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Home My WebLink About5382-zTOWN OF $OUTHOLD BUHI~ING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z.~3 9.7' ...... Date ............=~uguat. 2lt..., 19.7.3. THIS CERTIFIES that the building located at . .L~eqnash. A~e ............. Street Map No .....~C~ ...... Block No..L~ .......Lot No .... XXA..Cu.tchogue~. I~.,Y, ...... conforms substantially to the Application for Building Permit heretofore ~ed in thi~ office dated ........June. ~8 ~ .... , 19.72. pursuant to which BuiMing Permit No... %3.82Z dated ........Jm-~e..2.9t ..... , 19..73., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P.~ivate. or~e .family. dwelling ..................................... The certificate is issued to . .. Edward .E.. Harva~ ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...D.a.t..~l...~...~lmy...1.?~..~.??.~.,,.R.:..?/,..l~.. ~.~WIT~S C~.~TIFI~ ~o..~. ~..~..~.. ?.:.~..~:..~.~.: ..~?~ .......... HOUSE NUMBER .... .~0~ .....Street ...Pequash. ~v~.$ ........................ ................................................ Ct~tchogue ..................... ......... .... Building Inspector ( FOI~ NO, ~ TOWN OF $OUTHOLD 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) 5382 Z Permission is hereby granted to: .............. ;~'-'~e~ .................................. ................ 68'-" '~,~ea~:e~ "~m~ ........................... ................... ~d.~k'~]vZe ......... .~1.,.~.,i...-.1.t 80 ~ · to .... ~-a.~.3;~...ne~w...~ .. ~.~3~.. ~.~e.:~ -2 ~a~ ...................... .......................................................... at premises located at ..... ~/2..~eqla~sk...~.~e ........................ i ......................................................... ................................................ (~h~-e '' ~:~'~ ............. , ............................................ pursuon~ to application dated ........................... ~t~3~e.....~ ....... i'"", 19..~].., and approved by the Building Inspector. Fee $-.-~.0~J~qO .......... Approved 19 ........ Pemit No ..................................... Application No......~'..~..~,..,,,L--. .......... Disapproved a/c ............................................................................ ~ APPLICATION FOR BUILDING PERMIT Date .......~...U...~....~.......~....~. .................. , 19..~/. ...... INSTRUCTIONS a. This opplication must be completely filled in by,typewriter or in ink and submitted iQ duplic o the BuildingJ~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving 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, fhe 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 Deportment 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 code, housing code, and regulations. whether applicant is owner, lessee, agent, architect, engineer, gan]roi contractor, electrician, plumber or builder. ............................... ....... ....................... lame of owner of premises ............... ..~...~N~..~.~....~..?.....~....:..~.~.~...I~...~...~.. ............................... applicant is a corporate, signature of duly authorized officer. I Street and Number .... .~..e.~.~.~.,,e.~.~.~.(~...e.~.~,~...~..¢...~..~...~.x.g.~.~.,.~.~.Z.~..~9.r.~..~r.~.g~.; ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........... ,~..C-.~..~3..I ........ ~-.,t~.AJ..~ ........................ b. Intended use and occupancy ..; ................................................... ..~ ......................................................... 3. Na re of work (check which applicable): New Building .... :. ............ Addition .................. Alteration~ ................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................... .~. ................. 4. Estimated Cost ...?...f~..~...O...?....~.. ................................ Fee ....~/....~'....~.. ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......O...~....~.. ............. Number of dwelling units on each floor ....O,...~r.?...i ............ If garage, number of c~rs .............. '~....~....~.~. ................................................................................................................... 