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Home My WebLink About5586-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy No,..~...~...~..~..~t Date ............ . .~..~....~..qf~.., 19.~... THIS CERTIFIES that ~e building located at ~ ~.~...~ ]( ~'~.. ?~t Map No ...... ~. Block No ..... ~ ..... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ . .~..~....~.~, lg~/_ursuant to which Building Permit No..'.~...5..E~..~'. dated ~ ~T~/ ....................... , 19 :'~T, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ......... .~.~.-...(~ } F,~¥ /)W~r,- issued is . .~ /~ .... ................................................ The eertifieate is issued to ~//:~/4 A I~q - .~)L)f~A/~ d~t~/~ )~'. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... ~ ................. ~ ............. ........ 6 ff.; ................................ HOUSE NUMBER..~..~..~..~?...Street .... .~..A.~'..l?'[~..~'..~..).x.~ ~ ...... .~.~..~..~. ........... Building Inspector FOR~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N? 5586 Z Permission is hereby granted to: ........ a~..~ ......... ~..~83 ............................... .......... ~lhera~ ...... ~,~,......1.t~B6 ..................... to ~l~L~d.. ~®~..~ .. fma~.. ~hee 3~;Znl ................................................................................... at premises located at ..... L~lt~.~[;~....]itB,~ll~l~.~.O;}~l~..~.,"~O~ ........................................................ ............................... W/~..~gev.~..a~l ....... ~l~seaj .-Pela~t,,e .--.C~ateheg~e ......................... pursua:n¢ to application dated ........................... OP-t ......... ,~ ........... , 19...~, and approved by the Building Inspector. ][0~1 setbeek te be a~e~.a~e ef blee~l ~tmte~ e~ea to be 10~ f~Z' area ®eh Z'omlt ~JI epen for ~enttl&tton, Fee $..1.0,.~. .......... .................. l~.~,....~.r~-4L ........ ~;~...,~.~... ............... Building Inspector / SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROI~AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Anoroval tn construct said systems is requested,pertinent ma~a nerew~Ln. AddressldP ~t't' ' ~ 2...I~t "'51-t-"r"Z~#6,~' t'lf [ II~ 7-Section ~-Detaile~ property~ls~a~ion~/e . _Z~,,.,~z_~ 8-Lot ~o. - - - Dis~nce to nearest ~in ' 3-Public water supply name 4-Lot Size: Width/~KD__ft. Length~___~_~ft. (also enter on center plot plan below:) 5-Dwelling: Single Family~ Family? ~ /Cellar? /~Slab? ~ ~ Crawl Space? ~ / lO-Proposed system: Septic~ankTw° ; /Precast / /Cesspool-~-~_/Shallow pools / /Other / / il-Septic tank inside dimensions: Volume Gals.Length ft. Width ..ft. Liquid depth ft 12-Precast sections: /~/Number/ /Square Ft. Cesspools: Block sizeL incs.D ins. H inf Total blocks below inlet: ~1 /[~2 ,fda3 ~ PLOT PLAN Street ~V ~ ~/&-~ Tank - Capacity~..~al~ G.P.M. ~'~ ~te Data Feet 0 6 8 10 12 ~6 Indi No ;h 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 Disposa~ Date ./~/~-~//'7// Signed ~~~~~'' ~ Owner o~ Builder 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 Plot. Date ~/~-~ (10/65 Revis.) s-~5 Signed THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR:CITY -- ac] 85 JOHN STREET, NEW YORK, NEW YORK 10038 oal) tire clef{rural equipment ~ descrtbed below aad tatroduced by the appl~caat named oa the above appl~catioa nuo~ber in th~ preo. i~es of Upham Downs Corp. ~ ~aywater Rd. 145'n/o 0arrington Rd. Cutchogue, ,,, u,,, f.U,.v,,,~ ~o~.t.,,,. ~ '~,,,~.t ~ ~ Ft. ~ ~.d Ft. out Side ......... ,,,,,,,,,.