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Home My WebLink About8063-zFOK~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z?0.8.~. ..... Date .............. ~ .~..e...~.~ ..... , 19. THIS CERTIFIES that the building located at . .~./$..~....o~...S.~. ............ Street Map No.. ~ ......... Block No...X,X ...... Lot No. XX..~I'ae~pol~.~;.. N.,~, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. .~.I~....~ 19.. ?~ pursuant to which Building Permit No. ~..~.~.Z.. dated ............ .3'~l.1.~.....~.., 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 is issued is . Prl~ate..o~.e.f.~mil~ .dwe~Llt~g ....................................... The certificate is issued to . .~.oh~ .D~lu~,z:~O .... 0~e~ .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ?.~.1~...].?.. ~.97.6.' .b.~...R.o..V..~.~?. .... UNDERWRITERS CERTIFICATE No...N..2~2.~.~ ..... N..~?., .~...1.~.~ ............... HOUSE NUMBER ...... ~6~) .... Street ... Bl'.o~m. ~;,. G~.eenpor. t ................ ....... B~il'~ing Ins~eet~'[' ........ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEP.,kRTM~NT 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? 8063 Z Permission is hereby granted to: John binizlo ................... d~e.e~or.t ....................................... ~o .. ku...~.~....n..?.~...9..n.,?...~:~.~.~.~ ~ .. ~.x~.~ .].,.~ ................................................................................... at premises located at .....~../.~.......~.,Z'.,O..W.~...~..~..~..~...~..~. ............................................................................... ..................................................................... ~enp~r.~ ....... N.,.~.o ..................................................... pursuant to application dated ...................... ~LI,~. ....... ~ ............... , 19...~.~., and approved by the Building Inspector. Fee $.~.9.,..0..0.. ........... FOR31 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEI4POP&i~ Certi[icate O[ Occupancy Date ............ Jala.. 79. ....... , 19.7~. THIS CERTIFIES that the building located at l~/'~ ,BI~0~. $.~ ............. Street Map No.X?.{ .......... Block No...~X. ...... Lot No, X~..G:re.o. npor,~ .. ~.,.~(, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... .J.U~Y.... ~., 19 ~.~. pursuant to which Building Permit No.. dated .......... ~¥ .... ~..., 19 .'/~., was issUed, and eonf°rms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is i~sued is' 'P. ri.va~e, olde. £a~ily. ~wel3,i~g ......... i ...... ......... '. ~.. :'.. ~ ~'~.~ .'.. The certificate is issued to . . .~<?~'~...-Q. ID!~iO.. ~....~.w.~,~r ........................ ·.. (owner', lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval~ Ja.~...~.9 ...~9.?.~ .................... UNDERWRITER, S CERTIFICATE No...p~n~lr~ ..... ............................. HOUSE NUMBE~R ...... ~0 ..... Street..Br~X~. S~.ee~ .... Gl'o.enpor.~; ........... Building Inspector ~RK, i,BOARD: OF FIRE BUREAU OF ELECTRICITY UNDERWRITERS NEW YORK NEW YQRK 10038 N 272833 '7th, ,~ Greenport, -"iMOTORS TIME CI~OCK$ MULTI.OUTLt~T DIMMERS SYSTEMS OF CC. CONO. 3/0 ' "~'i.::',~Joh~' Dinizlo ::,~ ' ,;!,. :: 505 ~ Main St. -.-../::::~.Preenport, L.I.. 11994 SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ~,~21,~ Phone ~??~,~/ 5. Subdiv. Address Z,~:,~.~ ~,~ ~¢~ /~_~.~6~ Section 2. Property Locatio~~ ~~ _~_~?~:~] Lot Number ~ 8. Private Well Village Township_ ~ ~ 9. Public Water 3. Public Water Company Name ~ ~ ~-~ ~ Distance to main 4. Lot size: Width~ feet Length~ fe~t 10. Sewage Disposal System: (For Health Dept. Use) A. 900-gallon septic tank: Precast ~quivalent Block B. Leaching pools: Number of pools / Precast x~B1 ock .Special Il. If private well, fill in the following blanks: A. Ta~ capacity .~__gallons ~-~ B.. P~mp~. G.P.M. ~ ) T~al well depth ~ D~th to ground water_ ~_ At~unt of water in well ~ _ Th~unders. i~ned CERTIFIES: "Construction of authorized installations will be in accordance wi~q~ the S~folk County Department of Health's current standards thereto. This application will be va'lid for one year from the date of approval indicated b~low and may be renewed if a current local Building Department Permit is in effec~b~ Date ~igned ::::::::::::::::::::::::::::::::::::::::::::::::::::::::: FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Dep. artment that an adequate and satisfactory Sewage Disposal System and Water Supply can be ~nstalled on this pl,ot. _ ~ APPROVAL DATE ~ ' SIGNED_' ,, S-15 Rev. 4/1/73 .......... ........ ~o. ~S ~licoti~ mu~ ~ completely fil,~ i~ ~w~lter Or m '1'~ O~ s~mi~ in trlp'~ . ~ ,ui~,~ Insp~or, wi~ 3 ~ of pl~s, accum~ pl~ plan a~i~ ~ ~ule. b. Plot plan ~ing I~otion of lot and of buildi~s ~ premi,s, ~atlonship to ~joini~ premi,s m ~1~ ~r~ o~ areas, and givi~ a d~ail~ d~ripti~ of I~ ofpr~ m~ ~ dm~ ~ the diagmm~ich is c. ~e ~rk c~er~ by this a~lication ~ n~ ~ commenc~ before i~uance of Building Pe~it. d. U~n a~l of ~is a~l~ati~, ~ Buildi~ In--tar will i~ a Building Pe~it to the ~li~. Such ~rmit shall ~ ~t ~ ~e premis~ ~adable for i~tion th~hout ~e ~rk. e. No buildi~ s~ll ~ ~cupi~ or u~ in ~ole or in pa~ for any pu~e wh~eve~ until a Ce~ific~ of ~cu~ shall have ~en g~t~ ~ the Bui~Jng InCr. APPLI~TION IS HEREBY ~DE to the Building ~ment for ~e i,uance of o Buildi~.P~it pu~nt to Bu Idi~ Z~e O~i~e of the T~ of ~old, Suffolk County, New York, a~ ~er ~ph~m ~, ~ or R~u at OhS, for the constm~ion of buildi~s, ~Iti~s or al~mtions, or ~ m~l' o~ ~iti~, ~ h~l~ ~. ~e applicant ~r~s to comply with all a~licable I~, ordinances, bul ~ c~, admit authoriz~ i~o~ ~ premiss ~ in buildl~ ~ ~e~ i~i~s. ......................... . ............. ................... .......................... (Addm, of ~pli~) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......... .~.~.~.~.~......~..I.~..~..~..~..r~. ............................................................................................. Ifapplicant is a corporate, signature of duly authorized officer.; .................. ......... Builder's License No ....... ~ ...................... Plumber's License No..~ ................. Electrician s License No. ~.. ........ ~ ............ Other Trade's License No ............................................... ' ~. Location of land on w_hij:h proposed work will be do.~.ne. Map ~: ................ ..~..~.. ............. Lot No ...... ~. ................ I. Number,~... Munlcipalit~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ ~-~.....'~.. ~/..~-....., ....................................................................................... b. Intended use and occupancy ...... ...~....~.~.~..~.'~....-~.~.,~.- ./.... ....................................................... , .................... 3. Nature of work (check which applicable): New Building........'~... ........ Addition .................. Alteration ............ ',..~, Repair .................. Removal ................ Demolition .................... Other Work .................................................. '~~ ~ --~. 9 , ~ ~(Description) (to be pc~d on fll ng th~s npphcatlon) 5. If dwellln~'~ number of dwelling units ........ /. ................. Number of dwelling units on each floor ...... ~ ..................... If garage, number of cars ............................................................................................................................................. 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 same structure with alterations or additiori's: Front .................................... Rear ............................ Depth ................................ Height ......... : .................. NUmber of Stories ............................... 8. Dimensions of entire new construction: Front ....... .~..~... .................... Rear ....~'...~..... ................ Depth .......... Height ..,~.....~ ...... Number of Stories ...... ./.. .................................................................................. ' ......................... 9. Size of 10t: Front .... ~.,~..~'..,.~....?~... ............................. Rear .~...~'...~..~...."~.. ...... 11. Zone or use district in which premises are situated ............................ 12. Does proposal construction violate any ~oning tow, ordinance or regulation: ..... ~.~. ......................................... Will lot be r~.'~raded .......................... t. Will ex~,l~s fill ? remo~ecl from prernis~: { ) Yes ~""No Name of Contractor ........ ~..'. ...................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether .existing or proposed, and indicat~ all set-back dimensions from property lines. Give street and bl.ock number or description according to deed, and sh~v street names and indicate whetber interior or corner lot. STATE OF Ul ~YO~ '//' [SS , ........ ~ ~~ ..................................... being duly sworn, d~es e~ soys t~t he is the epplic~nl He is the ........ ~.~~ ................................................................................ (Contractor, agen% co,orate officer, etc.) of ~id owner or ~ners, and is duly aut~rized to ~orm or h~e performed the said work a~ to ~ke and file this application; t~t alt st~ements contoined in this application are tree to the best of his kn~ledge and belief; th~ the work will ~ performed in ~e m~nne ~t fo~h in t~e application fil~ t~r~th. m .,.,,I '~'~¢~' //,~"= ILO" ,,1 IL.J_ '"L, L-- s - II 2 SHEET- I REVERSE TOTAL -~, b q -q co'B I "5 ?_oI/ 2_1L,4t'' e L/o" 4 '-/o'/ l/I; S -112 IsHEET-~' REVERSE ~ TOTAL -$ r ,,? II '/"-" =/-° S - II 2 REVERSE SHEET TOTAL