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FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20172 Date AUGUST 27, 1991
THIS CERTIFIES that the building PUMP HOUSE
Location of Property PRIVATE ROAD #11 (NORTH VIEW LANE} ORIENT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 13 Block 1 Lot 22.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 25, 1989 pursuant to which
Building Permit No. 18468-Z dated SEPTEMBER 12, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the Law. The occupancy for which this certificate is
issued is WATER SUPPLY SYSTEM FOR BROWN'S ESTATES AS APPLIED FOR.
The certificate is issued to BROWN`S HILLS ESTATES, INC.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL JULY 11, 1991
UNDERWRITERS CERTIFICATE NO. N-107164 - DECEMBER 13, 1989
PLUMBERS CERTIFICATION BATED DEC. 11, 1989 - MIKE JACOBI
---i~`==~~~~ 'lam
uil ing Inspector
Rev. 1/81
- FO&M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°- x.8468 Z Date ..~~~'.p-~:-t~+:......1..Z......., ~9..~9
Permission is hereby granted to:
o.,
i/4.,.: ,~i^ ti~.. i 19..x:.7
~ ` y
ct premises Iocated0ot ........~~...~..r.J'~t.:....F~.:~-~LN°...
..........................................................................................................~~..jj,,....................................................
Caunty Tax Map No. 1000 Section Block ......a..4......... Lot No....Q.~
r
pursuant to application dated ....4r.4S!~.~~6r?.:a~........a:~..........., 19...1., and opproved by the
Building fnspectar.
Fee S.,P..b.71.:...
Building Inspector
Rev. 6/30/80
n(] Form No. 6 - ~ ~"p
~ V TOWN OF SOUTHOLD lh~'////~~~"'
ti~ Y± ~ ! ~A(~~ ;I BUILDING DEPARTMENT ~ G~ • a d ~~G
fxiv 11.7 ~ TOWN HALL
765-1802 ~ jLC~ti~~
BLpG. DEPT.
TOWN OF SOUTHOLD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
1. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17. lead.
'S. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property shocaing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
Construction..., Old Or Pre-existing Building
.o~ ion ~dPro~erty e.~..u?!U.':S fF/C;t.S- _~:f~!?~.S /DJG t»r2JE~/!-
House No. Stre t Hamlet
~nwer or Owners of Property...b~.'~.u.~~.'~ LF~GGS' ~YA~':S~J~1/G • • _ • • • • • • • • • • .
g~ivs r~iGCS ~o 0
:ounty Tax Map No 1000, Section ..............Block................Lot......................
~ieou/AlS rF~CC. tugf~ ~}.~y~.f
subdivision ...............Filed Map............Lot......................
io- s~-~ ~-fl6J ursa a~J s'g sf
~ sli`t'..... A ,S,a~~"a fJ~~s Esrxsr~s, •nc
'ermit No. Date Of Permit, pplicant
Iealth Dept. Approval...... .................Underwriters Approval..
'lanning Board Approval...........
equest for: Temporary Certificate........... Final Certicate...~...
•ee Submitted: Z ~ A/~3 <F/
~~S ..~s,
c ~ ~ a o, • APPLICANT LtNk
c!'7:
}
New York State Department of Environmental Conservation
Building 40-SUNY, Stony Brook, New York 11794
(S1Gr /'~l-/JUO July 14, 1989
AMhNUML:N'l' 'i'O 1'I:RMI'I'
- Thomas C. Jorling
h r n:a r Commissioner
(/Fl n tt r
Ri;: Pr;rmlt No. d Location: - 10-88-2061 WSA 8188
Brown's Hi11s Estates, Inc.
P.__0__Box 2050----.-__--
Orient.,_N. Y. 11957
(>ear Sirs:
I
'i vut recent. request lv extend lh~~ ahuve permit has been reviewed
pursuant t.; 6N'f~RR, Part o2J. It has been determined that Lhere has not
beer. a material change in environmental conditions, relevant technology or
applicable law or regulations since the issuance or the existing permit;
therefore, the expiration date is extended to
~ 'iJUC recent request. to modify the above permit has been reviewed
pursuant to 6NYCRK, Part 621. It has been determined that the proposed
modiP.icari~ns '.ail! not substantially onange the scope oP the permitted
actions or the axisLing permit conditions.
