HomeMy WebLinkAbout6478-ZFORM NO- 4
TOWN OF $OUTHOLD
BUTt.DING DEPARTMENT
Town Clerk's Ot~ice
$outhold, N. Y.
Certificete Of Occupancy
~THIS CERTIFIES that the building located at .L~ac. &. Hol, ton. I~ ...... Street
Map No.~.a.s.s..a.u. .g.a..r~. ~lock No ........... Lot No....P.a..I~...~..1.2..~ ..... .Ctj. t.e.h..o .igOr.....II,T.
conforms substantially to the Application for Building' Permit heretofore filed in this office
dated ..........N..o.v....~.0...., 197.2.. pursuant to which Building Permit No.
dated ........Apr...~2 ....... , 19Y3., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which thi.~ certificate is
issued is . P. riv~te, one. fa~ly, d~LlAn$ ..... ¢2nd. floo~..belnl, emepl&ted).
The certificate is issued to .... Chal'~$. ~a~;1;~..~.1~ .................................
(owner, lessee'or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .. ]~®nd,t.l~. ~..temp.
UNDERWRITERS CERTIFICATE No ..... N1 .~9~)0 ..... ]~... ! ~... ~ 9~ ...........
HOUSE NUMBER.. 90~..L~kae. Street .......................................... 600 Ho~toa 1~
........
FOBM NO. ~
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? 6478 Z
Permission is hereby granted to:
Charles Watts ~
............. C~tebo~m~ ............................................
to .;Ih~ ..new...one.. £am~J~..dwal3An~ ....................................................................................
at premises located at ........~A'.~L..Qf...p~.O~..~i~....~&s~&tL~'.a~'~,~ ...........................................
............................................ ~or. to~..~..IJ, lac.. La...CP..~..~I~ ....... .~tmhOlme ......................
pursuant to application dated ..................... ~.~/Z.....~) .................. , 19..~.~,,., and approved by the
Building Inspector.
Fee $..~..20 ..........
Building Inspector'
THE NEW YORK BOARD OF FIRE UNDERWRITERS
SW BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CE~IFIES THAT
~ly the e~t~al ~ulpme~t ~ ~scH~ ~ a~ int~u~ ~ t~ a~li~t ~m~ on t~ a~ ~pl~t~n numar in t~e ~es of
Charle~ Watts, Jr., Horton and Lilac, Sterlin~ and Plnetree, ~utcno~ue
~n the following l~ation; ~ B~ement ~ 1st FL ~ 2nd Fl. Out side s~t~o.
w~ examlm~ on ~ *~ ..... ~ ~ " ' ' and found to be im co~iance with the requirements of this Bmrd,
fiXTURE ~ECiRTACLES SW~TCHES RXTURES
DRYERS FURNACE MOTORS FUTURE APPuANCE FEEDERS
AMT. K.W. OIL H,P. GA! H,P. AMT. NO. A.W.G.
SERVICE DISCONNECT ] NO. OI
1 200 CB
RANGES
mT. K.w.
I 10.
1 30
R
EXHAUST FANS
DIMMERS
NO. OF NEUTRAL,$A.W.G.
OF NEUTRAL
1 ~/o
Water Heater: 1-4.SKW
Motor/s: 1-1/3hR
Elec. Room Heaters: 1-2.5KW, 1-1.oKW,
2-1.25KW, 1-1.OKW, 3-.75KW
RobLvt A. Goodale
525 ~!rchard St.
Mew ~ ~, oJ.~, New York
11956
11 ',~
Per ./i
-- COPY~FOR BU~ILDING DEPARTM~T._~THIS ¢OuPV OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF SOUTHOLD
Building Inspector's Office
Town Clerk, Building
5outhold, N.Y. 765-2660
TOWN OF SOUTHOLD
Building Inspector's Office
Town Clerk Building
Southold, N.Y. 765-2660
I~ILII~
T~ _kl .............
~H~D, N. Y.
· ~ I~ ~/~
~om ned ........
~.~ , PP .............
....................-- :: ......... 'J ....... , P,m t
...........................................................................................................
~ :' APPLICATION F~R BUILDING P~
--~..,.....~ ..... ,,~....~ ]9 ............
~. Tkis ~li~ti~ ~.~t k ~l~t~l~ fillad i. ky ~rit~r or i. i~k ~d ~,b~itt~ ~ ~ ' ' m~aor.~i~
~ ~l~ of ~, ~.r~t~ ~lot ~l~n to ~cal~. [~ ~rdi~ to ~kd~l~.
k. Plot ~1~ ~ko~i~ Iocatio~ ~ lot ~d of buildi~
giving a det.iled description of layout of pro,rty must ~dr,nondiegramwhichis~tofthis~pli~tion.
c. The wo~ ~vered by this application may not ~ commen~d ~fore issuan~ of Building Permit.
d. U~n approval of this appli~tion, the Building Ins~ctor will i~ue a Building Permit to the applicant. Such ~rm t shell be k o
the mmi~s available for ins~ctJon throughout the work.
e. No ~ilding shall ~ ~cupiad or u~d iff whole or in pa~ fore, ny purpo~ whatever un~l a Ce~Jfi~e of O~u~n~ shall have ~n
gran~ by the Building Ins~or.
APPLICATION IS HER~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold, Suffo~ County, New York, and Other agplicable Laws, Ordinances or Regulations, for the construction of
buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable taws.
ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder:
Name of owner of premises ...... (~Mt:~l...~.t,~;&..eT~. ..........: .........................................................................................
If applicant is a corporate, signature of duly authorized officer, b
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: .~...~..I.,.~..~.....~..aLl~o....~..~...~..~...~o..1.~. ...................
