The URL can be used to link to this page

Home My WebLink About6211-zTO~[N OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z608~ ...... Date ............ A~g ..... j~0 ..... , 19..74 THIS CERTIFIES that the building located at R.~0,W,..N/~. ~orth..Road. .. Street Map No..XX ......... Block No...~ ...... Lot No~.. Gx'aenpor. t.. ~.,Y, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............0c$~ .. '3~-, 19.?~. pursuant to which Building Permit No. 621 ~Z- dated ............0et .... 34.., 19.?~., was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~i~ate..one. f~,,il~..dwelling ....................................... The certificate is issued to .Nieholaa. 1,9~6a~o ....... 0~nel, ...................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ABg...23...1.~....1~'..R.:..V~.~ ..... UNDERWRITERS CERTIFICATE No. N~ 7.~6~ .... Ju~... ~...~ ~7~ .............. HOUSE NUMBER...6~1~0~ ..... Street. lfol~th. Road. - .¢]L2.7 .................... --Building In~tor [ ~0~ NO. ~ 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) 6211 Z Permission is hereby granted to: ..... ~ ......................................... ~.¢..A.L.~-o $.. ~.o...o. ~/,~.0..c~.T'......Z?....o...~.~. .. ,o .~ ............................................... ~ ....... ~ ......................................... at premises ,~ated at ~.~,......~ ...... ~.~..~-~.....~ ~ ...... ~'~"~J ............... Ge~U ~ ~-~, . .......... pursuant to opplication doted ..... i~....C~......'7~......r~./. , 1~.~.., and opproved by the Inspector. Buildiy ~ Fee $~... Building Ir~spect~r~ / SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No.~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM 1. Applicant~6~$ ~ tiu~.~ ~o1¢~o Phone&~$~lY75. Subdiv. Address ~ ~.~,,n'- ~o ~ ~.;. ~'Y- 1IVY& 6. Section 2. Property location~o~4~ ~ 0~ ~o~ ~ 7. Lot No. ~tt~ ~,~ ~ ~ 0~ I~- 8. Private well ~o Villase G o Township $~uT~ 9. Public water ~ 3. Public Wa~er Company name=~mo~o~kt Distance to main 4. Lo= size: Width ~oLe. feet L~nsth %~7 + feet (Enter on center plo~ below) 10. Sewase Dispos~ystem: A. ~00] Ballon septic tank: Precast~ Equivalent Block ~ B. ~chin8 pools: Number [ Precas~Block Speclal If private well fill in blanks below: Tank capacity Gals. Pump.~~ Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 be ~ ~- -~f~'~'-' :al~h's_~ ~ Icurrent ards thereto." Date {~ ~ ~ I---7~ Signe~~ Owner or Builder installations will stand- FOR HEALTH DEPARTMENT USE ONLY.' Based o.n the information presented herewith, it is the op'inion of the .Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this plot. Date (/'~z/b ...__ Signed S-15 Revised 4/1/72 APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate 1-Means Owner or Builder. Address to which mail should be directed. 2-N~ans detailed description of property location, together with street name and distance to nearest intersection of main thoroughfare, also Hamlet/Village & Township. 3-Enter name of Public Water Supply District, together with the distance to their main. 4-Enter Length and Width of Lot under appropriate heading, also enter these dimensions on center plot plan shown on the face of this application. 5-Name of subdivision. 6-Section number. 7-Lot number. 8-Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. 9-Public water: Enter "Yes" if Public water supply is available. Enter '1Io', otherwise. ~OPOSED SYSTEMS: Answer to Item number 10, consult the Suffolk County NealthDepartment's Standards for Sewage AndWaste Disposal Systems Design of Residential Subsurface Sewage Disposal Facilities. Part I-Residential Subsurface Disposal Systems covering cesspools. PLOT PLAN: The following information is required concerning the Applicant's lot: ~ size-Length and Width in feet to be indicated at the lot lines of the heavy lined square in the center of Plot Plan shown on face of this application. ~ 2. Surface waters-Streams, Lakes, & Hays, etc., located within a distance of 1OO feet of Applicant's lot lines, must be sho~n on the plot plan also. 3~ Wells and cesspools now on adjacent lots must be shown on the plot plan, together with the distance to the Applicant,s proposed Sewage Disposal