'l'herafore, the permit is amended to authorize: Changes in Special Condition
2, 3, 7 and 10 and removal of Special Condition 8. Please refer to the
attached modified permit 11 10-88-2061 and review Special Conditions 2,
6, 7, and 11 which re€lect these changes.
rhr~; I6t tcl is Nn .~wendwcr,r t~, Lhe or:y!nal permit. and es s•.,ch, _1;311 br.
(,G~~ rd 3l Cn2 J.:,tl c l l.r.
All uthtr l.euu:; antl conditions remain as written in Lhe o[iginnl permit.
B. Stanton-Sidney Bowne & Sons
S.C.D.H.S.> P. George-Water Div.
Public Service Commission
File
~ i
45i0~b (7'H41-:5, NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DFC PENMIT NUM&'R ~ fFFkCTIVk UATf
10-88-2061/W 8188 ~ July 14, 1989
FACIIITI'PROGRAM NUMOFR(sl MODIFIED PERMIT E%PIRATION DATEIsI
Under the Environmental Conservation Law i'
I' i
WSA 8188 May 31,.1999
Article t5, Title 3; 6NYCRR 327, 6NYCRR 608: Article 25:
328. 329: Aquatic Pesticides ~ Water Quality Certification ~ Tidal Wetlands
Article 15, Title 5: Article 17, Titles 7, 8: Article 27, Title 7; 6NYCRR 360:
Protection of Water ~ SPDES ~ Solid Waste Management' ; It,
WatereSupp~ytle 15: ~ artiPolfuton Control' ~ Hazardous Walste,~Management3~ ll`
Article 15, Tiile 15: ~ Article 23, Title 27: ~ Article 34: I`
Water Transport Mined Land Reclamation Coastal Erosion Management
Article 15, Title 15: Article 24: Article 36: ii 1,
Long Island Wells ~ Freshwater Wetlands ~ Floodplain Management l..
Article 15. Title 27: N-New, R-Renewal, M-Modification, ~ Articles 1, 3, 17 19, 27, 37; I
Wild, Scenic and Recreational C-Construct ("only), 0-Operate ('only) 6NYCRR 380: Radiation Control
Rivers
PERMIT ISSUED TO
Brown's Hills Estates, Inc.
ADDRk St Of PFRMITTFF
P. 0. Box 2050, Orient, N. Y. 11957
AGENT FOR PERMITTEEICONTACT PERSON TELEPHONE NUMBER
Bob Stanton, Sidney $owne & Son Cons. Engnr. 746-2350
NAME AND ADDRE 55 OF PROIECT;FACILITY Uf different from Permitter)
LOCATION OF PROIF.CT;FACILITy' COUNTY TOWN/CITYNILUCE UTM COORDINATES
Orient Suffolk Southold
OE $CRIPTION OF AVTHORIZED ACTIVITY
To construct a public water supply well, 6" in diameter approximately 42'
deep, and to equip it with a pump with a capacity of 55 GPM. The total
pumpage shall not exceed 2.85 million gallons a year.
GENERAL CONDITIONS
ey acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli•
ante with the ECL, all applicable regulations and the conditioro specitied herein or attached hereto.
1 The perm rttee shall Tile in the office of the appropriate regional permit administrator. or other office designated in the special conditions, a nonce of intention to commence
work al least ag hours m advance of the time of Commencement and shall also notify him/her promptly m writing of the completion of the work
The perm fined work shall be sublet to m:pection by an authorised representative of the Department of Envvonmental Conservation which may order the work wspended d
the pubbc interest so requves pursuant to ECL ¢71-0301 and SAPA §101(3)
3 The perm,ttee has accepted ezpressly, by the ezecution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature. and by whomever
wiiered. arising out of the proles descnhed herein and has agreed to indemnify and save harmless the Stare from wits, actions, damages and cosn o4 every name and descrip,
bon resulting from the said protect. i
i The Department reserves the right to modify, wspend or revoke this permit at any time after due notice. and, if requested. hold a hearing when:
al the scope of the protect is exceeded or a vrolanon of any condition of the permit or provisions of the ECL and pertinent regulatwns are found. or
b) the permit was obta med by mssrepresentation or failure to disclose relevent facts: or
<I newly discovered information or significant physical changes are discovered s,nce the permit was issued.
i To maintain a valid perms. the permrttee must submit a renewal application, including any forms, fees or supplemental information, wh,ch may be regwred by thr
Department. at least 30 days poor to the expvanon date of the existing permit p80 days poor far. State pollution drsc harge elimination system permns ISPDE SI. Sobd
waste management laulities permns (SWMf). or Hazardous waste management facilities permits (HWMFl1
4 Thn perms shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the
permitted work or as authorizing the impamment pf any rights, title or interest in real or personal property held or vested m a person not a party to the permit.
