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Home My WebLink About1713-zFO~,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...P~.S...~r...V.i~w..i~o~d .......................... Street Mop No..~ .............. Block No .......... ~ ..... Lot No ...7..~ ....... .~..g..~..~...~.~.,~...~.].t .................... conforms substantially to the Application for Budding Permit heretofore filed in this office dated ............................................. ~,p~'.JL~....2,.~ 19..6~,. pursuant to which Building Permit No..Zl.~.t.~... dated ........................... ~p~i!....2-~ ....., 19..62., was ,ssued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for wh,ch this cert,ficate is issued is ........ ........ P~L~ at e...oz~e.. ~.aml 1.~..~well.$n~ ...................................................................................... The certificate is issued to ...t[er~.~...,~'.,...C~'~es ............... ~ ................................................... (owner, lessee or tenant) of the aforesaid building. HoD,approval July 30,I~62 by R.Vil!m Building Inspector "-t FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEFARTMENT T~'WN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT N? (THIS ~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1713 Z Date .................... ~l.]i~;l~.... ;~ .............. 19~9.... Permission is hereby granted to: Tt~ar~.~n~truc~on .~o..Z~uc....~/~ llei~.y N. Cordes ............ ~ .5~l~..l~/.. ~T~l~p ............. to ...~..~e~..o~e...~'~.~..d~lli~ ............................................................................ at premises located at .~.S ..... ~ .;]~r~w...R~,~l~ .................................................................. ........................................................... ~.o~I~I~,... l~,.~ ............................................................... pursuant to applicat,on dated .................................... ~l~"ll 2'~ ..... 196.9..., and approved by the Buddihg Inspector Fee $ :7&.Q ,.(~ .......... Building inspector SUFFOLK COUNTY DEPARTM~hWf OF HEALTN Riverhead, New York Application for Approval to Con, strict Private Sevm~e Disposal System TYPE OR PRINT LEGIBLY IN INK To the Suffolk County Department of Health Date .......... Application for Approval to construct' private sewage disposal system is hereby requested congerning which the following information is submitted: 1. Name of applicant ~, .... ~__~_~ .'~ddress (a) Deed location of proper~y ~ ~ ...... .~ (b) ~mle% om Vi~a~e .... (c) 3. Cellar l X ~; Slab ~l; Crawl Space t .... 4. Water ~p~ (a) ~blic ~t~: E~e ~ivate Well Distance to nearest main 5- Cesspools i"' ~' ~~ (a) Number of pools (b) Blocks below inlet (!) (~) (3). Proposed Bystem 6. Septic tank. I.:. (a) Inside-width (c) Liquid depth 7. Seepage field ft;(b)Lengt~ ft. /7/ /2/ (a) Trench-W . in.; (b)L~t. (c) Number of trenches '(c) Block size-I~ in., W', ~ in. (d) Precast pool (e)No. of sections~ (d) Depth from bottom of seepage pipe to ground water (f) Sq. feet per section I hereby certify that I am familiar with the requirements of the latest bulletin of the "Standards for Private Sewage Disposal System" and will construct this system in conformance with these standards, or r~visions thereof, prevailing at the time of constructiono ~/Z )Z ~.~ Applicant ' s Signature ~ ~ .. ~'--"'"~'~z,,., FOB USE OF HEALTH DEPART~T ONLY Based on information presented hereon it is the opinion of this De~ar~ent that an adequate and satisfactory sewage disposal syste~onstruc_~e~ this Date ,~, - ~/.~: ,~ ~"~ Signature, SCHD S-15 ~Revis.) / Ground ~;ater Data iCapacity~__~als, Capacity Level ~ _ Test Hole Data --- 10 , 12 __ 16 ~-~1~ 8 __2o Indicate North FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........ ' ' 19 Permit No ,Z- t 7 I ~ D~sopproved o/c ...~.~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a This apphcation must be completely filled in by typewriter or ~n mk and submitted in duphcate to the Buddm Inspector. b. Plot plan showing Iocahon of lot and of buildings on premises, relationship to adjoining premises or pubhc streets areas, and g~ving a detailed description of layout of property must be drawn on the diagram which ~s part of th~s apphcatJo, c The work covered by this apphcat~on may not be commenced before ~ssuance of Building Permit. d Upon approval of th,s apphcahon, the Building Inspector will ~ssue a Building Permit to the applicant Suc permit shall be kept on the premises available for inspection throughout the progress of the work e No building shall be occupied or used m whole or in part for any purpose whatever until a Cerhflcate of Occupan,_ shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of $outhold, Suffolk County, New York, and other apphcable Laws, Ordinances c Regulahons, for the construction of buildings, additions or alterations, or for removal or demolihon, as here~n descnbe~ The apphcant agrees to comply with all apphcable laws, ordinances ~/nd regulations. ................... ~ ~ z - ~ , / ~ (~n?