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Home My WebLink About2657-zFOI~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEP~K'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ~No ..Z.-a2~ ........... Date ............................ lgO-~r,.. 10 ...... , 39.6.~. THIS CERTIFIES that the building located at .. W/~..~wood...]~.,[.~.e ........................ Street Map l~e......~...°°.~...~...c..r~t~ck No ...... ~ ....... Lot No '3'~ ....... ~O1/.~h<~.t%f...~.-~.~ .................... conforms substanhally to the Apphcahon for Building Permit heretofore filed in thru office dated ..................................... · [~'l~e~ ....... ,o...., 19. $.~' pursuant to wh,ch Build,ng Perm,t No ..,~.~...~ dated ............................ IJi~,~'~h.....8 .... , 19..~', was ~ssued, and conforms to oil of the requirements of the apphcable prows~ons of the law. The occupancy for whmh thru cerhficate ~s Issued ~s ........ · . ~ .~.¥ a.~e...o~e...~are~ t.~ ~we~.]..:~g ......................................................................................... The cerhficate is issued to ....J~:be~'.t,.....l~oz~d.ol'~..,...~l~li.t, lrt..&..~i£~ ......... .O~l.e~.s ................. (owner, lessee or tenant) of the aforesaid building H. D. App,'oval Oct. by R. Villa ...... .... Building Inspector\ ................. FOI~i~I 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? 2657 z Permmsion is hereby granted to: ~ez,aini & 8&ele3.....A/¢..Atl~e~t..Go~e~,-~4.~l~.&..W.~fe ..... ~mt~toa..~4 ............................................. to It~lzL1 d...~w. · e~. · .~.ed~ .2~-. ~wet .~.~ul~ ..................................................................................... et premises located at ,.;]Lo:t,..,~l~! ..... ~a~'oe~...~x~l~e~ ................................................................... ........................................... ¥/8.....8ea~c, ea..D'z,t.~e,.....~leat~otd~,...l~,.Lr., ................................ pursuant to application dated J~e~.e,h..~..-(.al/~el~e&-) .................. 196~'..., and approved by the Building Inspector Fee $ ~.'O'e'O0' ........... Building Inspector s-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located %t ~ ~ / -(~ve deed location) ' ~ have been inspected by this Department and found to be satisfactory. SUFFOLK COUntY DEPARTI~'~NT OF HEALTH Riverhead, New York Applicat~n for ,Approval to Construct Private Sewage Disposal S~rstem TYPE C~ PRINT LEGiBLY IN II~ To the Suffolk County Department of Health Date . . . Application for Approval to construct private sewage disposal system is here- by requested concerning~ff~ich.the__ following information is submitted: 3. Cellar~; Slab ~ ~; Crawl Space 4. Water Supply (a) ~blic ~stem: Name Distance to nearest main Private Well~ Propos ed S~stem 5. Cesspools ! .~1 6. Septic ta~k ~ I (a) Number of pools ~ (a) Inside-width ft;(b)Length (b) Blocks below inlet (1) ~ ~ ~ (2) t- . (3) " (c) ~loc~ size-L ~ in., W. ~ in. (d) Precast pool (e)No. of sections (c) Liquid depth 7. Seepage field (a) Trench - W in;; (c) Number of trenches (f) Sq. feet per section (d) Depth from bottom of seepage pipe to ground water ft. I hereby cert~y ~at I am f~iliar ~ t~ retirements of the ~test bulletin of the "Stan~rda ~r Pri~te Sewage Disposal ~s~m" and will const~ct this ~stem in co~ormance ~th these standards, ~ revisions thereof, prev~ling at the t~e ~ ~nstr~tion. Applicant's Sigmt~e FOR USE OF HEALTH DEPART~D2NT ONLY Based on information presented hereon it is the opinion of this Department that an adequate and satisfactory sewage disposal system can be constructed on this plot o Date SC~D /61 S-l~ (Revis.) $ig~t~e Well Gro un___~d Water il C apacity~Gals. ~ , Capac ity__~Z Level Test Hole Data ~_ 10 ~ 12 -- 16 __ 20 Indicate Nor th o% TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. ¥. NOTICE OF DISAPPROVAL File No .......... To ...T.~.~lir~i..& Siegel.. A/.G A~&~I,...Qordon Smith ......... ~o~ta~..H~ .............. ... H~ton B~s, N. ~, .......... PLEASE TAKE NOTICE that your apphcation dated .. I~srGh.. 2 ....... 19.~.. for permit to construct ~V~.~I~ .... at thc premises located at ..~ .... ~.~aW.O.0~ Dr ................................... Street Southold ~ N.Y. Map ..,~eawo~d, .Acres ...... Block ........... ~ ..... Lot , ~1 ............. is returnea herewith and disapproved on the followin~ ground, .... FOIU~I ~0. 3 TOWN OF SOUTHOLD BUILDING D£PARTM~-NT SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No ............................... Date ..... F.~rch · .3 ............. 19.~.~.. To ...T,e~ni...& Siegel AZ.C A.&M.. Gordon Smith ....... Mont ~uk H~y ..... ..... tt~mpton ~ays,.. ?/. Y, .......... PLEASE TAKE NOTICE that your application dated . . ~3~ch., ~ ........ 19~5 for permit to construct . ~'g~.~,~,~II~ at thc prem}ses located at ..~/.S... ...................................... Street Southold! Map .. 