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HomeMy WebLinkAbout36470-Z Town of Southold Annex 5/12/2014 P.O.Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36913 Date: 5/12/2014 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 520 Lakeside Drive, Southold, SCTM#: 473889 Sec/Block/Lot: 90.-3-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/13/2011 pursuant to which Building Permit No. 36470 dated 6/13/2011 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: one family dwelling The certificate is issued to Gerchak, Ralph&Marie (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL S0929 8/29/73 ELECTRICAL CERTIFICATE NO. 36470 4/28/14 PLUMBERS CERTIFICATION DATED "tho tur e =:rte TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY ��rzrzccri'1' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 36470 Date: 6/13/2011 Permission is hereby granted to: ADLER, FRED &WF BOX 1481 SOUTHOLD, NY 11971 To: BUILD A SINGLE FAMILY DWELLING REPLACES EXPIRED BUILDING PERMIT # 5516 At premises located at: 520 LAKESIDE DRIVE SOUTH SCTM # 473889 Sec/Block/Lot# 90.-3-17 Pursuant to application dated 1/1/1900 and approved by the Building Inspector. To expire on 1/1/1900. Fees: PERMIT RENEWAL $200.00 CO -NEW DWELLING $50.00 Total: $250.00 Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO5516 Z Date ...........................&apt.....in........... 19......71 Permission is hereby granted to: ............ftad..r;�tUer........................................... ..........'1$....3 4 W-•16kW. ..................................... ................."ftb#t2Xy........L-rl-i...:t 1.59.0............ to .......fh2l.ld..new...me..fami lit..dwal li ng............................................................................. ................................................................................................................................................................ at premises located at ..Z41s....77....C*&w••,"0h4'a-r k................................................................ ........................................... ........... ............................................. ................................................................................................................................................................ pursuant to application dated ....................................ia.Dt.......2"l..., 19...`)x., and approved by the Building Inspector. Fee $...MAO........ Building Inspector Form No.6 TOWN OF SOUTHOLD. BUILDING DEPARTMENT TOWN HALL 765-1802 , APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building$50.00, Additions to accessory building$50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 te. New Construction: Old or Pre-existing uilding: (check one)�klll Location of Property: 0 House No. Street Hamlet Ad Owner or Owners of Property: (�(� te/i Suffolk County Tax Map No 1000, Section_Q O Block Lot Subdivision C� Underwriters Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: j Approval: N _ Planning Board Approval: A) A Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: cIp SApplicant Signature pF SO�lyolo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. ox 117 Southoldd,,NY 11971-0959 Q roper.riche rt(a)_town.southold.ny.us .�` � �� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gerchak (Adler) Address: 520 Lakeside Dr South City: Southold St: NY Zip: 11971 Building Permit#: 36470 Section: 90 Block: 3 Lot: 17 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor X Hot Tub Addition Survey X Attic Garage X INVENTORY Service 1 ph Heat gas Duplec Recpt 52 Ceiling Fixtures 13 HID Fixtures Service 3 ph Hot Water GFCI Recpt 6 Wall Fixtures 5 Smoke Detectors 4 Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures 32 CO Detectors Sub Panel A/C Blower 5 Range Recpt Fluorescent Fixture 2 Pumps Transformer Appliances N36 Dryer Recpt 1-30 Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: 2-combination smoke/co detectors, 7ft multi port strip, 2-exhaust fans, 2-dead front GFCI's, 1-20KW standby generator with 200a transfer switch Notes: Inspector Signature: Date: April 28 2014 81-Cert Electrical Compliance Form.xls TOWN OF SO 140 B NG DEPT. 765-1802 S IN PE N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESIST CONSTRUCTION [ ] RRE RESISTANT PENETRATION REMARK S• &j LE03 DATE INSPECTOR lD��© ,�o��OFryo6 '`�bUNiY, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULA _ N [ ] FRAMING/STRAPPING [ FIN [ ] FIREPLACE A CHIMNEY ( ] FIRE INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRI � (ROUGH) [ ] ELECTRICAL (FINAL) R rA R KS. c ^ �`?i t r— d1., 34- A �-d4- --o DATE ANSPECTOR TOWN OF SO ILDING DEPT. 765-1802 INSPP 1 N [ ] FOUNDATION iST [ ] ROUGH G [ ] FOUNDATION 2ND [ ] IN TION [ ] FRAMING/STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION I I FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION I I ELECTRICAL (ROUGH) I 1 ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR OF SOUryo`o V TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ) FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ) FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [�$ ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE �� INSPECTOR FORM ENO. 1 TOWN OF SOUTHOLD SUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. Examined . . . . . . . . . . . . ., 19. . . . Application No. . . . . . . . . . . . . . . . . Approved . . . . . . . . . . . . . . . . . . . .. 19 . . . . Permit No. . . ...'.. . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT �y'4 C", r r Date . . . . . . . .... . . . . . . . . . . . 19. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings o n premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue .a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole oil in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuaxlt to the Building Zone Ordinance of the Town of Southo Id, Suffolk Gaunty,New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or,.duo- lition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. o J . . . .G_�1 X"' .. . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . (Signature applic t, or.name if a corporation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . `!:� .. . . . . . . . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . . . . . . . .... . . . . . . . . . . . . . . . . .l�C . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . .. . . . . .. .. .. . Name ,of owner of premises . . . . . ��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If applicant is a corporate, signature of duly authorized officer. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) 1. Location of land on w ich proposed work will be done. Map No. . . . . Lot No. .7.7.... . . . . . p , Street and Number »Iunicipality 2. State existing use and occupancy +of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . .1-4. . . . . . .` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . Addition . . . . . . . . Alteration . . . . . . . . Repair ... . . . . . . Re ioval . . . . . . . . Demolition Other Work (Describe) . . . . . . 4. Estimated Cost . . . . j l 0 0 0. . . . . . . . . . . . . . . . . .Fee . . . . . . . . (to be paid on filing this application) 5. If dwelling, number ,of dwelling units �!xR, . , , 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: FnDnt . . . . .... . . . . . . Rear . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with .alterations or additions: Front . . . . . . . . . . . . . . Rear . . . . . . . . . .... . . Depth . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . Number of Stories . . S. Dimensions of entire..new construction: Fr�7nt „ . . . . . . . . . . . C . . . . Rear . . . Depth 2:7. .... . . . Height . . . . . . . �� e� g Number of Stories . . . ` r ./. /.0. . . . . . . . . 