .................................. HOUSE NUMBER ..... ~300 .... Street ... l~tax'~. $1oad~ .......................... .... ......... FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7200 Z Permission is hereby granted to Is~m~..~c~e&..I~...~'C....,l,ee..~lA~m. ....... ........ ~t.tJ.J;~k ................................................. at premises located at ...Z*~.t~..~....~OZiZ~F~.~...lf~4d~ ................................................................. ......................... &ter....'2ead ......... ~, f,..~=~.o~ ....... ,~.~.. .......................................................... pursuant to application dated .................. ~.pFJ~..~-3 .................. , 1~ ...... , and approved by the Building Inspector. g.9 15 ............ Budding Inspector [ . FOF,~ NO. 6 TOWN OF SOUTHOLD Building Department 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 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, 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: 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 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 ..L~o../3o.1.'i.s~ ............................................................................................. Subdivision ........~.~.9,~.~..c..r...e..s...C....~..9..o...d..s. .................. Lot No...8. ......... Block No ............. House No....1..3...0..0.. Permit No....7..~...O..O.....Z.... Date Of Permit ....~../..~...3../..?..~..Applicant ..... ~..~..]:.a..~.c].....~..o...~.?...s....Z...~..c..:....A.../..C.....L...e..o.. Golisz Health Dept. Approval ..... Z/.~/..'7..~ ......................... Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........ ~ .............................. Fee Submitted $ ..... 5.,.O.Q ...................... Construction on above described building and permit meets oil applicable codes and regulations. %D..1. and Homes~ Inc./~ber .K.W. T urbe Applicant .................................. ~~ .......... Sworn to before me this .............. day of. ........................... (stomp or Z Notary Public ..O~ ........... County SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Leo Oolisz Applicant~. Phone Address ~Greenport Property L0cati0nE/S of Stars Road 1256 N/O RT-25 Eas~ Marion Village ~+ M~ ~ Township .~n,,th~la Public Water- Company- Name Lot size: Width :~o3 feet Length 198 feet 5. Subdiv.s°undcr4k~t Woods 6. Section "I 7. Lot Number 8 8, Private Well yes 9. Public Water Distance to main 10. 11. Sewage Disposal System: A. ~gallon septic tank: Precast × Equivalent Block B. Le~ching pools: N~er of pools 1 Precas~k~'Block Special If prf~te well, fill in the fol 1 owing blanks: A, Tan.k..capacity 4.2 .gallons B. Pump G.P.M. 5 C. Total well depth· :1oo D. Depth to ground water 60 E. Amount of water in well (For Health Dept. Use) The undersigned CERTIFIES: "Construction of authorizations 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. Date April 22, 1974 Signed ~ ~--~ ~<Z J~ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 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 ~7/~ ~ SIGNED ~ S-15 Rev. 4/1/73 'rOWN OF sc~rl'HOLD ,.~/. 1., ,~/ _ ,~ ~... ~ , BUILDING DEFA~TMIN'r?/ ~ ,v r~- z~q~/ ~/~ ~ SOUTHOLD, N.Y. /- ...... - - ,- V~ Application No ............................... ), o INSTRUCTIONS~' ~ a..This ..~ol. ication.mu, st be completely ill!ed in by .typewriter or, in ir~ and a~,~itted in triplicate to the Buildlng~ ~sp, e~:~[or,.~- 3 sete OT~lans~ccu~gt? plot.p~an to sca,e. Fee a~-~ording to schedule. ~t. 'Plb~lVn sh~ving I~lffi~l~'~lot anb'~f buildings on prern~S~, teldt~'~tO~c~ining premises or public streets o~ c~c~'~g a deto,led ~l~script,on of layout ofpraperty mu~t be d~e~.~th~d~gl~l~,~[fl~h is Part of this application. c. The-Wo~ covered by this application may not be commenced before issuance of ~uildJng Permit. "8. Utx~*apprOval of this application, the Building Inspector will iss'di; 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 ~cupied or used in whole or in pa rt f~r any purpose whatever until a Certificate of Occupancv~ shall have been 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 Regulati.o. ns, for the construction of buildings, additions or alterations/ o,r .flor ~eval or demol t on, as here n described. The apphcant agrees to comply with all applicable-Jewerem~nances, ~,u;,u;,,a codF,, h~s~ng c---"-o~-~'nd regulations, and to admit authorized inspecfors on premises and in buildings ~ necessary inspections. (Signature of applicant, or name, if ,a: corporation) ................... (Address of applicar~t)/: State whether applicant is owner, lessee, agent, amhifect, engineer, general contractor, electrujciar~, ~f~mber or builder. Name of owner of prem ses ~ ' ' .... ~ ...... ~Z ;~*~Z ..................................................................................... f applicant is a co,~porote, signature of duly out~ '"'rized office'r. ' (Name and e of corporate officer) ,,ne and (~lle --' . Builder's License No ..................................................... Plumber's License No .......... Electrician's License No. .2'7-~ ~,~' Other Trade's License No ............................................... I. Location of land on wh ch amoosed work_w be done Ma~ No' ~.,~./'~ ' - ' ~)' Street and Number .... ~. ~ ' ........ ~...~ ........ Municipality 2. State existing use and occupancy of p}'emises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~..~ .. .................................................................. f 3. Nature of work (check whiclf applicable): New Buiiding .......... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) 4. Estimated Cost .......... .~.~.~.~.....~....~. ........................... Fee ~7Y (to be pa d on filing this al~p ication) 5. If dwelling, number of dwelling units .......... /.. ............... Number of dwelling units on each flOor i...../.. ................... If garage, number of cars ..........~ ........................................................... ................................ ~ ................................. 6. If business, comn~ercial 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 a~terotions or additions: Front · ~ Rebr ' Depth Height Number of Stories --- ~ 8. Dimensions of entire new construction: Front ............ .~.l..~ ............... Rear ...... .~.L ............... Depth ~,:.~. ........... Height .J..~ ............ Number of Stories ........ ~. .......................................................................................................... 9. Size of lot: Front ......... ..~..~,.~. .................................... Rear ........ /..O..?,;~. ....................... Depth .~...~.~.:...~. .............. 10. Dote of Purchase ...... ..~.~.Z~'...~.. .................................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are s~tuoted .................................................................... ~ ................................ 12. Does proposed constrUction violate any zoning law, ordinance or regulation: .~..~ .............................................. 13. Will lot be regraded ...~.:~../~...~... .......... Witl excess fill be removed from premises: ( ) Yes (/,~No 14. Name of Owner of pre~nises ~.-~....~'.~-.i[~..~..: ............. Address .~.:. hone No.~.~]..'...O./.....~.... Name of Architect .~/~,~.J~..t~l~../.~..~.. ......... Address ................................ Phone No~..-.~:~.~... Name of Contractor ....... ..a~... ..................... ~ ................... 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 hames and indicate whether interior or corner lot. ; STATE OF NEW)F4:)P-J~,~ ~S.S;, ~ in ......................... ~ ....... ~ ........................................... be g duly sworn, ~dl~oses and says that he is the applicanl (Na~e of individual slcjning contract0 ' above named. /~ ,~...~._~.~ . - .. He is the ............................................................................../~'~1,-~,,~,~-~ , ........................................................................................ (Contractor, agent, corpor~te~officer, e~tc.) 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 conta~ned-~.,this applic~'ion ctretrue to the best of his knowledg~e and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swomto methis ~~.! ............... · Notary Public, ......... · ...................... (Signature of applicant) THE NEW YORK BOARD OF FIRE UNDERWRITERS '-i~': BUREAU OF ELECTRICITY' ~- 85 JOHN STREET. NEW YORK. NEW'YORK 10038 THIS CE~IFIES THAT ~examinedon ~ ~7~ ~ a~foundtobeiflcompliancewiththerequiremen~so~th~sBoard. RANGES iP~C~AL REC'PT SERVICE DISCONNECT [ NO. OF 10 ~) C ~ METEE. S COOKING DECKS OVENS [DISH WASHERS 1 1.~ TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS A~T,. AMps. TRANS. NO. OF FEET V I C E EXHAUST FANS AMT. H. P DIMMERS AMT, WATTS OF CC, COND. 2 NO. OF HI-LEG OF NEUTRAL ~Wurnaces: oi1 1-1/Shp, 2-1/12bp George Zim.llnfi:haus, ~ Park Place, PatchogueF L.I. llT72 il r C · Per ~ ~ . COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. cot · ~ 0 SUFFOLK COUNTY H~ALTH DEPARTMENT Tho sewage disposal and ~ater supply facilities for this location have been inspected by this department and found~ to be satlsfactoz~~ ~. ~h~af of General Engineer~nE Services APPROVED AS NOTED NOTIFY BUILDING DEPAP, TM;NT P r 765-2660 C)AM TO 4PM FOR REQt. IR. ED INSPECTIONS: 1 BEFORE BACKFILLING FC, UNDA. TION OR START FRAMING 'Z. BEFORE COVERING pIPLLINr: 3. FINAL WHEN JOB COMFLETED NOT RESPONSIBLE FOR DESIGN OR CON* f /5