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Home My WebLink About5608-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No ~(~0 Date ~'Jlle 22 19 THIS CERTIFIES that the building located at lI[~..8~._~.~d. ¥few Ave Street Map No. . ~ .. . Block No..~ ... Lot No....:~...]ttat%i%ue.k..N.*Y~ . . conforms substantially to the Application for Building Permit heretofore filed in this office dated 1t[O~. 4... , 19 .~ pursuant to which Building Permit No. dated ....... 1~.0.~.... 3... , 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 . Px'i~l~e..one. f. am.%l~..4¥ell4ng ................................. The certificate is issued to . Vie~ol~ tl. Za~k~e ...... 01~I~I~ .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~p~e...~ .~..~.9~. ................. UNDERWRITERS CERTIFICATE No...1~. 3.'1~..0 .................................... HOUSE NUMBER .. 2~.~5[. Street . .~O~ ~f~O~..~r~ ............ Braiding Inspector / . TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5608 Z at premises located ;t .........~*~......~...'I~'~¢...~.'LIt~ ..................................................................... ....................................... . .................. .* ........................ ; ................... . ................ '.....~.. ..............~ ................. ........................................................................................ .;.; ................................ .~.....~. .............:. .............. pursuan~ to appli~cation dated .............. ~ ............. ~.W. ......... .~ ............ , 17...~., and approved by th~ Building Inspector. Building InspectorI THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ , ~l,k 8~,~ JOHN STREET. NEW YORK. NEW YORK lO03E Victor E. Zalklne, n/s Sound View Ave., e/o Reeve Rd., ~ttttuck, b.I. ~?~'"~'"'i"~'" May 25, 1972 i '~'~ I ~o'F~b F , ~-[--~ ~ I ,xo .,-t' t~ I ~ .... 1"~ SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The,sewage disposal facilities for a structure located (Give deed location)} have been inspected by this department and found to be satisfactory. JUN 1 2 1972 SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference EASTER/~ DISTRICT, RIVERHEAD,N.Y. APPLIC.ATION .FOR, A..p.P~.OVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Approval to construct said systems is requested, pertinent data herewith: 1-Applicant ql C ~g- ~&,/(t~z4' , ...... Phone (q~-ggo~ 6-Sub div Address ~ ~4o~'/,'(- ~ f-. ~ /w'.Y, 7-Section 2-Detaile~ 'property location ~/~ ,~oa~a~t~ J~z[ 6 ~£~m 8-Lot No. Hamlet . )k"l~4/y-,roc--~' / Town ~7-/-~a~-,O .. 9-Private well? ~-Public water supply name Distance to nearest main , /w%~ &~-$ 4-Lot Size: Width ~,~? ft, Length ~ ~,ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~;Two Family? ; /Cellar? ~/Slab? ; ~Crawl Space? / / 10-Proposed system: Septic tank ~ /Precast ~/Cesspools /~/Shallow pools, / /Other /, / il-Septic tank inside dimensions: Volume Gals.Length ft. Width ft. Ei~uld depth,. ,fi i2-Precast sections: /F!Number/f~Square Ft. Cesspools: Block sizeL,-~ .incs~,D ins,H ,ins Total blocks below inlet: ~1____~2 ~3 PLOT PLAN o u~ ~-~ o ~o~-~ Data !~ee,t, 0 2 I No~th m Street o ~ e The Undersi~n~ CERTIF~S: "Construction of authorized installations will be accordance with the Suffolk County Health De~rtments' current Standa~s, Bulletins, and amendments thereto, covering P~ivate Se~ge Disposal Sy~ms". Date ~ - /9 ~ ?/ Signed ~- ~ 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-z5 Signed Disapproved a,c ....................................................... /~.o (Building Inspectlor) ~WN OF ~THOLD ~ BUILDING DEPARTMENT TOW. c n 's ? APPLICATION FOR BUILDING PERMIT 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 prem ses, relationship to adjoining prem ses or public streets or areas, and gJv ng a detailed description of layout ofproperty must be drawn on the diagram which is part of this 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 Certificate 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 pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. .... ........ ...... .. (Address of applicant) ....... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... ........................................... · Name of owner of premises i ~..L.~..t~....~....~:..;...~'/~../~.Cf ./~..~. If applicant.~r~o/) ~47- ..~..',is a corporate,..~...e...,~..~ ~signature of//~.?ly authorized officer. ~%. .................. i~;~e' ';;;[ 'bt'ii' ';i";J'~';';;,'/;," ;;~ii;:';';i ......... ~ 1. Location of land on whicJn proposed work will be done..Map No.: ...... .~.......~ ................ Lot No....~;.. ~ ~ ~ St eat and Number ............ .,~...~....~./. ............ ~..~..'g:. ............ ...~/tr.;~../. ~ .~, ~.~ .~.,. . Municipality 2. State existing use and accupancy of premises and intended use arid 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 .............. ~4, Removal ..................Demolition .................. Other Work (Describe) ........................................ ./.0 4. Estimated Cost ....... ~'--"t ............................................. Fee ...................................................................................... (to be paid on fiJing 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 ............................ Nu~mber of Stories .................. i ............. ~ 8. Dimensions of entire new .construction: Front ..... ..~....O.. ....................... Rear ...,~...O.. ................ Depth ....~.....O.. .............. Height ...~ ..~.." ....... Number of Stories ......... ~..~?. .............................................................................................. 9. Size of lot: Front ..... ../..~....~. .............. Rear ........ ~..~..: .................... Depth .....~...o....~.. ................ 10. Date of Purchase .....~....~....~.: ...... /..~....~....~.. .................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does propas~d construction violate any zoning law, ordinance or regulation? ........ ..~....~.. ............................................ 13. Name of Owner of premises ~..L.C~....~..~.~.~..~../~.( .~...~...Address ....~:....~...~../..~.~....c~.......~ ............ Phone No.~...f.~..;.~?.~?. Name of Architect . .~....~.SA.N......~....~..~..A'~.....'"i ......... Address ..~..e~...~.~.~...~-.J.~. ................. Phone No.~..~..Z..-..~..Z:.~-].. Name of Contractor ..~(.o...~.~...~..~...~..~.~..~..../...~....c. ........ Address ..~...~...~.....~....~.0.~..~.. ........... Phone No.~....~....~..~.~.~...~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and shOW street names and indicate whethe~ interior or comer lot. STATE OF NEW~O.I~ ~ ~ COUNTY~DF ...~:D~'L'~I2 .~, I~ .......... · .............. t ................................ being duly sworn, deposes and says that he is the applicam above no . . .1~. ............................................................................................. (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 belief; and that. the work will be performed in the manner set forth in the application filed therewith. Swo~to.. ~.~.J~/. before me this ...... ....... of ...... , ...... ............................... Notary Public,~,~..~~. County 0~.~ (Slgn~(~'r. of applicant, ELIZABETH ANN NEVILLE NOTARY PUBLIC, State of New York No. 52-8]25850, Suffo/k Term EXpire~, March 30, Co <~ ~/. ~4 °4? '10"' W'. - ..3 MAP OF Pl~OPEt~TY ICTO~ E. Z~IKINE MA TTITUCK, N. Y SCALg : SO'=/* to I ~ w, mc~ $,ZS' N. Z4 °47'!0" - - 703.$l MAP OF P/~OPERTY ~U~-V£YEO FO~ CTOR~ . ZAIK/NE Al" AlIA TT! TUCK, IV. Y. SCALE VAN l"uYz, 0 -I 15L4" F ,IQLo ,l , ; CLO