Loading...
HomeMy WebLinkAboutSan Simeon Nursing Home MR 175SU PERVISOR'S OFFICE 16 South Street Greenport, N. Y. Tel. Greenport 7-0550 BUILDINg, DEPARTMENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N. Y. TOWN CLERK'S OFFICE Main Stree9 Southold, N. Y. Tel. Southold $-3783 BUILDING I'NSPECTOR'S OFFICE CERTIFICATE OF OCCUPANCY No. ~llt'~ Date C~.~e "" 19 /~ THIS CERTIFIES that the building located at a la ~z_.~.~. o__.a ~ / ~ .... ~ I._ Street, Map No. ~ , Block No. in the Town of Southold, conforms substantially to the approved plans and specifications heretofore filed in this office with Application for Buildlng Permit dated ~T.~'C~ 8 19-(~, pursuant to which Building Permit No.~, dated ~ 19,~o't~ was issued, and conforms to all of the requlre- ments of the applicable provisions of the Jaw. The occupancy for which this certifica{;e is issued is This certificate is issued to of the aforesaid building. NOT]~I This certificate is subject to final written approval from the Suffolk County Helath Dep~;. Verbal approval received, today, Bu~'ld,ing I (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construction in compliance with the Multiple Res;dance Law and with other laws, ordinances .or regulations effectincj the premises, and in conformity with ~ne approved p~ans and specifications.) TOWN OF $OUTHOLD Multiple Residence Law Permit PERMIT NO McR,, ~~:~_19__ ~ ~ APPLICATION NO. 19~_ _ l~'k_ 8 19 f,,,R_ _ LOCATION lji' 615:60 North Road (CB2?) S/S North l~oad :[6~j.C)9_ 1~/ Cha.~e] ]f~,~al ~ Greenport Application having been made on covering construction on · ~{~I~ MaFeh 8 , 19_~___, for a permit (new, altered, or converted) multiple residence building, by or in behalf of Abl'ah~m Sham~_S . Obrlle~F. 1211 SteYa:rt Ave (ow..r) ~ ~e~ ~.~. , for a dwelling located as above stated, end the said application having been exami~d end recommended for approval on Ap~ /~, 19 ~ · PERMIT is hereby issued for the performance of the ~~&[ ~ ~h~C~ ~ GO~S~G[~O~ [architecture'l, sf~cfureJ, mechanical, etc.) work described in the above numbered application end any accompanying plans and specifications. If no work is performed w~fhln one year from the time of ifs issuance, this PERMIT shall expire by limitation. ~ PE~IT I~ S~CT TO A~ S~ ~ C0~ APPHOVA~ BEING FI~ WI~ BUI~INO INSPECTOR. FLled Estimate of cost Fee Paid Affidavit of F~nal C~st Adjusted Fee 68 $t hOO,O00.O0 $ 67e00 Permit is subject to Final affidavit of cost and iteas listed 2n lette~ dated Y, arch 30 1968 to James Canellos P.E. and ,a,%/ State and County approvall TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW New Multiple Residence Building APPLICATION NO. ]~ LOCATION s/s Middle (North) Rd. C.R. 27A 365.09' East of Chapel Lane House Number Street Distance from Nearest Corner Highest Ridge 20'-4" Height: Cup°I~Mt~:35"-O~'~ '- Area: CoV&r~e 25:%50 skf' {I) Type of Occupancy NURSING HOME PERMANENT (Permanent or TranslentI (2) Type of Construction ~TANT - FIREPROOF (F~reproof or Non-fireproof) 13) Estimated Cost of Construction $400~000 141 State what disposition will be made of waste and sewage IPublic sewer, private sewer, cesspool, etc.} (S) Occupancy (in detail) as follows: Story (include Cellar & Persons to be Basement) Apartments Rooms Accommodated CorB 2 6 2 First fi~. ~ 1 ~,-1 pl ~ 62 SeCond Third Fourth Fifth Sixth Seventh TOTAL 2 64 DIAC=RAM. The said land and premises are situated as follows: The north point of the diagram MUST- agree with the arrow Page I MAYOR ARTHUR LEVINE HERBERT L. KALIN SAMUEL KATZ WILLIAM J. QUINN GEORGE W. HUBBARD HARRY L. BELING ' ~//[~'e o/r ,~r'ee~)oor'/ ~reenport, Su~o[[~ Count% ~. Y. January 20, 1969 Holzmacher, McLendon & Murrell 500 Broad Hollow Road Melville, New York 11746 Dear Sam: Attention: Mr. Samuel C. McLendon, P. E. The alternator was placed in the electric control panel for the booster station which serves the Eastern Suffolk NursinE Home. The sewer system is now on automatic operation. for your inspection. It is