Street and Number ........ ~4~t,~d~l..~dL.~t,,~[O~.~O~..~,Qad. ......... b'~lZ~ ...... ~..~,. ............................................
-~¢~ ~'"' r" ° 0 ' Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... .~le~t,..~a~l[ ................................................................................................
b. Intended use and occupancy ....... ~lt~..fl~'..4[l~,~ ............................................................. ~. .............
Nature of work (check which applicab!ei: New Building ..... ~ ........ Addition ..................... Alteration ..............
Repair.; ..................... ,.. Removal ......................... Demolition ........................ Other Work ....................................
(Description)
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..(~ ........ Number of dwelling units on each floor .........................................
If garage, number of cars ............................................................................................................................................
6. If business, commemial or mixed occupancy, specify nature and extent of each type of use .....................................
7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ...................................
He!ght ........................................................... Number of Stories ..... .. .......................................................................
Dimensions of same structure with alterations or additions: Front .......................... Rear .......................... i ..............
Depth., .......................................... Height ......................................... Number of Stories ........................................
8. Dimensions of entire new construction: Front ......... ~...~. .....Rear ..... ~..1...--~.. ............ Depth ......~ ......................
Height ................................................. Number of Stories ..... .~1.~ ...............................................................................
9. Size of lot: Front ........t~..~ .................. Rear ....... .$~k ......................... Depth .......lt]~...~. ...............................
Height .................................................... Number of Stories ......................................................................................
10. Date of Purchase ..........~l~.;[ .................. Name of Former Owner ....... {~;~T~..~ ................................................
11. Zone or use district in which premises are situated .......... ~,?....~;~,ltf~ ........................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~ ..............................................
13. Will lot be regraded ............ ~ ................. Will excess fill be removed from premises: [ ] Yes [~] No
14. Na me of Owner of premises ..{~g;~,,~.L ~lkt~f~...~ ..................... {~9&'lle .....................................................
(Address} (Phone No.)
Name of Architect .....................................................................................................................................................
(Address) (Phone No.)
Name of Contractor ....... ~l~gll~ ...................................................................................................................................
(Address) (Phone No.)
properly'lines. Give street and block number or description according to deed, and show street names and indicate
er interior or corner lot. ~ 1~2, "-/,~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from
STATE OF NEW YORK, ) ,,~ ·
COUNTYOF ............. J~,~ ..................... )
................................. ...C~..~.~i.~I.....~.~.~.~...~.~. ............................ being duly sworn, deposes and says that he is the applicant above named,*
(Name o£ individual signing contract) '.
He is the ......................................................... OtlrA~.~_...i~i~.]~],~ .........................................................................................................
{Contractor, agent, corporate 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; tha~ all
~tatements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner
set forth in the application filed therewith. TERRI ErE
#OTARY PUBLIC, State of New York
.............................. Z0...day of ........ ......................
~ . ~nlrni~d~h 30, 19
'~ Notary Public, :~..~..*,.~-.~ ........ County ........ ~..~.~.....~_2..~..~ .......
{Signature of applicant}
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, N. Y. 11971
TEL. 765-1802
February 28, 1979
Mr. Charles C. Watts, Jr.
Box 556
Cutchogue, New York 11934
Dear Sir:
I received a copy of a letter dated February 21, 1979,
from the Health Service regarding your not getting their
final approval of your well and septic system.
Please send us a copy of their final approval.
Yours truly,
GEORGE H. FISHER
Sr. Building Inspector
a /pOs
SUFF LK COUNTY/DEPARTMENT OF HEALTH
/ / H.D. Reference No.
3- so- to
APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM
1. Applicant~HAi~i_lL~ C ~,JATT& ~ ~hon. L/~. S.bd~. ~
2. Prop~r~y loca~ion~c~i~ ~lcsl~c~ t4~. Lo~ No.
8. Private well ~
Villa~e~.,T(~.~ i~ Township %~, ,~ot~ 9. Public water ~
3. Public W~er C~mpany name Distance to main ~
i. LoC size. Width ~ feet Length ~] ~ feet (Enter on cen~er plo~ below)
10. Sewage Disposal System:
A. 900 8allen septic tank: Precast ~Equivalen~ Block
B. Leaching pools: Number ~ Precas~ Block ~pecial__
Amount
If private well fill
in blanks below:
Tank capacity Gals.
Pump C.P.M.
10
14
Street
The undersigned CERTIFIES: "Construction of authorized installat,ions will
be in accordance with the Suffolk County Department of Health~s current stand-
ards thereto."
Owner or Builder
FO~HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith~ it
is~the opinion of the Health Department, that an adequate and satisfactory Sewage
Disposal System can be installed on this plot.
Date ~/~ ~3:~ Signed~
S-15
Revised 4/1/72
COUNTY OF SUFFOLK·
DEPARTMENT OF HEALTH SERVICES
DAVID HARRIS, M.D., M.P.H.
Feb. ~1,.1979
RE: ~-'---,-. Corner of Morton & Lilac L~ne, Cutchog~ae, N. Y.
A recent check of our files indicates that this office has never issued a
final approval for the above referenced job.
Please be advised that it is illegal to occupy the building until the f~l-
)owing paper¥~ork is submitted to this office and/or the following inspec-
tion(s) are completed:
~ell Drillers Certificate
Water Analysis
k~Cesspool Certification
[~Final Surveys .
r"-lother
Very truly yours,
CC:
Should you have any questions, please feel free to contact this office.
.. '.. '(~j~t¢, 'P/¢ '
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CEDAR HOMES."
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"THIS DRAWING IS CONSIDER.,
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UNLESS WRI~rEN CONSENT I~
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