The URL can be used to link to this page

Home My WebLink About7807-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerfi~icnte O~ Occupnncy No. Z6833. ..... Date ......... ~..~TB ...... 2 ..... , 197~. THIS CERTIFIES that the building located at . Ig/,8, D~ep. Hole. D~. ....... Street Map No. D~ .~o~ .~o ........... ~,ot No, .~. ..... ~o~..~,×, ...... conforms substantially to the Application for Building Permit here{ofore filed in this office dated ............ ~I~I':L1..-~, !9.?~. pursuant to which Building Permit AIo.. -7~0.~ dated ........... April.. 8..., 19.?.~., was issued, and conforms to all o£ the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Pti. vote..olie. £amily .dwellilll~ ....................................... The certificate is issued to .Ben. t~l®ndo~,z~l ..... o~tneI, .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .De~., 30...197:~. · .blt'. B.. Villa .... UNDERWRITERS CERTIFICATE No. N.~3.~9.03 ..... JULY....29...! 97~. .............. HOUSE NUMBER ....... '373~' ' Street.. ~eep. ~01®. D~ive ...................... .......... ~i~'~,~'i~t~ ...... '~" ' FOI~ NO~ 2 ~TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUiLD!I~G PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL'FULL COMPLETION OF T~EWORK AUTHOR ZED) 'N.O Permission is hereby granted to: ...... ~:.1t~..-~3.3 ....... ~ .................. .:....., ........ : ....... ........ .....::.~oa~...~.~/~....~.:~....~..t ~.7.~... to .... ~,¢],rl. ~.~...o.n.e..: ~.~,l~...~f~t3,.;t~g ........ :... ..................................................................... at premises located at ...... ~..~.~...,~. ....... ~.gf~,...}.].O.~,~...~.f~.~...]~l~.~. .................. : ............................... ................................................ t//.o..... ~ ~;.. ~0~..D~.t.~.e ............... P~. ~u~k .......................... pursuant to application dated .....................A]O~.'I1....,~ ............... , 19.,~.~,, end approved by the Building Inspector, Building Inspector TOW~ O~ $O~TNOLD , Building Deportment Town Clerks Office Southold, 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, anci unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form 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 Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), 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 3. Copy of certificate of occupancy $1.00 Date New B~ d ng ~/' Addition O d or P ......... /' ............ ~ ....................... .... ~' ........ ' ................ re-existing B~lding ........... ':Z" Vacant Land ............... Locat'on Of Pro err p y .... - ~ . //D~~ ............. ............. Permit No...~..~g.~.~.. Date ~ermit ~.~:.~.~pplicant ...~.~....~...~~ ...... ..~,,~ ~,. ~o~, ...~ ............................... ,~o~ ~,. ~o~, .... ~.~ ................................. Underwr ters Approva ...~..~.~ ~/~..Z..~..~.~ ........... Plan. ng B~rd Appro,a ~ .~...m ................. Request For Tempora~ Ce~ificate ........................................ FinQI Certificate Fee Subm tted $ ......... ~ ......... on above described building an~mit meets all applicable c~es and regulations. Construction Applicant Sworn to before me th s ~ ~ - ~..' .~.~.., ' .~.~...- ~...~ .... ...... ~ o~... ~=.... ..... (~,~m~ o~ Notary Public ....... [. ...... L.., ,~:~...~', ~b ~ ..... Coun~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Reference APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM iCEN ~ENDOZZ¢~ 7z~4 - 1414 1. Aoolicant ~'~AI~C~'~S R0~ HO~S,INC. Phone 5. Subdiv. D~P H0~ C~',~ ESTA~S Address ~JA~U~ .L~,~,~,X(JC~Y Fi. , ~.~. 11~ 6. Section 2. Property location W/S DEEP HO~ OR, ~961.13' 7. Lot No. S/0 ~f SUFF0~ A~ 8. Private well Village_ ~TTITUCK Township SOUEOLD 9. Public water ~0 Public Water Company name Distance to main Lot size: Width lP0. O~eet Lengthl~9,~2 feet (Enter on center plot below) Sewage Dispo~Sys tem: A. /~ gallon septic tank: ~t X Equivalent Block B. {~aching pools: Number '~Precast X Block Special --3~ gals. If private well fill ~3~. 88 ~ ~o_ O~ __P_,.29_ 2~,,-~-' .... ~ ~! Street OE}~P HOLE DRIVE The undersigned CERTIFIES: "Construction o~ authoriz in accordance with the Suffolk County Department. of H~ in blanks below: Tank capacity 4__~2Gals. ~Pump G.P.M. 5 Total well depth 60' ~ 20' ~ Depth to G.W. ~Amount water in of % well 40 ~als Test Hole ~ Data Feet } o 2 6 8 10 12 16 18 ~nstallations will be ~'s c~rrent stand- . wner 'or Builder ' BF2f i~ENDOZZA,PR~S. ,FRANCES Rosr~'~$,INC. 4. 10. ards JULY 26~ 1974 Date 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 plgt_. Date ~ ~ I~1 ~ ~ S-15 Revised 4/1/72 tT:!o" . i I / ,i 1