ready If I can be of further service, please call. Very truly yours, ~ (JJames I. Monsell Superintendent of Public Utilities cc: Eastern Suffolk Nursing Home Howard Te~ Of~¢¢r$ MAYOR ARTHUR LEVINE HERBERT L. KALIN SAMUEL KATZ WILLIAM J. QUINN GEORGE W. HUBBARD HARRY L. BELING ~/La~ae of ~reenpor[ ~reenport, Saffolk County, ~. Y. October 29, 1968 R~. Howard Terry Building Inspector Town of Southold Southold, N. Y. Dear Mr. Terry: The Eastern Suffolk Nursing Home was connected to the Greenport Water Supply on October 9, 1968. ~ae colmuection consisted of a 4" cast iron water main tapped off a 12" cast iron water main on Coomty Road, Greenport. ri~ne installation meet all the rules and regulations of the Water Department, Village of Greenport. If I csna be of further service, please call. ~ Very truly yours, ~// James I. Nonsell Supt. of Public Utilities SUFFOLK COUNTY DEPARTMENT OF HEALTH SUFFOLK COUNTY CENTER RIVERHEAD, NEW YORK 11901 October 31, 1968 DIVISION OF ENVIRONMENTAL HEALTH SERVICES H~I~' W. DAVIDS,, p.i~. DIRECTOR Mr. Howard Terry ~t 1 ding Department Southold Town Main Road Southold, New York 11971 Re: Eastern Suffolk Nursing Home Dear Mr. Terry: This department is in receipt of "as-built" drawing for the in- sts]lation of the gravity and forced m~n sewers connecting the Eastern Suffolk Nursing Home to the sewage treatment plant of the Incorporated Village of Greenport. The engineering firm of Holzmacher, McLendon and Murrell has certified that the installation of the sewer lines and pumping station has basically been in accordance with plans and specifications. On occasion representatives of the Suffolk County Health Depart- merit have also inspected and tested the system. However, some work must still be performed on the pumping station which consists of in- stalling the exhaust fan in a cemponent of the automatic controls. At the present time the pumping station is on a manual operation. Conversation was had with Mr. Monsell of the Village of Greenport at which time the village has agreed to accept this pumping station on a ~-'m~! operation. This department, therefore, has no objection to the use of these sewer lines and pumping station. Should you have any questions on the above, please feel free to contact this office. WFG/gph cc. Michael D. Buscemi, M.D. Abraham Shames Very truly yours, Senior Public Health Engineer Holzmacher, McLendon & Murrell JAMES CANELLOS, P. E. 1211 STEWART AVENUE BETHPAGE, LONG ISLAND NEW YORK 1.1714 CONSULTING ENGINEER 516 GE 3-1730 April 17, 1968 Mr. Howard Terry Office of Building Inspector Town of Southold Southold, New York Dear Mr. Terry: Enclosed please find copy of letter from State of New York Department of Health sent to our office. We are sending you this letter as requested per our telephone conversation. Very truly urs~ Robert Nerzig STATE OF NEW YORK DEPARTMENT OF HEALTH 84 HOLLAND AVENUE ALBANY, NEW YORK 12201~ March 21, 1968 DIVISION OF HOSPITAL REVIEW AND PLANNING JAN T, LOUDON, BUREAU OF HOSPITAL CONSTRUCTION SERVICES IRVING A. MENNEN, A.J,A. ~IRECTOR 1211 Stewart Avenue Bethp:~ge, Nev~ 'fork Re: Application No. 5-49 Eastern Suffolk Nursing Home Greenport~ New York Dear Mr. ianeiio :: The foL.Lowlp, q com:nents result from a review of the above project based on drawings received March 14, 1968. Correction of deficiencies is manda'[~ry for tk..cse ~tem~; marked with an asterisk. .. i~ is recommended that toile_t drains be a minimum of 4" diameter. $pecificatiom~ - iqeating and Ventilating, Pa9e 3 - Fir<~ dampers are required at duct penetrations of ~tvrage room and laundry walls in the basement and duct penetrations of structural first floor slab. 3. Drawing £-3 - A smoke or heat detector is recommended for the laundrY. TNe e~r~e~by power system shall be arranged for auto matic starting and switching. Indicate the loads to De re6 by the emergency system. Please reply item by item igdicating your intended disposition of the above deficiencies. FEB:g:; cc: Mr. Edward