Loading...
HomeMy WebLinkAbout5623-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-18891 Date MARCH 13, 1990 THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING Location of Property 895 TOPSAIL LANE & 145 T.Rk~ARD DR. SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 7 Lot 47 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 29, 1971 pursuant to which Building Permit No. 5623-Z dated NOVEMBER 11, 1971 was issued, and conforms to al~ of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED 2 CAR GARAGE* The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *THIS CO UPDATED CO Z-4728 DATED 8/1/1972. RAYMOND T. & KATHELEEN FEENEY SO-933- Build~ng Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5623 Z Permission is hereby granted to: - ~ ~-. ........... ~o'~ ......... ~,~-~.~.-~.~-~.-..4-t?a? .... to .-~ t~JL~ .-~e~ .-~e..-£~1~-' ~re~ ................................................................................. at premises Iocoted at ........... ~O~).~a~L...~...~[~..~,L~,~..~...,~,~, ....................................................... ............................ ;[ett...~..../,.e.e~.~.~..~.~.est~.~tho~....~,~ ......................................... pursuo~ to application dated ............................ ~C;~.....[~ ............... , 19...~-.~., and approved by the Building Inspector. 110~t ~e~e ~at meet a3~ p.~rov~s~o~.__~ oF ~tttg Cecte~ ~:~ Ste-~D ........... SUFFOLK COUNTY DEPARTI~,NT OF HEALTH H.D.Reference No~ EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Approval tn construct' said systems is requested,pertinent data herewith: 1-Applicant ~3~. 4¢ ~ ~-F~, ~ ~ __Ph~ne~k .6-Sub.dzv Z£~w.~,zw3 Address ~ ~,.n~7~ '~3/'% (]~ ,,~ /& ~ Y/)~7 7-Sec~ion o ~ 2-Detailed property location ~/3 XF, .- F{;,:~ ~/I~, /~7 ~'~2 8-Lot No. Hamlet %~%~ "' To~ 3~ tl~C ~ 9-Private well? 3-~blic ~ter ~pply name Distance to nearest ~in ~ 4-Lot Size: Width ;~o ft. Leggth2~. ft. (als'~ 'enter on center plot plan below:) 5-~elling: Single Family ~ Two ,a~ily? ~eLlar? ~ /pl/b? / ~Crawl S~ce? lO-Pro~s~ system: Septic tank ~ /Precast ~CessPools ~Shallow pools ~ /Ot~ / / Il-Septic ta~ i~ide dimensions: Volume Gals. Length ft. Width ft. Liquid depth ft. 12-Precast sections: /X/Number//'~Square Ft. Oesspools: Block sizeL incs.D tns.H .ins. TOtal blocks below inlet: PLOT PLAN Street ie rth Data Feet ~,~ 0 ~-~ ~ 2 I ,'~,"-'~ 10 ~6 Indi No 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 Disposal Systems". Date /~'/'~-~/ Signed f~ C~ ~' Owner or Builder .~OR HEALTH D~PARTMENT 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 /~ '/~--/~( Signed (10/65 Revis.) EXCAVATION INSPECTION REQUIRED FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ~ ' 9..: ......... .~. ~ ......... ......................................... 1 Pem~t No. ~.. ...~..... ~ D~sapproved a/c .......................................................................................... Applicotion No .... ,.'~..~.?.....~.. ............ APPLICATION FOR BUILDING PERMIT Date ................... , ...... INSTRUCTIONS a. Th~s apphcat~on must be completely filled in by typewriter or in ink and submitted in duphcate to the Buildmt Inspector b Plot plan showing location of lot and of buildings on prem,ses, relationship to adiommg premmes or public streets o areas, and gwmg a detailed descnpt~on of layout ofproperty must be drawn on the d~ogram which ~s part of th~s apphcatlon c. The work covered by th~s apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of this apphcation, the Building Inspector will ~ssue a Building Permit to the apphcant. Such permi shall be kept on the premises avadable for inspection throughout the progress of the work. e No budding shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc; shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bu.lding Department for the ~ssuance of a Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply w~th all applicable laws, ord~naj~lli~ building code, housi_nj_code, and regulations. (S.gnature of apphcant, or name, if a corporation) (Ad~ ~'~'~'~?' ~hcant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................. ....................................................................................................................................................... Name of owner of premises Bruce D Regina ~tae|uk If apphcant ~s a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) 1 Location of land on which proposed work will be done. Map No ...... L~.~w.~.~..~.o.~.~.~ .....Lot No...~ ................ Street and Number .... ~..~.(.~ ..... ~..~..~..~.~.fl.m ................................................................................. Mumcipality 2 State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Exis~tmg use and occupancy .............................................................................................................................. b Intended use and occupancy ............ ~.~.J.~.~gg. ........................................................................................... 3. Nature of work (check which applicable) New Building ..~.f~. ......... Addition .................. A, Iterotion ............. Repair ................Removal .................Demolmor .................. Other Work (Describe) ...................................... 4. Estimated Cost ..$.~.0.,.0.~L0.~.Q.0. .............................. Fee .......................................................................................... (to be pa~d on filing this apphcahon) 5. If dwelling, number of dwelhng units ...... an.e~ .............. Numb. er of dwelling umts on each floor .......................... If garage, number of cars .... .T.w.~. ............................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..':.-...-..m.-..'...'. ......... 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 ..54, ...........................Rear ..... 5~. .................. Depth .....2...4. .............. Height ....[..2,. ............ Number of Stories ....... ..0n.e.. .................................................................................................. 9. Size of lot: Front ...I..~.0. .................. Rear ....i...~..0. ...................... Depth ...... .2,.~..0. ................... 10. Date of Purchase ...L~..7...I. ....................................... Name of Former Owner ....k..e..e...~.~..r'..cl.....A..a...~..e...~. ...................... 11 Zone or use d~stnct m which premises are s~tuated .... ..R..~.~.~ .................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation? .... .N...0. ................................................... 13 Name of Owner of prem,ses ...B~.u..q.e.....~..~...~.~.j.~.lf. ....... Address ..H..o...~..e...~..~..e...~..cl.....D..r?.r..0..o..~.a...m. Phone No ~..3.2,..-..I..0...2,..~.. Name of ArcMtect ..................................................... Address ............................................ Phone No. Name of Contractor .... C.|.~U.~.91~....0..~.I1.~.t~..,....~.9.~ ..... Address ..B..j..q~'.9..I..9.....~.~..h.~..~...e..[..d..e.r~hone No. '~'~'~'~'~"~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and md~cate all set-back dimensions from property hnes. Give street and block number or description according to deed, and shaw street names and indicate whether interior or corner lot Lot: 46 CORNER STATE OF NEW YOR.Ie, ~J:~tK[¢¢ ' COUNTY OF ............. ..................... ~.~.~.~.....~Z~.~:.~.~ .............................. being duly sworn, d~oses and says that he ,s the applicar (Name of ~nd~vidual s~gning apphcation) above named He is the ...................................................................................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to ~ke and this application; that all statements conta, ined m th~s apphcation are true to the best of his knowledge and belief; an tha~ the work wdl be performed in the manner set fo~h in the applicati~ filed therewith. Sworn to before me t~s ....... _ ......... ...... .... .....................