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Home My WebLink About6954-z FO~ NO. 2 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) 695(1 'Z Date ............................ .{~.~ ....... ~[ ......... 19..~.3.. Permission is hereby gn3nted to: · ..,.,.~tl~3,:t a:.i~tc~, ................................... ................ I~t,t~Lt~l~ .......~,X.*. .......................... to.. ~ :l~...new...one.. ~:aml~....4w~l li~ ................................................................................ at premises located at ~.~.~...~,3......¥~,;~I:'~..~..~.~.3~. ......................................................................... ......................................... ~;L;~s.~...7~.~ .............. ...~.~..~ ~.tu~.~.....~..~.X,. ....................................... pursuant to application dated ......................I[~t,.....~.~ ................. , 19.~ .... and approved by the Building Inspector. [N~-tc-~ ¢_~.~-G---~ ~.~A[~ Fee $..~.~ ~,~ ........... AT' H.D. Reference No APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date Oct. 11, 1973 Approval to construct said systems is requestedj~rtinent data herewith: 1-Applicant Vincent Restivo Phone vIg-56646-Sub div Village Manor Address llO-11-1Ols~ '.~ve.; Richmond. Hill, N.Y. 7-Section 2-Detailed property locatmon ~/~ Village Lane 8-Lot No. Hamlet Mattituck Town Southold .9-Private welT? Yes 3-Pablic water supply name Distance to nearest main 4-Lot Size: Width l~ft. Length. z°lft. (also enter on center plot plan below:) 5-Dwelling: Single Family IXI Two Family? ~_./Cellar? / /_Slab? ~ fCrawl Space? / 10-Proposed system: Septic tank / /Prec~CesSpools /~/Shallow pools J /Other 11-Septic tank inside dimensions: Volume~90~Ts.Length ft. Width___ft. Liquid depth '.ft. 12-Precast sections: ~7~umber~_~.~ quare~. Cesspools:'Block sizeL incs.D___ins. H ins. Total blocks below inlet: ~1..___~2 PLOT PLAN ~ · C~city ~20als. Street Vi~ llage Lane N Indi e No 'th 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 10/11/73 Signed Inland Homes Inc./Kenneth W. thurber, VP Owner or Builder ,,~..~~~ FOR HEALTH DEPARTMENT USE ONLY. Based on the information 'presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this Plot. Oate Signed , (10/65 Revis.) ' ' S-15 Data Feet 0 2 6 8 10 12 18 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEP T-MENT TOWN SOUTHOLD, N. Y. Examined ......... :~:..~.~ ........ ~.....~ ....... , 19...~..~.. Approved ........................................ , 19.:i..~.. Pemit No. ~- / ~-' / / - Application No ................................. (Building Inspector APPLICATION FOR BUILDING PERMIT Date ....... Ocrt. M~l~'-'J~ ................. , 19...'~.3 .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, J'elationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on 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, the Building Inspector will issue a Building Permit to the applicant. Such permit,shall be kept on the premises available for inspection throughout 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 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) Be~ L1.7~ Nl~t~L~l~dr.~ ss s ........................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... V'~II~I~.~ ....................................................................................................... If applicant is a corporate, signature of duly authorized officer. ............. ..................... Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's ~nse~o ..................................................... 1. ~-_-C~ -' (~"' ' ~~ '~ ~ ....... ~ ............ S ree -- ............... .......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~I¢l~tlll~ ................................................................................................................ b. Inten~d~,~se and occupancy, ......~..p~,~,..~m~1.~:lt~ ................................................................................... Nature of work (check which applicable): New Building ..... ~ ............. Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work (Description) 4. Estimated Cost 26~ 683.00 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 ........................................ 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ,.,.1.,,O..O......O. ....................... Rear ..... ..1..4.7...'..8...9. ...................... "+" 201.15 10. Date of Purchase ..................................... Name of Former Owner ............................................................ 11. Zone or use district in which premises are situated ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: No 13. Will lot be regraded Yes Will excess fill be removed from premises: [ ] Yes [ ] No ........... V~'~'C'g~'%'"k e s t i vo 212-VI9-5664 14. Name of Owner of premises .. · ............................... (Address) (Phone No.) Name of Architect ...................................................................... i~,~,~'~i ................................... i[5~'~"~:i ............. " N .... Inland Homes- Inc. 298-9696 .... ame o? ~ontrac[or ................................. , .................................. i~'~[~')' ................................... i~'~'~'~i ........... PLOT DIAGRAM 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. /,. 2'. A~. /~, C~ ~ · STATE OF NEW Y(~rl(,_///~'~ ) COUNTY OF ....... c:~/.~./)St '~. ~,~.... .................. ) ......................... ~:~:,.:~....,.~ ............ being duly sworn, deposes and says that he is the applicant above named. ' (Name ofindividualsigr{ingca~ac~)_ Ne ~s the ............................................. ~~....-..~:~- ..( ............................................................................................... (Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fi~e this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. '""'"---N°tary .... ~i~ ~;~- ' ~"' '''~ ....... (.~ ..... {Signature of app ican / blOTIFY BUILEiNG gEPARTM~NT AT 765-2660 9AM 30 4PM FO~ REQUIR- ED iNS?~CTIOHS: 1 EEl'-ORE BACKFILLING FCUNDA" //- 0" 17.4 '(5' _:£~_