Systems and well. 4. Where no buildings exist on adjacent lots, state "Vacant" on the plot plan. 5. Streets adjoining applicant's lot to the right, left or rear, enter street name. WELL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the following Standards must be observed: Well-lOO feet minimum distance from the nearest cesspools. Well- 25 feet distance from rear and rear sides of property lines when possible. Well- 10 feet distance from front, and front sides of property lines when possible. Well- 50 feet minimum below grade for well point. Well- 40 feet minimum into ground water for well point. Well- 4 feet 6 inches minimum below grade to well head and lateral water pipe. ~SSPOOL LOCATION: Upon determination of the Sewage & Waste Disposal "type of systems" re- quired, the following Standards must be observed for the location of same: 1-Cesspool- 5 feet minimuTM distance from lot lines to exterior of cesspool. 2-Cesspools exterior must be 1OO feet minimum distance from nearest well. 3-Septic t~nk exterior must be 75 feet from nearest well. 4-Cesspool exterior must be 7 feet minimum distance from nearest water line. 5-Cesspool exterior must be 10 feet from house foundatie~4 6-Cesspool exterior must be 1OO feet minimum distance from surface waters, streams, lakes, &Bays, etc. 7-Cesspools must be 20 feet minimum distance from large trees. 8-Cesspool exterior to cesspool exterior, must be at least 8 feet. 9-Cesspool cover top to grade must be held to minimum of 1 foot to maximum of 2 feet. lO-Bottom of cesspool to ground water ~st be held to minimum of 2 feet. TOWN CLERK'S OFFICE~ ~ ~ ~ ~ SOUTHOLD, N.Y. ~,~,L/ Exomined ......... ( ................ 19 ........ ~ Applicotion No ................................. Dimpproved a/c ........................................................ ... ................................. w~ ~ ~.,~ ' ............................................................................................................ ...................... .....................................................: _ APPLICATION FOR BUILDING PER~,IT ~ .... ~ / uote ........... I.~ ....... 2 ....................... , 19.....~..~ a. lhi~ application mu~t ~ complet~l~ fillod in b~ t~writer or in ink and ~ubmitted ~n triplicate to th~ Buildin~ Inspector, wit~ 3 ~ots of ~lan~, accurat~ ~lot ~an to ~eale. ~e~ accordin~ to ~chedul*. . ~. Plot plan ~howin~ location of lot and of building* on pr~mi~ relationship to adioinin~ premises or ~ublic ~wm~ a d.tailed d~cription of la~out of pro~rW mu*t ~ drawn on diagram which is part of this a~plieation. e. The work co~r~d b~ thi* application ma~ not be commenc0d befor~ is~uan~ of 8uildin~ Permit. d. ~n ~roval of thi~ a~pfieation, the 8uildin~ Inspector will i~su~ a Buildin~ Permit to the a~pficant. Such ~rmit th~ ~remi~ ~ailab~ for in~etion throughout the work. ~. ~o buildin~ ~h~ll ~ occupied or u*~d in whol~ or in part for an~ purpose what~r until a ~rtifieat~ of ~rant~d b~ th~ Buildin~ ~n*~ctor. ~PPUC~TIO~ IS Hfi~fiBY M~D~ to th* Buildin~ D~a~m*nt for th~ i~uan~ of a Buildin~ ~rmit ~ursuant to th~ Buildin~ Zon~ Ordinan~ of th* To~n of Southold, Suffol~ Count, ~w York, and other a~plieable kaws, Offiinane*~ or ~ulation~, for th~ construction building, ~dditions or alterations, or for r~mo~al or d~molition, as horein de,cried, lh~ ap~limnt a~roo* to com~l~ ~ith ordinance, buildin~ cod*, housinfl cod~, and re~ulations~ and to admit authorized in~*ctors on promi~*~ and in buildin~ for nem~r~ in~ection~. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, arch~itect~ en~]in~er, general contractor, electrician, plumber or builder; blame 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 be done. Map No.: ........... ;.., ..... Lot No .............................. ~ ............... Street and Number..~..~...~......o.~.....u~.~.....o...F~.....~.~..J'../~.~....o.~...../~..0....~..~....../~..,..~,~&..~.?J. ........................................ ~' ~ ~'zP ,~ . Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy .................................................................................................................................... Intended use and occupancy ....................................................... 