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Home My WebLink About5245-zFORUM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office South&d, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ¥;l~ow. P.t .~oad ......... Street Map No~4!liow..P.t. · Block No ......... Lot No..2.~ ...... ?.q .~.~.h. ql~ ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ &Dril.. 16,~(~97].. pursuant to which Building Permit No. dated .... .~r$~_... 16... , 19 ~.!., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Private. one .family./~we!Ltn~ ..................................... The certificate is issued to C~.i£fc~r .Cot. nell ..... Owner ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. A~lg. J.Q ~. ] 9.7.] ...b.y..R....V.$~.a.... EC~E: C/O issued subject to insta~_!ation of bath tu~ & tiling House ,~3 25~ ... //,. Building Inspector / TOWN OF SOU1HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO_LD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTI-~ORIZED) 5245 Z Permission is hereby granted to: to ..... l~t,~l..n~..~r~..tm~X~v..~l~ ................................................................ : .............. at premises located ot ......... ~'~...~.,- ......... ~.~.~..~qj~....~,..O,,~.?~..'~ .............................................................. .................................................. ~..S.~.,~..~ .............. ..a.~..e. ........................................ pursucm~ to application dated ........... : .............. ..~.~ .......... ~ ....... , 1~... ..... , and approved by the Building Inspector. SUFFOLK COUNTY DEPARTMENT OF HEALTH AU8 1 0 1971 Date 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. AU$1 0 tqTi Chief of General Engineering Services SUFFOLK COL~NTY DEPARTMENT OF HEALTH H.D.Reference EASTERN DISTRICT, RIVERHEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTF~.. Date Approval to constract said systems is requested,pertinent data herewith: 1-Applicant '~/~, ~/~ Co&~b ~ C Phone~6-Sub div Address 7~ ~~/ ~ ~.-~;; ?-Section 2-Detailed property locationm~ W,~ ~w f£ ~D, 3, ~ · ~./~ 8-Lot No. Hamlet £~v /,',~ ~0 ~7~[..., ~,,~Town ~A,~ ;~ ' 9-Private ' ' ~ -Distance to nearest main 3.Public w~ter suppl7 name ~-Lot Size: Width~__ft. Lengthen_ft. (also enter on center plot plan below:) 5- elli : lo- o sed Septic il-Septic tank inside .d_imensions.: Volum.~ Gals.Length~Z_ft. Width/ ft. Liqulc cep%n~_..m%. 12-Precast sections: ~u~Number~Square Ft. Cesspools: Block sizeL__incs.D___ins. H/ ins. Total blocks below inlet: ~1 ~2 ~3 PLOT PLAN G 'ade~ Capacity Gals. e 10 12 l& 18 Indi Nc Street 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 or Builder FOR HEALTH USE ONLY. Based the information presented herewith, it is the of the Health Department, that an adequate and satisfactory Sewage Disposal System be installed on this Plot. Dat. 6( r/,l TOWN CLERK'S OFFICE ~ ~'~ SOUTHOLD, N. Y' ............. ~ App cat on No. 2.~..~.~ ................ ........................................ , ]9 ........ Pemit No ................................... ................... .......... ................ (Building Inspecto~ ~.~...~ APPLICATION FOR BUILDING PERMIT "~ ........... .............. o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to t'~e Building I n specto r. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout ofproperty must be drown on the diagram which is port 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 port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southo d, Sulfa k ,County, New York, end other applicable Laws, Ordinonces.o~ Regulations, for the construction of buildings, additions or o terot ons, or for removal or demolition, as herein describe~ The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations. ~;~;fignc~re o_f applicant, o/'~;~;':'if"g';g~'~i;~i ........ ..... ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ////,,' n ,~ n~ .................... Name of owner of premises ............... ~:_...~ ....... . ....... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will b_e done. Ma_p No.: ........ ..~...~...~...~.. ............ Lot No .~...~.. Street and Number ........... ,~/~..f~~ ............ ~ ....... '.iii.iii. ' .............. '7"'~t ~ ~ ~ Municipality ' ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................. -- /b __ b. Intended use and occupancy ............... ../....~'~...~,P~ ........ . ............ property lines. Give s Whether interior or cor~ V 3. Nature of work (check which applicable): New Building .....~. ....... Addition .................. Alteration r Repair .................. Removal .................. Demolitior .................. Other Work (Describe) ........................................ /0 4. Estimated Cost ............ ................................ Fee (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 ................................. x Rear ~'~ ' Depth ...~.~. .... of construct,on: Front ~. ~/ D,mens,ons enhte new ..7....~...~.. ................ ..... ~..,,. ................ .............. 8. Height .................... Number of Stories .................................................................................................................' ..... 9. Size of lot: Front ..... ~.~.. .............. Rear ..... //...~. ........................ Depth ....../.~..~....~../..~..Z... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ..... .,~..E..Z..~72..~.~....2-.~/~...~. ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.> ..~...~....,....~..~...~ ............................ 13. Name of Owner of premises .~~..^ddress ..~..?...~..~.~..~....~ne No..~...~'..?..-..~..~..?..~ Name of Architect~'~...~'~.~/. ............. Address~C..~'....:~.v'~'~4~: .......... ~-~n. No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from feet and block number or description according to deed, and show street names and indicate ,er lot. STATE OF NEW Y~_I(~//L .............................. ~.~ ...... .~....~..~.~.being duly ~orn, d~es ~nd ~y~ t~t h~ i~ th~ ~pplican~ (Name o~d~ig~n~ opplicotioD, ~ ~ above named. He is the ................................... ~~ .................................................................................. (Contmctor, agar, co,orate officer, of said owner or ownem, and is duly authorized to perform or ~ave perfo~ed the said work and to ~ke and file this application; t~a, oll statements contained in this application a~ t~ ~o ~he best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the ~plic~i~ fil~ therewith. Swam to beforebme this .~~~ ................... ........ . ........ o, ............................. ELI~B~H ANNtN~ILLE NOTARY ~BL~, ~ of New Y0~ No. 52-8]258~, Suffolk Term Expires March 30,