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Home My WebLink About5110-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.. ~8.0 ..... Date .......... ganuarz.. 19 .... , 19. THIS CERTIFIES that the building located at . .Sound .View. Aw,* ......... Street Map No .... :KX ...... Block No.. ll~ ...... Lot No...xx.. 14~tt:l.tuck..1~ .~., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Doe...5 ....... , 19.70 pursuant to which Building Permit No..511 dated ......... Dee...21 ...... , 197[~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pl~iva~a. one..family, dwelling .... ( summer..occupancy. ,~ .no. heat.). The certificate is issued to ... ~ll. llgm.. R....l~oyrall ....... 0wlael~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .Oc.t...13.. Ag?]...bY..t~,.Vllla .... UNDERWRITERS CERTIFICATE No.. 1i'.1.7829.... l~tZ .3,. 1972 ........................ [lOUSE NUMBER .... 1'~ ...... Street ....,q, on~rl ~'te~. ,/~,~'e ............................ FOR~ NO. ~ TOWN OP SOUTNOLD 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) NV 5110 Z Permission is hereby granted to: ...Iti&ga..Itoy~a..A~...;f:l. Ll.ia~..ite~ .... ~3 ......... llsx, t,i.s.. ~,ve .. ~e st ................................. ............. ~"l-ve-z'1,1 .......... it..it.o ............................... to ...... b~]t ~ d.. ~e~..t:~L £,~k].~.'...~.~ :L~.~'~g .............................................................................. at premises located at ............ .~I/~..~-Ol~li'l~...'~/~'~-.~¥~ .................................................................... ............................................................. l~t.t,:i ~,uok ...... E.:Z. ............................................................. pursuant to application dated .................................. ~[~ ....... ~,,.~. ...... , 19..~...0.., and approved by the Building Inspector. llO~'l~, SubJeot t.o Averaga se~baek Fee $ ...~.O~.g~t .......... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~tl~. ..... Date .... ~O . 21, , 19.72. THIS CERTIFIES that the building located at .. ~[]B. 8o~_m,d. View Ave Street Map No. ~ .. Block No. 33; ...... Lot No. 3C3~ l¢~t;tltUek$ lq,II, conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Dec, . 5 ' 19 ,~. pursuant to which Building Permit No. ~10Z . dated ......... Dec .21 , 19.~O, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. ~iva~e .e~e .~amil.7 dwel~_~g .............................. The certificate is issued to ~i]k~'iala..Rt.t4eTTol~ · · · 0WIIOI' ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 0et. '~'3 ~. ¶ 9.~[ · bF' ~R,. Villa .. UNDERWRITERS CERTIFICATE No... p811~ls ........... }lOUSE NUMBER '175t Street . .[tql. llld VioW A~e Braiding Inspector~ TOWN OF SOUTHOLD BUILDING ,DEPARTMENT ] · TOWN C:LERK'S OFFIC:E SOUTHOLD, N. Y. ~. .......................................................................... 7.:..._z ...... ........ ~. Thi~ ~pplicotion must b~ complot~¥ fill~d in by ~pewrit~r or in ink ~nd *ubmi~ed in duplicot~ to th~ Buildin~ b. ~lot plan ~howlno Ioc*tion o{ lot and of buildih~s on pr~mises, r~l*tion~h¥ to adioinin~ pr~mise~ or public str~t~ areas, and giving a detailed description of layout ~ pro~ must be drown onthe diagram which is ~ of thi~ application. c. ~e work cover~ by this application may not be commenced ~fore issu~ce of Buildi~ Permit. d. Upon approval of this application, the Building InspectOr will issue a Building Pe~it shall be kept on the premises available for inspection througho~ the pr~r~ of the work. e. No building shall be occupied or used in whole or in paff for any pu~ose whatever until a Ceffificate of ~cupancy shall have been granted by the Building Insp~tor. APPLICATION IS HEREBY/v~,DE 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 al applicab eaws, ord nonces, buUd ng code, housing code, and regu arians, .