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Home My WebLink About5718-zi! • FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Cleric's Office Southold, N. Y. Certificate Of Occupancy No. ZI P5.9 ...... Date ............ .4.ctober ..1.7..., 19. 72 THIS CERTIFIES that the building located at Meada�,r .Lar]e .............. Street Map No.. A=....... Block No. .......Lot No.. xxx Cu" ... 1�.Y.•.. , .. _ . . conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Feb ... 1.7. , 19. ?a pursuant to which Building Permit No. .15718Z . dated ........ Feb . 23..... f 19 72 . , 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 . orie..i"amily . d3'Te,1J_in.g........................................ The certificate is issued to. ji@,jq . E.xlger i ssex„ _ , _ G?lri-er (owner, lessee or tenant) of the aforesaid building. Vlla Suffolk County Department of Health Approval August.. 1.1. 1.197?, . ......y R. `. ?.... . UNDERWRITERS CERTIFICATE No.. N.�.7AW....................................... HOUSE NUMBER..535........ Street... Iie,?.dox .L@� ae................................ . 14Ww4 �7 ............ Building Inspector FORM NO. A 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) N? 5718 Z Dote ....................... ................ 19"... Permission is hereby granted to: to fti]A..lMW..Oan -1841i}.YAWALL AS.......... at premises located at ....... Ne"ev .1aw ................. ..................................................... CIkbimikllgw..... N Y'T y................ ......................................................................................................... pursuant to application dated ......... Building Inspector. Fee $.#S,4.......... ... sob .....ig................. 19.7$.., and approved by the I T) t- r" ' SS F C P. �i isS ["Y - J % /Jfl,. . r��..?� ........ Building inspecto SUFFOLK COUNTY DEPARTMENT OF HEALTH EASTERN WZTR=NICTjAt RHEAE,.Y. H.D.Reference No V CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMSDate b g G / y systems is requested.pertinent data herewith: !-Applicant ��/moi (�j B. �i�/! eTly Phone A(,r--2!C V V6 -Sub div &C& £ Address .D V • 7 -Section 2 -Detailed property location ' �sT Sjd _ c�se.AJ 8 -Lot No, o, AN "C 9 -Private well? 3 -Public water supply name , Distance to nearest main S M �/c_ 4 -Lot size: Length/e,- ft. Widthiy o ft. Also enter on center plot plan below: 5 -Dwelling: Single family? c/ family?"Cellar?,Slab?LLCrawl Space?/� 10-Propo3ed system:Septic tankL/Precast=Cesspools(�/�Shallow- geols(_[otheru ll -Septic tank inside dimensions:Volume Gals.Length Ft.Width _ft.Liquid depth—ft. 12 -Precast sactions :Z&Number.LO!!e/Square ft.Cesspools:Block size L ins.D_ins.H_ins. YN +M e 4- 9 E3 qpy A a0o O e w 010 1 e 4� 0 43w m ,~j tb o 0 CO -4 1200 90W Street Tank ICapacityqLGals Indi ate No th Test Hole 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 Aswage Disposal Systems". _ Date-�2 / 6 Based on the information presented herewith,it is the ,that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date y v Signed (lo/65 Renis.) Q, 5 r1% Za IQ rS VA-:- 0.; U Street Tank ICapacityqLGals Indi ate No th Test Hole 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 Aswage Disposal Systems". _ Date-�2 / 6 Based on the information presented herewith,it is the ,that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Date y v Signed (lo/65 Renis.) be submitted in 1 -Means Owner or Builder. Address to which mail should be directed. 2 -Means detailed description of property location, together with street name and distance to nearest intersection of main thorofare, also Hamlet/Village & Township }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 -Dwellings: Check -mark "V" items applicable to the proposed new dwelling. 