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Home My WebLink About4946-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMEN'T Town Clerk's Office Southold, No Y. Certificate Of Occup No. ~1+16~ ..... Date ............ .~.ia.]TC~` .9 ...., 19.7! THIS CERTIFIES that the building located at ~]i4. ~'e-Ck. }".lace ........ Street Map No. liar.vest. ~ Block No ......... Lot No. ~1.~ .: ..... ~e~th~lcl~. l~!...](, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 5epic · · ' 9' , 19. ?O pursuant to which Building Permit No..brg~+.6.~. dated ............ ~ep2. · '9 ', 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 . PI~ivai;e.. o~le..£amily. ~)~:q~ ].;L~g ....................................... The certificate is issued to .. Freed. & .Fiarie .~all~nb~aFn ...... (~wne~.~ ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Underwriters Cert// i[OUSC /~ 260 Dee. 8, .1.970. · .by. ~, .Villa ....... Building Inspedtor TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL EULL COMPLETION OF THE WORK AUTHORIZED) N? 4946 Z Permission is hereby granted to: .... ,~a~...-.~u~.~.~..~..~....i ................. ....... 8~e ....... ~q,:~, ....... .t~l~iJ~,. ................ to . .~u~.~ L.zze~...o~t..£~.~...~t~;g~t ..................... . ......................................................... at premises located at ......... ~...t~.....~g~.~.~..~..,~.~...?.~ ............. , ............................. r ...... ................................ ~/a.....v..~..~.~.~,. ......... ~.e~t~' ~ ....... ~.,...~_ ................................. pursuan¢/to application dated . ...................... ~ep~.~..~t.....e;...;,;~..,.~' · ' 19~.,., and approved by the' ~uilding Inspector. Fee $.-~,~ e~O. .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF REALTR Bldg. Permit fro. /7~r/~//" ~ TO WHOM IT MAY CONCERN: at The sewage disposal facil£t{es for a structure located (Give deed location) have been inspected by this department and f'ound to be satisfactory. Chief ~f General ~ngineeP~ng Services D~lst rict Engineer EASTERN' DiSTRICT~'I~~Y. H.DoReference No.. "' APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE ~.EWAGE DISP~AL SYSTEMS Date Approval t~ construct said systems ie requested,pertinent'~data her~ith: 1-Applicant ~/,:~ '~ /~/ ~.~ ! Y)~ Phone ~3~J~J~ 6-Sub div "~/ ~ >//~'~"~t Address f~ o~,~, ~.~ , '~'~'~'~/~ ~,'J3/_.: 7-Section 2-Dot aile~d property l~cation ~/-~ /:e~ /~, ~Y~' ~/~ ~s 8~Lot No. /-/~= .~., r~,~ /'/ '~ 9-Private well? 3-Public ~ater suppl~. Dame~r~*~m M/~ DiStaUce to ne~est ~ ~-~t size: ~n~h .... ft. Width /Y~ ft. (A~o ent~ ~n center plot p~n below:) 5 ~e~g. S~le f~./. ~o fam~?~CeHar.~b?~Cr~l Space?/ / 10-Proposed s~t~:Septic t~/ /Precast/ /Cess~ols~Sh~~/ /other~ H-Septic ~ ~side d~ensions:Vel~e ~.Len~h~ Ft.Width f~.~Uid depth ~-Precast section:/ ~ber./~,O/Sq~re ft.Cess~o~:Block size L ~.D % ~s.H~s. PLOT PI~ Grade G. 4L. Street Test Hole I Data iFeet O 2 8 10 18 The Undersigned CERTIFIES: "Construction of authori ied installations will be in accordance with the Suffolk County Health Departments' Current Standards,Bulletins, and amendments thereto~covering Private Sewage Disposal Systems", Date f/~//? o Signed ~ ~~ , ~r i ~dilder F(~ HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith,it is the opinion of the Health Department,that an adequate and s~tisfactory Sewage Disposal System can he installed on this Plot. Date ~'/~/'~0 Signed APPLICATION FOR APPROVAL TO C.O.NSTRUCT pRIVATE SEWAGe. DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate i-Means Owner or Builder. Address to which mail should be directed. 2-Means detailed description of property location, together with street name and distance to nearest intersection of ~ain thorofare, also Hamlet/Village & Township 3-Enter name of Public Water Supply District, together with the distance to their main. ~-Enter ~ength and Width of Lot under appropriate heading, also enter these dimensions on center plot plan shown on the face of this application. 5-Dwellings: Check-mark "V" items applicable to the proposed new dwelling. 6-Name of sub-division 7-Section Number 8-Lot Number 9-Private well: Enter "No# if Public water supply is available. Enter "Yes" otherwise, PROPOSED SYSTEMS: Answers to Items number 10, 11, & 12 please consult the Suffolk County Health Department's Standards, B~ulletins and Amendments for Sewage & Waste Disposal Facilities. i.e., Part II-Residential Sub-surface Disposal Systems covering Cesspools Part III " . e . e " Septic Tanks Part IV " " " " " " Unusual soil conditions Part V " " " " " " Shallow Leaching Pools PIDT PLAN: The following information is required concerning the Applicant's Lot: LOt size-Length and Width in feet to be indicated at the LOt lines of the heavy lined square in the center of Plot Plan shown on face of this application. Surface waters-Streams, Lakes, & Bays, etc., located within a distance of 50 feet of Applicant's Lot lines, must be shown on the plot plan also. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. Where no Buildings exist on adjacent lots, state "Vacant" on the plot plan. Streets adjoining applicant's lot to the right, left or rear, enter street name. WELL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the following Standards must be observed: Well-100 feet minimum distance from the nearest cesspools Well-25 feet minimum distance from rear, and rear sides of property lines Well-10 feet minimum distance from front, and front sides of property lines Well-50 feet minimum below grade for well point Well-40 feet minimum into ground water for well point Well-$ feet 6 ins. minimum below grade to well head and lateral water pipe CESSPCOLS LOCATION: Upon determination of the Sewage & Waste disposal "type of systems" required, the following Standards must be observed for the location of same: Cesspool-10 feet minimum distance from lot lines to center of cesspool Cesspools exterior must be 100 feet minimum distance from nearest well Septic tank exterior must be 75 feet from nearest well Cesspool "Center" must be 12 feet minimum distance from nearest water line Cesspool "Center" must be 15 feet from house foundation Cesspool exterior must be 50 feet minimum distance from surface Waters, Streams, Lakes & Bays, etc. Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center must be at least 16 feet Cesspool cover top to grade must be held to minimum of 1 food to maximum of 2 feet Bottom of Cesspool to ground water must be held to minimum of ! foot /'7 /c>:,z Lo'l' I '7' (Bulldinganspi~:tor) APPLICATION FOR BUILDING PIRMFI' b INSTRUCTIONS a. This application must be completely filled In by typewr tir or in Ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiere or I~JJc streets or areas, and giving a detailed description of layout of property must be drawn an the diagram which Is part of ~hle 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 Certlfi~te 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 purduant to the ~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~nd other appll~ble Laws, C)edlnances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolltlofl, ee hel~ln dlKribed. The applicant agrees to comply with all apl)licable laws, ordinances, building code, houslng~ade, and reg~lcItlons. /Z Z]., , 'P,',.. (Signature cf applicant, ?r name, If cs caq)orofl'a~t) . ~2,~0 S~rtae ,.~...~.,. Sa lle ~! ~.~.782 (AddreSs of applicant) State whether applicant is owner, lessee, agent, archit&ct, engineer, general contractor, electrician, plumber or builder. Co~t,r&ot;or Name of owner of premises ..... ~'.e'l ..IU~.~II3~J.~L..~3,3,~L1;).g3~% ............................................................................... ~ 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.: ....~J3.~ ........................... Lot No.: ..~. ................. .~ S a laeok ~. .~'.~./..9 · ~. AY ou~ho d ]1' Street and Number ..~ ........ .~ ........ .ts...XT. ..........~L.~i ....... .q.,....~. ............ ~...JL.....~. .......................................... ,,~.0 ~/ . . . . Municipality ' 2. State existing use and occupancy of premises and intended use and occupancy of preposed conctructlon: a. Existing use and occupancy ~ b. Intended use and occupan? ..cme..~.mL~...r. ei2.4~Ge ............................................. ; ................................. 3. Nature of work (check which applicable): New Building ....X. ............. Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ....2...0..q0.0..0..;..0...0. ................................... 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 sarna structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... .~ ..................... Rear ...... ~a.. c~.e. ........ Depth ...~}~.". .............. Height ...~.~.. ............. Number of Stories ......... ~, ........................................................................................................... 9. Size at: lot: Front ...... ~,~.,~. ............... Rear ....... ~,~.~.~ ..................... Depth ..l~J.~.." ..................... 10. Date of Purchase ........ ~.0.~.,...1.9.~.9. ......................... Name of Former Owner .M~r~..~T.,..~zr,~is~ ................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed constructlon violate any zoning law, ordinance or regulation? ....... ~D ................................................ 13 Name of Owner of premises ~'.o...~.8,~].~DJD.O~ ........ Address .P.&b~"l~ne..N'~'. ...............Phone No. Name of Architect ..~...e..q.]..~..q...~.~.~ ..................... Address .~.O.~13.]Kg~,&.s..,~][ ........ Phone No. ~..~.-..~.~l.0.cJ. 52~0 Sunrise Name of Contractor .~.9..~...a~..~.....~...o..q..s.~.r...a..~.t~..~.o...m. ...... Address ....~a.~v$..t.te..N.l~ ............. Phone No. ~,.8.9.-..203.Q. 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. STATE OF NEW YORK, COUNTY OF ............... S~.f~lk. f''''~' Richard Soilep. pi h, nn duly sworn, deposes and says that he is the appJicant (Name of individual signing application) above named. He is the ...~..~...e.~8.i..~...e..~..~....~.~?.~.~..?~8~.~.~..~...~..~.?..~.r...~.~.~.~.~..~g.g~..'~..g.~p.t~gz ..................................... (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 bel ef' and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ..... .......... _i I LL~L~L H ,t 8532 5250 suNRISE' NIGH,WAY,, SA'CVILLE ' '.' 'LT 9J203~':<* ' , ~ P~AL~ 14!,0" I0~, .4? -? 8532