A. Breitenbach Ver truly yours, d. Francis E. Boldt Engineer (P-156) (.3~U - t~/$/68) PERMIT UNDER SECTION 136 of ARTICLE YI of HI(~HWAY LAW ~e~, ~tlon 1~ of A~Icle VI of the Highway Law provides: "No strut surface or other rall~ad shall be contacted upon any potion of a ~ad co~t~ct~ or improved on a county road system, nor shah any pe~on, ~m, cor~tlon or municipality enter upon or co~t~et any wor~ In or upon such road, or co~t~ct any overh~d or underground c~sslng thereof, or lay or maintain therein dml~ge, sewer or water pipes underground, except under such conditions and regulations as may be pr~crlbed by the county super- lntendent, notwlths~nding any cogent or franchise grant~ by any town or by the municipal authoritl~ of any village or town. Any municl~l co~oration may enter upon any r~d eonstruct~ or lmp~v~ on a county road system for the purpose of widening the ~vement or for any other purpose authoriz~ by this s~tlon, but only after s~uring a pemlt as p~vid~ herein. Notwithstanding the ll~l~tio~s in any. general or sp~lal law, eve~ municipal corporation shall have and is hereby given authority to deposit with the ~unty superintendent such a sum of money as may be required by the county superintendent as a condltIo~ precedent to the granting of the permit p~vid~ In this s~tion. Any pe~on, firm, or co~oration violating this s~tlon shall be liable to a fine of not less than o~e hundred dollars nor more than one thousand dolla~ for each day of such violation, to be recover~ by the county superintendent and paid In to the county treasu~ to the cr~it of the county road fund created under section 117 of A~icle VI, of this chapter for the .co~t~ctlo~, r~onst~ctlon and maintenance oi county roads on the county road system In accordance with the p~visions of said S~tlon 117 of Article VI, and may also be removed therefore as a trespa~er by the county superintendent upon petition to the ~EAS, a ce~En highway known as the b~dd~e R~d CR No. 27 h~ ~en ~p~v~ ~d is on the Suffolk County Road System and Abraham Shames - Peconic b~d e~ne.te e~b, b~ev e~b, concrete v~ ~nd ~PV~ved e~h. asvhalt ~v~nt as per ~evxsea-~lan on s/i ~iddle R~t, Ci , 5~-t. e/C~l Ave., ~ ~r sketch or map attache. Ha~et of G~en~, T~ of Sout~ld NOW, ~ERE~RE, ~mission is hereby grant~ to said Peeonie Nursi~ ~ Ad~t Cente~ to do said work u~n the following conditions: CONDITIONS AND RESTRI~IONS 1. ~en concre~ is remove, cut eoncre~ ~th cone~te ~w two feet outside the iiml~ of the pro~ excavation ~d for the full ~el ~dth. ~en the cut is ~e in pavement ~t~n 10 f~ of the panel joint, ~e psvement sh~l ~ removed for full p~el width from t~e cut on the far side of the excavation to ~e ~nel jolt. 2. B~IH ~d t~roughly comp~t fill us~g POWER TA~ER, pl~ing ~lls so that v~ious ~pes of so~ are in ~ relative position ~ ~fore excava~ng. Gr~e to o~ su~ace. ~.' ~pi~ pavement, sid~alk or surge ~ ~ e~flng; if conc~te, repi~e u~g 1:1~ :3~ ~ s~ne m~ co.fete; ff bi~nous mateNal, repla~ using s~e ~ 4. If conc~ c~b is remove, replace with si~lar curb 1:1~ :~ ~. 5. ~ge of J~king ~ts or ~y othor excavation s~H ~ not less than 5 f~t from ~ge of Pavement. No undercutt~g ~owed in Pit. 6. Notify the Depar~ent at Y~ph~k t-i~l when ~he work is to ~n ~ that an ~s~c~on can ~ m~e of ~he o~ratio~ ~is ~it shall not be assigned or tra~f~ without the wEtten consent of the Com~ssioner of Public Works. The work authorized by this ~it shall be perfo~ed under the su~ision ~d to the satisfac~on of the ~m- missioner of Public Works or his ~presentative. Particular attention is call~ to the ne~ssity of thoroughly ~pacting the ~cK fill, which will ~ requi~ by the Com~ssioner of Public Works. ~e C~missioner of Pubic Works sh~l ~ given one w~k's notice by said applicant of the date when it in- tends to ~n the ~rk autho~z~ by this ~it, and p~mpt notice of its ~mpletion. ~e said applicant he.by agrees W hold the State, County and T~n ha~less on ac~unt of damag~ of ~y kind which may a~se during the progress of the work