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Home My WebLink About5113-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z.h'379 .... Date ........... Selot -'9' ", 19~t.. THIS CERTIFIES that the building located at ~l'.a~ge. B~d ........... Street Map No. 3,~,~Block No ........ Lot No..~. · S~u2ho~dt. B,~, ....... conforms substantially to the Application for BuildMg Permit heretofore filed in this office dated ...... N~ 27 , 19~0 p~suant to which Building Permit No. 5~]~. dated ........ j~ ~. , 19 ~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .... ~.2vate .o~e..f~[~. ~ll~g .................................. The certificate is issued to . ~~. ~er.p~s Inc ..................... (owner, lessee or tenant) of the afores~d b~g. Suffolk Cowry Department of Health Approval ~e~. ~t. ]~.~.. ~.~. ~$~ .... (...C.. ../ ............... Building InSpector 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) 5113 Z Permission is hereby granted to: ............. ~~..bt~~.-~e ........ ............. ~.....~.~,~..~ ............. pursucu~t to opplicotlon dated ............................ ~_ . , ~k~Y~..~_ ~ ~9..,.~ and oppr~ by:_ the Building I~s~r.~ .... : S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date June 2, 1971 Bldg. Permit No. 5713 Z TO WHOM IT MAY CONCERN: Thee sewage disposal facilities for a structure located at ~outh Harbor iiome~, Lot ~la~ S./~ Gr~ Rhea. Ro~,~q~d (Give deed location) have been inspected by this department and found to be satisfactory. Chief of General En~fneerin¢ Sezwlces SEP $ 1971 District Engineer ~- © SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D.Reference NoW EASTERN DISTRICT, RIVERNEAD, N. Y. APPLICATION FOR APPRO¥'AL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS _ . /// m ~ c--6-~s~i~--s~ requeste~i~a h-~-~-~re~th: .uate /, ',./,,..~, Address '~3~-~9~ ~'~ ~ ~,,~.~ ~/' ' 7-Sectio~ ...... -Detatlmloo tion S-Lot ' Hamlet.~. ~.~// ' ~'~ Tow~/~ow~..~.~.Z~ 9-Private We~l? i /~ . 3-Public wate~r su~l~y~ nam6~/~~3.-~~ Distance to nearest main ... d~ 4-Lot Size: Width~O ft. L~ep~h~ ft, ~also enter on center plot plan ~below:) 5-Dwelling: Single ~amily ~-Tw~--~tly? f /Cellar? ~/~lab? ~ ~Crawl o~ce? / ~ lO-Pro,seal syst~: Septic tank F /Precast ~Cesspools ~/S~llow pools y /OtHer /. 11-Septic ~ inside dimensions: Vol~e Gals.Length ft. Width ft. Liquid depth ft 12-Precast sections: / {Number/ /S~re Ft. Cesspools: Block size~ incs.D ~ ~s.H ~us Total blocks below inlet. ~l/~Yd .~3 ~T P~N i Street Capacity Gals Date (10/65 Revis.) s-~f Signed ~ ~-7~y" The Undersigned CERTIFIES: "Construction of authorized installa be in accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". ""ul~ng~At ~, ~...11/79 FO~ HEALTH D~PARTNENT USE ONLY. Based on the infomat~&l~esented herewith, it is the opinion of the Health Department, that an adequate and sat~sfa, cto~y Sewage Disposal Syste~ can be installed on this Plot. Data ~et 0 2 10 I 1 FORM NO, ~. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined "~ , 19.Z.'.~. Approved ................ '.I..., 19.?.../.Permit No ..... ...~..../.... (.. ~...~ Disapproved a/c .............................. Application No ............................ APPLICATION FOR BUILDING PERMIT NoYember 27 19 70 Dqte .......... ~ ................................................. , ............ INSTRUCTIONS c. 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, relatmonship to adjoining premises or public streets or areas, and giwng a detailed description of layout of propertymust 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 o 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 or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto described. The apphcant agrees to comply with oil applicable laws, ordinances, building code and regulations. Sa!t-aire Enterprisas, Inc. (Signature of applicant, or name, if a corporohon) 3289 Veteran's highway, ......... ~!.o.~)~.o. ~ .k..gm~. ,... ~L... ~... ............................................... (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Salt-~ire E~terprises, Inc. Nome of owner of premises .................................................................................................................................................. ..~ If applicant ms.a ~arporate, signature of duly authorized officer. [ . -~ , r- ,~'(Nome and title of corporate officer) , ~./ I; Location of land on which proposed work will be done. Map No' 4096 Lot No: 14 ~' Street and Number ..... ~..°..~.?.~...?..J:..c!...e....?T.r..~.~..~..e...~.°...8:..cl: ............................................................................................. Mun c,pa, ty 2, State existing use and occupancy of premmes and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ?...~..o....~...~,.,~,.~.,.~. ................................................................................................. b. Intended use and occupancy .,..1~2~.~.~.d.~.e.~.1..];~.i..1~.~}~.1.s~.a~..~..~.e.~.e. ................................... 3. Nature of work (check which applicable): New Building ...... ..~. ......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Eshmated Cost ............................................................ Fee ......................................................................................... (to be paid on filing this application) 5, If dwelhng, number of dwelling units ......... ] .................. Number of dwelling units on each floor ........................... If garage, number of cars .......................................................................................................................................... 6. If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. D~mensions of existing structures, if any: Front ......... ~.9.,t?;..e. ........ Rear .......................... Depth ........................... Height ......::-: ................... Number of Stones .............................................................................................................. D~mens~ons of same structure with alterations or additions: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front 60 Rear 60 Depth 28 & Height ......... .'J.7. .............. Number of Stories ........ .]; .................. 9. Size of lot: Front ............................ Rear ............................ Depth ................................ (~ee 10. Date of Purchase .~..o..¥.9.~..e,;v...1.cJ.Z~. ....................... Name of Former Owner ........ .R...e..:p...e,....a..e.~.¢l,~'..o~ .................. 11. Zone or use d~strict in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation.:) ...... .~..q .......................................... ogl~-~ 3.Z~ ~r~ · !~C~.-- ~ ~ z, ~ . ~oma ]3. ~ame o~ Owner of prem,ses .....................". .............. L..~aaress ~..~.~.,9....[?..?.;.!.?[;.~.:..R..°.,,t/..k.,.°..~'~hone No. Name of Architect ........................................... Address ......... ~ ........................ Phone No ................... . · .......... p~o~ ~e~era~s ztwy Name of Contractc~..~.C..T..A..~.~.e....~.~...C..e...z?]~..z:~..e..~.,.]]RSdress ,.*~.°..~...~..o.P..~.o.m~.~.,.¥.., ....... Phone No.5.~.8...--.~..8.~.4. PLOT DIAGRAM Lac(~te clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street names and indicat whether mteriar or corner lot. STATE OF NEW' YORK, ~- S.S. COUNTY OF ................................ ~ ., ........................................................................... being dpJ/y sworn, deggses and says that he is the applic', · ' (Name of individual signing application) // /'// ~ above n med. He is the ............................................................ .............. ................................................ (C4ntractor, age.t, 'c~orote officer, etc.) of said owner or owners, and is duly authorized to per~.~orm or have performeqJ /he said work and to make and this application; that all statements contained in this ~',i~,!i..ogtion are true to~ane best of his knowledge and bali and that the work will be p~rformed in the manner~s~etof~fth,in, the application filed therewith. Sworn fol./fore me this ................ , ....... ~ ~/'~/"l/(J/~/~'~ r'Jr ....... ~,:~. '.9_.. -_ ..... ;",-: ..... o, .....................