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Home My WebLink About7260-zTOWN OF SOUTIIOLD BUILDING DEPARTS~ Town Clerk's O~ie~ Somhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the buildin~ located at . .Da,ray. It, d .............. Street Map No~lSel;. l~OL]~ock No ........... Lot No..ll'~ ..... .l~.t.t. ~t t.~.. 1~. :~.: ....... conforms substantially to the Application for Building Permit heretofore filed in th~ office dated ................~1~...;[~9. ~. pursuant to which BuiMtng Permit No. dated ...........~. y....1.6 ..... , 19...~., was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this cern_ ~cate is issued is Pr~¥&f,a .oa fm,at]y d~ll~ The certificate is issued to. Ittehami .&. ~n~ ta. ltous.t~n .... !0~ner, ............... (owner, lessee or of the afore--id building. Suffolk County Department of Health Approval .. Hay. ~,(~. 19~.~.. by. .1~,..V.l~ .... UhrDERWaITE~[ CERTIFICATE No.. 1~$3~$ ... ~.. 13.. l~ ............... HOUSE NUMBER..~Zi; ........ Street .... 9&l,sy. Road .......................... B~t&in~ ~,,_,pector ~ 'I'OWN OF SO4J'rHOI. D BUIL~IN~ DEPAItTMINT TOWN CLERIC'S OFFICE SOUTHOLD, X. Y. BUILDING PEIUAIT (THIS PEPu&AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7260 Z Permission is hereby granted to: . l~s,~..,1~,m~Im~..&. ~t4 ....................... ........ .~..~t4~q~$..P.~, .......................................... .................. m~l~e=..~.~ee ....... .t~ ............. at premMs located at .,~,~..~ ......... ~llll~..~..lll..~,~: ................................................... pursuant to application dated .......................]~. ....... ~J& ............. , 19~k...., and opproved by,the Building Ir~3ector. ~/.~,~, TOWH CLERK'S OFFICE ~./~f~/ / / ., _ .~ · ,-._ ............. ' "-F:_ ' 0 ' ' ~---" -- ' .......................... Di~oppraYed o/c ............................................ ~. ~ ~ /~ ...... : ........ ......... ............ ..... - ..... ...... . ' ~- INSTRU~I~S o. thi~ ~pplicotlon mint be co ' '~b~ ~writ~r o~ in i~k ~ ~mi~ in b. ~1o~' Plan ~hOwing ~otion Of lot ond o{ building~ on promises, relationship to ~oinino premi~ or public ~/reet~ ~reo~, ond ~ivi~ ~ d~tail~ description o{ I~ouI ofpr~ mu~t be drewn on the di~omm ~hich i~ ~ o{ ~i~ ppplic~tlon. c. Th* ~ork covered by thi~ o~licotion mo~ n~ b~ comme~ed be{ore issounce o{ 8uildi~ ~rmit. d. Upon pppmvol o{ thi~ ppplic~tion, th~ Building In,p~tor wil~ issu~ ~ Building ~rmit to th~ ppplicont. Such p~rmi sh~ll ~ k~pt on th~ premise~ ~voilobl~ {or in~p~tlon thm~hout th~ ~rk. e. ~o building ~hall ~ ~cupi~ or u~d in whol~ or in pa~ {or on~ pu~ose wh~ewr until ~ sh~ll h~v~ ~en ~mnted ~ th~ Building In~p~tor. 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 for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing ce~e, and regular ons, and to admit authorized inspectors on premises and irt buildings for nece~~ /~ . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ses ................... ~ ............................................................................................................... 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 Trode's License No ............................................... 1. Location of and on wh ch osed work w be 'one Ma No L t p n:;~)~ cl . P .: ........................................ o PlO ......................... Street and Number .......... .~...../~.../...~.........~.Z~...~...Z~.'..'~. ............................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting Use and occupancy ................................................................................................................. b. Intended use and occupancy ~ I//~./.~.C ...~....'~.'~'~'- ...................... Repair .................. Removal .................. Demolition ........ ~ ........... Other Work ...................................................... 4. Estimated Cost ee (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... y.. ............ Number of dwelling units on each floor ............................ If garage, number of cars ............... .~.. ............. ; .................................................................................. 7 ........... 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 ............... ;L... 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 ..... .~.?....Z~/.'..~. ............ Rear Depth ./...~... .... Height .................... Number of Storie. s ............. ../.. ............................................................................. :z ...................... 9. Size of lot: Front .................. .//~....5.~../... ....................... Rear ....... ./.../.....'~..../. .......... : ......... Deptb..~.....~...-~.....'..--'~""-'~ ....... ,~... 10..' Date of Purchase ......:..i~/...~'.../....4~.. .................... Name of Former Owner~'../..Z..~../...~..x..'./..,~...:..../~..~....~/4~.r. 11. Zone or use district in w½ich premises are situated ..................................................... ....~ ......................................... 12. Does proposed construction violate any zoninI law, ordinance or regulation: ....... r. ............................ ~ .............. x cass fill removed from pram' es ( ) Yes '( I~)No 13~ Will Iot'be regraded' .~.~...~.. Wills .......... 14. Name of Owner of prem,sesT./. ............ .~.........~... .................... Address .~. ........................... Phone No.~.' .............. Nome of Architect .............................................................. Address ................................ Phor~ No ....................... Name of Contractor ............................................................ 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 names and indicate whether interior or corner lot. STATE OF NEW ,,.~I~,K/', ,,;.,d ~c¢ J COU N"I'~. OF ~ ...... ~?'~ 1 ' "~ being duly sworn, deposes and says t~t he is the applicant (Name of individual signing contrac~ ~bove name; 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 ~ke 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 fo~h in the application filed t~ Swom to ~e me this ~ [ [ ~ ~ - .... ............................. J~.5~OD44963 ~fuffoJk Count~ ~ ~ommisdon Expires March 30, 1~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-~ ak B5 JOHN STREET, NEW YORK, NEW YORK 10038 .or, March 13, 1975 ~pp,i~tio.~o.o.~,l. 75~2~ N 213519 THIS CE~IFIES THAT ~5 the e~tdc~ ~u~p~t ~ ~e~d ~ a~ int~uc~ by t~ applico~t ~ on the a~ applicat~ numar in t~ p~m~es of ~.~Io,o~.~o.; ~ S~.~.~ ~ ~*~r:. ~ ~ r~. outside~" s~t~o~ B~ ~ ~ ~.~i~d o. March 10, 19 7 5 .~fo.~ ,o be in compliance wlth the requiremem, of this Board. "XTUeE I 33 IRxTUREs 2O 23 2O DRYERS I FURNACE MOTORS I FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT I NO. DE I S E ' 1 100 CB~ETEE X 1 ~. A~. ~ EQUIP. ~2w ~sw 3~3w z~w NO-O~E~C~C~O. RANGES SPECIAL REC'PT 1 30 R COOKING. DECKS OVENS I DISH WASHERS M LTl OUTLET TIME cLOCKs BELL UNIT HEATERS USYS?rEMS AMT. AMPS. TRANS. ~ ND. OF FEET 2 HI-LEG A. W. G, NO. Of NEUTRALS *Furnaces: Oil 1-1/Shp, 1-1/12hp *Future appliance feeder/s: 2-B#10, 1-2#12 EXJ UST DIMMERS John Augustitus, Box 29B L I. ll"~ East Setauket, . This ce~ificate must not be altered in any manner; return to the office of the ~ard if ~ncorrect Inspectors may be ident~d by th~,~.~ntials. SUFFOLK COUNTY DEPARTMENT OF HEALTHReference Heal th Department Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATERSUPPLY Address .X~,,Td,,"~.~) )~,,~)T~ /~/~-~Z-2~.~qZ-- 2. Property Location - ~Y~ Z~ Village ' ~DtTz7~ Township 3. Public Water Cbmpany Name C'~7~ 4. Lot size: Width~/~feet Length /~ feet 10. 11. 5. Subdiv. 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main~;F4~ Sewage~isposal System: A. 90~gallon septic tank: Precast~/~quivalent Block B. Leaching pools: Number of pools Precast4~j Block m~pecial If private well, fill in the following blanks: C. Total welltdepth lons D. Depth to ground water E. Amount of water in well (For Health Dept. Use) 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 e~ ~ 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 ~'//~C/~r SIGNED ~ ~.~. -- s-1 EXCAVATION IEPECTIOM Rev. 4/1/73 TITLE NO. S-521220 po~O ·: MONUMENT ~UBDIVISION MAP FILED 1N THE OP~I~E O~ TH~ CL~RK O~ ~MFFOLK COUNTY ON APRIL ~,19~0 AS FI~ NO. 5~ ~ 5far~ley J. ~ Leo forr~erl~ or ooW .00 SHOWN HEREI~ ARE FROM FIELD OBSE~VATIO~ A~DIOR F~O?~ D~TA OBTAINED FROM OTHERS J,,.. ~4. ,~ 400 o~.~.~. ~w.~..,v~..~ ~cu~ ~..ousrou ~ sous, ~uc. LOT 48 "SUNSET KNOLLS, SECTION TWOv AT GUARANTEED TO: MAT T ITU C K SOUTHOLD SAVINGS BANK SECURITY TI~E a GUARANTY CO. TOWN OF SOUTHOLD co., SledzteS~ UNAUTHORIZED ALTERATION OR AOOITION TO TO BE A VALID TRUE COPY ONLY TO THE PERSON FOR WHOM THE S'.5*"