-(Signature of applicant,--~or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Nome 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 which proposed work will be done· Map No.: ......... 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 property lines. Give street and block number or descri~otion accordina tQ d ,~,~$show street whether interior or corner lot. /~o 3. Nature of work (check which applicable): New Building....~/ ......................... Addition ....... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ /0 4. Estimated Cost ..~..:...../..(.:....W..~...~. ..................... 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 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 ................................ ~ ~ '~" ~ ' ~" Depth - 8. Dimensions of entire new construction: Front Rear Height~:..~.~./.. Number of Stories ...... .~.~ .............................................................. ~ ........................................ 9. Size of lot: Front .......... Z/~ ........... Rear ........ Z~ ................... Depth ..... Farine- ~'"ner 10. Date of Purchase ....... ~L.:...-...w..~.~.m~ .............. Name of · ~ ............................... 11. Zone or use district in which premises are situated ~ 12. Does proposed construction violate any zoning Iow, ordinance or regulation .............. ,.,,..~ ...... ~,.~ ...................... 13. Name of Owner of premises .~,{~,~,,,,~Address ~...,.~.~~ Phone N6, .~.~,...~ ........... PLOT DIAG~M Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set~ck dimensions from names and indicate STATE OF NEW YORK, t c c COUNTY OF ................................ ~'~' ~&~l...~....~..' ..?.....~..~,..'~ .......................... being duly sworn, d~oses and says t~t he is the applicant (Name of individual signing gEplication) above named He s the ~.~-~.~.....~...,~ ..................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this a~plication; 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 fo~h in the application filed therewith. ............Sworn to~ me this ..... --~'~'~' - - ~ ~' ~ .~~ ;~ ~~. ................. : .......................... :.I..~;. day of ~.~~....., NotaW Pu~i¢~.~..,~'~~ ........... Coun~ ' ~ ~ ~ / ~ r SUFFOLK COONTY DEPARTMENT OF HEALTH EASTERN DISTRICT County Center, Riverhead, New York PA 7-4700 APPLICATION FOR APPROVAL OF INSTALLED PRIVATE SEWAGE DISPOSAL AND WATER SUPPLY SYSTEMS Inspection for approval is requested, pertinent installation data herewith. 1-Name of R 3-Subdiv. Address ~/;/a/V'ff/-~'/fr~/ZrS~/~Zr?[~ff:F~.~honeX?$-/~ 4-Section No. 2-Nam~ of Builderg~'f~- ~W~ne~-1~SO 5-Lot Number , 7-Sewage ~te~'l~st~lle~ gy~' ~ /~ Phone~3,-~o~ Address ~~ S~, ~/~-~, ~ ~ // 8-(a)Deed location of pr~erty~/~ ~g~ ~/~~ ~0~ (b)H~let or Village ~W~/~ ' (c)Town 9-Septic tank-Gal L ft.W ft.Liquid Depth ft. lO-Cesspools-(a)No.pools ~ (b)Bloc~ below inlet-l) 2) (c)Block size-L in.W in.H in.(d)Precas~po~/(e)l. 2 (f)H/~ ft. ~ in; Di~ ~ft. d in.(g)Finished grade to cover ~ ft. (h)Backfill Material~R~ ~F~ ll-Water Supply: Public Syst~ ; Private Well If Private, the following questions are to be answered: 12-Private Water Supply Syst~ instated by P- ~~ Phone Address ~Oc TW ~ ~l ~*--~ ~ 0 . '~ 13(a)-Total Depth of Well (b)Depth to Stat'i~ Water Level 14-Diameter of well pip~ 15-Name of Mboratory 16-Method of Disinfection 17-Date ready for inspection ~e undersigned CERTIFIES: Above syst~s have been constructed and are in compliance with the Suffolk County Health Department's current Standards, Bulletins and ~endments18-Datetheret° ~/'// Signed ~~ e.