The perm,ttee n respons,ble for obtaining any other permns, approvals, lands, easements and rights~obway wh¢h maY be regwred ror this prolecL
g b+uan<e or this permit by the Department does not, unless ezpressly prawded for, modrfy, supersede or rescind an order pit consent or determination by the Commtss~oncj'
issued heretororr hp Ihr Department or anv of the terms. <ondmans. or regwrements contained m wch order or determination
9 Any modmcation of thu perms granted by the Department must be in writing and attached hereto (
PLRMIT ISSUANCE DATE PERMIT ADMINISTRATOR Deputy Re- ADDRESS ROOM 219
July 14, 1989 David DeRidder gional B1dg.40,SUNY,Ston Brook,NY-11794
AUTMONIZFD SIGNATURE ~
Page 1 of 2 '1
CC: B. Stanton{; SCDHS, P. George,Water Div. :t
. ~ s-~~c-a:, c~°-_-l0^:c - ks,=. algg_ to-as-noel (July 14, 1989)
.:~e app ~c,°._~,, sn~_1 _ns.",1., -'~_^ta ~r. and orate sat_.,: ac..o~~ r.
_t=--
CthC_ Cf\'1C05 tC ctiaS~lr@ a^.c reCCrd the a*00'1.^,t Cs dater ?.r`K'C
~~e District's ~re11s. The apw'_i=ant shall record the arpunt c° ^--~=ce
a rrrnthl}` basis and report the arount of. psrtasge to this Deaart-~-t.
Included in the District's ann;:al pwnpage report shall be-the na;*~ and
the total atrount of pwraage si.~plied to, or received fran, other
Districts. Metering devices aad pu.^.,page records shall be made
available for inspection by the ~partinent.
0. x,11 land c:ithin 100 feet o.f. any tirell shall be protected and contre'_led
in order to arevent pollution of the Ground or aroundtratPr by ~akine
appropriate measures approved by the Suffolk County Health Department.
"_'his area shall further be protected fran pollution by surfacecraters
originating outside thereof. by the construction of. suitable diversiai
ditches or embankments and the developrient of. the grater sources small
be so carried out that there shall be no opportunity for pollution
entering the 4rater sources.
4. The physical pw~ing facilities and controls shall be protected against
damage of. tampering either by a fence or other suitable enclosure or by
their mariner of construction and installation.
5. Before an Dater from the urell ma be used for an ~ '
y y y purpose, after
prolonged pwnping test (s~ ) , the applicant shall have caused a sampi of. ~i~i~
the crater to be collected and analyzed (pursuant to Neer York Sate "
Department of. Health requirements? shall have sukamitted the results'of
such analyses to tine Depar~nent and shall have been advised by the
Department either that the Dater is of.a satisfactory sanitary quality
or that cer'-a;*+ specified treatment or purification thereof is
necessary. In tlzfs Last case such crater sha12 be used only afte_f full
c~?cpliance c:ith all- of. the recuireme7~ts of. the Depaztment.
6. i~ot_ining Goa+`;n~ this permit and approval sY~ll be held to
aT1tRv^r_Ze t"t° appl_ca:r.. ~ ° 'tE 4r2L°_'- C_"...R:
to Sapp.}., s_lI cr cS,=~':.
5O'.irC°_ C- SL-pp1V ~ = Z'ly PllrP05° L?ll?SS all re.'~.lir~-!L°',:s O~. :.=i:
Ycrk S==-_=_ aad 5-`olk County nealt'1 Depar~nts z=.e met.
r' Tdith in 90 days from the effective date of this permit modification
the applicant shall submit to this ,Department a copy of its official
water conservation program.
i 8. t^.r'2_ ~1-~>_=`1°d ^°'_0=*3 51'!all ~ }1O_ld t0 atl
t'1.^J_^_Z° t_}!° p.°~^.._`_'~
i Cistri~ute 4 ~'..er tO a.'7V Ogler Gi 5tri Ct Or SerV1Ce area 4.ili ; L?.e nct
clrccdV ~1??-~ cTr^•+'CT~d iJV the D°~
~'^OnL Or i S =~v-c SS.^._a ~
_ r~Cc_:~ ~ c =i.r-..[3°Z p° ~L =^iL ~R° DE_=".-1°':L.
i
9.. ~-r•.--_...'S S_~ ..c..,, _ -..e a0°__ a=e C'~~l r ..°r C..