9. Size of bat: Front . .7.� . . . . . . . , Rear .Depth . . . . .j6.0, f 10. Date of Purchase . ./.z,�6.$. . . . . . . . . . . . . . . . . . . .Name (tf Former Owner 11. Zone or use district in which premises are situated . . . . . . 12. Does proposed construction violate zoning law, ,ordinan or regulation? . . . . . . . . . . . . . . . . . . . . . 13. Name of Owner,of premises' . . . . . . . .Address t$. W . . . . .� Phone 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 property lines. Give street and block number-or description according to deed, and show street names -and indicate whether interior or corner lot. fDC' l�w I W ri V to 0 %19 '�7' -7 t ,as�a�T J)U49T STATE OF NEW YORK, S.S. COUNTY OF . . . . . .5fl�f`'�-! ., . . . . . . , .FRt,. . AD L , . . . , , . , being duly sworn, deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the . . . . . . . . . . . . . .. . (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; that all statements contained in this application are true to the best of his knowledge and belief; and that the wiurk will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . day of . . . . . . . . . .... S'E T19 ?�. �\ Cu& S U 1=F Notary Public unty . . . . . . re of .applicant) . . . . . . . . . . . . . . . . . . (Sigrlture of applicant) Y ELIZABETH. ANN NEVILLE NOTARY PUBLIC, State of New York No. 52.8125850, Suffolk Coun Term Expires March 30, 19z-? c ' � 'ORM NO. i 7 8 �`�i V w J hu 7 TOWN OF SOUTHOLD ��,�� �� y r BUILDING DEPARTMENT /` k TOWN .CLERK'S OFFICE � �r � �,�li �•/ss. D M SOUTHOLD, N. Y. �,,, �•c"�` f 73 Examined °�" l 1.9. Approved . . . . . . . . . . . . . . . . . . . .. 19 . . .�. Permit No. . .�.1-. .. 6 y�? 7 Qi� '�,�►-,,P C'.D Disapproved, a/c . . . . . . . .... .r Q � hA. �i-;.j.,y. . : : . . :^ . . . .... . . . . . . . . .. . . . . c/o cry.. a6 ,� H a.• na.A a / Gm- . . . . . . . . . . . .�;�W . l W(e gL � � � (Build ) P. APPLICATION FOR BUILDING PERMIT`S ' � �Q �•" '� y� � �Z' Date . . . . . . . . . INSTRUCTION a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. `, mss, b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is R part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. -d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Oounty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings,.additions or alterations, or for removal or demo- 41- lition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, i housing code, and regulations. � . .. . . .. .. .. .. . . .. . . .. .. .. . (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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . . .. .. .. . Nameof owner of premises . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on "iched work will b e done. Map No. . .�Q. . . . . . Lot No.Street and Number . . .�12C�,:�.�A-�4�:�J�R .pO�,t�2 .j. .. . �! r. .°. . . . . 5'� Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy . . . . ."k2ty-1A, . " . . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . ... . . . . . . . . b. Intended use and occupancy . . . . .1!. . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s 3. Nature of work (check which applicable): New Building // .. . . g Addition . . . . . . . . Alteration . . . . . . . . Repair ... . . . . . . Re oval . . . . . . . . Demolition . . . . . . . . Other Work (Describe) . . . . . . . . . 4. Estimated Cost . . . . . . . . . . . . . . . . . . . .Fee . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A? (to be paid ,an filing this application) 5. If dwelling, number of dwelling units .a? . . . . Number ,of dwelling units on each floor . . . . . . . . . . . . . . If garage, number of cars . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial aor 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 additions: Front . . . . . . . . . . . . . . Rear ... . . . . . . . .... . . Depth . . . . . . . . . . . . . . . . Height . . . . . . . . . .. . . . . . Number of Stories . . . �... . . . . . . . . . . . . 