~re of apphcan~or n~e, if a corporation) (Address ~[ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu~lde ..................................... ~. ~.~..~.. ~ .................. } .... Name of owner of prem,ses .../~..4'./vz'~.~...x~.....~.. ~z/~_~_.~. ................................................................................... If opphcont ~s o corporate, signature of duly authorized off,car (Name and t~tle of corporate officer) 1 Location of land on which proposed work will be done Mop No ................................ Lot No' . .............. Street and Number ..... /t-~..~./-K..,,'...~..f-4¢/... ~'t'~c~. ........--,%:~ ~.~./~.~.~..~ ...................................... Mumc~pahty State ex~st~ng use and occupancy of premises and ~ntended use and occupancy of proposed construction a Existing use and occupancy ................................................................................................. b Intended use and occupancy .............. 3. Nature of work (check which applicable) New Building .~.. Addihon ............... AIterabon ...... :u"' Repair ................... Removal .................Demohtion ................... Other Work (Describe) .................. 4 Estimated Cost ..... '.r.../...~....~....~.....O.. ........................ Fee ............................................ : ........ , ..... (to be paid on fihng th~s applicahon.) 5 If dwelhng, number of dwelling units .... /. ....... Number of dwelhng umts on each floor If garage, number of cars ....... /... ~.i~ ........................................................................ :.: .... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use~ ' ..:'..~ ........ - 7. D~mens~ons of exishng structures, ~f any Front ..... Rear ......... Depth ................... Height ......................Number of Stones ......... Dimensmns of same structure w~th alterahans or addJbons Front ......................... Rear ......................... Depth ......................... Height ............................... Number of Stor~es ........................................ 8 Dimensions of ent,re new construction- Front ...~ .~. '~. ".. Rear ,~.~7~.....~..~ ......... Depth . .~..f; .................. Height j,~- i Number of Stones .(...4'~'¢ ~. 9 S~ze of lot Front ...../.~.¢: ........... Rear / ~ ~ ...... Depth . j ~.~.../ .................. 10 Date of Purchase .... /,~.//.....¢..z~ ......... ~'.~&./ . .. Name of Former Owner .....~.'..' ..(<.~...r...~..~....~.: .... ]1 7one or use dmtrmt m which premtses ore s~tuated ...... ]2 Does proposed construchan wolote ~ny zoning Iow~ ordinance or regulohonP ...................................... 13 Name of Owner of premises~.t/~.~.....~--~/"i~.~.~... Address ~/~/2~.Z~.~.~p.~ No Name of Architect ............................... Address ....................................... Phone No ............... Name of Contractor . .~.Z~.~.~.~.. ~--~t~'~..~.r'~'~t&~/ddress ,2,~.~ .~¢,:tv~.,.£.~../~./~/: ...... Phone No~...~./...z) ~..~ PLOT DIAGRAM Locate clearly and d~shnctly all buildings, whether exishng or proposed, and red,cate all set-back d~mens~ons fror property hnes G~ve street and block numbers or description according to deed, and show street names and mdlcat whether Interior or corner lot. 2 STATE OF NE¥¥~¥p~,, ....................................................................... being duly sworn, deposes and says that he ~s the apphc~n (Name of ind~wdual s~gning apphcahon) . ~ ~ ,,.~ ~ above named He Is the ...~.¢~....~..~. ~. ........ ~.~...~...~q~.~0. ......... (Contracto~gent, corpo~e officer, etc ) of sa~d owner or owners, and is duly authorized to perform or have ~erformed th~sa~d work and to make and this applicatmon; that all statements contamned m thins applicahon are true to the best of his knowledge and belme; and that the work wmli be performed mn the mann~n~gt ~Nm the~pphcahon filed therewith Sworn to before me thms Ne~ o .............. Gay o, ............... /~....N. 8o i ~2~ / // ~ ~ ~., ' ~. ,. ~ ~ ~xp,res ~.¢b.~.~.~~.~....~..~.~ ................. Notary Pubhc, ~ ~ ........ County ~ ~ (S,gnature~'~plicant) Tornark Ccmstruction, Irlc. ~100 Sunrise |slip, New York J L Islip, New ................. ]F-3-_l~ ?- 'I'