1 'L..^.S°-r°.=iC L ..,.5- ~__VaL2 L7°l i ~ ~-oT a}rS-..°'°-.__£' C_.__..:1°_..
"eG rO~ ~e p}` ^e CC t51e W~l's °\'=_IO~c
_.._..~t
iC. :rOD_.ced Sul ~ a.. :^..'.St CeSigned c"'.d ..0.^s`.'-1"_=_ S'C` _
....,rzer as to r..=s4 _ ~xssible po mras'1re perroa_call< <_c. _ =Y
I1. 'rho applicant shall submit to this Department,ouarterly reports i
of chloride analysis of samples taken from the supply well.
- _ ~
COUNTY OF SUFFOLK f- I
~ v~'g
' PATRICK G. HALPIN
SUFFOLK COUNTY E%ECUTIVE
DEPARTMENT OF HEALTH SERVICES June 23 1989 Dwwo HwRR1s, M.D., M.P.N.
~ COMMISSIONER
Mr, Paul George
New York State DEC
State Univ. at Stony Brook - Bldg. 40
Stony Brook, New York 11794
Re: Browns Hills Estates Association
WSA 8188
Dear Mr. George:
Thank you for your memo of June 8, 1989 inquiring as to our posi-
tion on Special Condition ~3 of your approval of the referenced
Application.
This Bureau shares your desire that the supplier control all land
in the sanitary radius. However, in this case, this preexisting
system has' been unable to attain such agreements from neighboring
property owners.
As part of the new construction plan review process, we have seen
to it that our Sureau of Wastewater Management has located Browns
Hills wellsite on their base-line maps. As neighboring vacant
parcels subdivide and are developed, they will take steps to en-
sure optimal locations for cesspool systems, This practice is
partict;larly important for older wellsites developed prior to the
development of current minimum sanitary protection requirements.
In the case of Browns Hills Estates, we are already ensuring
that the necessary sanitary protection is provided to the exist-
ing Association wells in a recent subdiviion to the east known zs
Hillcrest Terrace. There are several lots ultimately to be
developed that have been deignated on the base-line maps as re-
quiring special consideration as outlined above.
This Bureau has no objection to relief of Condition x3 on this
basis.
If you have any questions, please feel free to contact .e.
Very truly yours,
Paul J. Ponturo, P.E.
~Tp / ,7,,, Senior Public Health Ennineer
euREAU o~GMir7KM~Gk%TER Bureau of Drinking Wate-
225 RABRO DRIVE EAST
MAUPPAUGE, NEW YORK t t]88
1516) 3wB~2]]6
{
TEL. 765-1802
oOc~QFFOU(~~G TOWN OF SOiJTHOLD
~c OFFICE OF BUILDING INSPECTOR
~ 'pcT P.O. BOX 728
v' yc TOWN HALL
"oy~ol ~ SOUTHOLD, N.Y. 11971 .
C E R T I F I C A T I O N
Date a"
Building Permit No.
Owner LUY~ l5
( lease print) /
>~1 _
Plumber `,b~.s~ ~ /~-`U~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
(plu s signature)
Sworn to before me this
day of ,{~¢.c~ ~
19~• Notary Public
Notary Public, ~ County
HELEN K DE VOE
kDTARY PUBLIC, State at New York
No. 4767878, Suffolk CouM~.
Term Expires March 30,19._ZL
THE NEW YORK EIOARD OF FIRE UNDERWRITERS r'Aaa 1
tgtitl1.','A BUREAUAF ELECTRIC[TY
83 JOHN STREET, NEW YORK, NEW YORK 10038
Date I)Et:E.ftBf_k I,i9f19 APPlicotionNo.onfile b66~~9GH~)/R') N IU7IG4
THIS CERTIFIES THAT
oniy t/ta electrical pwipmsnt m dstcribd 6tbet and intradreed by tks wpplirw+st nomad on tM aberoe aprlieadon numbs in tke promww Q< °6
#3kQWN'°i HI1..1 i Ay`.iUt;CAI~I-5. HkiIWN'tS HIL1. kOAU, URPIiNi, N.Y.
in thefoNortinR tocoCion; 0 Basement ® ht F6 ? Ynd Fl. Ulf f Section Bloek Lot
mot examined un 17 F': i; I: (iHf`. K 1:1 b , 198'A and found to 6e in compliance mirk the requircmentt of tku /sard.
