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Home My WebLink About7958-z FOILM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 7958 Z Permission is hereby granted to: I~..~io~s...I~e...~/g...~eo..~up.r ......... ............... F~.~t~.t~ .......................................... to ...~J,l.q...~,.e.~...g.~.~...~:~m~.~,:,:...d.::,:.g.li ~u~- ................................................................................ at premises located at ...Lzz~,,~...C=:o.~,~:..~;[:,~.'Je. ......... Lut..%9. .......................................................... ......................................... ~en~,e~o.tt..~aa'k ......... ;~ot~t~ld.....~;. ~J.. ......................................... pursuont to application dated .................... ~la~......2.1 ................... , 19J7.~.., end opproved by the Building Inspector. Fee $..~6.,.J~.Q .......... Building Inspector/ TOWN OF $OUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR tnk, and submitted in DUPLICATE to the Budding Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buddings, 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 mmilar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote 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, build,ngs 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 inspectfon of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: J. 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 Date August l~ 1975 XX New Building ................ Addition ................ Old or Pre-existing Budding ................ Vacant Land .............. Location Of Property ............................ Owner Or Owners Of Property ..~.o..~..~.e.....J..,.....K...e..~..~.~. ................................................................................. Subdivision ................................................................ Lot No .... .1..9.. .... Block No ............. House No900 .................... 5/29/75 ]3~ILAND HOlV~,S, ]~1'C. Permit No 7958Z Date Of Permit .................... Applicant .................................................................. 5-so- s /z /Ts _. ................... Health Dept. Approval ............................................ bOmOr Dept. Approval .......................... Underwriters Approval ~.~.~..~..~.7....7./...~.~/..?...5. .......... Planning Board Approval ..... ¥...e.~ ............................ Request For Temporary Certificate ........................................ F,ncd Certificate yes Fee Submitted $ .5..%.0..0. ........................... Construction on above described building 3~~l~ji~?l~/Tes and regulations. Applicant ...~,;~ ...................................................... K~nne~h W. -Thurber, INLAlkrD HOMES Sworn to before me his ........... .~/~.. day of ~ · ' ................ ~ota~ Public ~//~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS --- ak BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.,r,. J~]-Y 29. :]-975 A.p.~,,t,,,. .',,. ,,,.>,. 8024:~8 N 237917 THIS CERTIFIES THAT ontv ~he el~rlcai equipment a. described below and introd~red by the applicant named on the abo~e appilratio~ G. Keupp, s/side Long C~eek Drive, ~900, Southold, L.I. Job 2~2 ~n the/allowing laeatlon: ~ a..~.t ~ ~.t r~, ~ ~.d r~, outside s.oti.. ~"'*~"~;""'~"" July 24, 1975 and fot~nd to be m comphn,,ee with the reqm. re,nent~ofthtsl~ % ~6~ ~ ) FmxTuR~s RANGES C~KING DECKS OVENS [DISH~W~SHER5 ~X~AUSf FAr OUTLETS [RECEPTACLES SWITCHES NCANOESCE~ FLUORESCENT "' ~[~Y ' '~T ' K W" ~T K W ~T I DRYERS~ ' FURNACE MOTORS ~ FUTURE APPUANCE FEEDERS [SPECIAL REC'PT~ T ME CLOCKS ', BELL )UN T ~ATERS George Zimlin~ams, Patchogue, L.I. 11772 Per ~ _ D T~s certtftcote must not be altered m any manner, return to the ofhce of the Board t( incorrect Inspectors mo7 be LoNG 2he sewage disposal and water supply facilities for this locatzon have been inspec t'edOy-tn~s ~d foun~' 8~part~ent ~/~ Chief G~n~ral Eng n~r~- SeNices ~ 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 - Phone Address ~ ll? 2. Property Location ~ Vi]lage 5(~$~o~&(~ Township 3. Public Water Company Name ~ 4. Lot size: Width 3_~5 feet Length~feet 5. Subdiv.Y~e~ott 6. Section ~. Lot Number 8. Private WeT1 9. Public Water~ ...Distance to main 10. Sewage Disposal System: A. ~900~allon septic tank: Precas .t~ Equivalent Block B.Leaching pools: Number of pools Precast'~ Block Special 11. If private well, fill in the fol- lowing blanks: A. Tank capacity y~,/~ ,gallons B. Pump G.P.M. /,,~,/'U C. Total well dbpth D. Depth to ground water E. Amount of water in well (For Health Services Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' 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. Date Nm~, 19~ 1975 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 ~;ater Supply can be installed on this plot. Rev. 4/1/73 ~%~,%~,~,,~u ~;~ ~ ~{~d~ ~"~ L O~4G zO /9 6EOIP6£ J. ¢ /-/£££N L. JNAUTHORIZED ALi~E~ATIOI4 OR ADDmON APPP-,OVED ,AS NOTE(~ NOTIEY BUILDING DEPARTMENT ,~ i 765.2660 9AM TO 4PM FOR R~QUI~. ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA. TION OR START FRYING 2. BEFORE COVERING PIPELINE 3. FINAL WHEN JOB CO~TED NOT RESPONSIBLE ~R DESIGN OR CON- STRUCTION ERRORS ,,,--