8. Dimensions ,o� entire .new construction: Front .34. . Rear ¢. t Depth �. . Height . . . . . . . . Number of Stories .2 . �. . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . .$.' Rear . .1/P.. . . . . . . . Depth . . . /<V1 Q . . 10. Date of Purchase . . 1..2 j/. -0�&. . . . . . . . . . . . . . . . . . Name of Former Owner 919'n. . . . . . . . 11. Zone or use district in which premises are situated. . . . . . . . . 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate //��ny zoning law, ,ordinance or r gulation? /2d-. . . . . . . . . . . . . . . . . . 13. Name of Owner,of premises R D. 940 9. . . . .Address/Q. W. . . . . . . hone No:-.p¢'sQp7 Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . JPhone Na: . . . .... . . . . Name of Contractor . . . . . . . .... . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . Phone No. . . . .... . . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether e xsting or proposed, and indicate all set-back dimensions from property lines. Give street and block number or de scripti,on according to deed, d show street names and, indicate whether interior or corner lot. LAKESIDE- 'I VF Df Hou"E to 34 Z1 701 . p f 0 78 STATE OF NEW YORK, )S.S. IjU L Er COUNTY OF SU Fi L'EAS�AJ T� . . . . . , . . C fl D L C.`T . . . . . . . . . . . . . . . . . . being duly sworn, -deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the . . . . . . . 6 P w (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perfa rm or have performed the said work and to make and file this application; that all statements oontained in this application are true to the best of his knowledge and belief; ,and that the work will be performed. in the manner set forffi in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . of . . . . . . . . ' .f T19.7 i. SUFFoi,� . . . . . . . . . . . . . . Notary Public{,-, unty (Signture of applicant) ELIZABETH ANN NEVILLE MOTART PUBLIC, State of New York No. 52-8125850, Suffolk &MtY term Expires March 30, i Sa�/lyo `� ho Town Hall Annex 6 Telephone(631)765-1802 54375 Main Road lb-6 g L' P.O.Box 1179 •• 0 r0 er.richert #own soUttgokn .us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: c I -,ff S Date: f /� Company Name: Name: License No.: g Address: r Phone No.: �S O S 2 2 . i JOBSITE INFORMATION: (*Indicates required information) *Name: beOLL i *Address: v I *Cross Street: `J *Phone No.. 1 Permit No.: ; Tax-Map District: 1000 Section: Block: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) 2 C\-�-Or C_Ja i (Please Circle All That Apply) *Is job ready for inspection: i NO Rough In Final *Do-you need a Temp Certificate: YES/ Temp Information(if-needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead E Additional Infon-nation: PAYMENT DUE WITH APPLICATION i 82=Request for Inspection Form I ,,3-1 .2,zu . T01A/N OF SOUTHOLD PROPERTY RECOR CARD m 1s OWNER STREET VILLAGE DIST. SUB. LOT , . . , FORMER OWNER N E ACR L S W TYPE OF BUILDING RES.-,;�Jo SEAS. VL. FARM 'COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 0 6 o a 6 L- tP Q � vvt� x, l o d oa 7 6 ..� po � ooa S 9 ..d GE S G C B I 1NG CO DIT N NEW NORMAL BELOW AB VE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 d Woodland Swampland FRONTAGE ON WATER o ' Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total DOCK ■■■■■■ MONO■■■■■■■■■■■■■■■ MMmmmMMMMmMMmMMMMM MONO 0 M MEN= rmaxViummmomm ■M■■■ ■■L -9mM■■■■■ 'IN ■■� ■■■WRLAM_E_r muna■■■■■Ma lamm N■Mr. MMM mmmmmAmmmmmmk A■■ ■■■WMR3AM■M2MA ■■■■ , A ■ ■■■■■■® ■■■E■■■■■■■■■■ ■�■ ■■ mmanum m■■■■■■■■■■■■■■■ ■■■mi■■■■Evi■■■■■■■■■■■■■■■■■ ■M■M mff mmM©■■■■■■■■■■■■■■■■■� ■■■■■■■■■■■■■■■■■■■■■■■■■■■ Ir r. Foundation NINE Fire Place wa ■.