H1I1tIY X HApfYFM OOOK41G 0/fYJIS OVlNf Ntl11 fAiK
OUiIlTS AClif fdtR101K NoesctM nudatrn+r orxtn tint. t. w. M1i. e. w. uer: t.w. iwr. k. w. utr. x. e.
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FOR BUILDI D PART THISCOM Of CERTIFICAT!lfAK2 MIOT II#
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [FINAL
REMARKS:
DATE ~ ~ INSPECTOR
l ~ ~ 765-1802
BUILDING DEPT.
INSPECTIQN
[ FOUNDATION i5T [ ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~ \
mr-
DATE INSPECTOR .~1
~~~/y~
(51fi) 765 802 ~O~pSpFFO(~.COG
VICTOR LESSARD, Principal ~ y` ~~6-`""`-'
CURTIS HORTON, Senior r°n Z .~t~ l
VINCENT R. WIECZOREK, Ordinance p ~ ,F ,e~~~ U
ROBERT FISHER, Assistant Fire y,~~l app! 7 ,
Building Inspectors ~
THOMAS FISHER ~o
GARY FISH (__F1- _ (~~Q`~~~,
OFFICE OF BUILDING INSI
TOWN OF SOUTHOL I, /
5~
February 14, 1991
Ms. Venetia Hands
Browns Hills Association
P.O. Box 2050
Orient, N.Y. 11957
RE: Building Permit 184682 Water Supply System
Date of permit 9/12/89
Dear Ms. Hands:
On Dec. 1, 1989 our office did an inspection for the above
permit. The work was approved. We sent a letter an Dec. 12,
1989 explaining what was needed for a Certificate of Occupancy.
I am enclosing a copy of that letter and also a copy of the
letter from the Board of Health stating what was needed for
their approval.
Please send us the Health Departments approval, the
enclosed application and a check for $25.00 to finalize this
permit. It is a violation of the Code of the Town of Southold
to use a facility without a Certificate of Occupancy.
If you have any questions please call our office.
Yours truly,
Ol llae-
Secretary
~~y~ ~ COUNTY OF SUFFOLK
Y,.~
Pte, {~-~.,,,,aa'~ '
C Q ~~c,eee..~~1Jpp'~ ~
~ .
/ PATRICK G. HALPIN
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES DAVID HARRfS, M.D., M.P.H.
COMMISSIONER
February 9, 1990
Ms . Venetia Hands ~ ~ C='`,, ~ ~ al
Browns Hills Association ~~~i~
PO Box 20s0 r ~ i~
Orient, NY 119s~ 4~;~ FEB i 3199(1 i1
Re: WSA 8188 ~I~~._""'°°".°..''-"_.''.._:.
~;',~;r. E'tYi
S-90426 Well ~k3 Browns Hills Assoc. TC~1:~t G'= Snit"i~C~il`
Community Water Supply
Dear Ms. Hands:
On January 22, 1990, in response to your engineer's certification
of construction, a Completed Works inspection of the referenced
project was made. All facilities were found to be in substantial
conformance with the approved plan. Enclosed find GEN 219,
Approval of Completed Works. This approval is issued subject to
the following conditions:
1 - A Well Completion report is to be filed.
2 - As soon as site conditions are favorable, provide grading
away from the well casing.
3 - Provide locks for vault and generator structure.
This approval constitutes our acceptance of the Association as a
community water supply system, as originally cutlined in my
December 22, 1986 letter to Mrs. Robertson (copy enclosed).
Unfortunately, as you know, the new well does exceed the standard
for nitrate. Notification of all users of the water system on a
quarterly basis must continue.
A copy of a sample notice is enclosed and must go to all users of
the system for a long as the quality problem continues.
The Bureau will continue to bear the burden of analyses for the
pesticide aldicarb, as we have for the other wells.
BUREAU OF DRINKING WATER
223 RABRO DRIVE EABT
HAUPPAUGE. NEW YORK I1]BB
(316)348-2]]8
~r._
-2-
P49. VP,lletl.3 Hands
Browns Hills Association February 9, 1990
At the time of inspection, the well was sampled for carbamate
pesticides. Within the detection limits, no aldicarb, car-
bofuran, oxamyl, or methomyl residues were encountered.
