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Home My WebLink About8008-zTOWN OF $OUTHOLD BI,RI,DING DEPARTSfk':NT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z67a7 ...... Date ............. 0c.~.-3 ........ ,19.75. THIS CERTIFIES that the building located at .. ;~a. ttlae~s · Lane .......... Street Map No.l~o~th~oo~te. Block No ........... Lot No, .~ ..... C~t~chog~e.. I~.,X, ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~l~me. · .tS., 19. ~$pursuant to which Building Permit No.. ~08Z. dated .......... ,Itme. · .l~..., 19.7~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate issued is P.~ivtt~. ona. £a~ly. t~e].LLng ....................................... The certificate is issued to .. £rne~t. &. Lois. 3~andall ...... ~m~.s ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Depa~-hhent of Health Approval . .~.~p.t...l P...197~. ................. UNDERWRITERS CERTIFICATE No. II2~%01~.. aapt. 1.1..197.% .................. HOUSE NUMBER .... %0% ....... Street .. I~aht, hewa .Lana ........................ Building ~n~pector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Nm. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8008 Z Permission is hereby gronted to: ..Ea~rm:v&ear...~uA~&r,g...oo.....A/~..Ez,nes.~ & Lois Randall ....... · 'J .~ .7...-. ~&~e.~'- ~ultke .-t~r ................................ ................ · laa. teJ~offue .......................................... to b~i.Z~ · · ne~...olae...£azalZ, y.- ~lwe .t.l. in.g ...................................................................................... at premises located at .J.O.~;...~. ....... ]qoz~.~,Aat~ood. lt ............................................................................... ........................................................... tIa.t~l~$. Z, aae ......... ~,~.t o~o~ue ....................................... pursuant to application dated .......................... ,~.lg.i~e-.-..'~J~ .......... , 19~...., ond approved by the Building Inspector. Fee $~. ~ .9.~. ............ Building Inspector ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ~I~tV,F~,) gLO, ~ Phone Address ¢~ S~/~/,t~ /.~ .~._ ~T~t~¢~E~ 2. P~operty Lo'cation 1~1~ ¢l~Fj'i~z~J~ J_/J~, Village' C gTC k~o ~0 ~_~- Township 3. Public Water Company Name 4. Lot size: Width ~ feet Length I,S~ feet 5. Subdiv. ~O~t,~> 6. Section 7. Lot Number 8. Private Well 9. Public Water Distance to main 10. 11. Sewage Disposal System: A. /9~gallon septic tank: Precast J Equivalent Block B. Leaching pools: Number of pools Precast'~.6~~ Block Special__ If p~ivate well, fill in the fol- lowing blanks: A. Tank capacity ~b~ gallons B. Pump G.P.M. C. Total well depth (For Health Services Dept. Use) == D. D1~'~h to ground water -- Amount of water in well ~/~ T~nder ned CERTIFIES: "Construction of authorized installations will be in accordance wi~the ~folk County Department of Health Services' current standards thereto." This ap~J~!cation will be valid for one year from the date of approval indicated below and may be~-r~qewe~f a current local Building Department Permit is in effect. Da~ ~/~J~/ ~<' . Signed ~/~' [~~ . FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~/,~-'/? ! SIGNED ~___~ ~_,.~ ~ S-15 Rev. 4/1/73 THE NEW YORK BOARD OF FIRE UNDERWRITERS '. ' Ernest Randall, n/side Mathews Lane, app. 427' e/O Cox Lane, ~.. ' . Cutchogu~ L.I.' ~.~t ~ ~t~'~. ~ ~ ~'outside in the followlng locat~o~; ~ .~ectlon Block l~t 4 ~ ~ o. Sep temb er 8, 197 5 FIXTURE; ' ! ........... I ' I ' FIXTURES I" RANGES ]COORINO DECKS l OVENS -OUTLETS.. ~JRECEPTACLES"' ' SWITCHES ~NDESSNT, ~LU~)R~E-NT 25"." ! ?0 ~ 24 25 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMECLOCKS DIS~H WASHERS~XHAUST FANS 'ix: : *Furnae'es i. 0ii "2&l/Shp, Motor/s: !-I/2hp .... ,,, Sapanaro...&. Mlneo Inc Li?~' ' ,102 Oak: Avenue, Shirley,~ L.I. 11967 MULTI-OUTLET DIMMERS SYSTEMS I 1 GENERAt MANAGE~ D Thi~ certlficatd must n6t be,offerbd in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their -, 46`5 sq.ft' ,,~Zu' ,~ , THE LAND SURVEYOR'S IN~ED SEAL OR AGENCY AND LENDIN~ INSTITUTION LISTED AUG 19,/975 400 OSTRANDER AVENUE, SURVEY FOR: LOT NO. 4 ' NONTHWOOD~" S~HOLD TO THE TITLE COMPANY~GOVERNMENTAL HEEEON~ AND TO THE LENDING INSTITUTION NOT TRANSFERABLE TO TOWN 01~ SOUTHO~Z NSTRUCTiONS a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate to the BuildingZ Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. :b. Plot plan showing location of Ic~t and of buildings on premises, relationship t.o. adjoini .rig. pre. raises or p,u~. lic str. ee.~. or areas, and giving a detailed description of layout ofproperty must be drawn on the dmgram which as par~ of th~s apphcat~on. 