HomeMy WebLinkAbout7457-z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certific te Of Occupancy
No. 26205 ...... /, I
. , Date .......... No~. .... 24. ...... ,19~.
THIS CERTIFIES that the bufldi located ,at ~'.S. P~tdd],e. Jtd. (2P,27.). · · Street
Map No.. X~ ........ Block No.;. ~ ..... Lot No, . ~,.... 8cm~;ho.~ ~I · · l~.wE, ......
confoms sUbstantially to the Application for Building Pemit heretofore fried in this office
dated ............ A~g..~.'.., i9.~?L~, pUrsUaz~t t0 which Building permit
dated ............ A~g... ~...,' 19. ?.1~., was issued, and conforms to all of the require-
ments of the applicable provisions of the taw. Th8 occupancy for which ~b~ certificate is
issued is .?~:h~.a~;e..o~e. £a~.l.~, :d~e~l~[~~ , '. ..................................
The certificate is issued to . ..E.:~e~2e...~..t~0~,~e ~ ~/;l, sno$ak~ ..... v.~mer~ ............
(owner, lessee or tenant
of the aforesaid building.
Suffolk County Department of Health Approval ' .h'o.v...20..].97~...bit.//.. ¥:~.ila ....
UNDERWRITERS CERTIFICATE Ne...Pen~Aing ..................................
HOUSE NUMBER .. 36~.5'~ ..... Street .. ~ktddle..Road..~CR~.7) ..................
FOI~M NO. ~
TOWN OF SOUTHOLD ~
BUILDING DEFARTMENTi
TOWN CLERK'S OFFICE
SOUTHOLD, N~. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 7457 Z
Permission is hereby granted to:
..~;.¢~ne:Ll....~ons.Cr.~tica~..~ox~..~..CJ ....... ~ L. W:Lsnofsk~
................... ~.o.~th~ia ........................ i .................
S Middl~ Rg..~d (OB~q) i
at premises located at ...... ./.~ ...... : ................................. -a ..................................................................
Southold N.Y. i
Building Inspector.
Fee $ .........1..'1...0. A ~..0...
pursuant to application dated ....... ~.¥ ........... J,134~ ....... .~. ............ ~....., 19.?~., and approved by the
.............. $ ....... I~uilding Inspector
<SUFFOLK COUNTY DEPARTMENT OF HEALTH
Health Department
Reference Number
APPLICATION FOR APPROVAL TO!CONSTRUCT
A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY
Appli ' ~ ~
1. cant ,' , Phone? ~ ~' ~ 5. Subdiv.
Address -~ ~ ~ ' , ~ 6. Section
2. ~Proper ~
Village. : '.~ ~ownship ,~ r~F 9, Public Water
~, Public ~ater Company Name Distance to ~in
4, Lot size: ~idth~ feet Length ~ feet
lO, Sewage Disposal System: ~(For Health Dept, Use)
ll,
A. 900-gallon septic tank:
Precast/'~quivalent Block
B. Leaching pools:
Number of pools ~
Precast ~/~lock Special
Co
De
If private well, fill in the
following blanks:
A. Tank capacity Y~ gallons
B. Pump G.P.M. J
Total well depth ~ ~
Depth to ground water JO ?
Amount of water in well /i/O
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 effect~
FOR HEALTH DEPARTMENT USE ONLY. Based on the informati6n presented herewith, it is the
opinion of the Health Department that an adequate and s~tisfactory Sewage Disposal System
/, and Water S~pply can be installed on this plot.~/~,/~t~/.L.~ ' "'-'~"+'")'~i(~'~,~'''/~.~:~.i .' "? , ~'~'~'/'
APPROVAL DATE SIGNED ,~ . ~
S-15
Rev. 4/1/73
·
THE NEW YORK BOARD OF FIRE UNDERWRITERS
PC BUREAU OF ELECTRIC11Y , ..
85 JOHN STREET, NEW YORK, NEiW YORK W938
Date November 26, 1974 Application No.onfile T62256 N 196145
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the abode application number in the premises of
Eugene aeanoPeke, Route 2T, Peconic Lae I AOkerley Pond Rd. ,
Peconic, L.T.
in thefollowinglocation; ® Basement ® 1st Fl. ❑ 2nd Fl. outside Section Block Lot
was examined on November 21, 1974 and found to be in compliance with the requirements of this Board.
RXTURE RXTURES I RANGES JCDOKING DECKS OVENS OISN WASHERS EXHAUST FANS
OUTLETS �RCMACLRS SWITCHES INCANDEECEM EllIOIIESCENT AMT. K.W. AMT. K.W. AMT. K.W. AMT. I K.W. AMT. H.P.
23 39 25 23 1 12.2 1 11l.5 1 F
DRYERS MENACE MOTORS FUTURE APPLIANCE BOERS ISPECIAL R1C'PTj TIME CLOCKS I- ,&L I UNIT HEATERS MULT&OUTLET DIMMERS
AMT. K.W. OIL H.P. GAS H.P. WT. NO. A W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS ,qMT. WATTS
NO.OF FEET
r 1 30
SERVICE DISCONNECT NO.OF S E R V 'I C E
AMT. AMP. TYPE METER I,e 3W 1 p 3W 3$3W 3/!W NO.OF CG GOND. A W.G.. NO.OF HI-LEG A.W:G. NO.OF NEUTRALS A.W.G.
