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Home My WebLink About8868-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 8868 Z Permission is hereby granted to: ...... ~.?..e..e..e....~g,~.e....~g.~.e.,~....~.~g ..................... .......................... ~t~w ................................. at' premises located at ...~Q~...6~.....~On~__~.~D=ff, V~ ........................................................................... Dee~ ~.1~ .g]~ ~tate~ ......... ~t~£tuck .............................. Fee $. ~..6..9~.0. .......... -pursuant to ~application dated ........................... ~e~l~......~.~ .......... 19.~J~.., &nd aPproved by,-the Building In~ector. ............ ~"r;'~~ ............ FORM NO. s TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Soul'hold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 farm or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planmng Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April ]957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 ,,I 3. Copy of certificate of occupancy $1.00 ~.....~J~ ~.// New Bqilding / Addition Old or Pre-existing Building~ . Vacant Lan~ Permit ,o.~..~?...~.., .... Dote Of Permit .................... Applicant /.~~..'~..,,'~.....~;. ...... Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate .......................................... Fee Submitted $ .................................... C~nstruction on above described building and p~ni~, meets//~app,~tb~/~lC~ an~ regulations. ^pp,,cant ....... Sworn to before me this "~ I 5'~.. ................ day of ............................................ (stamp or seal) Notary Public .................................... County ~'/'/~' ~/~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number ~----~'~ - /?3 APPLICATION FOR APPROVAL TO CONSTRUCT ~) ~ ~ A PR~ATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY l Address~O~;~-~ iO ~q ~,~.~ ~/~'~ ?'~- '- ~'" ~-6..,.Section 2. Prope~ L.6'~ation~ ~ ~~,~3~ .... 7.~Lot ~=~'~ .-.~ ~.~<~.~'~~ 8, Private Village ~ T. ownshi~_~. 9. Public Water~ 3. Public Water CompanY Name /1>~ - Distance to main ~.~ 4. Lot size: Width//~ feet Len'gth~? feet 10. Sewage Disposal System: ll. A. 900-gallon septic tank: Precast ' Equivalent B. Leaching pools: Numbe~j pools / Precast "Block Special__ If private well, fill in the fol- lowin~t~blanks: A. Ta~kocapacity~'~'' gallons C. T~I well D. Depth to ground water~~'" E. Amount of water in well (For Health Services De~t. Use) Block , ~ The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' current standards thereto." This application will be valid for one year from the date o~approval indicated below and may be r~emewed i~a current local Building Department Pern~/c is in effect. Da~~.~/. ~S Signed /~~~ FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information presented here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE S-15 Rev. 4/1/73 S UF'FOL K - N 87°1~ 20 ~ 1~2 00' Lot GE NO TE · = MONUMENt' SU~DIi//$/O'/V MAP FILED IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON REVISIONS YOUNG 400 CSTRANDER ~VENUL, RIV[.RH[AD, NEW YORK ALDEN W YOUNG HOWARD W YOUNG SURVEY FOR. HENRY D. OSCHMANN 8~ GRACE OSCHMANN LOT 67 "DEEP HOLE CREEK ESTATES" AT MATTITUCK TOWN of SOUTHOLD SHFFOLK CO, N Y SCAL~ I" = 40' l DATE JAN. GUARANTEED TO' FIRST AMERICAN TITLE INSURANCE CO OFN Y THE NORTH FORK BANK 8~ TRUST CO. /V w SUFFOLK lot GB 87o19 '20 I~2. O0 ~ 1~2, O0 ~ NO · -' MONUMENT 0 -- STAKE SUBDIVISION MAP FILED IN ~'HE OFFICE OF THE CI. Et~K OF SUFFOLK COUNTY ON dAN 28, 1965 AS FILE NO. 4256 REWS,ONS YOUNG & YOUNG 400 OSTRANDER AVFNUE, RIVERHEAD,'NEW YORK ALDEN W YOUNG ~ARD W YOUNG SURVEY 'FOR. BEN MENDOZZA LOT 67 DEEP HOLE CREI "rowN o~ SOUTHOLD SUFFOLK CO, N Y, ~Y DA'rE OCT 10,~975 I¢~° 7~-695 APPROVED AS NOTED FEE: ? .~ ~ .BY ~'~_ NOTIFY BUiLDiNG DEPAI~TMENT [bAc I< ¸FI ,/ FULL