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Home My WebLink About7680-zFORM NO. ~, TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice $outhold, N. Y. Certificate Of Occupancy No. Z6~68 ...... Date .............. ~O~. .6. 19. THIS CERTIFIES that the building located at ~..l~/~ &elme~r .'~t~. Street Map No.KeI~e~oo~L Block No ........... Lot No, . 6 ..... 8~%~0~L~1.. ~.J/, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Zlee~,...30., 19 .~.L~. pursuant to which Building Permit No.. dated ............. Ja~...~.., 19.75., 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 . .Pri.v. ate. nne. fam~.l~ .d~ell~l~g ...................................... The certificate is issued to L~w~en~e. Fiu~e ..... L~e2 ........ ~ ................... (ortner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Oc~... :~ .... tg?.~. .................. UNDERWRITERS CERTIFICATE No .... 1g~.].$7~. ~.: · ..;AU$. ~ 9..~ .~ 97'~ ............. HOUSE NUMBER ...~.~2.~ ....... Street .. I~zn,,l~. l~oaS.. J ........................ FOR~ NO. 2 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) 7680 Z Permission is hereby granted to: )¢m~.t 0=.. AS ~o...Lt~ ....... A/.~.../~v=.e~e...~iume ct premises located at ~,at,..~, .......K~IIz~ ................................................................................ .................................... .W/.~..Kena~,lr.. ttoad .............. S~u~ol,d. ..................................................... pursuant to application doted .......................D~-c,....~O ................ , 1~'~.~. ..... and approved by the Building Inspector. Fee ~:).8~.c~'. ............ ~ ! - BuildiKg Ifispector SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM ANDA WATER SUPPLY 1. Applicant ,, Address -¢ __ 2. Proper~ Loca'tion_ ~ V~-TTT~-ge t ...... Phone Township 3. Public Water Company Name - 4. Lot size: Width feet Length. 10. Sewage Disposal System: / ~ 5. Subdiv. 6. Section ~` ~' 7~ Lot Number ~. Private Well -~ ,'i9~ Public Water ,, Distance to main ~ feet ll. (For Health Services Dept. Use) A. ~9~O~gallon septic tank: Prec2st ,,~' Equivalent. Block~ B. Leaching pools: Number of pools ~' Precast/_~- B1 ock Speci al__ If private well, fill in the fol- ?~__gallons lowing blanks: A. Tan'k'capacity B. Pump-G. P,M. C. Total well depth D. D~pth to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services! Q!urrent s~andards thereto." This application will be valid for one year from the date of 8pproval indicated below and may be renewed if a current local Building Department Permit is in effect, Date -' , ' " Signed FOR THE DEPARTMENT OF HEALTH SERVICES' USE ONLY. Based on the information presented here- with, it is the opinion of th~ De~rtment of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~~ . SIGNED ~_.,,-"~.._ --' 1'OWN OF SOUI'HOLD BUILDfl4G DEPA~ ............. 19 ....... Permit No.7-.--- APPUCATION FOR BUILDII~ PIIbMIT · · ~f.~ ! ~.~../., . Date .......................... :..,L...~ ............ , .... INSTRUCTIOI~ a. TI~ ~ n~z~' Il cemlgefoly filled in by typewriter e~. in ink and mbadltll i~ I~¢afo t~ I~tallJ,t Impect~ ~dlh 3 ml~ d ig.m, ~ ptal- plan te male. Fee ocm~llng t~ a:hedule. d. ~ i~ ~f th~s a~4gk~ the ~u~k~ ~r~pect~r wi~ issue a~Bui~ding P~m~R ~ 4q~k~"t~ Such ~ shell I~ impt a~ the ~ eveildlle for ~ throughout the work. sh~i'l NIi'Jmltdintl~l! be ~r reed in wlxge or in port for any pulsate whatever ~ ~ ~ of Oa~am~-y B~A.m~ICATieN iS klB~EIY.~ fo the Bu'~ng Department ~ ~e muance of a ~ I~emm ~mme m .~ ~ ~ ~m ~ ~y ~h all ~h~ ~, ordi~, ~ ~, ~ ~, ~ ~, ~ m (Sigm of ~1~, ~ ~, if ~ ~ ". :::::.~. .::.~.~.. .~..)