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Home My WebLink About7938-zNO. & TOWN OF SOUTHOI,D BUH,DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z(:~/ ...... Date ........... ~pt ..... 12., 19..7~ THIS CERTIFIES that the building located at . . ~/-atSh~.~.~. 314~ ......... Street Map No.. ~ ....... Block No.. ;~ ...... Lot No, .X~X...~.~.~l~.o~... ~., ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ l~y .... I~19, ~ pursuant to which Building Permit No. dated ......... .H~F., .~9. .... , 19..7.~, was issued, and conforms to all of the reqnire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.r.~..~J~..~.~...o.I1.~...~.a.m.~.~.y..~..W~..1.1..ir~ ................................. The certificate is issued to . .P~y$.e.~ .]l~l~l~pg .Q.o..~r~e....0~]~%* .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...8.qp~...~2...197~...bY. ~: UNDERWRITERS CERTIFICATE No... 1~2~:'!~ 5'~3 .... JS$p~;...9 .... 197~. ........... HOUSE NUMBER ...... ~10 ..... Street ...l~[a2.~h$~s...I~ ..... C~t~;chogtl~ ......... Building Inspector l~O~.~w NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER/vtlT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 7938 Z Dote ........................... ]1~ ....... 19 .......... 197~.. Permission is hereby granted to: ,, ~ ~',~.~---~ .~d:.~..¢(>z,Z~ ........................ ......... l.~?......~.~,,~?~.Z~a~e ................................. .............. ~,~,a~ ........................................... to,.b..~.~...~:...?.~..c.-...~.~,~4:....~.~,~,~t~, .................................................................................. at premises located at ---,~;,O~..~..--.~.{.~l~-~-~,.~.e~:~8 ............................................................................... .., ............................................ /~he~...~e ......... -¢~t~;~e.....i~.~-~. ....................................... pursuant to application dated ................. '.-....J¢l~.~...-'~ ................ , 19.~.., and approved by the Building Inspector. Fee $-~9--3(~ .......... Building Inspector~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY · · 1 Appl lcant F~,, %~ E' ~j Address I. 7 $..~,~ 2. Prop~rt~Locat~on Village ~ -~ ~ ~ ~:-~ 3. Public Water CompQny Name 4. Lot size: Width~C9 feet '~ Phone~7~. ~:V Township -,~'~ ~ Length, YX'; feet 5. Subdiv. '~ 6. Section 7. Lot Number 8. Private Wel 1 9. Public Water Distance to main 10. Sewage.~isposalF ) System: A. ~9~gallon septic tank: Precast ~Equivalent Block B,. Leaching pools: Number of pools ! Precast ~ Block__~pecial__ 11. If private well, fill in the fol- lowing blanks: A. Tank capacity ~ gallons B. Pump G.P.M. C. Total well depth D. Depth to ground water E. Amount of water in well ~ .- (For Health Services Dept· Use) 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 of approval indicated below and may be renewed if a current local Building Department Permit is in effect. 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 L:-,.. ~ Rev. 4/1/73 SIGNED SUFFOLK COUNTY EEALTN DEPAE'TMEN~ ~'aeil[ties for this l~ati~? ~ ~ inspected by this departmen~ 2~d ~')~.~ $-q ~ satisfactory. 0 Approved ...................................... i D~sapproved a/c ~"'"~'""~-~x.~_ APPLICATION FOR BUILDING PERMIT TOWN OF SOUTHOLD TOWN CLERKS OFFIC~/~/ro/-'/~'- ~ ~ ~/~O ,~ .. ......... 19~.~... Permit No .... ~.~.~..~..~.::'... INSTRUCTIONS a Th~s apphcat,on must be completely filled ,n by typewriter or in ink and submitted in triplicate to the Buildi~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ' b. Plot plan showing Iocatson of lot and of buddings on premises, retahonsh~p to adjoining premises or public streets areas, and giving a detaded description of layout of property must be drawn on the diagram which is part of thts applicatio c. The work covered by th~s apphcation may not be commenced before issuance of Budding Permit. d. Jd~on approval of this application, the Building Inspector wdl ~ssue o Budding Permit to the applicant Such perrr 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 untda Certificate of Occupon, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to t} Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) //~77 ~ State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or~u~ld.· Name of owner of premises .FI~..I~..~/.]:~ ..... ~1~--~ ........~ .......................................... If~ applicant bsa corporate, signature of duly authorized of Rcer. ......... ................ (Name and tltl~'~f corpor te o~icer) Builder's L~cense No ..................................................... Plumber's L~cense No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... j~ ~l~J~..~..~. ~.. Location of land on ~hich proposed work will be done. Map Ho .. ~. .~...~. Lot No .................. Street and Numl~/~...~....~..~..~.....~.~...~.. ....... ..~E/~..,...~.x . .~.~4~.~. ..... ...~...~.~....~...~.~_ ..... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction' / a Exlsitlng use and occupancy .......... .V.~,..T- .... b Intended use and occupancy .................... ~J 3. Nature of work (check which applicable) New Building .... ~ ........ Addition ................ Alteration .. Repair ................Removal .................Demoht~or .......... Other Work ................................................. t~'~..~] t ~ (Description) 4. Estimated Cos . .. ~.~ ....................................... Fee ,..~.Z,,~ .......................................................... (to be po~d on filing th~s application) 5 If dwelling, number of dwelhng units ......... 1 ................. Number of dwelhng umts on each floor ......................... If garage, number of cars ..... /. ...................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ........................ 7 D~mens~ons of ex~stmg structures, if any' Front .........................Rear ................................ Depth .................. Height ........................ Number of Stones ........................................................................................................ D~mens~ons of same structure with alterations or addmons. Front ................................... Rear ................. Depth ................................ Height ........................... Number of Stones ................................ 8 D~mensions/~/ofl ent, re new construct,on: Front, ..~.1 Rear ...... ~.l~. ................ I Depth .~':~ ....... Height-../..~ ..........Number of Stories ..... 1 ................................................................................................ 9 S~ze of lot Front ~-(~(~..~. .....................................Rear 1~.OOr .. Depth .... ~. ~ al ... 10 Dote of Purchase .... .~.l.~./..~....~... ......................... Name of Former Owner .....~..i.~/I~...L~/~A..I. '~...~ ............... 11 Zone or use d~stnct in which premises are s~tuated ........................................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation ....................................................... regraded .....'T[.~...~ ............. Will excess fill be removed from premises: ( ) Y~_ ~ No 13 Will lot be 14 Name of Owner of premises ~.g..I.~....~......~...~.... Address Name of Architect ........................................ Address ................................ Phone No ..................... Name of Contractor .... .~/~./~,~. ...................... Address ........... ..~.....(..~ ........... Phone No ........!..I. ......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex,sting or proposed, and indicate all set-back dimensions fror property hnes G~ve street and block number or description according to deed, and show street names and indicat whether interior or corner lot STATE OF NEW YORK, COU NT¥O.~ ._.. .... ........ ........... ...... (Nome of mnd~viduol s~nin~ controcO above named He ,s the ....... ~ ~.~ ............................................................................................................................. (Contractor, agent, corporate officer, etc ) of said owner or owners, and th~s apphcatlon; that all statements contained m th~s apphcot~on are true to the best of his knowledge and behef; an thor the work will be performed in the manner set foffh m the apphcation filed ~erewith. Sworn to before me this ..... of .... ........ , II ~I~ ~US~ NOTARY PUBLIC. Sh~fe o~ No ~-z~22~26 - Suf[e[k 0.47 ~ ~