authoriz~ by this ~it or by re.on ther~f. Applicant cer~fi~ all ~rso~ concerned with actual work under this pe~it are duly cove~ by Workmen's ~m- ~nsation Insuran~ ~d the State, County and Town shall ~ held ha~less on account ther~f. ~e ~m~ssioner ~ Public Works ~se~es the right to at any t~e revoke or ~nul this ~it should the said a~licant fail to ~ply with the te~s and conditions u~n which it is ~ant~. The applicant a~s to pay all n~essa~ e~es inddent to supe~ision and insp~tion by reason of the ~ting of such ~it ~ certifi~ by the Com~ssioner of Public Works, such pa~ent to ~ made within ten days f~ the rende~ng of the ~rtified ac~nt. Work und~ this pe~it to ~ ~mmenc~ within thirty days imm the date ~ ~it ~d ~ntinu~ in an e~fious ma~er. ~e appHc~t shall su,bmit a detailed pl~ of structure to ~ built, with a description ~ pm~s~ meth~ of ~tmction. It is unde~t~ that should future ch~ges in the alig~ent or grade of the highway ~uire cha~es in the work ~ver~ by t~s application and ~rmit, the a~licant shall on reasonable noti~ f~ ~e C~ssio~r of Public Wor~ make such n~essa~ ~anges at his o~ e~nse ~thin the time so s~ifled in no~. ~c sh~l ~ maintained by the applic~t on this s~tion of the highway while the work is in p~ss and until i~ ~al ~mpletion. Cert~ lied Cbe~k ~~ in the sum of $..2..0~.0flpayable to the County ~e~urer of Suffolk County is on file de~it~ ~ s~rity that the highway will ~ r~tor~ to its oriffinal ~ndition whe~ distur~ at the e~ense of ~e app~c~t, ~ soon as t~ work h~ ~en complete, ~d the said ~m~s~oner ~ ~blic Wor~ is hereby autho~z~ to ~nd ~1 or as much of such de.sit ~ may be nec~sary for that pu~e, should the s~d applicant n~l~t or ~use to ~o~ the work.  it the undersign~ accepts it subject to ~nditio~ des~i~~ Com~ssioner of ~blic Works, Surf Date ~ AVO~ S~O~S DAMAGE ~ V~AL U~GROU~ FA~LITIES, PLEASE CALL LONG IS~D LIG~- ~G ~MP~ AT J~I~ 2-9~ OR FOR T~LEPHONE FA~LrI'IIS CALL N. Y. TEL. ~. ~ P~K 2- O~'~'I~AL 25 BEFORE STARING THE WORK AUTHORI~D BY ~IS PE~rr. 'aXeuns~e ~T~ sano~ ~Tn~ ~aah ' ou3 aa: S£~L~ :NS~4 o~ pazTaog~ne uaaq seg ~a~nsea~& ~unoo ( ) ~E ~3 ~peo~ a~ppTH peo~ ~uno~ · ~V 1-~1~'~fL' TT~'T oee~ ~ ')tblOA AA'aN 'NNVHdVA $:>I~O/V~ :::)i=lEll'lci ..=!O .LN~iN.L~lVcI:EIQ ~4=10=-I-=1f'l$ =-IO A..LNf'IO::) NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , Permit No. Disapproved a/c .;~ ...... ;~ ........ ~: ...... ~ APPLICATION FOR BUILDING PERMIT Date March 8 19.6..8. ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval af this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress af the work. e. No building shall be occupied or used in whole ar in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, o~ for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordina, nc,es, building code, housing code, .end regulations. (/fSignatureff of applicant, or name, f a corporation) ' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. En~.ineer Name of owner of premises ......... Ab. rA~tte~..~.tl~el ..... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ......................... Street and Number ...... a/.a..af'.~iddle...(No~£h,)..iLd,,e...C~.,..~,?A,...~.e.~,p~¢E .................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................ ~llg~.v.t~g~.~.~ ................................ b. Intended use and occupancy ~.gKl~,.~.g H.9~..~ 3. Nature of work (check which applicable): New Building ...... ..X. ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...... .~. .4. 9. % . .0. .0. .0. ...................................... Fee ........ .8..4..6..7.:..0..0. .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units BftCL~;;l,~,ltd..]~.anNumber of dwelling units on each floor .................... ~ ....... If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use Nu~sJ, nt~..~ .... 7. Dimensions of existing structures, if any: Front ............................ 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 ..236!...~.zzel~ula~ ...... Rear .23&Z..&r~reg~l~'Depth ;L4ZZ..