6 -Name of sub -division 7 -Section Number 8 -lot Number 9 -Private well: Enter "No" if Public water supply is available. Enter "Yes" otherwise. V, PROPOSED SYSTEMS: Answers to Items number 10, 119 & 12 please consult the Suffolk County Health Department's Standards, Bulletins and Amendments for Sewage & Waste Disposal Facilities. i.e., Part II -Residential Sub -surface Disposal Systems covering Cesspools Part III ^ " " " " " Septic Tanks Part IV " " " " ^ " Unusual soil conditions Part V ^ " " " " " Shallow Leaching Pools PLOT PLAN: The following information is required concerning the Applicant's Lot: 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. Surface waters -Streams, Lakes, & Bays, etc.,, located within a distance of 50 feet of Applicant's Lot lines, must be shown on the plot plan also. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. Where no Buildings exist on adjacent lots, state "Vacant" on the plot plan. 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 -100 feet minimum distance from the nearest cesspools Well -25 feet minimum distance from rear, and rear sides of property lines Well -10 feet minimum distance from front, and front sides of property lines Well -50 feet minimum below grade for well point Well -40 feet minimum into ground water for well point Well -4 feet 6 ins. minimum below grade to well head and lateral water pipe CESSPOOLS LOCATION: Upon determination of the Sewage & Waste disposal "type of systems" required, the following Standards must be observed for the location of same: Cesspool -10 feet minimum distance from lot lines to center of cesspool Cesspools exter�or must be 100 feet minimum distance from nearest well Septic tank exterior must be 75 feet from nearest well Cesspool "Cgntgr" must be 12 feet minimum distance from nearest water line Cesspool "Center" must be 15 feet from house foundation Cesspool exterior must be 50 feet minimum distance from surface Waters, Streams, Lakes & Bays, etc. Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center must be at least 16 feet Cesspool cover top to grade must be held to minimum of 1 food to maximum of 2 feet Bottom of Cesspool to ground water must be held to minimum of 1 foot 7711, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 39 1974 752677 BateOetober Application No. on file N 73 1858 THIS CERTIFIES THAT Ci Q / J only the electrical equipment as described below and introduced by the a plicant named on the abaoe application number in the premises of W. 1:nerisser, 535 Mwadow Lane, G�u tchoque, L.S. f in the following location; ❑ Basement ❑ let Fl. ® 2nd Fl. O Ut s i de Section Block Lot was examined on ;epte mb e r 30, 1974 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT INT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. X.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT TRANS. HEATERS MULTI-0UTLET SYSTEMS NO.OF FEET DIMMERS AMT. WARS OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. Mrs. AMT. H.P. SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER EQUIP. 1.B' 1W 1 Jt 7W 1 b' 3W D,9' /W NO. OF CC. CO He PER . A. W.G. OF CC. COND. NO. OF HI -LEG A. W.O.NO. Of HI-LEGW.O. OF NEUTRALS A. W. TR Of NEUTRAL OTHER APPARATUS: :- 1/2 on A.C. Unit Z -Gun574 Z, 372, - Gunter ter Morchel, :-9t�in Road, *GvUA Mattitllck., L.I. 11952 R Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANN -R. k i -sty. I� � canefr., 9or. 760 S8 :ZO"N/ Scale 40 / 0 = cer, iP OO/ N 110 R x 0 k 4 Q 5 TEST f-/ot. E 4eot l --iP IoaEN �_ I a la or snnrJ. i _74, LA. Iq {E'r MAP cF PROPER T Y SURVEYED FOR i4 T CUTc VOGUE, N Y /L6 /, .. E/e. ✓a -v "ons show.+ are opt er/� � a✓l As 1u ht GC4r/ k GI�V//a// ri OM Of 8.0 i4i(�a T/�G{' y ✓10YTY1eQ5� GOfHtr O;A ORIUD4ILnRA�QORRADDITIdN TO THIS. SURVEY 15 A,. VIOLATION OF SECTICN 7709 OF THE NEW YORK STAT! EDUCATION LAW. CONES Of THIS SURVEY MAR NOT SEARING THE LAND SURVEYOR'S INKED SEAL OR EMROSSED SEAL SHALL NOT SE CONSIDeW TO RE A VAUD TRUE CORY. GUARANTEES INDICATED HEREON SNALE K" ONLY TO THE PE:SON FOR WHOM. THE SUpR IS PREPARED, AND ON HES DEHALF TO THE TITLE COMPANY, GOVERNMUTAL AGENCY AM UND" INSTITUTION LISTED, H.FEOH,.AND TO THEY ASSIGNEES OR TNE'wma. D6T1... TUTION. GUARANTEES ARE NOT ERAR6REMIIf TO ADDITIONAL. 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