EQUIP. PER B' OF CC.C OF NI-LEG OF MIftRAL
1 150 CB x 1 1/ 0
1 1/0
oTI R Furnaces t oil, 1-1/8hp, 2-1/12 hp,
Motor/et 1-1/2hp
C.9 S.Contracting Inc.
P.O. Box 215
Southold, L.I. 11971
Per 11
MEEK
COPY F�DIN6 AEPARTMENL THIS COPY Of CERTIFICATE MUST 1407 BE ALTERED,IN ANY MANNER.
4 low XO. 1 AJ,
111611111M)LD, N. Y.
JA
Examined ....� ... ........... 154.. Application No. 7cir5.....................
r
Approved ............. ..........-�.............. 19.....1.. Permit No. '.y.S.7..z........
Disapproved a/c .......
.. .... ........... W
(Bui dirng M r)
APPLICATION POR ILDING PERMIT
Date ..........................August....., 19.��.....�
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buikli
Inspector, with 3 seta of pknns, accurate plot plan to soots. Fee according to schedule.
b. Plot plan 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 the diagram which is part of this application.
c. The work 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. N
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanak ,
shall have been granted by the Building Inspector. V
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 code, and ngulatiorns, and to
admit authorized inspectors on premises and In buildings for necessary inspections.
GL7 ..C.ar�sxu&. 1az>..GQz�i..............................
(Signature of applicant, or none, if a corporation)
.........SQlhth4;a........Y .....................................................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...............................................Zutider..................................................................................................................................
Name of owner of premises ..Zugene..&.Louis&a..1i1.ffil0fik1.....................................................................................
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. ..Bob*.....{Qu",11a..........
Other Trade's License No. ..............................................
1. Location of land on which proposed work will be done. Map No.: .......xx........................... Lot No. ..xx...............
..
Street and Number .....u/3...MSdd].e..A=d..WR27..)........ outhold.....N..Y.#.................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ....SSWAII ..1iA-le...reinaved.......................................................................
b. Intended use and occupancy .......33.@W...dyalaum............................................................................................
1\'
+3. 'Nature of work (check which applicable): New Building ...7[9cX........ Addition .................. Alteration ... ....,�...
Repair .................. Removal .................. Demolition.........:.......... Other Work ................................................ .....
(Description)
4. Estimated Cost ......................".94D0iG-1..................Fee .410. ....................... ..
. ..............................................
o be paid on filing this application)
5. If dwelling, number of dwelling units .....QM...............Number of dwelling units on each floor ............................
Ifgarage, number of cars .........two.............................................................................................................................
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 some structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................Number of Stories ................................
8. Dimensions of entire new construction: Front ......85......................... Reor .s5..................... Depth .32_4/...39....
Height .................... Number of Stories ......one....................................................................,....................................
9. Size of lot: Front ......acerAgi................................. Rear .......................................... Depth ................................
10. Date of Purchase ........................................................Name of Former Owner ........................................................
11. Zone or use district in which premises are situated ..... ...........................................................•...........•....
12. Does proposed construction violate any zoning law, ordinance or regulation: ........As..........................................
13. Will lot be regraded ...lye&................. Will excess fill be removed from premises: ( ) Yes ( z) No
14. Name of Owner of premises ...guona--&..Louisa--Wlenoftfts ................................ Phone No. ......................
Name of Architect .F'49931e..r$.{i911&............................. Address ................................ Phone No. ......................
Name of Contractor ..QAS.Ap-11-13nn4.tr........................ Address ................................ Phone No. ......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-lock 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.
I
STATE OF NEW YORK, I S S
COUNTY OF .....LIXftak.........I '
G0--C4oMel:j..............................................being duly sworn, deposes and says that he is the applicam
(Name of individual signing contract)
above named.
Heis the .................................FiuIlder..............................................................................................................................
(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
thar the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
............5..... day of ..........August.................... 19-74...
Notary Public, ..
.,, �t�P. .................... County ............... . ..... 9. ....... ..pP...... .............................
(Si nature of a licant)
MURIEL BRUSH
NOTARY PUBLIC. State of NOW Y®Fk
No. 52-4522026 - Suffoik Count/
commission Expires March 30, 10::.:: 7
y Act. 4T) it - N �•14 AO'E NS5"i:I":A1'E NSH`31'00"E. l
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APFRUVED AS k'OoESi
DATE: A _
FEE: BY o
NOTIFY BUILDING DEPARTM NT PT
765-2660 9AM TO 4PM, FOR RECUR. p
C ° ED INSPECTIONS:
4- - 7
1 . BEFORE BACKFILLING FOUNDA-
TION OR START FRAMING rc
2. BEFORE COVERING PIPELINE
3. FINAL WHEN JOB COMPLETED
NOT RE5PONSIELE FOR DESIGN OR CON- \S'EREO ARCh;.
STRU�C�TIONN ERRORS /� �� 0T' J5T t15 SL rF0
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