We also wish to advise that in accordance with State Dedpartment
of Health directives involving corrosion of piping materials, we
will be pursuing a trial usage of your standby chlorinator for pH
adjustment utilizing a soda ash solution.
If you have any questions, pleas fe 1 free to contact me.
Ve7ry tr ly yours,
~,lr/
Pain ~ onturo, P.E.
Senior +Public Health Engineer
Bureau t~f Drinking Water
PJP/jdm
Enc.
cc: R.A. Stanton, P.E.
Sidney Bowne & Son
2352 Jericho Turnpike
Mineola, NY 11501
Gary Fish
Southold (T) Bldg. Dept.
53095 Main Road
Southold, NY 11971
Re: 18468-2
R. Reynolds, SCDHS
Paul George, NYSDEC
• TEL. 765-1802
S~FFOtkc
o~p Opp TOWN OF SOLTTIIOLD
r? OFFICT: OF B[IILDING INSPECTOR
P.O. BOX 728
TOWN HALL
~~~~1 ~~0!' SOUTIiOLD, N.Y. 11971
December 12, 1989
Brown's Hills Estates
Brown's Hills Road
Orient, N. Y.
To Whom This May Cohcern,
We are unable to complete your Certificate
of Occupancy because of the following reasons.
/x7~tC An application for Certificate of Occupancy
is not on file.
% / No Underwriters Certificate on file.
/x~lt The check is(oc~ka3mdstsd/not on file.) $25.00
No Health Dept. Approval on file.
No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit # ~ ~ ~ __g_ Z
Building Dept.
/ No Plumber Solder Certificate on file.
{ all permits involving plumbing being
issued after April 1,1984 )
Letter from Suffolk County Health Department
~ 1~4~ / ! ~Y' NEw YORK STATE DEPARTl(ENT OF HEALTH
IVI AuG p f 1991
A'FROYAL OF COf11PLETEO 1r011Kf
towN
o°F~s°aurwoE.o FaR PUSIIC WATER SUF~IY IMPROV IMENT
ais a royal is is:ued under the isions of 10 NYCRR, Part 5: _
Applicant: 2. Lxatioa of Works (C, V, T): 3. County: 4. Water District
(SpxiEic Arcs Serv.
Browns Hills Orient (T) Southold Suffolk Browns Hills Esi
Association
Plana for the construdian of this project were approved on March, 16, 1989
his approval Eor completed works is issued subjaM to the following conditions:
1 - A11 facilities shall be operated and maintained in conformance with
the plans and specifications and in a manner consistent with Part 5
o£ the New York State Sanitary Code and Article 4 of the Suffolk
County Sanitary Code.
ISSUED OR THE TE CO NER OF HEALTH
July 11, 1991 ~ - _
Date D eprcsenta ve - -
Paul J. Pon ro, P.E.
Senior Public He th Engineer
Name and !e (print)
EN 219 01ipyq~„ Ylhlta. Ap~lisen Yellw - FII• (1110 er OH01
Formerly San. 108, Rev. 3/78) P4ir-t:atrd OHlca l6ED) blw-Oerr
o5~Ef0i/rCo
VICTOR LESSARD ~ ~C Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR ~ ~ P.O. Box 1179
(516) 765-1802 ~ Southold, New York 1 1971
FpX (516) 765-1823 yo~l ~ ~~Q~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
December 6, 1989
Browns Hills Estates
Browns Hill Road
Orient, New York 11957
Re: Building Permit #18468-Z
Premises: Browns Hill Road
Suff. Co. Tax Map #1000-18-4-7
Gentlemen:
Please be advised that all necessary inspections required
by the Town of Southold have been made. These inspections
include a foundation, framing and plumbing inspection. All have
been passed by the building inspector.
In order for a Certificate of Occupancy to be issued by
this office, a letter from the Suffolk County Health Department
is necessary. The letter should state that the water meets all
requirements set by the Health Department. A Plumbing
Certificate is also required. Upon receiving these two items,
we will be glad to issue a C.O.
Sincerely,
SOUTHOLD TOWN BUILDING DEPT.
Gar J. Fish,
Building Inspector
GJF:gar
O, COUNTY OF SUFFOLK
At~~{i99f
ai.r~. U_.; T.._
Towra say
ll~rc~~
PATRICK G. HALPIN
sUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES DAV10 HARRIS. M.D., M.P.H.
