The URL can be used to link to this page

Home My WebLink About5509-zFORi~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupsncy No. Zh486 Date Dee, 1S+ 19.71 THIS CERTIFIES that the building located at E~stwaod Dr. .&..lq. Cr0.s.s' P~treet Map No.E..a.~..~.o..od. ~'S~loek No ......... Lot ~o..~.~. .... C.utqho..~u? .... ~:~. :... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~.$pt.. ~ 6., 19 7.1. pursuant to which Building Permit No. ~.~0~Z dated ......... ~.?p.t...1. ~ , 19..~1.., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Private. oho..f.a.~a~[~y..d.~.~.~J~.i4a, g ................................ The certificate is issued to ....~.o..hi3...& .I~. 9.~.e.13...~..~.~& .....(~..e.r.$. ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Dec . .7,..1.97J.. bT ..R., .V;[~la... House ~ 730 Eastw~od Rd [ ' ^ - ~ 21 5 N, Cross Rd ~? .~ , , , . "" ........ ' Building Inspee FORNI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) al: prem ses IOCa~ecl. at ............................................................................................................................ ......... ..r...~.~.~: ...... ~..~....~..~..L~. ........... L.C.t......&.e. ........................................................... /~ ~'~¢-~r 19..7Z and approved by the pursucm* to application dated ................. _ ........................... ; ............... , Building Inspector. Fee $ ...... /..., ............. Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH H.B.Reference No-~'p ,,, EASTERN DISTRICT, RIVERHEAD, N. Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS D t Approval to ~onstruct said systems is requested,pertinent data herewith. Address ....~_.~.~' 3.(,!~? ,~P ~l~'~ . 4. ~, 7Y ~ ~ 7-Section -Detailed prope=ty S-Lot ~mlet . . ~ .. ,+ ~ t, r. ~.Z -- T6~ .3~'~ * ~ ~ t~ 9-Private well? 3-~blic ~t~ suPpl~ name ~ Distance to nearest main 4-Lot Size: Width/~ft. Length~ft. ('alS0 enter on center plot plan below:) 5-~elling: Single Family ~; Two Fa~ly? ~ /Cellar? ~/Slab? ; lO-~o~sed system: Septic ~k ~ /Precast-/ /Cesspoo~Shatlow pools / /Other/ ./ il-Septic ta~ inside dimensions: Vol~e Gals. Length T~. Width ft. Liquid. depth ft 12-Preoast sections: / /Number/ /Sq~re Ft. Cesspools: "Block sizeU~, incs. D;~ins. H~ns Total blocks below inlet: ~1~2~. . PLOT PLAN C~pacit~ Gals Indd Nc ~e Data ~ee~ 2 4 6 8 12 14 ~6 The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendment/, thereto, covering Private $e~ Disposal Systems". FOR HEALTH DEPARTMENT USE ONLY. B~sed on the infor~ion present'ed herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. (10/65' Revis.) I CAVATI I S-15 THE NEW YORK BOARD OF FIRE UNDERWRITERS 85 JOHN STREET. NEW YORK NEW YORK 10038 q! CERTIFIES hajda S~/C North Cross Rd. & Eastwood Dr, Job~5170 Cu~chogue, 1-3#10., C ,. tlc, Ca, tabus Elect ~ie Re. ll2'P~x 242 Co~m, U.I. 11727 office of tl~ B,c~rd ,f [n~orrecL i~pector~ ~), be La'ed~ SUFFOLK COUNTY DEPARTMENT OF HEALTH DEC ? lg71 Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located · (Give deed location) ' have been inspected ~y thi department and found to be satisfactory. Ch~_ef of General Engineering Serviee~ District Engineer DEC ? 1971 TOWN OF ~TH~D BUILDING~wN CLnK'sDEPA:TMiNToFFICE Ex, ned ..............~.~ ........~...., 19 .... ~pr~ ......................~..~;.~.~, 19.Z~.. P~it No ................. ...~...~; umapprovea a/c .......................... ~ ...... ~ ....... ~ ..................... ....................................................................................................................... (Building APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be.completely filled in by ~pewriter. 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 ofpraperty must be drawn on the diagram which is part of this opplication.~ 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 appI.icant. 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 Certificate of C)¢cupancy~ shall have been granted by the Building Inspector. The applicant agrees to comply with 'all applicable laws, ordinances~uilding~.....~.~ '~146~' '"" I~'"" ~c°de' housilg code, and regulahons. ...................... .. ~,r~. rure ot app icant, or name, it a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~..l~l~..~V,e~.~l,~l~, ..................................................................................................... I f ~ a ~q~°~t~ ~'/~nZre °f "duly auth°rized °fficer'~ ~ ~,,~ .... ............ · "~"~'(l~g6n~l~ and-' **~' --title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..../42,1.D. ........................... Let No ....... .2.~ ............. Street ~nd Number .N..~.....c..e..~..e~....~..~..~.~e,.e~.. ................................................................................. ...... 4/'~ ~ ~/ Municipality 2. State existing use and occupancy af promises and intended use and occupancy of prol~sed' com~ruction: a. Exisiting use and occ,upancy ....... .¥~q~h~.$..~.~ .......................................................................................... b. Intended use and occupancy ............. ]~e~:~u~mac~ ................................................................................................. 3. Nature of work (check which applicable): New Building ..... .~ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... ~..~a,~).O.~).O ................................. 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 .............C~,..e ............................................................ ~ ............................................................... 6. If business, commercial or mixed occupancy, specify nature add extent of each type of use ....... .~...e~..e. ............. 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 ...~L! ................ Height .'~i.~. ............ Number of Stories ....... J~lt ......................................................................................................... 9. Size of lot: Front ...~.~..~. ................. Rear ..... ..3'~.! ....................... Depth .......... ~.0..t. .............. 10. Date of Purchase ...Ll...m~...8..'......~....~.O.~..~P...~.. .................. Name of Former Owner ...... ~IQ~I~.~..~,IIII~I..P.~e~,~ ................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... .~...e. ................................................. 13. Name of Owner of premises ...~eb2LJ~.~c~. ................. AddressB~...~..~,..~.~^e~e~,~,e~a Phone No...7~Jt-r-,~ .... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~&~.~t~.J~eme&~t~¢,...j....Address i~lm~e~..~re~..~.o~., ........ Phone No.~..~t~ ..... 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 comer lot. STATE OF NEW YORK, t S S COUN'rY .O~ ...~.~,t-.~J~. ...... ~ ' . ........ duly sworn; deposes and says that he is the applicant (Name of individual signing application) above named. He is the .......................................................... 4.re~ 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 applicatibn filed therewith. Swam to befpre me this //'_.~ .... ~ _ ~, , .... /..~ .. aay or ..... ~ ........................ , l~x'X' .... , , . D ..... ........ .............................. . mota , Pr~.~ic.,.., ,.~--/~.~:~,4:,.~;4.4~,,~<'~1/ ..... County ~ ~ (Signature of applicant) ~Ji~J~l~yon~ ~ Public, $la~ ef Nm~ ¥0~ ~,' ' J~ 52-2055~te-Suff°lk Counly ~/ "*~ Co~. ...... ~:~i:~ ~*~ch 30, ,q ,F,D~'I~L !/~N,M EM:T' L~FT iI I