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Home My WebLink About7879-zTOWN OF $OUTHO~.n Buo.nlNC DEPART~gNT T~vm Clerk's Somhola, N. Y. Certificate Of Occupancy No ............. Date . '37 ~'/~ ~g~ ~/~' · ' ' I'~A'~", 19 .... T~IS~FI~l~hat the buila~ located at .... p. ...................... Slreet ~ap No ............. Block No ...........Lot No .................................. conforms substaz~l~ to ~_e~,pplic~n for Building Feb-mit heretofore filed in tl~ dated ............~ ~. :f... ~., 19..-/.~,-pursuant to which Builalng Permit No ......... dated ......................., 19 .... , was issued, and conforms to all of the require. ments of th~ apl~i~e ~dsio~.4,he l~j~ccup~)~L~o[~_~_~j, certificate is ~sued is ................. H'ff.'~ · ~~ ,~ --~ .... ~. ~ ~..~ ~ ~ The certificate is issued to ........................................................ (owner, lessee or tenant) of the aforesaid buil&ing. ,o[.~/~-,, 5- $0-.~' I Suffolk County Department of Health Appro~l '?_*T 7 '0'r .b'~r' ..................... UNDERWRITERS CER~TE No ..... 6 tt6~:- .... ."~O,~.'~, .................. HOUSE NUMBER .............. Street .... ~..W..':t. -t~ ~qO @.u.£ ..... t,~ :¥: ......... BuiI&ing In~etor FORM 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) N? 7879 Z Date };~a7 2 19.?. Permission is hereby granted to: ..l';. :.~:.,.~....c..o. ~. ~ ~. ,...-b~r ....................................... .............. ~. ~;&.~.t. uc~ .......................................... ]3u~!v_ new one fan.~!v dvze~ling tO ....... ::' ........... .~ ........................... , ......................................................................................................... at premises located at .... ~,~./.,~...~-~.~g.e,'J2,~...~.~.9..o,.~ ................................................................................ ................................................................... C.ut~hog.~ze ....... 1,.,,Z ........................................................ pursuant to application dated ........................ .~...a.~. ....... .2. ................ 19..?..[, and approved by the Building Inspector. Fee $...27. a.C~t. ........ FOKM NO. 6 TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink., and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Rte ................................................ New Bt~ilding ................ Addition ................ Old or Pre-e×isting Building ................ ¥ocant Land .............. Owner Or Owners Of Property ................................... .~.~..~....?. ...... ~.~.'~.~.~N..~......~.,...~....~..~....~ Subdivision .,~...~.?. ..... .?..t..~....~.,.~.. .......................... Lot No......~m'.. ..... Block No ............. House No ............. ~'~ Dote Of Permit .../.. -~"/2'"'1'} I"~Applicant /i~.~' ~J' ~'~r--~'TrC,~'C7, o.--~ ~-~t~'~ Permit No Health Dept, Approval ...,..~...-..,S,...~...,.--...~..! .................. Labor Dept. Approval .................. :...'~. ......................... Underwriters Approval ..~......[:..~.L,'~..~...I,.~.. ................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ...~ .............................. Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. App,cant ........ ........ Sworn to before me this ................ day of ............................................ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS __ ~'I BUREAU OF' ELECTRICITY 85 JOHN STREET. '4EW YORK NEVV vO~.K 10038 t,.,. September 23. 1975 ~ppt,,.,,',,,,'. ..... r,,. 816732 ' TH~5 CERTIFIE% THAT ' Robert Loblnscn,. Evgene P.d. Eout~ 25 & SeLe's, uu~cnogue, L.~. ~ ~,A~'4G[S COOKING DECKS OVENS D~SH WAS~ 1 Il. !a i , I~L[ U4q,,'TI,tffAT'E~S M~LTI-O,UTLET 0~?,I~R5 ---- $Y$ IT. MS V I C ii *Furnace/s: 1-1/Shp, 1-1/12bp Motor/s: 1-1/3bp Gustan 5artra kR#is 227Z, Ereakwater Rd ::attituc~, L.I. 11952 Health Services Reference Number 1. Applicant ~4j,~¢O.~?~r.~,~.~ Phone Address ~- '-~ ;-.*--~r..'~¢ ~ ~,~, 6. Section 2. Property Loc~f6n'" ~j , e~q~ ~ ~ ~ ~.~7. Lot Number ~' ~ 8. Private Wel~ ~)]~g~ .~C~,~ ~,~ Township J~,~O 9. Public Water 3. ruvm~c wa:er uompany mame ~~ Distance to main 4. Lot size: Width~et Length ~eet 10. Sewage Disposal System: (For Health Services Dept. Use) APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY ll. A. 900-gallon septic tank: Precast d~i~quivalent Block B. Leaching pools: Number of pools '~ Precast~ ~pecial__ If private well, fill in the fol- lowing blanks: A. Tank capacity, ,~?.~gallons ~ Pump~m, P.M. ~ ., . ~Tot~well depth ~. Dep~ tq g~ound water '~. Amo~r~t of water in well The ~ndersi~ed CERTIFIES: "Construction of authorized installations will be in accordance wi-th ~he Suffolk County Department of Health Services' current standards thereto." This appl'~cation~ll be valid for one year from the date of approval indicated below and may be renewed i'fa current local Building Department Permit is in effect. 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 SUFFOLK OOUN~Y ttF~L~TH DEPAI~T~ DA~.~iCLO~. ~. ~m. # ~- - 3 C, - A- / The sewage disposal and water suppl facilities for this location have inspected by this de~art~eat~an~ ~ene~ E TEE r. OC.