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Home My WebLink About5559-zFOItM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Offdce Southold, N. Y. Certificate Of Occupancy No. Z.k, ~].~. ...... Date ......... F. eb, .. THIS CERTIFIES that the building located at . -Neo~,eg La .It & .Ila~.et;. Pol~rel~ Map No. Eastern Sh Block No ...... Lot No. -96 ..Greenpor. t · conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... 0~t; ~ .... , 19 ?]. pursuant to which Building Permit No.. dated ....... 0. C$ . .~ .... , 19~.. , 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 . Private .otle 'family' ~wetl~ug .................................... The certificate is issued to .A,. 'Tow3asend' · · of the aforesaid building. Suffolk County Department of Health Approval tIouse ~ t07~ Moores 950 Inlet Pond La "0~ l' .................. foUwner, lessee or tenant) · .D. ec...16s. .~971. by.R,. Villa FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL coMpLETION OF THE WORK ^UTHORIZED) 5559 Z Permission is hereby granted to: .............. .&.....,.&.L.S...s.,..q. ............. ..F..~E.~.'.~.~... ............. · .~ .~ ........ .A ...... ..T..~.~..6t.~.~.L~ ....... ot premises located at ................................... 4~..~.I,~,,ff..!~ ...... t.~,A.e,,t&.T. ...... bl.~F'~."~.,a4 ..... ~. ............... ......................................................................... ~t. tu.~.J~..T. ....... ~.~.~ ..... z~,~ .......................... ~.~`~r.~.~.`u:~.s~'~.~..g~.~s~:~.~.~`.`.3.~.z~.z:~.~.~.e~..~..~.~u~.~ ...... -i~..Y- ................ ~ J ) -/ · . pursuc~¢ to application doted .......................................... ~..~.~..., 19..~.~., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date BEC ! 6 1971 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at "¥/ / ~ve deed l~ation) Jj have been inspected by this department and found to be satisfactory. OEC i 6 't971 r-'t rO ! ,C SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference Nc~ EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS O ~--~ Approval to construct said systems is requested,pertinent data herewith: Date 1-Applicant ~OaR$ M~m~S iIqC,. Phone7~''~3~0 6-Sub div~ Address ~'--~ ~ ~uT~'b~,.O' 1'~ ~ 7-Section ~ 2-Detailed property locatiqn-~/~ c~,a.;g m~.~a~.~, ~- ~r. ~.~ 8-Lot No. Hamlet I/V~T ~;o~D ~o- ~e~To~ ~o'v~u 9-Private well? , 3-~blic ~ter supply name ~ae[m~u~ ~mt~R ~?f Distance to nearest ~in 4-Lot Size. Widthl3~ ft. L~t~ ft. (also enter on/enter plot plan below:) 5-~el!ing: Single Family ~ j T~ Family? ~ /Cellar? ~l~b? ; fCrawl S~ce? lO-Proceed system: Septic tank f ~Precast ~ /Cesspools ~Shallow pools / /Other / , / il-Septic ta~ inside dimensions: Vol~e Gals.Length ft. Width~t. Liqu~ dept~ft 12-Precast sections: / ;Number/ /S~re F'%. Cesspools: Block sizeL/~incs.D --ins. H° ins Total blocks below inlet: ~1 }~2 ~5~3 ~OT PLAN ~ earle , q¢ G W.L. No~th Data ~eet 0 2 4 6 8 10 12 14 ~6 18 Street Ind~ The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current Standa~s, Bulletins, a~ amendments thereto, covering P~ivate~~~l~t~s". Date O~ ~, ' ~5 ' O~er or Budder 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 installed on this P~,ot. Date Signed (10/65 Revis.) EXCAVATION IN P[CTION REQUIRED TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ ~ TOWN CLERK'S OFFICE SOUTH~D, N. Y. ~ ~x~,,ed ............ ~~, ~/. 1'~ . ........................... ...................... Disapproved a/c .......... ~ ............ '......~ .............................. ............................................................... , ................................................... ...... ........................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote...O...C'...T/. ....... .~ ..................... , ~.~.1 ...... 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 areas, and giving a detailed description of Ioyout ofproperty must be drawn on the diogrom which is part of this opplicotion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. U on a roval of this application, the Building Inspector will issue a Building Permit to the applicant Such permit~ P PP · 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 Occupancy~l 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 ?pplicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................ .~.~.~..~.~.~.~. ............................................................................................................................... , Name of owner of premises ..~..~.. ...... .~.. ...... ..~...q....V~....~...~..~...N..~.;....:; .................................................................................... If a~te~re of duly authorized officer. ......~~~.~.~..:... ........ .:....:.~.~. ...... ~ ...... (Name and title of corlYorate officer) l. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.....~...~. ............... Street and Number ...~....~..~.'/:..~..~ ......... ~..~ ................ _. ........... , ......................................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy ...... ~.F..I...L:...~.. ...... .G.~.~......~.,~.~.h.L..~.......~...~.....E....L.~.L..~....~. ................................. 3. Nature of work (check which applicable): New Building ..... ~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ .... ...................................... Fee .......................................................................................... 4. Estimated Cost (to be paid on filing this application) 5. If. dwelling, number of dwelling units ......... ..r-~. ............... Number of dwelling units on each floor ...~.~0~..~....~..:.~...~..~ If garage, number of cars ...... L....C..~.~.. ........................................................................................................................ 6. If business, commercial or mixed occupancy, speedily nature and extent of. each type of use ........... . 7. Dimensions ote; ?ing structures, if any: Front ................... Rear ....~ .................... DeptF{ ..~...; ~-. Height ..................... Number of Stories ................................................................................................................ Dimensions of same structure with alterations or additions: F~ont .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of/entire new construction: Front ..... ..~I ........................... Rear ...~..~ ................... Depth .~.~....; ............ He ght : ~.~ Number of Star es ./.~ ...................................... 9. Size of lot: Front ..../...~...i~.~. .......... Rear .../..~.,.~.z~'.. ................ Depth ..../.~,~..,~.~. ............ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;> ............................................................ 13. Name of Owner of premises ~..~.qt~UN~r~O Address t~¥'~'~' .................................. · ~..~;..~.,~.~....~. ...................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor . .~... ......... .~... ................... .~L~/...:.Address ................... 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 descriptio~ according to deed, and show street names and indicate whether interior or corner lot. 83 STATE OF N~ YORK, ~ __ ~ ~ ................... ............ // ................. · ;; ........... ?....;.....~.,.; ................... ;.,; ........ :....,;~.~ ........ ~ing ~uly ~o~ d~S a~ s~s t~ he is the applicant ~mame ot inaiviaua~ signing a~ication) J Jj ' h ~ LD ~ / I1 above named. He ,st · .......................................... .............. ~.~..~......~.....~ ................. +~ .................................................. (~p~ctor, ag~, co~rate officer, etc.) of said ~ner or owners, and is duly authorized to perform or h~e pe~o~ed the said work and to ~ke and file this application; that alii statements contoin~ in this applic~i~ am tree to ~e best of his ~owledge and belief; and tha~ the ~rk will ~ perfo~ed in the manner set fo~h in the ~plic~i~ fil~ ~er~i~. Swam to before me this ........................ ............................................ ........ Nota~ Public, . ........................................................... C~n~ ( 'g a~re of applicant) t _ j~ F ./