~t~ - ~,~~ ~er - ~uilder 19-Insert sketch of location of Water & Sewerame Facilities with accurate dimensions. ~ F/3R HF. AIi~/H DEPARTMENT USE ONLY Inspected by {~.z~x~ Date ~ ~ ~ 7 ~'7/ Based upon the info~ation stated above, satisfactory functioning of the above syst~s can be expected w~th proper maintenance and care. Chief of General~gineering Se~Ices, S-Se SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference No~ ~ EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS ~.. Date Approval tn construct said systems is requested,pertinent data herewith. . 1-Applicant ~,/>/~$ ~. /~r~ ~, Phone ~-3-/~d]~-Sub div Address , '~~S ~' ~ '~J~V~.~I' ?-Sectio~ 2-Detailed "property location~ ~ m ~ U/~ /~f ' ' ~ 8-Lot No. - 'Town ~7~7~ 9-Private well? Distance to nearest main Hamlet 3-Public water supply name 4-Lot Size: Width/.~....ft. Le~gthC_~_~ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~/~ Two Family? ~_/.~ellar? / /~lab? ~ ~ Crawl Space? ~ ~ lO-Proposed system: Septic tank ! fPrecastz~_/Cesspools/ /Shallow pools / /Other / ii-Septic tank inside dimensions: Volume Gals.Length . ft. Width ft. Liquid depth 12-Precast sections: / ;Number/ /Square Ft. Cesspools: 'Block sizeL incs. D ins. H Total blocks below inlet: ~1__~2 __~3 PLOT PLAN Street apacity Q,(G'Ji~ · P.M. ~' _ Ind~ ~ate NoPth 18 [ i - [ i F' 1~6_- I, The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". Date Signed ~O~ ,eraSer 11 Buildsr FOR 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 instal~on~~this Plot. ~ Date Signed (10/65 Revis. ) EXCAVATION INSPECTION REQUI S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date OCT ~ $1~71 Bldg, Permit No. .6-/10 ~ TO WHOM IT MAY CONCERN: (Give deed location) have been inspected by this department and found to be satisfactory. Chief of Generml En~ineerin~ Ssrvioem District Engineer SUFFOLK COUN~ DEPARTMENT OF HEALTH EASTERN DISTRICT County Center, Riverhead, New York PA 7-4700 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~//,<Z////;-~ R /~:'F/~///L/ 3-Subdiv. Address ~ ~/~ W~3 ~i ~fPhone~ 3-/~3 4-Section 2-Name of Builder~;%~ ~F~- ~~ne L~- I~)0 5-Lot Number Address ~7~,'(~.' ~//~/_~ ~ . - 6-Bldg. Pe~it No.~//~ 7-Sewage ~t~'~t~lle~ ~y~' ~ ~ Phone323 Address ~~ ~ ~/~ff~ ~ ~ .// 8- (a) Deed locat ion of pr~erty ~/~ .~p ~/~ ~/ ~o/~ ~f~ (b)H~let or Village ~/~¢~ ' (c)Town 9-Septic tank-Gal L fc.W ft.Liquid Depth lO-Cesspools-(a)No.pools ~ (b)Blocks below inlet-l) 2)__3) (c)Block size-L tu.W tu.H iu.(d)P~ecast pool (f)H/~ ft. ~ in; Di~ft.~.(g)Finished grade ~o cover ~ ft. (h)Backfill Material~ ~a ll-Water Supply: Public Syst~ ...... ; Private Well If Private, the following questions are Co .be answered: 12-Private Water Supply Syst~ instated by ~.. ~ ~ Phone Address ~ ~, ~ ~'~-~ ~~ 13(a)-Total Depth ~-f Well ' (b)Depth t0 ~t~t'i~ Water Level 14-Diameter of well pipe 15-Name of ~bora~ory 16-Me~hod of Disinfection 17-Date ready for inspection 7//'~/~/ - · / The undersigned CERTIFIES: Above sysC~s have been constructed and are in compliance with the Suffolk County Health Department's current Standards, Bulletins and ~endments thereto, 'I / ~er - ~uilder 19-Insert sketch of location of Water & SeweraRe Facilities with accurate dimensions. ~ r C Ff?~R HEAI~? DEPARTMENT USE ONLY Inspected by ~/~,~ Date ~ ~ / - ~.f functioning the Based upon the info~atiou ~tated above, satisfactory of above syst~s can be expected w~h proper maintenance and care. S-Se