July 10, 1991 COMMISSIONER
Susan Egan, President
Browns Hills Estates
P.O. Box 2050
Orient, NY 11957
Re: Browns Hills Estates
Water Supply System
Dear Ms, Egan:
- Encloasd find a copy of the Approval of Completed Works, dated
February 9, 1990, covering the Estates' new treatment vault and
standby generation set. Please note that a copy of this went to
the Town at the Homeowners Association's request.
Aa requested in the November 19, 1990 letter of Victor Elefante,
Well 5-53337 has been approved.
To clarify this further, I am enclosing an Amended Approval
reflecting the modification.
Hopefully, this will provide the needed clarification.
The Bureau does regard the Estates' water system to be a com-
munity water supply, as currently operating in conformance with
our requirements.
If you have any questions, ple s fee free to contact me.
e tru ours,
Paul J. turo, P.E.
Senio Health Engineer
Berea of D inking Water
PJP/jdm
Enc.
BUREAU OF DRINKING WATlR
227 RABRO DRIVE EAST
HAUPPAUOE, NEW YORK 11788
131B13aB•2778
BOARD OF HEALTH
3 SETS OF PLANS
~fORMNO.t SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765.1842
MAIL T0:
Examine I , 19 89
1~
Approve .....~.~?:.,19~g.PermitNo.1..~.to..... D ~ (q ~ ~
Duapproveda/c aU~ 2 ~
BLDG. DEPT.
,t c~il+. , TOWN OF SOUTHOLp
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ....B~Z Z 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Itspector, witi
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre:
or azeas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap
cation.
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 issued a Building Permit to the applicant. Such pen.
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 Occupan
shall have been granted by the Building Inspector.
APPLICATION IS IiEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t
Building 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 describ:
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary inspections.
...IYRC,Q04:9L0 .c.ioepwo~KiNF Go=
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build:
C
Name of owner of premises ....B.~d".^!T./f/.~!-.5....,was.T,!~l,~f
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
-i~..~...
.~~.w.
r`?--
(Name and title of co orate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No. !.3.7..?.. ¢..K.1..... .
Plumber's License No . .
A/tI~S~Ra' 1t1ET'cas 1C ~
Electrician's License No . S~NL~y JI K G S l~
Other Trade's License No . . .
1. Location of land on which proposed work will be done
. .
House Number Street Hamlet
County Tax Map No. 1000 Section ~ ~ Block Lot ....7 .
Subdivision Filed Map No. Lot..............
(Name)
2. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy N..~ T~f~lf-.. J; ~Pt'O.~r , S,XS,r7p.?~?
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building ~ Addition Alteration .
Repair Removal , Demolition Other Work .
(Description)
4. Estimated Cost ....../.°,..4 ° 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 .......N~n .
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 ...............NumberofStories........................................................
Dimensions of same structure with alterations or additions: Front Rear
Depth .......................Height ......................Number of Stories .
8. Dimensions of ert~ir7• new construction: Front l ~ Rear Depth ~ .
Height ! ~ Number of Stories ~ .
9. Size of lot: Front Rear Depth
10. Date of Purchase .............................Name of Former Owner .
I I . Zone or use district in which premises are situated .....9.: l !!~4'!'f
ii9 ~ .
l2. Does proposed construction violate any zoning law, ordinance or regulation: .
I3. Will lot be regraded ............................Will excess fill be removeo~or~zgmises: Yes/~ No
14. Name of Owner of premises 1'~°:~!!"F!!!;-~-f.~rf!!~,'~dldress . r~~r!~ .:!''......Phone No .
Name of Architect ...........................Address ...................Phone No............... .
Name of Contractor !'/.!KP.~!'.'i9! uu~o?!~!•Cr~?~Address ....Q.ie!!y!''T..... Phone No..~ ~
15. Is this property located within 300 feetYof a tiidal wetland? *Yes No
*If yes, Southold Town Trustees PermitPLO"1' DIAG1tAMed.
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 whether
interior or corner lot.
STATE OP NE~4' YORE, S.S
COliNTY OF .
being duly sworn, deposes and says that he is the applican
(Name of individual signing contract)
above named.
tie is the
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
~a•ork will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
~ S.......day of~.... 19 .~9
\otaryPublic, ........':`.tJ!Z.,!.!.(1:.~~.. County
NOTFRY PURL G Sk~ih
~ Hew Yak .
No.~T07876,Su0elkCoaMY Signature of applicant
Term Expires kkrch 30,19~~