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Home My WebLink About8531-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southoid, N.Y. Certificate Of Occupancy No...~.~5..8.6 .......... Date ............... J.~ly. IL, ........ 19.7.9 THIS CERTIFIES that the building ................................................ Location of Property ... 31.6.0.. Orchard. ~treat,. Orient ....................... h~ioi House No. Street County Tax Map No. 1000 Section ...2 7 ....... Block .... 3 .......... Lot ...3 · 1 ........... SubdivisionBea.~.] .o.:[:%~,s...~.c.~.¢+, ........... Filed Map No ..... Lot No..l. conforms substantially to the Application for Building Permit heretofore fried in this office dated ...... ApriJ~ .23., .... , 19 75. pursuant to which Building Permit No. ~53tZ ............... dated ............ April..23, ..... 1976., 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 ......... .............. ~. ~.~y.~.~.~..o.~.1, ¥~4~];I.J. ~.W~/~.~ .................................. The certificate is issued to . . .~I~O~I/~S.. an~ .~g~lC.~.. De.V.Qt~ ............................. · [owner, lessee or tenantJ of the aforesaid building· Suffolk County Department of Health Approval .. 6.-~qO,7~..-:. Ap~:il. 12~. 19.73 .* ......... UNDERWRITERS CERTIFICATE NO...hi. 3.66350 ...................................... · ~-ligl.~ Ni~rates~Water not to be used.for // preparatlon of baby formula or consuml~t~on · / by infants under 6 mos. of age. // Rev 4/79 FOILM 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? 8531 Z Permission is hereby granted to: . ~ zLzs .. ~... ~,a~c ~...DP,,Y. DP,, ................................... ................ ~. ~.~.. ................................................. to .....~.~i~..:ae~ ..t.~ue...~ ~:...d~r.~: .. ~.i~ g .................................................................................. at premises located at ...Lo.t...1.....~e~u~.Qi~i.$....~ ........................................................................ Orchard Stroct Orient pursuant to application dated ....................... .~?.~:~.~......;~.~. .......... , 19~...., and approved by the Building Inspector. Fee $~.~.~O ............ // .......... · ;~ 'Ac,.a.c~:~.,~ ........ ,~,~...~:~,..~ ............... '~' Building Inspector [ FOI~M NO. 6 TOWN OF SOUTHOLD , Building Departme.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. Final 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 disp0sal--(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, 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 1957), 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, o~ccupancy and condition of buildings. 3. Date of any housing code or safety inspection of buiJdir{gs 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 Bqilding .....¥'.. ........ Addition ................ Old or Pre-existing Building .......~. ....... Vacant Land .............. Location Of Property ~'~/'t~,~'c~ ',~J, ~",t~/~'' Owner Or ~ners Of Prope~y ...................................... J ........., ....................... ............................................. Subdivision .. ~ .~J....[~ ......................... Lot No .... ... Block No. ..,......... House No ............. Hearth Dept. Approval ............................... b ~pt. Approval ...... ~ ................................ Unde~riters Approval~..~..~ .................. Planning B~rd Approval ...~. ...................... Request For Tempora~ Ceffificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .......~~ ....... ~(~1-~..., ......................................... Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County /"'k'~ ~ m~'9.,.,/~' COUNTY OF SUFFOLK DEPARTMENT OF HEALTH SERVICES The attached approval was issued subject to the notation coutatned below our approval st~. 2bald you please t~qoe the £ollowfmg condition of appro'zal on the final C of 0 as t~s will ensure th~.t any ~.~u'ture owner will be. made a~a~'e cf the ~itr~te proble~. "Private well with hT.gb ni ,.,~ a~,e~ - see HeaP. th note on final su~eyo _ COUNTY OF SUI-FOLK March 5, 1979 Thomas Devoe 15 Main Road Orient, Ne~1 York 11957 DAVID HARRIS M.D, M,P.H, · RE: 6 So 76 s/side Orcha!d St., Orient Dear Mc, Devoe: Beadjolais Acres, Sot #1 A recent check of our files indicates that this office has never issued a final approval for the above referenced job. Please be advised that it is illegal to occupy the building until the fol- ~l?tng paper¥~ork is submitted to this office and/or the following inspec- tion(s) are completed: [~-]Well Drillers Certificate '~Jater Analysis L.~cesspool Certification [~Final Surveys [-_=~Other Should you have any questi'ons, please feel, free to contact this office. Very truly yours, ~(~6~o~,' '~.i-' '.. . .... .' "' ' / cc: To,,m Building Departmen[ TOWN OF SOUTHOLD .I ~,, , /. -~ ~ --~ BUILDING DEPARTMENT~u~ ~ /~ ~ ~'~ ~ TOWN CLERK'S OFFICE ~((~h~ ~ ~) ~ ~ ~m ~UTHOLD, N. Y, ~ ~ ~ ~ ~ · ~ ~proved ........................................ , ]9 ........ Permit No...~ ......... ~...~ ..... ~ ~~~ ~ ~ - ., , .......................................... ~ ......................................... ~'"-~ ............ ~": ~W ~. :M~ : ~' ~ ............................. .. ~FLIC~TIO~ FOR BUILDI~ FERMIT~ ~C(~c ~ . ~ ~ ~ .................... ........ ..... INSTRUCTIONS 7~/t~ ~ 0'0' ~ ~ o. T~is opplicotion must be completely filled in by typewriter o~ in i~k ond submitted in triplicote to t~e Building ~ Inspector, with 3 sets of plans, occurote plot plan to ~ole. Fee occordin~ ~o schedule. ~ b. Plot pbn showin~ Iocotion of lot ond of buildings on premises, relotionship ~o od~oinino premises or public streets o~ ~ oreos, ond giving o detoiIed description o~ loyout ofproperty mus~ be drown on the dio~ro~ wMich is po~ of this oppHcotion. c. The work covered by ~his oppIicotion moy not be commenced before ~ssuonce of Buildin~ Permit d. Upon opprovol of t~is opplicotion, t~e Buildin~ Inspector w~I~ issue o Buildin~ Permit to ~he opplicont. Suc~ permi~ ~ shoII be kept on t~e premises ovoiloble for inspection tMrougMout tMe work. e. ~o buildin~ s~oll be occupied or used in w~ole or in por~ ~or ony purpose w~otever until o Certificote of Occuponcy ~ sMoll ~ove bee~ gronted by the Buildin~ Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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, 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 to admit authorized inspectors on premises and in, buildings for necessary inspections. ..................................... (Signature of ~pplicant, or name, if a corporation) ~ Orient N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner - builder Name of owner of premises ....... ~..~.gP.:.....~...~.~,~g.~.......g..e.~...o.~. ............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) o~'le z' Builder's License No ..................................................... Plumber's License No ........... ~.~.g.e.Z~ .......................... Electrician's License No ....... O~.]~ .......................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done, Map No.: .....~...e.~.~j.q~$~...,C.¢.~'~.ot No ....... .J ................. Street and Number ............. .Qr.¢.h~,.~.l~z~.a~.t .............. O~.il~ ...................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ........ .o,~..?....?..~..~..~.~...~..?~..e...~..].:~..~..~. .......................................................................... 3. Nature of work (check which applicable): New Building'. ................. Addition .................. /~lterati~n .............. Repair. ................. Removal .................. Demolitior-. ................... Other Work .................................................. (Description), 4. Estimated Cost ...................... ~.0..~..0...0..0.+ ..................... Fee ..6..~?...8..0. ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....o..D...e.. .................. Number 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 ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of sarne structure with alterations or additions'. Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ .6..8.,.-,8. ................... Rear ...... .6...8..-...8. ............ Depth . .. .2. . .~..-. }8" ./. ~. .0. T.8 Height Number of Stories one 9. Size of lot: Front ........................................................ Rear .......................................... Depth : 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..... ~!..A.!!....d.,i..~. ............................................................................. 12 Does proposed coastruction violate any zoning law, ordinance or regulation: ......... ,Z3. O. ........................................... 13. Will lot be regraded ...ma .................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .T~omas~..&..Na,no.~......D~,'z.D.e. Address ....... 0Z'&~m.~ ........... Phone No .........~ ............. Name of Architect ....................... s,~,me ............................. Address ................................ Phone No ....................... h!ome of Contractor ............................. ~.~ ...................... Address ................................ Phone No ....................... 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 stree~ names and indicate vd~ether interior or corner tot See filed plans ~-I>\'FE OF NEW 'WORK, l S ~ COUN'i'Y OF ....... Su~£.o. lk ........ ~., ................. ~[.~.aD, Q~T..]~.~p.e. ................ being duly sworn, deposes and soys that he is the opplicor, i (Name of individual signing contract) above named. Owner kle is the .................................................................................................................................................................. , ............... (Contractor, agent, corporate officer, etc.) of said awnor or owners, and is duly authorized to oerform or have performed the said work and to makei end file this application; that eli statements contained in I'h]s application are true to the best of his knowledge and bphef; thor the work wilt be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ~ - ~ ~ /-~'~ ~ / L~(Signoture of applicant) NoJCtty public. S c~le of New No. 52.0344963 SutfoJk County,.;../ THIS SURVEY ~AP NOT B AR NG i preparation ~f baby formula or consumptio~ by infants under 6 mos. of ~age. APPROVED ~$ NOTED DATE: f~i,.~ ~,I~, I NOflFY BUILDING DEPARTMENT :1 /I // ro