3. Nature of work (check which applicable): New Building ...... ,,v. ............ Addition ..................... Alteration ............... Repair ....................... .. Removal . ...... .............. .... Demolition ..... ............... ... . Other Work .................................... (Description) 4. Estimated Cost ............................................... Fee ..................... ..~...t.~ .................... .~ .............................................. (to be paid on filing this application) 5. If dwelling, number of dwel(ing 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 ......................................... Height Number of Stories Depth ....................................................... 8. Dimensions of entire new construction: Front .....~.].[.-...~.~.[ ...... Rear ..... ~.~.~....~..". ....... Depth ......~...~......~ ................ Height ................................................. Number of Stories ................ ~/~.~.~.. .............................................................. 9. Size of lot: Front go * Rear .............. ~.9.[ ...................... ~ ?° ~ v ...................................... Depth .....~. ........................................... 10. Date of Purchase ..................................... Name of Former Owner ....~.~...~. .............................................................. 11. Zone or use district in which premises are situated .............................................................. z:. .................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ .............................. Will excess fill be removed from premises: [ v~ Yes [ ] No 13. Will lot be regraded He ' 14. Name of Owner of premises ~..,~..~..~..~. ~c~~-~"~?~?~?~?~~1~u.~;~;~ ............... (Addre[ss) (Phone No.) & ?~ Name of Architect ....~...4~...~.,,D.......~....u..I;~.,~. ....... .~....~..~.....~..,F.7...'~......~..T*,:...F...Y.,...~..;.~. ........................................................ (Address) (Phone No.) Name of Contractor ....~.~..c..../~......Cf~.,. ~. ~ ,..o~..~ ............... j~.~X~.t~..~.~. ............................................. {Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW Y~RK, ~, ~ -- ) COUNTY OF........ ~l~m~:~ ........... .......................................... ..~..~..~...~. ............................. beinG duly sworn, de~s and says that he is tbe appli~n~ above named. (Name of individual si~ing con~act } ~e i~ the .................................... ~.~ .................................................................................................................................................... [Contractor, a~nt, co.orate of~cer, etc.} of said owner or owners, an~l~E~horized to ~rform or have ~rformed the said work and to make and file this application; that all statements contained~l~fl ~r~ the ~st of his know~d~ and belief; and that the work will be ~ormed in the ~n~r set forth in the applicat,~ ,~unty ............ .~,~ ................... day of ....... ~.~.D~.%~ .......... 19 ..L~. Notary Public, ..~.~.~.C.., CounW ..... ~.;...,: ............. ~..; .......................................... ~ak oate J~ly THIS CERTIFIES THAT THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK toO3B 31, 197~ Application No. on file N 173981 only the electrical equipment as described Iwlow and introduced by th~ applicant named on the above application number in the premises of Lo Scalzo, n/elde Soudd Avenue, on Pvt. Road, Oreenport, L.I. in the follmving locatlon; [] Basement [] lst FI. [] 2.d ri. outside s~tion mock ~ot w~ exa,.~,~d on J U ly 2 5, 19 7~4 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANOES OVENS DiSH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 31 DRYERS MULTI-OUTLET SYSTEMS NO. OF FEET S E R I C NO. OFpERCC.~CON D. A. W, G. NO. OF HI-LEG A.W.G. NO. OF NEUTRALS A.W.G. 4/0 1 4/0 Alco Electric Co., 336 Concord Street, Dix Hills, L.I. 117~6 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. /OSCAL ZO // .~co/~ ,CC)' = /" iL¸ L ,1 ,i II¸ '1 ' 7 n DAVID E. GUISE ,, A R C H IT E C T