~ o., June 5 ~ 1972 ..a fo,...~ ., ~ ......... ,;,;,,,,,~o FiX?ORE ~ E I FIXTURES I RANGES ICOOKING DECKS; OVENS DISH WASHERS E~-~I~UST FANS REC PTACLES SWITCHES M, ERCL~Ry ~ 12.9 ~ DRYERS ~URNACE MOTORS ~UTURE APPUANCE ~EEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS ~ULTI-OUTLET ~ DIM~E~S ~ERVICE DISCONNECT ,NO OF S E R V I C E METER i ~ NO OF CC~,CONO A W G NO OF HILEG A W O NO OFNEUTRA~5~ A W G ~ i ~ I ' APPARATUS *Furnaces: 1-1/8hp., 2-1/15hp., 1-10 amp Garbage Compacton L killiam J. Davis P.O. Box 287 Rocky Roint, N.Y . 11778 GENERAL MANAGER ,~' Th,s certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be idenhfled by their credentials S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date~ Bldg. Permit No. ~3 TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at have been inspected by this department and found to be satisfactory. JUI'~ t S 1978 ~hie£ of Oener&l ~ngineering Services .~, ;;EIVED JUN t ,~ 197~ 560 § N 8~~ 59 f FO S 87° 59'W O CESSPOOL 565 Vocoo ! 5ET STY ~/ 7 RED,TED 6- 14- 2 RS. CARRINGTOW 38A I DATUM ASSUMED TEST saRoNG AS MR APPLICANT 37 LOAM 55 SAND 23 NO GROUND WATER SURVEY OF LOT SGG MAP OF NASSAU POINT CLUB PROPERTIES,/NC S£CTION D - F/LED M4Y 7, 192G- NO 80G N4SSA U POINT TO~/N OF SOU?HOLD SUFFOLK COUNTY, N Y WIt.~_IAM G MEIER WoOing R~ver, N Y Land Surveyor N ¥ State L,censeNo 21656 Surveyed - 9- I- ?1 Scule-I = 40 MopNo /~2905 360 36l N 87° 59 E ~'O PIPE 364 S 87° 59'W CESSPOOL 367 365 2d7.80 CESSPOOLS gSkt* ....... 39 0 9.~ O0 FO MON 281. 16''/~' -g CARRINGTON 38¢ DATUM ASSUMED TEST BORING AS PER APPLICANT NO GROUND WATER SURVEY OF LOT MAP OF NASS AU POINT CLUB PROPERTIES, IIVC SECT/ON D - F/LED MAY 7, 1926- NO_ 80G IVASSA U POINT TOWN OF SOUTHOLD SUfFOlK COUNTY, N Y WI~_LIAM G MEIER Wod~ng Rlver~ N.Y Lond Surveyor N Y Store License No.216§6 Surveyed -9- I-/I Scole - I"-' 40' MopNo 712905 BUILDING'DEPARTMENT O . ~ --~ ./~ TOWN CLERK'S OFFICE /~ ~ ~ ~ ~ . Application No ................................. D sapprove~ a/c .............................................................. I NSTRU~IONS a. This application must be completely filled in by ~pewriter or in ink and submitted in duplicate to the Building~ Inspector. b. Plat plan showi~ location, of lot and of buildings on premises, relationship to ad oining premises or public streets or areas, and giving a d~l~ description of layout o~prope~ must be drown on the d agram which is pa~ of this application. c. The work cove~ed by this application may not be comme~ed before issuance of Building Permit. d. Upon approval o~ this application, ~e Building Insp~tor will issue a Building Permit ~o the applicant. Such permit shall be kept on the premises available for inspection throughout the profess of the work. e. No building shall be ~cupied or used in whale or in pa~ for any purpose whatever until a CeRificale of ~cupancy shall have been granted by the Building Inspector. APPklCATIO~ IS HfiR[~Y MAD~ to the Buildin~ Dep~rtment {or the issuance of o