&~rre~ .... Height ....2..0.!..-~'.'. ..... Number of Stories .......... ~, ............ ..-. ............ ~.e,~...F.~.].~..P.I~in ................................................... 9. Size of lot: Front ...390.1)/) ............. Rear ...... ~1)~00 .................. Depth ....4OO,.OO ............... 10. Date of Purchase ...~,.c~ab~r..2.l.,...].c2~7. .................. Name of Former Owner .... ~.uet..i;n~,. ............................. 11. Zone or use district in which premises are situated ...... B.-.Z ..... ~l-~-~.~l:~.cl:..6....Nu~s~,n§..llo~ ................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .................. Bi~[l~j~i~ .......................... 13. Name of Owner of premises .Ab.r.&b~un..~.h~ea .......... Address ..J~..LL.$.~£1:.~ee., ..... Phone No~,33,-.~31) ...... Bethpage Nome of ][ilJi~...~i~er .... o¢~l~..g~ne~tosAddress ..-1.2.!.l..-Sl~rt~..Ave:.....l~. Phone No.433=lSt3/) ...... Name of Contractor ...A..b..~..n.h...n..~....~..h...n~..~ ...................... Address ...:[;~.~.~..S.~,~.~,~:L~,.~.C~^,..~.~onne~eNo?]~.Z.Z.~~ ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, t S S COUNTY OF ................................ .f ' ' .................... · ~..~.-.~.~....C..~..R.~..]...1-.°..". ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the Coneultin$ Engineer (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of hisJ~nowledge and belief; and inthe manner set that the work will be perfc~r~ed forth in the app44cation filed therewith. //f Swornt?_~beforemethis "x ,r /~...-/~ / ' ~' \~./.~. .~..~. ....... o, ..zc. ,,, ,,,, Notary Public ' ...../....~r~; (Signature of applicant) " ' NORA.'" ~';, '.:'~ :;"~;;' ¥~;'V'rZ:/r~ ........./ / : "::": :;~"': ~ I / Abraham Shames 1211 STEWART AVENUE BETHPAGE, NEW YORK GE 3-1130 ED 4-3100 October 29, 1968 Mr. Howard Terry Office of Building Inspector Town of Southold Southold, New York RE: Eastern Suffolk Nursing Home Town of Southold, New York Dear Mr. Terry: To the best of my knowledge, the above project was constructed in conformance with the New York State Building Construction code applicable to multiple dwellings, the revised filed plans, and the rules and regulations of the Building Department of the Town of Southold. /× ~arY truly yours, ~raham Sham~s State of New York County of Nassau & Suffolk Sworn to before me this ~ 29th day~tober, 1968~"~ Abraham Shames 1211 STEWART AVENUE BETHPAGE. NEW YORK GE 3-1130 AFFIDAVIT - FINAL COST OF CONSTRUCTION Applicant, Abraham Shames~ deposes and says that he is the applicant named in the application for the building permit dated March 8, 1968, relating to construction or other work to be performed on, or in connection with the premises located at South side of North Road, East of Chapel Lane, Greenport; that the estimated cost stated in said application of the construction or other work described therein was $400,000; that the actual final cost of such construction or other work was $~{O0~ and that the said construction or other work was performed in accordance with the applicable provisions of law. State of New York County of Nassau and Suffolk Sworn before me on this 28th day of October, 1968 Permit # M~R. 175 FILED COST $400,000 PERMIT C $467.00 FINAL COST - ADDITIONAL C JAMES CANELLOS, P. E. 1211 STE~VART AVENUE BETNPAGE, LON~, ISLAND NE~X'~ YORK I 1714 CONSULTING ENGINEER $16 ~,E 3-1730 October 29, 1968 Mr. Howard Terry Office of Building Inspector Town of Southold Southold, New York RE: Eastern Suffolk Nursing Home Town of Southold, New York Dear Mr. Terry: To the best of my knowledge, the above project was constructed in conformance with the New York State Building Construction code applicable to multiple dwellings, the revised filed plans, and the rules and regulations of the Building Department of the Town of Southold. _Very truly yours, ~mes Canellos, P.E. ~onsult±ng Engineer State of New York County of Nassau & Suffolk Sworn to, before me, this 29 day of October__s1968. ~-- br ~ / IZJL. EEN T~ Fq'~F' ~o ~], 2~77',~ C. 0 J 0 '00~ - '=J.Ol~ ,92 .iCJ :¢J © ~> m NEW YORK STATE DEPAR'fMENT OF HEALTH PERMIT TO CONSTRUCT A WASTE DISPOSAL SYSTEM Abrah~m Shomes 12]_! Stewart Avenue This permit is issued under the provisions of Article 12 of the Public Health Law and I0 NYCRR 7;5. 