HomeMy WebLinkAbout5333-ZI~OB~ NO. &
TOWN OF SOUTHOLD
BUn.DING DEPARTMENT
Town Clerk's Office
$outhol~ N. Y.
Certificste Of Occupancy
No..~..b~. ~ ..... Date ............ .~.o..V:...1..0 ...... , 19.7.1..
THIS CERTIFIES that the building located at . -Leng .Creek .Dr.i. ve ....... Street
Map No. Yer~n, · Pk.,. Block No ........... Lot No..6 ...... S.o~.t.l~01.~...~.~,.Y... ..... :..
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .........~.ay.. 22 .... , 19.7.~. pursuant to which Building Pe~lt No..~33~ ·
dated .......J.une.. ~ ....... , 19.2.~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . PYiv~ke..on.~..f~ki~'. ~tKe~ 1Lng .......................................
The certificate is issued to . ThnmaS. F. eele~ .Jr .............. .Q'~.r~;r ................
(owner, lessee or tenant)
of the aforesaid budding.
Suffo~.County Department of Health Approval ~o~-- .8. -1-971. - .by. tL, .¥$~.%a .......
Underwriter Cert
House ~ 95 .......... ~'~i~li~' ~o~,c~J;'c~' ...........
FO]~I NO. e,
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)
N? 5333 Z
Permission is hereby granted to:
............... · 111~el ......... I1,~, ............................
at premises located at ..... : ........... ].l~.~l.....~tlllll~t...]~l~ ........................................................
.................................. · atl~J,t..ll..&..i, Jll..lJj~el~..~ ......... SeJtlmdsl.....ll~, ....................
pursuant' to application dated .......................... I1~'""~" .................. , 19...~.1, and approved by the
Building Inspector.
Fee $....~,~ ........
· ' Building Inspector
S-9
SCND
SUFFOLK COUNTY
DEPARTMENT OF HEALTH
Date NOV - 8 1971
Bldg. Permit No.
TO WHOM IT MAY CONCERN:
~2' f ~/ (Give deed location)/
have been i/nspected by this department and found to be satisfactory.
Chief of General Engineering Servicee
NOV - 8 1971
SUFFOLK COUNTY DEP;~RTMENT OF HEALTH
EASTERN DISTRICT, RIVERHEAD,N.Y.
APPLICATION FOR APPROFAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL Si~TE~S
Approval tn construct said systems is requested,pertinent data herewith:
Address ~ ~2'/v~-~ z~ ~.~ ~,~ ~. ~ ?-Section
2-Detailed property loca. t'.z~n ~a~7 ,z~,~/~ . 8-Lot Not
Hamlet %'~ ~Z ~ ~ , Town ~ ~ }~, o! 5, 9-Private
3-Public water supply name $~m~-m ~7~ ~ ~oDistance to nearest main
~-~ot Size:. Width/~ft. Le?~h~q~t. (als3~enter on center ~lot plan ~elow:')..
5.Dwelling. Singl.e Family
10-Proposed syste~. Septic tank.~recast
il-Septic tank inside dimensions. Volume~__Oals.Length ~ ft. Width ~/ft. Liquid deptb~__ft.
12-Precast sections: / ;Number~_/Squ~re Ft. Cesspools: Block sizeL~ incs.D__~ins.H~ns.
Total blocks below inlet: ~1/~.,, .~2
Street
Date
PLOT PLAN
GCipa city__Gals ·
?. ~.~_______
Data ~eet
0
'~ 8
Indi ~te
No ,th
The Undersigned ~RT~S: "Const~ction of authorized installations ~11 be in
acco~ance ~th the Suffolk County H~lth De~rtments' current Standa~s, ~lletins,
a~amendments thereto, coveri~PrivateS~~pos~st~'. ~
FOR HEALTH ~NT USE ONLY. Based on the information presented ~re~th, it is the
opinion of the H~lth De~rtment, that an adequate and satisfacto~ Sewage Disposal S~tem
Signed
can be installed on this Plot.
Date
( ~o/6~ Revis. )
CAVATION INSPECtiON P,F. QUI
TOWN OF' SOUT~OLD
BUILDING D~PARTM~NT
TOWN _ev~*.R~,~ OFFIC~
NOTICE OF DISAPPROVAL
roue .~o .................................................................. Date .........................
To 11~ A, F®el.e.~. J~
.................. i/l&i~.3,~. ........ L..I.r. .. ~.$?&~. .......
pT.'E~.~,~E T..d,.~ NOT~CE 'that yOtl~ Gpp~icatioll dG'~e~ .................. ,,~. ......... .~. ....... '19..~..~.'~..
for permit to construct ..dW~:l~,4~. ................. at the premises located at ...~..P-~eek..gF
......................................................................... Street S®uthold
Map]i~eott Park Block ...... Lot 6 . ,. is
returned hel~with and disapproved on the followin,~ Eround~ ........
..... ~...~e.t...p~..n~...b~l~d~n_- .~La~,...~t..~l...~...~t~ .....................
/ /
(~
Approved ~ ................................. , Permit No.