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 .....'...' ............ I~jght ........................ Number of Stories ................................................................................................................ Dimensions of same structure ..................... ~ .............. Rear ............................ ......................... Number ................................ ' Depth ................... ~Jght cf Stories 8.' Dimensions of ent. ir~ new 'construction: Front ....... ..~....: ..........Rear ...~,..O. .... : Death .~.;~. Height ...~.~.~...~i.'.~..~..'~ 'Number of Stories .,.::._.~...~....~.. ...... ~ ....... ~ .... : ". ............ 9. Siz-e'o~f-I~;~-~r0~t ...... ~..'~...~. ........... Rear ........ ./....~..~ ................... Depth .../..~..-.~.. .................. 10. -Date o~ Purchase ...~.g. ff~...-../..?..~...t. ................. ~......Name of 'FSI*ruer Owner .....~..~.~.6..~..~.:..~.:..~,~i~f.~. ......... 11.. ~ Zone or use d,stnct m which I~mises are situated ...... I~i~$.A.~..~k~TI..~...~....~ ...................................... 12. 'Does proposed construction violate any zoning law, ordinance or regulation? ...:~.~... ............... i ........................ i3. Name of Owner of premises .~.....~{t.=~.~.~e..~...~. Address ~.~..'..~f,¢A.~..~..~[e...~.j[~ ~N,0.J~..;~L../...~.. Name of Architect ..j~..:...~.~.~..~l.,;..~...~.~..~.!..e...~.. ........ Address ~..~.~...~.*...~.~..I...~.~.~...~... ..... Phone N~.'~..~.:.&...5....~...~, · No. Name of Contractor ...~.~.:~..~..~./.~..~U[.~. Address ' ' ' PLOT DIAGRAM L.oc~e clearly and. di.stinct!y]~ll .builcr~t~gs, whe~.,h~r ex sting or p,.mposed, and indicate ~11 set-back d mensions from propert~y lines. ~ive street:~ and DlO4~K narfiber or aescription aecoidmg to deed, arnCd sho~-street names 'and indicate whethe~ interior or comer I~c. ~ ? STATE OF NEW YORK, COUNTY OF ....... ~ ................ ~....($ ~'~ ................ ..~...t1~/d~, .~...~ ............... '.~...~../~..~....~'~.....~ .............. being duly swam, deposes'and says that he is tl'm appl;icant ' (Name df ndividual signing applicatfon) above named. He is the ...... '...C. dt..'~.~JT.~t.~...~'..e/..'. ................... , (Contractor, agent,'corporate officer,, etc~) of said owner or owners, arid is duly puthori~z~d to pe~rform or have performed the said work and. to make ond file 'this applicat e~; that all statements .cbnToihed~ in fhis,opplicdtion ere frue to the best Of. his Enowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith~ Sworn to b~. lore me this /? ....... ~...~....?....... day of ~.~.~.. ....... ~ ........... , 19...~..../. ,,,~__~~_ /~ N0tary.~ Pub~a~,,~[~__~,~ic,. .......... ~/~. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH dUL 1 7 1972 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. Chief of General Engineering Services JUL 1 ? 1972 EASTERN DISTRICT, RIVER~EAD,N.Y. APPLICATION FOR APPROFAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTE. MS Date Approval to construct said systems is requested,pertinent data herewith: 1-Applicant ~:~ ..,....,,,I /~, ~a~lJm~ Phone~ I.le~'~ 6-Sub div .--- Address , /-~_~..~.~.. z.~, ~;,;~,,,;~l.. ,,AN~. ,,~.~ ?-Section 3-~blic ~te~ ~p~y ~6 '-[ ,~ ..... DistAnCe to nearest ~in ' 4-~t Size: Width~ft. Length~ft. (also enter on center plot plan below:) 5-~elling: SingIe Family ~ T~ Family7 / /Cellar? ~lab? ~ ~Crawl S~ce? lO-~o~s~ syst~: Septic tank ~ /Precast ~YCess~ols ~ /Shallow ~ols il-Septic ~ inside dimensions: Vol~e Gals. Length ft. Width ft. Liquid depth ft. 12-Precast sections: ~Number~re Ft. Cesspools: Block sizeL incs.D ~s.H ins. Total blocks below inlet' : ~1 ~2 ~3 ~ ~ooL&- ~,~? ~c . DcM= ~Thw~A& , ' · 0 ~ O~ PLOT PLAN ,G 'ad~ GW.L. Capacity~Gals. G.P.M. RS · Data. ' Feet 0 2 6 8 10 12 14 ~6 18 N~ The Undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Health Departments' current ~tandards, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". FOR HEALTH DEPARTMENT USE ONLY. Based on the znformation pr~hted herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date 7/~/ Signe~~ (10/65 Revis.) i .t II, Co" i $?,~cE ,4¸ /h .L z'-U'.. t&'~ z.m. tr,-- ~