~ ~ , ~ ~., ~: ~1 .................... ~'~'~i~i ............................... State whether applicant is owner, L_~_, agent, architect, engineer, general contractor, electrician, plumber or bu~kler. If appli,cant is a coq~:z?~gignature of.~duly, autho~zed officer. (Name and' title Of corporate officer) Builder's License No ..................................................... Plumber's License No ...... ,-: ....................................... Electrician's License No....': ........................................ Other Trade's Liceme No ................................ I. Location of land on w~lch proposed work will be dine. Map h~o..' .._? ................................... Lot No ......................... Street and Number L .~ . _, /'- -,~'- .~-. ~ State existing use and occupancy of premises and intended use and occupancy of pre(x~led cgn~ucflon: a. Exisiting use and occupancy ........................................................................................................ , ......................... b. Intended use and ,;,~upancy ............................................................... ,~ ...................................... ..~. .................. / 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal , .~6molitior. ............. Other Work ................................................ . .... 6. If b~l~, c~ial m mi~ ~¢~ncy, s~ci~ nature o~ ~t of ~ch ~ ~ ~ .................... t ....... Di~ns~ ~ ~~ 'i~ ~: Front Height ........................ N~r of S~ri~ .................................... ~ ............................................................................ Dlm~i~ of ~ ~ ~ al~r~s or additions: Fret '. ................................... ~ ............................ ~t~ ................................ ~t ............................ 8. Di~i~ of ~tim ~ ~n: Fr~t~ ............................. ~r ............................ ~ ........................ 9. Size of Jot: Fret ........................................................ R~r .......................................... ~ ................................ 10. ~e af~ ..;...~..~ ............ ~....~ ............................ N~ of Fo~r ~r ..................................... . . .......... ~. . 1 1. Z~e or ~ d~rtat in ~h p~ ore sit,ed .~ ............... "~ ~~~~;'..~.~ ........................... ~...~ .................... ' PL~ D~G~ ' STATE OF NI[WXOJilIC ~..'~'~-?~- ~i;.~ ~:' ~ ,, ? / - · ..................... 4~....~ .......... w~r ......... ~......%; ......................... ~emg duly sworn, deposes and soye:,~t~t)i~ tll~. ol~plicam ~,:~j~, ~ '6f Th~liglduet' ' sii~flng 'cant ract0 above nd~ He 'is the ................................................................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ~luly authorized to perform or have performed the said wo~k .and t~ mqke and file th. is apg.~!~jgrl;. [~:lt .aJ[..$tat~g~lllSt:s..cor~toined in this application ar~>.~ to the best,'e~'.h.j~blijlljj~l~lbeJlef; and that' the _M~.'.~.wtll be perfon,floel'i~ ~ rt~nner set fo~h in the appleton flied they~/ith. // ,~" Swomto~methte ~ / ~' ~ / . ~...?Z~.... ~. ,__--°~ ~.~:.-~ ,~ ..... .............. ............... --~"~,/~ ' _r~.~-~_~_..~<=..~ . _/~ (Sigp6ture of applicant) NO,"AIrY PUBLIC. Sfaf~ ef New YorJ~ No. S2-¢B~202& - S~ffo;~ _Gernmlislon J~plre~ Marsh 30. ~'9~...~ MAP OF KENNEWOOD MAR,"50,1954 MAP21150 ~ ~,R~I~,, ,,- . ' ~ ,m~ .~,~¢ ~,'"~'~':~ ~ I, ~"~ ~ FINAL ~CATION 10 7 75 ~ ~ ,~ ~ ~ HOUSE LOCATION 5 75 ', ~¢~.,,~ ~ HOUSE STAKE OUT EXPRESSWAY FED, SAVINGS & bO~ AS~OC, GUARANTEED %ITLE DIV, AMERICAN TIT~: IN&GO, , MAP O~ ~ND LOCATED AT SOUTHOLD TOWN OF ~OUTHO~D C~UN~ OF SUFFOLK ..? , ar