Buildin~ P~it pumu~nt to the Buildin~ Zone Ordin~nc~ of the lown of S~thold, Suffolk Count~, ~ew York, ond othor ~pplic~le L~,, Ordinonc~s or ~ulotion~, for the constrmtion of buildings, ~dditi~* or alt~otion*, or for mmovol or demoliti~, as h~rein d~eribed. The opplic~nt aOreos to comply with oll ~pplicabl~ laws, ordin*nces, buildingc~e, housin~ cod~, and If applicant is a corporate, signature of duly authorized officer. ........................................................................................(Name and title of corporate officer) 1. Location of land on wl2it:~prop.o,ed work will~e dane. Map No.: .?..~.,......T~. ................... Lo.t_~o....~'.~.....~. ...... Street and ' / ~'~¢'~ ~'~., ~ Municipality 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 .~.~...~ ........................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................ .. ............... 4. Estimated Cost ...~,~..~...~... .......................... Fee ~..1~ ~ (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 ................................ 8. D mensonsofentirenewconstructon Front ~~ Rear ..... ~.~..; ..Dm:>th...~....~..' ' t. . / ..................... '~.~.~'~ ...... He gh .................. Number of Star es ........................ 9. Size of lot: Front ..... ./...~...O.,f.c~//_ ........ Rear ..,/~..~.~...~.....~... ......... ~~Depth ..,.'~../.~.../..~...: ......... ............. ....................... 10. Date whichUpremises 11. Zone or use district are situated ..... ~...~.~ ... 12. Does propOsed construction .vi, olat~ any zorji~jl law, ordjjla.nce~or~egulation? ..~~~.'.'i.'.' 13. Name of Owner of pLemis~~~~o. Name of Architect~...~~..-.....~.Addres Phone t~...~..~...~..? Name of Contractor~ ........................... Address ..~ ................ Phone N~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-lx]ck 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 N E'V~ YORK.. -- ! c · co /N7 OF ........ So' ..-i~:../~I-~..."~.~...~.~....~--~/-.'~'...../~.-.C~..~.-../~..D.....i ................... being duly swam, deposes and says that he is the applicant (Name of individ~ksi~ning application) _ named He is the ~./.~.. ~.~.~.'T' above . , ........................................................ . ................ ~ ................................................. (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 ~nd 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 application, filed therewith. Sw~m to 13e~fore me this ...... .; ........... ' ' Pbl .... Notary u i~J~J~i~.~ ....... Coun~l~re of applicant)'~ ...... NOTARY PUBLIC, Sta~e of NeW Y~ No. 52.8125850, Suffolk Tem~ [xpiTes Milch 30, Ii 3#££T #~_ 7 0£ ~ ,N _ . / II '7" CdO,56T ~P,4 TH DINI/V6 F.41'? / L ~r /1 '~., 9"- - ]lIVE OK DRAFT1N~ S~r~%~C~ F 'RIYERBROOK DRAFTING SER¥'ICE pine Road, RFD 2 Box Middae Island, New York Ph~c: {~16) UP. HA/VI ?~ '0" I _J 21 '0" z~A~' E/~E/V T El 'H" [] [] RtYER]~ROOK DRA~/TNG SERVICE Pt~e Road, BFD 2 ~ 315 ~d~e t6=nd, New York 119~ Phon~: (516) 924.64~ ~ ~0~ ' ,t9,70~ ,,~% Bhone~ {~16) 924.64~ J:l- RI; ERBROOK DR/LFTING.~ER¥~E . Pine ROad, RFD 21~ox 315 ~':'~'~: ; Middle lalaad, New York 119~,~~ -. Phone~ {516) 92~.6~8 ' " CPNST£ U C TIbZl .~ZTfA] L. ~5'cA~ .~"= ~'~" JA