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Home My WebLink About9005-z ~Ol~M 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) N.° 9005 Z Permission is hereby granted to: ..~¢....~.o..~.~...z...rt..,. ........................................ Mattituek to bu. ild new one famX. l~. dwellXng ................................................................................ at premises located at _...L...O..~......].O.......P..e...b..b...~.~....B~..~...~..h.. ..................................................................... The Short Way E. Marion pursuant to application dated .......................... .D.~......?..~. ............. , 19..~.~.., and approved by the Building Inspector. Fee $ 63.0~ FOBM NO. S TOWN OF SOUTHOLD , Building Dep. rtme.t Town 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. Fina~ survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, o 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 os to use, occupancy and condition of buildings. 3. Date of any housing code ar 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 $1.00 oat, ......... .... ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. New Building ××× ' ' Location Of Property ..... .~]3.~...$..,.]R.o..~,,t;,.. ,N..~,.',v.~,....~.~..s..t,....~,~?:,~.,~°..~.,~....~...'.~.~. .................................................. Owner Or Owners Of Property ......... ~3,l,a.D..~.....H..o.~..e..s..~....~.~..q,'. ................................................................... Subdivision ................................................................ Lot No .....,3,0... Block No ............. House No ............. Permit No....9...0..0...5..Z.. ..... Date Of · 12/1;3/76 Inly. nd Homes, Inc, Perm,t .................... ~pplicont .................................................................. Health Dept. Approval . . .G. .-. .~.. Q, ,-. .2. ~. .3. . . ,5/. 6. ./. .7. . .7. ...... Labor Dept. Approval ........ ~.r, ................................. N336889 5/6/77 Yes Underwriters Approval .............................................. P~anning Bo~rd Approval ........................................ Request For Temporary Cedificate .......... ~.Q ......................... Final Certificate ............ .Y...e..s. ....................... Fee Submitted $ .......~.~..O..O. .................... Construction on above described building~e(e~l~ ~ colt t~,c°des/~d regulati°ns' App l ica nt ..~~...'~. ~..~. -...~ ............................. Kenneth W. Thurber-Inland Homes, Inc, Sworn to before me this ................ day of ............................................ (stamp or seal) ~/~. Notary Public .,,,.~D,~.o.~ .............. County dL~'~ / TOV/N OF SOUTHOLD BUILDING DEPARTMENT TOWN C,ERK'S OFF,CE ~ ~_ ~~ ~, ~' ~ SOUTHOLD, N. Y. -~ .~ -~ .~ ~x.~,~ ........ ~ ........ ~ ....... , ~..~..~ ~~~~,o~ ~o....L.~.~.,~ ........ ~isopproved o/c .~ .......................... ~ ........... .~. ..................... ].. .......... /~/~7t/77F~ ~ d~ ~ m t~ ~ ~ .................... - ........................... w Date November 30 76 INSTRU~IONS ~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pMn showing ~dcation of lot and of buildings on pr6mises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty 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 of 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 work. e. No building shall be occupied or used in whole or 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 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in, buildings for necessary inspections. ............ ?!!.'.~?,...~..~55:...~!:..c:. .......................................... (Signature of applicant, or name, if a corporation) Bo~: 117~ Iqattituck~ N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Oeneral Contractor Name of owner of premises ...i[n..]:.~...n..d.....H...°..m:S..s.,,....~..c..~. ...................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ................... Z ................................ JS17-P Plumber's License No ................................................. 2 I~J, 8-E Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No....]:,.O. .................. .lbo Shozt Lane, Pebble Beach JSazras~ asr Marzon, .~o~.tho.]..c, .. Street end Number ............................................................................................ ; ................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .......................V..a..c..e,.~.l.~. ............................................................................................ b. Intended use and occupancy ...................... l.z...P:?.t.~i:..l..Y...H..°..u.:~ ....................................................................... 3. Nature of work (check which applicable): New 'Building ...' ............... Addition ....~f..X..X.;~ .... Alteration .................. Repair .................. Removal .................. Demolition... ................. Other Work ................................................~ ..... 4. Estimated Cost 30,000.00 Fee ~-~,O ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units .1. .......................... Number of dwelling units on each floor ............................ If garage, number of cars .......... ..2. ................................................................................................................................ 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 ........................ 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 50 50 22 .................................... Rear ............................ Depth ........................ Height ....~.~ ............ Number of Stories .~.~..~.~,q~ .................................................................................................. 9. Size of 1at: Front ........ "~ ............................................ Rear ....ZZ ................................. Depth ....~.0. ..................... 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ...~.~ .................. Will excess fill be removed from premises: ( ) Yes (x) No 14. Name of Owner of premises .~J.~D.~...~J~.~....~.q~. ........ Address .~9~..~Z..~.~ Phone No. Name of Architect .............................................................. Address ................................Phone No ....................... 117,. ~latt Name of Contractor Inland Homes, Inc. Address Bo~ ~hone No. 298-9696 PLOT DIAGRAM Locate cleflrly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. ~ive s[reet ond block number or descr[p¢ion accordJnfl to deed, and show street names and JndicaCe ~hether interior or corner lot COUNTY OF ..... ~.~ ~.~. ~.~.~ .......... [~'~ T ......... ~9~A~.~,.,~.~,.....~.~.~ ............................................ being duly sworn, deposes ~nd s~ys that he is the dpplic~nt' (Name of individual signing contract) ,. above named. Con¢~Ac¢o~ He is the ................................................................................................................................................................................. (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 aH statements contained in this application are true to the best of his knowledge and belief;',, and that the work will be performed~ the manner set taCh in the application filed therewith. Sworn to before me this / ) ~ -, ~otory Public, . ............... ~~.... Coun~ .... ~~r..~:.~ .................................. Konn~h W. T~t~e or oppuc~nt) LO! 1~5 vocon! Lo t 12 vocof~! ,,.,,.~ ' ?HE . .~WS~ONS YOUNG & YOUNG --- ~ 400 OSTRANDER AVENUE, RIVERHEAD, N~'W yORK OFF/CE OF THE CLERK OF 1S75 AS FILE NO. GSGG. ALDEN W', YOUNG sURVEY FOR: I/VL.,4/VD HOMES,/NC. / D T /VO. I0, "P,~'£lfH. ~t!~ ,qEACH FAt?M,'7," NOTE: Lot 14 VACANT facilit£e,~ For thl~ location ~ve ~nspect~bis~epa~t~nt and foun~ Chief of General Engl~eFr~ LO! I$ voCO~! ~ = MONUMENT Q-'STAKE SUBDIVISION MAP FILE IN rH~ OffICE OF THE CA~RK OF SUFFOLK COUNTY ON dUNE 11,19?~ AS FILE NO. 6R66. LO! 12 voconf THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD APPLICANT: ADDRESS __ TE! YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ;ALDEN WIYOUNG ~ HOWARD W. YOUNG ':SURVEY FOR: INLAND HOMES,/NC. LOT NO. I0, "PEBBLE BEACH FARMS," EAST MARION GUARANTEED TO: ~oW~ OF SOUTHOLD SUFFOLK CO., .Y. jay scA~:/ --40 ! A~: IVOV. 15,19?6