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Home My WebLink About5331-zTO~N OF SOUTHOLD BUILt,lNG DEPARTMENT Town Clerk's Office Southold, IN. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .~&~*~. ~ ......... Street Map No. ~.~$!.~ .1~.,. Block No.. ~ ...... Lot No..~9~.....~i....~...~... :..;.~ .... confo~ subst~tially to the Application for Building Pe~it heretofore fil~ ~ ~ office dated .......... J~.. ~: ..., 19~.. p~su~t to which Build~g Permit No .... ~$ dated .......... ~.. ~ ..... , 19 .~., was ~su~, and confo~s to ~1 of ~e r~e ments of ~e applicable pro~sions of the law. The occupancy for which ~s ce~ificate is ~su~ is ...~..~. ~% .~.%~ ..................................... The ce~ificate ~ issued to . ~. · ~%~...~D~ .... ~ ............ (owner, lessee or ten,t) of ~e ~ores~d b~d~g. S~olk Co~ty Dep~ment of He~th Approv~ ~.. ~.. ~.~...~ ~ .~ .... ................. ~ufl~ ~ec~or BUILDING TOWN SOUTHOLD, No Y. BUILDING PERMIT, (THIS PERMIT MUST BE KEPT ON THE PREMIS~ UNTIL I:ULL COMPLETION OF THE WORK AUTHORIZED) 5381 Z D~e ........... ~ ............................................ , ~9 .... Permission is hereby granted to: J~) ........... ~.~.~....,~,v.~.k~.&~..... .................. ....... ~..a.;.....~...~....../2..~.~.~,,.5...,...&..]..: .... ~J/LD /Vr.~¢~I 06dC ~..I,~t',t~,f ............... .............. !.~...J~Lt.-~/k/~. ........... ..... ,~t ~ ......... L~otod at ................................................................ ~: ................................................. .................... ~?..~..:...~.~...T..s...q. ...... t~.~t ..... :.C~..kc. h.o....r~ ~.,...c ............ pursuan¢ to application dated ....................... ~...L..~....i....., 19..?..i./., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTH Permit No. Z TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure O (Give d~ed l°catio~) J located have been inspected by this department and found to be satisfactory. '/~ SUFFOLK COUNTY DEPARTMENT OF' HEALTH EASTERN DISTRICT, RIVERIrEAD,N.Y. APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS ~a-~'~ ~'~o~s~i~-syT~,~ ~eq~ested, ~'rti~ent data herewith: uate /~,/~ ~,~ ,,/ 2-Detailed Pro~er~ location ~, S,c/c (~,,~,~ ~" , 8-Lot No. '' ' 3~,.~ Hamlet 3-~blic ~'t~ supply/hame7 -- ' Dista~ce to nearest main '" ' 4-Lot Size: Width~ft. Length,~_ft. (also enter on center plot plan below:) 5-~elling: Single Family lO-Proposed system: Septic tank ii-Septic ta~ inside dimensions: Volume ~ Gals.Lengt~ ft. Width ft. Liquid depth ft. / Total blocks below inlet: $1/~i~ ~2~$3 PLOT PLAN The Undersigned CERTIFIES. apacity~Gals ,P.M. Irade 6o H~ Indi No "Construction of authori2ed installation Data 0 2 8 ~0 will be in accordance with the Suffolk County Health Departments' cur~at~a~dards, Bulletins, and amendments thereto, covering Private S ew~sal~ystlf". ) ate 7/ si ed .... , e ' a~k~ ~resented ~erewzth, it is the opinion of the Health ~nt, that an adequate and sat~sfacto~ Sewage Dis~sal System can be installed on this Plot. Date Signed (10/65 Revis. ) ~ ~,~ ~ TOWN OF SOUTHOLD . .' _~' ~ ~- BUILDING DEPARTMENT'~//$/~/ ~/" mo~ ~LERK'S OFFICE ~ u .OLD,.. ~)/ ~ppfic=tion Ho ................................. ................................. , ~..~.~... PemJt ~o. ~ ~/ ~ ................................................. ........................... ~ ..................................... ~..~ ........................................ ................... ............. ~/_ ~ (Building Ins~tor) ~ 0 ,; [(~ ~ ~ '- APPLICATION FOR BUILDING PE~MI~/ ·..... a. This application must be completely filled in by ~pawriter or in ink Inspector. b. Plot plan showing iocation of lot and of buildings on premises, relat ons~ p to adjoining premises or public streets or areas, and giving o detailed description of layout ofpropar~ must be drawn on the diagram which is ~ of t~is application. c. T~e work covered by tMs application m~y not be c~me~ed before issuance of Building Permit. d. U~n approval of this ~pplic~tion, the Building Inspector will issue a Building Permit to the applicant. Suc~ permit shall be kept on t~e premises oval[able for inspection throughout the p~ress of the work. e. No building s~ll be ~cupied or used in whole or in pa~ for any pu~ose whoever until s~al[ have been granted by t~e 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 herein described, The applicant agrees to comply with all applicable laws, ordinances, building__ ~c°de' hou~ing code, and regulations, --. ............ zl..r-c- .................................. .~...~ ................... (Signature of applicant, or name, if a corporation) '" (Address of applicant) State whether applicant is owner, lessee, agent, architect, engir~eer, ger~eral contractor, electrician, plumber or builder ............... d:.. ' II /_. -,4 "~ .......... , ................... : ......................................................... Name of owner of premises ............ .~'..,O,.,~....Cf,..r~,.,!..,~..,... 5 ,~,, k'/~ ~. /..../~....~..1 ~.'~.' ' If aj;~olicant is o corporate, signature ?f duly authorize~'~f'ii~'~'~.~' .......' ....... '~'"' ......................................................... (l~me and title of corporate officer) '. Location of land on which proposed work will b, done /~ap No' .~....,.(:~ .~.,..O. Itl~ ,,~. lu,, ~ ~ ~ Street and Number ..(W..~..~.F'.).'~ ~"C~"~ ' ~'"'~',~ /~:>! c~ 0.~ '~ 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 .......... ...~..l~.~. ......... 1 ...... ~ ...... . 3. Nature of work (check which applicable): New Building ..~. ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... .~.~....~..,z..7...~.?.. ................................. Fee .......................................................................................... (to be paid on filing this application) /.j0t4 t1~7~'1. . ~ r ............................ 5. If dwelling, number of dwelling units ................... Numbe of dwelling units an each floor If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, speCi~ 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 .................................... Roar ............................ Depth ................................ Height ............................ Number of Stories ................... ,/,~ I ........... 8. Dimensions of~entire new construction: Front ..... ..................... Rear ......~....~... .............. Depth ..~...~...- ............. Height ,......~....r ........ _Number of Stories ...... ~ ..................................................................... ....., ....... o ......................... 9. S,ze of lot Front .................. Rear .......................... Depth ~:,~,~..~....~.~.~,....~.eff 10. Dote of Purchase ........................................................ No, me of Former Owner ...................................................... ;: 11: Zone or use district in which premises are situated ...... .-.~ .................... , ...................................................................... 12. Does proposed-construction violate~ ~ __~ar~y ~Gning jaw, ordinance orl/~.~.~l.~,~rk,f..~n,,..~ooreaulation? ........................................................... 13. Name of Owner of pre_mjb_es ./'f.e...~....~/i../..l~.~.!.~.~ ........ Ac~dress ..::..~.f' '~'..~.~'~..~...:... Phone No ..................... Name of Architect .....C....~...~..!.~........//.~..K....~....f..~.. ........ Ack:lress ............................................ Phone No ..................... Name of Contractor ....~...{'..¢:....'~....L~..!.'!.~t.~.r'...'?....'~:....t1.~:.....Addre.~ ..;~,.~.~.~..e4.~..~. .......... ~hone ~;~ ~[.~.7~..~.. PLOT DI^~RP~ Locote cleorl¥ and distinctly oil buildings, whether existing or Propo~d, ond imti¢ote oil .~t..~k dimensions from property lines. Give street and block number or descrlpfio~ o¢cordin~, to de~t, ond show street names ond [ndicats whether intsrior or corner lot. ,9- STATE OF NEW' ~Ol~(- ~ S $ CouNTY~OF ..~.~ ............ ~ .............. ~ ............... ~~ ............. ~ing duly ~o[n, d~es and says t~ he is the applicant (Name of in~vidual signing ~plication) above named. He is the ............................. ~ ............ ~ ......... ' ................................................................. (~tmctor, ag~t, co,orate officer, etc.) of said owner or owners, and is duly authorized to perform or h~e pedo~ed the ~id work and to ~ke ond file th s application; that all statem~s contoihed in this aPplic~ion am t~ to the ~st of his ~owledge and belief; and tha~ the work will be performed in the manner set fo~h in the ~plJc~i~ fil~ therein. Sworn to ~fore me this ~ ..... ....... ....... ................. ~o~ ~ubli .... Coun~ ELIZAB~H ANN N~ NOT~Y PUBLIC, State of ~o. 52-8~2~50, ~ff~ Term Expires M.~b ~.