®� :• - �■■■ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date AUG 29 1973 Bldg. Permit No . TO WHOM IT MAY CONCERN : The sewage disposal facilities for a structure" l`ocate3"""''' a t ��� "al- 'hod (Give dee location) L, have been inspected by this department and found to be satisfactory. 71 2*V- Chief of General rIngineering Services AUG 291973 v SUFFOLK COUNTr DEPARTMWT OF HEALTH H.D.Ref. No. APPLICATION FOR APPROVAL OF INSTALLED PRIVATE SEWAGE DISPOSAL AND WATER SUPPLY SYSTEMS Inspection for approval is requested, pertinent installation data herewith. 1-Name of Owner F-14 F1) 14401 e R 3-Subdiv.'//t*7 Address I Portl Phone 4-Section No 2-Name of Builder � Phone 5-Lot Number_ Address r 7-Sewage System installed by - 6-B1dg.Permit No.Phone Address 08-(a)Deed location of pr erty "0 (b)Hamlet or Village JG V T�4 Q L U (c)Town ; 9-Septic tank-Gal L ft.W ft.Liquid Depth ft. `-10-Cesspools-(a)No.pools�—(b)Blocks below inlet-1) 2) 3) 1� (c)Block size-L in. in.H in.(d)Precast pool (e)1� Z 3'( �y (f)HL_ft. (J in; Diam. ft. in. (g)Finished grade to, cover ft. (h)Backfill Materiali�i4�__ . W0001 ll-Water`Supply: .,Public System Private Well If Private, the following questions are t e answibred• 12-Private er jupply System installed 4G � Phone Address 4NE j / 7 13(a)-Total Depth of Well COT (b)Depth to Static Water Level 14-Diameter of well pipe 15-Name of Laboratory - 16-M thod of Disinfection 17-Date ready for inspection—WI T-- -C 7, *1/.* r7ep The undersigned CERTIFIES: Above systems have been constructed and are in compliance with the Suffolk County Health De artment's cur ent Standards, Bulletins and Amendments thereto. ? ' 18-Date Signed Owner - Builder 19-Insert sketch of location of Water b Sewerage Facilities with acc ate imension's. o A 11L . . t~ STREET A -------------------- --------- FOR HEALTH DEPARTMENT USE ONLY -- Inspected by Date . Based n ormation stated above, satisfactory function ng of the above systems can be expected with proper maintenance and care. AUG 29 1979 -� f -- Date Approved , Chief of Geri;ral Ene;ineering, Serviops, STANDARD MOTOR PRODUCTS, INC. Long Island City, N.Y. 11101 Exeter 2-0200 From the desk of Fred Adler To /0 73 fu //' Cti �iFcc-ate mot" .r��¢ 4 - i P s _ TOWN OF SOUTHOLD 7e�5 - :5V14? TOWN OF SOUTHOLD Building Inspector's Offic Building Inspector's Office Town Clerk. Building Town Clerk Building Southold, Y. 765-2660 Southold, N. Y. 765-2660 1A i ,1 #I/ Ac 4/4C74 rt#�) �r-'d'Ve., fit t/ s pF SO!/jyolo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 COU BUILDING DEPARTMENT TOWN OF SOUTHOLD April 30, 2014 i l Ralph Gerchak 2011 154th Street Whitestone, New York 11357 RE: 520 Lakeside Drive, Southold TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of$50.00. Final Survey. Plumbers Solder Certificate. (All permits involving plumbing after 411/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT -7-7 '78 5URYEY OF LOTS 8 j ..SUBDIVISION MAP OF CEDAR BEACH PARK" N FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY DEC. 20, 1927 AS MAP NO. q0 51TUATE: BAYVIEW TOWN: 5OUTHOLD 5WFOLK COUNTY, NY s SURVEYED: AUGUST 11, 2011 SUFFOLK COUNTY TAX # 1000 - qO - 3 - 1-1 it CERTHq ED TO: 9v B.Ge:chak Ridge S• Mane Absbid 00 '�FoG O � Republic iVatt�anal Title Insurance Company d s al a�T O 5.0 E 0 00 .� Q 30 � r' lam+ r � rn MAY — 9 2014 I _D d OF NEW Y QC C. E p NOTES: /� f t� MONUMENT FOUND �/ * * t �� no c)�A 4-1 o-pea sea ce cws -ea w ce�a a e THE TOWN OF SOUTHOLD CLAIMS OWNERSHIP �, c,tiG �p OF ALL "UNDERWATER LANDS" / �F rep. .n eaN the eIn.s- � Pocece.or cma S-ve teo i / C SJ a.Ltne�s,��ewrsy soea�o vore o nly 4N o�the pe-w :-„nom——7.,,p-eparea / nena.to the t t e a�a .gave mmen- EDGE OF GREEK IS NOT REPRESENTATIVE OF ; �,a� .or the iena[g insueuton cer[aco- THE EDGE OF WETLANDS j4 Area = 30022.60 cl ACR ES Sa FT Area = O.bq ACRES JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO. 50202 _6-RAPHIG SGALE I"= 40' ._- _ -- _ RIVERIiEAD,N.Y. 11901 I i __ 369x8288 Fax 369-8287 REF.C:\Users\John\Dropbox\1l\11-148.pro