2. Location of Works (C,V,T): 3. County: J Eastern Suffolk Nursing Home I County Route 2[/ & Greenport (V) Suffolk I ?roperty, Soutaold (?) 4. Entity or Area Served: By initiating construction of the approved works, the permittee accepts and agrees to abide by and conform with the following: THAT tile construction permit shall be maintained on file b) the permittee. THAT the permit is revocable or subject to modification or change pursuant to Arzticle 12 of the Public ftealth Law. TIIAT the facilities shall be fully constructed and completed in compliance with the engineering report, plans and specifications as approved. THAT the facilities shall not be placed in operation until construction has been completed arid an operation permit has been issued, or unless ordered to be operated by the Commiskioner or bF' a Court. TIdAT the construction of the facilities shall be under the supervision of a person or firm qualified to practice pro- fessional engineering in the State of New York und,er the Education Law of the State of New York, whenever engineer- ing services are required by such law for such purposes. 6. THAT where such facilities are under the supervision of a professioual engineer, he shall certify to the Department and to the permittee that the constructed facilities have been under his supervision and that the works have been fully completed in accordance with the approved engineering reports, plans, specifications and permit. 7. THAT the construction of the facilities shall commence bv September 6, 1968 and be fully completed by September 6, 1969,. 8. THAT the Suffolk County Department of Health shall be notified in writing ~8 hours prior to the start of construction s~ud that the licensed professional engineer shall submit weekly~ progress reports to the Suffolk Comity Department of Health. m THAT the Suffolk County Department of Hea2th shall be notified when sp$cific tests as outlined in the specifications, are going to be performed and that a licensed professional engineer shall certify to the SuffeLk County Department o£ Health as to the conformance to plans and specifications at the completion of the job. San. 2 (rev. 11/67) ISSUED FOR THE STATE COMMISSIONER OF HEALTH DATE W. Davzds, P.E., Dir. Div. Env. Health Services Suffolk County Health De~artm=nt Yellow -- ~ile (LHO or DHOy' Project Description: 5. Type of Ownership: Municipal ~_~ Commercial [] ~i8 Private-Othe,. [~t ~,u;h~rity __~'~] 67 Private-Home [] 26 Board of Education ~g 20 State ~] 40 International [] ]8 Indian Reservation Collection Treatment and/or Disposal 6- Type & Nature of Construction: [~ ! New [] ! New ' ~ 2 Additions or Alterations [] 2 Additions or Alterations 7. Estimated Cost of Construction: Collection System Treatment and/or Disposal 8- Type of Waste: ~ ! Sewage ~_~ Industrial Specify Specify ~ Degree of Treatment: ~ , None I~ 3 Primary ~ 5 Secondary ~ 7 Complete ~: Septic Tank ~ 4 Iht .... diate ~ f Tertiary ~ 8 Not Applicable 10. Point of Discharge: Location (C,V,T) ~O~.~O~ Major Drainage Basin Ser~oce Water: N~nic o~ Watercourse Ground Water: Name of Watercourse to which ground water is tributary ~ ~ ~O~ 11. Name of Receiving Treatment Works: Village o£ Greezzport Sewage Treatmeat 14. Design Flow (Gals./day): 15,0OO Description of works 12- Grade of Plant Operator Required: 15~ Design Equivalent Population (BaD Basis): ~/~ such as number, name and capacity of units: " Surface Water Class Ground Water Class Disinfection Required: ~/;~ E~i Continuous ~__~2 Seosonal ~--_~ 3 None 16. Design Plant Efficiency (% BaD Removal): ~/A Approximately 4,500 feet of 8" gravity sewer Pump station having two 100 gallon per minute pum~s 1,600 feet of 4" force main ~