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. e, No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purSu..ant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Oral,nantes or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, aa herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulotlo~, and to ec~l~ I tions. admit authorized inspectors on premises and in buildings for n (SJgna ur. of applicant, ~ilr/flame, it ~).?orporation, .......... ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,-plumber o~ Name of owner of premises .E'J~J~..~..T.....'Jz/..L~.!.~........~....~...~...~...~..~L":....L~.. .................................................................................. If applicantAs a corporate, signature of duly authorized officer. ......... ................ (Name and rifle of corpo'T6te officer) Builder's License No .................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ................................................ i 1. Location of land on whichJamoosed worll/~¢l' be done. Map No~../~.... ~...0~....~...~.. ..... Lot No....~.. .............. Street and Number ..... ..~.~J~~i....~... ..........................................~. ................................................ . Municipality 2. State existing use and occupancy of premi's~S and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... .~..~J.. ................................................................................................... b. Intended useandoccupancy ............ !~.~r~S.~...~-.?...(~.'..~... ............................................................................... 3. Nature of work (check which applicable): New Building.....~. ........ Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... .~.o~.1 j~...' ~' 0 (Description) 4. Estimated Cost ............ ........................... Fee ._~..t~.___._.........~'-. ....................................................... ; ................ (to be paid on filing this application) / 5. If dwelling, number of dwelling units .......................... Number of dwe!ling units on e°~:h floor .........~ .................. If garage, number of cars ..... I~ ................... .~,.: .......... : ............................................................................................... 6. If business, cOmmemial or mixed occupancy, specify nature and extent of each h~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ................. ~ ...... Number of Stories ................. i ............................. ./ ................................... v....,t .............. ~ ..... Dimensions of/same structure with alterations or additions: Front ...6.~. ........................... Rear(O.~ ...................... Depth ..~'. ....................... Height ..J.~.. ................... Number of Stories ...J. .......................... 8. Dimensions of entire new construction: Front ................... , ................ Rear ............................ Depth ........................ -~'~ '~ Height .................... Number.of Stories ................................................ t .............................................. 7"1 .................. 9. Size of lot: Front .... L.~'....~... ........................................ Rear ....J...?....~.. ........................... Depth .L~.../. ..................... 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: ........................................................ 13. Will lot be regradecf .......~..~. .............. Will e~cess fill be removed from premises: ( ) Yes ~ No 14. Name of Owner of premises~J~x~..~-./dl~[....~(~'...~. ...... Address ................................ Phone No ....................... Name of A~chitect .............................................................. Address ................................ Phone No ....................... Name of Contractor'S'../~.~/...~......~.,...~.,..~'.C, ........... Address/~..tT......~.~..~.~:-.-~.,~hone 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. COUN~ OF .~~_~..I ' ' ................................................................................................. being duly sworn, deposes and says t~t he is the applicam (Name of i~ividual signing contrec¢ 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 t~e 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 therewith. Sworn to b~or~me this . . ......... (Si~n~tur~ at ~pplic~nt) JUDITH T. BOKEN Nota~ Public, State of New York No. 52~0344963 Suffolk Counly. Commi~i~ Expir~ Ma~h 3~ INSPECTioNs' r~ FOR REQUiR BACKFILLING FOU~,~ '