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HomeMy WebLinkAbout1749-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ........ ~/~....~,l_trt~...~.¥~ ............................ Street Map No....~ ......... Block No..-:X~ ........... Lot No .......... ~ ........~.t,¢.t-~t~ok-t ...... Nv;~.v ........ conforms substantially to the Applicahon for Building Permit heretofore filed in this office dated ...................................... Ha.~ ......... .32. ...... , 19.~... pursuant to which Building Permit No ...~_.~)~ dated .................................. ~ ....... 2.~,, 19..~., was ~ssued, and conforms to all of the requirements of the apphcable provisions of the law. The accupancy for which this certificate is issued is ........ ..... ~.~-i.v a.t e... eme ...f.n r~-~..l.y.. ~wet..]L. tng .......................................................................................... The certificate is issued to ..... 0'~(~..~.~..$+,,Alka$ ...................... 0wirier. ............................................ (owner, lessee or tenant} of the aforesaid budding. H.D. Approval Oct. 16~ I962 by R. Vitl~ 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) N.° 1749 Z Date ........................... I1~.....~.~ ....... ~9..6.;~.. Permission is hereby granted to: J..em~.. ~t~ulca~ .................................................. ............ ~t~(~...~.te. st~ ............................ .......... i.~.~ ~e .~, J., .................................... to .... .t~.t~¢~.i4 .~. ~-el. it~l~ ........................................................................................... at premisbs lacated at ..... ~.....~...A~ .................................................................................... ............ ~-~, .................................. ll~t~¢~.~ ..... l~...~. .................................................................. -i pursuant to apphcahon dated .................................. ]~r.....~?~ ............. 19..~., and approved by the Budding inspector Fee $""t~)~,'1~)O ...... L ' Build~ncj Inspector SUFFOLK COUNTY DEFAR~NT OF HEALTH Riverhead, New York _Applicati°n, ~ for Approva,1,. to Construct~ , ~.. , Private. , .,, Sewage Dis~,osal, ,, .S~,stem., TYPE OR PRINT LEGIBLY IN INK t ] To the Suffolk County Department of Health Date /~ Application for Approval to construct private sewage disposal system is here- by requested concerning w~ich the following inf.~rmation is s~bmitted: (a) Deed location of property /~'~ ~ ~ z, f~..~_~ .... (b) Hamlet or Village ~VlF^4~4~,;~ ~C. (c) Town ~_.~ -. _ 3. Cellar~ SlabI !; Crawl Space~.~I. [~. ~ater Supply (a) Public System: Name Distance to nearest main Private ~]el! ~ ~. Cesspools~ (a) Number of pools ~ (b) Blocks below inlet (1) ! 7~% (2)~ (3): ,, (c) Block size-L/~ in., vS. ~( ?r, opos ed ,Sy?tem, 6. (a) (c) 7. in. (a) (c) (~) (d) Precast pool (e)No. of sections (f) Sq. feet per section Septic tank I Inside-width Liquid depth , ,, ft;(b)Length ft. Seepage field ~ I Trench - W in.; (b)Lft. Number of trenches Depth from bottom of seepage pipe to ground water 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 revisions thereof, prevailing at the time of constructzon. FOR. USE OF HEALTH DEPARTIf6NT ONLY Based on information presented hereon it is the opinion of this Department that an adequate and satisfactory sewage disposal system c~ be constr~d on this / / sc~ s-:t5 (~evis.) Gro u_~nd Water Data Capacity Level Test Hole Data Ft. 0 2 __ 6 , , , __ 10 12 18 20 Indicate Nor th [ ,.] TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned .......... ,9..? Approved ........................................ , 19 ........ Permit No ........ .~../. ....... Application No ..... ./..~....?'...?. ........ (Building Insl~ctor) APPLICATION FOR BUILDING PERMIT 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 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 p6rt 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 pa rt for any purpose whatever until o 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 County, New York, and other applicable 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 laws, ordinances and regulations. (S'gne~ at appli~ont, or name if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,., ...................... ......................................................................................................................................................... Name of owner of premises ............... ...~..~..~.../~.......~..' ....... $'..?.~..~...~..~ .......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No: ............ ;~x,.......~.... ............... Lot No: ...../~.....J~ .... Street and Number ...... .~.O.//..~..~.....~..~.~:..)...'~...~..T..?.~..?.?...c..~' ........................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /V~a/~- b. Intended use and occupancy ~...~...~.//V & 3. Nature of work (check which applicable): New Building ~/ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ......~.~.....Z~f~....:...~i ...................................... Fee .......................................................................................... (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, commercial or mixed occupancy, specify natureand 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 of entire new construction: Front .......... ~ .............. Rear ...... ~ ................ Depth ....~..- ............... Height ............................ Number of Stories ........ ~ ....................... ,~-oo / 9. Size of lot: Front ....... ~ .................. Rear ...... ~ ................ Depth ....... ...-ff~,.~.~-..~..~...&. .............. 10. Date of Purchase .............. /.~..~...~.. ................................ Name of Former Owner ..~...~.~(..~.....7~'...~......?ff..7'.~/..~.../= ........... 11. Zone or use district in which premises are situated ........ ~. .......................................... ;~/./.~,~ ................................ 12. Does proposed construction violate any Ton ng aw, ordnance or regu at on? ..... ~..-;.E~..'.~.];.-.::].-.:~.~:-'..~f:~..~%.=~ 13. Name of Owner of premises ....:..~.L.~..'...~.~...~..~.~ .......... Address4~'t~.~.'...~..,'Y'×~'~...~..../'/...~..,~. Phone No...6.-~,~'~.... Name of Architect ...~.~.~.~./.A'.L.Y...~./.f.~.~..~..~.~.C/-.~.~....Address .~..~.~Z~.q..R'...~...~..~'..~..~.q.~..~.~'.~ Phone No...~.~:,~.~,z~..~.~ 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW,YORK, -~ ),-- COUNTY OF ~.....) S.S. .............................. ...~..,...-,~..:.....-,~...?~..~.,4..~ .................................... being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ....O.~.~/.~.J¢ ...................................................................................................................................... (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 work will be performed in the manner set forth in the application filed therewith. · JUDITH T. BOK£N Sworn to bef. or~e me this ~o~ary Public, State of New York c~9 ~ .................... ..~.. day of ........ ; ............ .......... .............................