~TION OF 'WEr. Y,$ AND CESSPOOr.~ SHOWN HEREIN ARE FROM FIELD OBSERVATIONS AND/OR FRO[Ii DATA OJ~TAINED FROM OTHERS we// 4559~ .sv,s,o.s YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVE. RHEAO, NEW YORK ALDEN W YOUNG HOWARD W. YOUNG SURVEY FOR: ROBERT ROBINSON ~ KAREN ROBINSON GUAR~NT£~E~ CUTCH O GUE UNITED STATES OF A~ERIC~ · ow~ o~ SOUTHO~D rN~ T/T&F GUA~NTEE CO. SUFFOLK CO., N.Y. e UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7909 OF THE NEW YORK STATE EDUCATION COPIES OFTHIS SURVEY MAP NOT 8E~RING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED S~AL SHALL NOT BE CONSIDERED TO 8E A VALID TRUE COPY TIlE I, OCATION OF 1","'ELIS AND SIIOWN HEREIN ARE FEOM FIELD OBSERVAT~ON~ ANDIOR FROf4 DATA OBTAINED FROM OTHERS MONUMENT UNAUTHORIZED ALTERATION OR ADDITION TO THiS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE ~CUCATION LAW COPIES OF THIS SURVEY MAP Nor SEARING REViSiONS YOUNG & YOUN~ ALDEN W YOUNG ~u.w~ Fo.: ~ \ *"~ /'/ AT CUTCHOGUE GUARANTEED TO' ~OW" OF SOUTHOLD SUFFOLK CO., N.Y. ~ ~v Examined .....~.~..[L~....~... ....... , 1~....~.... -- Application No 2.~... / - - ~te .................. ~....~ ........... ,19.: .......... INST~I~ *. lhi~ ~licoti~ must ~ ar~s, aha ~w~ ~ ~m.~ ~npn~ .~all ~ ~t ~ ~ ~ ~ail~ e. No ~ildi~ ~11 ~ ~i~ or ~ Jn ~ole or in Pa ~ for any pu~se ~otever until a ~if~ of ~c~ ~atl have ~n g~t~e Buildi~ I~r. ~ ~LI~ATI~N .~S HERE~Y.~DE to u,~ ~ ~?nanc~ at ~he ~.~ ~d,.~k .C~, N~ Yo~, a~ ~r ~e ~, ~ m ~ at,~s, ?r the c~tmcx?n ~,u~a,~F ~t,~ or a~, ~ ~or m~l ~ ~it~, ~ ~ ~. aam T au~rlz~ ~n~tom ~ p~l~ a~ i~ ~ ~ ~ i~tJ~. ~ ' (Sign~m ~ ~licant, m ~ if a ~tl~) ................. ~..j...;~-;: ....... : ....................... ~ ....... ~ ........ ' ....... State whether a~licant is ~ner, Ieee, ~ent, a~hitect, engineer, general c~tractor, el~rician, plu~r or builder. Name of owner of premises ................... ~,~....i~....~ ...~ ............. If ap~[L~ant is. a co~m_.~[~gnature of duly authorized officer. ...... ~~~;'~¥~E~;i ......... Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No.....~.....~....?~...'~.....~...../~........~..~---'~-T~t~- Other Trade's License No ................................................ - Location of land on which prapased work will be done. Map" r~o.: ........................................ Lot.No ......................... N" .............................................................. ~ ................................... ~.,.~...~.....~ State existing use and occupancy of premises and intended use and occupancy of propaeed construction: a. Exisiting use and occupancy .............................................. b. Intended use and occupancy /~'~"~'/ · property, lines. Give street and block number · whether interior or corner lot. 3. Nature of work (check which applicable): New Building". ................. Addition .................. Alteration ....v ........ ~.~ ; Repair .................. Ren~val .................. Demolition ................ ~... Other Work ............................................... .. ..... ' ~3% ~'" (Description) . (to be paid on filing this application) 5. If dwelling, number of dwelling units............................~ Number of dwelling units on'each floor ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ : ............... 7. Dimensions of existing structures, if any: Front ........,~r.~ ...... Rear .............. ~ ...... Depth .....~ ...... Height ...... ~.. Number of Stories .............. ~.. ................................ ..... ........................... :; ........................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ...................... r ........ 8. Dimensions of entire new construction: Front ........ ...~....1~.. .................. Rear ......... ..~'.....~T.. ......... Depth 11. Zone or use district in which premises are situated ........ ~....,~....~..~.~..~t..~ ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............. ...~.....~ .............................. 13. Will lot be regraded ...... ..~.~-~. ........... Will excess fill be removed from premises: ( ) Yes ( ~ Name of Architect .............................................................. Address ................................ Phone 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. or description according t° deed, and show street names and indicate ~'TA.TE OF NEW' tc S ........... ~~...~...~ ................... .~. ........................... being duly ~vom, d~o~s ond ~ys t~t he is the ~pplic~m (Na~e~of indi~dual signing contmc~ above name. ............... He is the ................ ~ .......................................................................................................................................... (Contractor, agar, co~orate 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 ~taJned in this application am tree:to the best of his knowle~e and belief; amd that the work will be performed in the manner set fo~h in the application fired ther~ith. Swam to bef~ me this ~.. ............... ~y o{ ~ot~ Public, : .............. ~;2 ' ,Slgna~re ~ applicant) ~. 52-~S22026.