APPLICATIOH FOR BUILDING PIRMI? / /' ~
to ........... 7""'-"""P"'"'" .............. 7'" ............
INSTRUCTIONS
a. This applicotlon must be completely filled In by typewriter or in ink und submitted In duplicate to the Building
Inspector.
b. Plat plan showing location of lot and of buildings on premises, mlatlonlhip to odj~inlng premJsel ~' public ~treets or
areas, and giving a detailed description of layout of properly must be drawn on the diagram whlch il part of thll alspllaation.~t,
c. The work covered by this application may not be commenced before is~Jance of Building Permit.
d. Upon approval of this application, the Building Impector will I~ue a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the progre~ of the work.
e. No building shall be occupied or used in whole or In part for any purpoee whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS I-~REBY MADE to the Building Department for the Issuance of Q Building Permit pumuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lava, Ordlnance~ or
Regulations, for the construction of buildings, additions or alterations, or for removal ar demolition, al herein deecrlbed.
The applicant agrees to comply with all applicable laws, ordtnonc.~es, b~llding code, housI. D~ code, and regulations.
...... · .................
(Signature of applicant, or nametu/f a ct~paraflon)
(Ad~fess of applicant) //~.,~,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder.
......... ............. , ........................
Name of owner of premisel .......... ~..~l~.~;~;..,, ...... ~....'.......~..~d~../.~../'~........Z?.. X: .................................................... ...~
If applicant Is a corporate, signature d ly auth~lzed ce
........................................................ ~\~ ~,.
(Name and title 'of corporate officer, ~ / ~_ '7~- ~ '~
1. Location of land ~ne~ ..~.~....~'.../~'~, L~ No.: ...'...4~......~..; .........
Street and Number ............................. .~. ............................. ..P/...., ................ , ........... ~,....~..~.... ...... ..~ ..................
u Municipality
2.State existing use and occupancy of premises and intended use and occupancy of prppmed comkuction:
a. Existing use and occupancy ....~..~....~...~;;...~......7:... ; ....................
b. Intended use and occupan? . ...... ........ .......... ....... ...... ../.~..~;..&.~.....Y,~...~.
3. Nature of wink (check which applicable): New Building ~....,~ ....... Addition .................. Alteration ..............
Repair .................. ~,?emoval .................. Demolition .................. Other Work (Describe) ......................................
4. Estimated Cost .....~...~1 ............................................. Fee ............ ./. ...........................................................................
(to be paid on filing this application)
5. If. dwelling, number of dwelling units ...~.....W'...~....~...~ ...... Number of dwelling units on each floor ...... .~.. .................
If garage, number of cars ............. .'--~.....~......~.. ...............................................................................................................
6. If business, commercial or mixed occuponcy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ..........TT.. ............... Rear ........ ;. ...................... Depth ......-. .............
Height . . .~. ..... Number of Stories
Dimensions of same structure with alterations or additions: Front ..... ,...'~. ......................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ........ .~... ................... Rear ....(....~..~......~.. ....... Depth ...L~.~..'~.~..../.. .....
Height .../~.....~. ....... Number of Stories .............~....~..~ .............................................................................................
Size of lot: Front ...... ./....-~....O..;../ ....... J~ear ..... ~'....~...~.'~....~. ............. Depth ...... ./....~'..~.....'. .........
9.
Date of Purchase ..........~./..~.~./.....~..~. ...................... Nome of Former Owner ........ ~.~'..-----------------~...~'.y .........................
10.
11. Zone or use district in which premises are situated ...... ~;,,~..~.~."rl..~'./~...4 ...........................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ../~..?.~..~ ......... ,. ..............................
13. Name of Owner of premises .~.~:.Z~..:...~'~./r./.~/,~ddress ..~...~..~...'?~.~.~.~.~'.~.: ....... ~'o~e No.~..~.~'.:T.~.~....~~.
Name of Architect ..... .,~./~..~.../S.~..~..~ ........................ Address '' Phone No.../.: ........
Name of Contractor ....~/~...~....~..~..~..~...~........~...~......~.,....Address ....~..~....~L....~..~..~./.{ ...... Phone No..?'..~...~..?...~'..~.~-
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-beck 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. ~ (,
/£0 ~
/ -
STATE OF NEW~(,OP~ ~ ~-
COUNTY OF~....J.~'~' .
above named. He is the ........... ~.~..~.~,:....~...~,.Z~.....~..~......~.:...~.~ ......................
7 (Contr~tor, ~t, co,rate officer, ~c.)
of said owner or ~ners, O~d is duly authori~ to pe~orm or h~e ~do~ the ~id work and to ~ke ~d file
this applicati~at~ all statements contain~ in this applicat ~ am tree to the ~st of his knowl~ge a~ belief; and
that the wO~t ~ pe~o~ in the.ma~e~ ~t fo~ in the ap~ati~ fil~ therein.
.... ................ . ,,7/., ·
~ ~ ' i~ ....... ~'" = '~' =: ~'~'"" '= '~' ;"'" ~f'~'"' '~'" '~' ~ ...............
Nota~ P~lic,~~~......:~.:~.~m~.~.~.~
~ 52-3369600 Su~.~
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