5.ea~.oad Acres .Block ... X~XX .... Lot . 31 ............... is returned herewith and disapproved on the followin? ground, Appllcaiion no.~.lzed .AWD lnsufficie~ .~e~ha~k - 35£.t. ~inimum r. equir, e.d, .... · ~..e..ry..t.h.i.n.g....e..1...s..e... 0,.~,...-..h. oldin..g, check & ~ther papers, for .c. orrected appl uilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO~.D, N. Y. Examined .....~..~-~....~...~ .... 19...~'-..~.'-'' Approved ........................................ , 19 ........ Permit No .............................. Disapproved a/c .............................................................................................. Appl,cat on No. ......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatior c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl issue a Budding 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 in whole or m part for any purpose whatever until a Cerhf~cate of Occupanc shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply w.th all applicable laws, ordinances, building code and regulations. (Signatur~c~nt,. or name, if a corporation) ................... ..:. ...... State whether apphcant is owner, lessee, agen~t, architect~ engineer, general contractor, electrician, plumber or builde Name of owner of premises ...~....~.....~........~...~...~......~.~...~ ......................................... If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be,done. M~p No' . .................. Lot No' ~ i 2. State ex~shng use and occupancy of premises and intended use and occupancy of proposed construction: a. Exishng use and occupancy ................. ~ ..................................................................................... b. Intended use and occupancy ........... ~'"'~....~.~...:~~~ .............................................. 3. Nature of work (check which applicable): New Building X. Addition Alteration Repair .................... Removal .................... Demolition .................... Other Wark (Describe) ..................................... 4. Eshmated Cost .../...D.t..~ ......................................... Fee ......................................................................................... (to be paid on filing this apphcotion) .5. If dwelling, number of dwellinfl units ........... .J. ............... Number of dwelling units on each floor ...... .J. ................... If garage, number of cars / 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~ 7 D~mens~ons of existing structures, if any: Front ..........................Rear .......................... Depth ........................... Height ............................ Number of Stories .............................................................................................................. Dimensions of same structure with alterahons or additions: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of ent,re new construction: Front ........ ..~..~..~.. ..................................... Rear .......... .~...,, .~.. ........ Depth '~- ~l~ / Height ......... !....~.... .......... Number of Stories 9. Size of lot: Front ....... (....1~).. ............ Rear ........ /......1~... .......... Depth .../......'~......~... ............. 10. Date of Purchase ......... ,./..~..~....,~... ................................ Name of Former Owner ....................................................... 11 Zone or use d~stnct ~n which premises are sttuated .................................................. '7 ........................................... 12. Does proposed construction wo. late a/~,y., zonina law, ordinance or regulatic~n? ..... ~...~. ....................................... 13. Name of Owner of premises ..... ~[-~,.m.~ddress ,~,~.-4~./~-~,,2~.~,,,~.;. Phone No ...... ;.L,~.,./,',. NomeName of of Architect Contrac,o?'"~' ~'.~J,~.~.. ;..J..:.,..~.., '~~--~ ........................ Address :::~~,.:~::: Phone No. - ddress Phone N o..~...~,.~:./, .,~. ,~ ' PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fron property lines. G~ve street and block numbers or description according to deed, and show street names and indicat~ whether interior or corner lot. STATE OF NEW fi~'l~,K.,I,I. ~)~ '~ ¢ S COUNTY OF ..... ...'~T:...~...I ~' · ..................... .~...~.....~-~..~/~.~..~....~........~..~..~..~...J....~...j ............... being duly sworn, deposes and says that he is the applicon (Name of individual s~gning application) ~ ~.~_. ~_. obove named. He ~s 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 ill, th,s apphcation; that all statements contained ,n this applicat,on ore true to the best of his knowledge and belief and that the work w,II be performed in the manner set forth in the a_pplication filed therewith. Sworn to before me this ~),o -- Notary Public, ~T~.~ ! ~¢ 't,~ · Qq~t~fte,J in S,H~O,~' ¢~nty T nn tx~es h~,ch 30,