The URL can be used to link to this page

Home My WebLink About9093-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate O[ Occupancy No..Z90:/.6 ..... Date ..... June.. 21 ............. , 19..7.8 THIS CERTIFIES that the building located at .'[035...The~.esa. D.~.lv.e ..... Street Map No .... /4256 ..... Block No ........... Lot No ........ 57 ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... l~Ial~.ah...1.1 ......, 19.7.7. pursuant to which Building Permit No...909.~Z dated ..... ~Iam. ah...1..5 ....... , 19..7.7., 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 ..... PRIV. ATE..ONE. FAI~ILY .DWELL.ING ................................... The certificate is issued to ....... B~n .l~endozz~ .................................. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval 8-S0-168 UNDERWRITERS CERTIFICATE No ........ N5.8.7.558. ............................ HOUSE NUMBER.. ~. 035. ....... Street ....... .T~h~I'~a~ .D~'.~,¥e ................... ............................................. ............ Building Inspector FORI~ 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) 9093 Z Permission is hereby granted to: Frances Rose t!om~s Ina A/C ~n Mendozz~ I3ox 992 ~atn Ro~d Cutehog~le Build new one famil?, dwel~,in~ Lot 37 Dee:-: Hole Ck Estates at premises locoted at ...... .- ........................... E/S Theresa Dr Mattituek pursuant to application dated M~r ] ~' 19..~.~ and approved by the Building Inspector. ......... Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number ..~o-~_6~>~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY l. Appl~cantFRANOES ROSE HO~ES,II~Q~one ~ 744-1414 Address P.0. t033, BROADW_AY~KY POII~'£'~ I1. Y. 2. Propert~ca~nE/S ..... SA D. New Suffolk Ave~ ~%tituck~ N.Y. V~ 11age ~attituck Township 3, Public W~ter Company ~ame none 4. Lot size: WidthllO feet Length 182 feet 10. Sewage Disposal System: DEEP HOLE CREEK 5. Subdiv, ESTATES 6, Se c t i o n-~-~ZP~-~ 7, Lot Number ~- ~ 8, Private Well ~ 9, Public Water~ Distance to main (For Health Services Dfc_t, Use_) 11. A, 900-gallon septic tank: Precast X Equivalent. Block B, Leaching pools: Number of pools 1 ~P~ecas t~'~ X Block __Special ~f privB,i~e well, fill in the fol- .1 owing !~anks: A', Tank~apaci ry. 42 .gallons B~ Pum~ ~G.P.M. 6 g~l C. To,{~1 well depth. 60 O, Dept~ to ground water 16 ' E, Amount of water in well 46 NEW SUFFOLK AVE. q The undersigned CERTIFIES: "Construction of authorized instatlation~ will be in accordance with the Suffolk County Department of Health Services' current standards thereto," 7his 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 effec~ FRANCES ROSE. H0~ES, I~C. Date 10/20/78 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 SI NED S-15 Rev, 4/1/73 FO~ NO. 6 TOWN OF $OUTHOLD , Building Department 'rown 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: 1. Final survey of property with accurate Io~ation of all buildings, property lines, streets, and unusual natural or topographic features· 2. Final approval of Health Dept. of water supply and sewerage dispasal--(S-9 form or equal). 3. Approval af 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 ]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 3. Copy of certificate of occupancy $1.00 New Building ....~.o.~ ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .... ~/~\-~;~L~!~?~D~?~V~?~`~:~-~j~~:~{~-?~;~ Owner Or Owners Of Property ...... .~.c..~.~...!!.°..~..~..!:!.°.!?..G.~.L..~?;.c..: ....................................................... "Dee$~ Hole Creek ]Estates" -. . 3.7.. 103~ Subdivision ............................................................... LO. No ......... Block No ............. House N~ ....... ~ ..... ?/iendoz za, · 9o3z ~,'ranc es Homes Perm,t No ......... -: ........... Date Of Permit ~a.7. d[..:..;....Applicant Health Dept. Approval ............................................ Labor Dept. Approval ...... ~/.'.~ ................................... Underwriters Approval ..~.~...8..~.~.~..8......~/..2.~./.~..8. ...... Planning Board Approval ...~!'/.!~! .............................. Request For Temporaw Certificate ........................................ Final Certificate .......;~ ............................ · Fee Submitted $ ..2 ...... : ......................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .....~ ...... ~ ..... .~ ................ ..... ~.. , ....... ~ ........... Sworn to before me this ................ day of ............................................ Notary Public .................................... County Lot 3~ MONUMENT STAKE T~E CLEnK O~ SU~O~X ~ouNr~ O~ ¥0UNG. &i YOUNG :4~O OSTRA~D~R AVENUE,';RIVERHEAD, NEW YORK ALDEN W. YOUNG HOW OUNG SURVEY FOR: . . / ~qx~ ~ ' > · X LOT '7 'D*EP H~LE CREFK ES A E~ ~')* ~ ...... OUTHOLD" ' ~ ./ SUFFoLK V -NU - N, 87~19'20 182, O0 ' NOTE: · = MONUMENT r3 = STAKE SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK OOUNTY ON U~N. 2B~ 19B~ AS FILE NO, 45~6, LAW REWS,ON$ YOUNG & YOUNG AUG. 22,1977 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK OCT: 20t lB?? ALDEN W, YOUNG HOWARD W, YOUNG SURVEY FOR; BEN MENDOZZA LOT 37 "DEEP HOLE CREEK ESTATES" -- ' GUARANTEED TO: ~T MATTI TUCK AMERICAN TITLE INSURANCE CO. BOUTHOLD SAVINGS BANK ~ow.o~ SOUTHOLD Y . ~/ ......... ~: OCT. ?, '975 NO. ?{. 70~i I SCALE: I": 40' ir¸ ROSE jaOCK¥ BROADW:AY POI~4T~ N. ¥, ll?'f8' I i.