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Home My WebLink About8295-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~.2~ ...... Date .............. .~t .... 11~ ...., 19.76. THIS CERTIFIES that the building located at .. ~he. Lo. rig. Wa~t ........... Street Map No. P. ebl~l® .B¢i~ Block No ........... Lot No, · .~ ..... .E ,. Ma:o~.on. ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... nov...].2..., 19.~.~. pursuant to which Building Permit dated ............. No.v...13- -, 19.7~'., 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 .Pr/~va~;e. orle. family. <twel-l:t3tg ....................................... The certificate is issued to . .Theo. &. Jo~n. S~'~l ....... 0wnarz .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · OCt...].l+...1.9?&...b~r- R.,..¥~i[.la ·.. UNDERWRITERS CERTIFICATE No...N~01 .].39 ..... A~g.-.31..]~ ............... HOUSE NUMBER ...... 2.~60 - · - Street .... Tt~e-LOng. WaT~ · - ]~...l~&~'i. Ol~ ......... Building Inspector FOB~ NO. ~ 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? 8295 Z Permission is hereby granted to: Tomark ¢onstro A/¢Theo & Joan stab1 · .~..~,~q ........ ~.~..r.~.,s.,......H...~. .................... ............................... .s.'....~.?. ........ ?.~l.s3. .......... ~ ..~.~...?...w.....o?...,r.,:,m.%.~...~,~. .................................................................................... at premises located at Lot ~+ ,..~...~.., 6266 ~.ebble ~each. L E. Mario~ , ................................................. .~.ho.....mp~..~. ................................................................................. pursuant to application dated .......................... .~...O..V.. ....... .1..~.... ..... , 19~.~...., and approved by the Building Impect~. FORM NO. S TOWN OF SOUTHOLD , Building Deportment 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 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, 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~ex'st'ng' land uses: 1. Accurate survey.of property showing all property lines, streets, buildings end unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, OCcupancy and condition of buildings. 3. Date of any housing code or 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 $1.00 Date . g.m'b.o.b.ez ...~ 3., ... %.9.2.6. ........ New Building .x~ ............ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property e/$ The Long Way, E~st Marion. Owner Or Owners Of Property ..... ~b.9.o.~..o.~.~...~....~.9.~..q...$..~.h.~, ............................................................... Subdivision ..... .~..b,.b.,.1..e...~,~c~ ............................. Lot No....~.~.... Block No ........... ;. House No..~.5.~.0.. Tthe Long Way Permit No.....~..~.~.~Z ..... Date Of Permit ll/l~/..2.~Applicant .?.Q~J~,~....g.Q.~.'~T.C~TI.,QN. .................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and~ermit meets all applic~l~e codes and regulations. App cant .~. ~ .~'~ ..~.~...~..~ . ,~....~...~ '// ...... ~.t,, ....................... =...= ........ t.t..:...~.. ....................... Sworn to before me this ' ............. y . . :,t.c ....... ? ...... .L.~.., (stamp or s~l)~ - . / Nota~ PUblic ~g.~]b.J.~. .......... Coun~ Com~e~ THE NEW YORK BOARD OF FIRE UNDERWRITER5 BUREAU OF ELECTRICITY BB JOHN STREET, NEW YORK, NEW yORK 10038 ~.~. August 26, 1976 a"afou"dt°bei~c°mPllancewiththerequireme~ts°fthlsB°ard' 1~. 75kw Smoke Detector Let Elec. Co., Say 11 , Per-- -- D ~ ~e bd y t credentia~s~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Services Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1 Applicant--7~tbrA/z:'~: ~.~>', Phone ,5 /'57~2o,3o 5. Subdiv. x~/~,i~,~m,,.,~,~,,~, ~' '~' ~!~ ~ '~ G. Section 2, Pr~erty Locat on ~/~ ~ x~,~ O~x~ ,q.s'~x~, '~ 7. Lot Number ~ ,~ L~'~ 8. Private Well Village. ~,~ ,~%~,~z, ~,~ Township ,~-o~.~,~,,, ~ 9. Public Wate~.~,~_ 3. Public Water ~pany N~ x~-<~x,:,~.~,~: ~ Distance to main 4. Lot size: Width ~'~ feet ' Length ~,, fee~ 10. Sewage Disposal System: (For Health Services Dept._Use___) 11. A. 900-gallon septic tank: Precast ~'~Equivalent_ Block B. Leaching pools: Number of pools ~pecial If private well, fill in the fol- lowing blanks: C. T~tal well l~depth D. -O6pth to ground water E. ,!Amount of water in well Precast Block The undersigned CERTIFIES: "Construction of ~uthorized installations will be in accordance with the Suffolk County Department of Health 'Services' current standards thereto." This application will be valid for one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. !_a!_e ...... _/_/_L~'/L: ........... Signed ,~/~ ~ ,Z~,/~....~ ........... ....... :___::::_:___::::::___:::::====================================== FOR THE DEPARTMENT OF HEALTH SERVICES~ USE ONLY. Based on the information prese~ted here- with, it is the opinion of the Department of Health Services that an adequate and satis- factory Sewage Disposal System and Water Supply can be installed on this plot. ^pPROV^L DATE S-15 Rev. 4/1/73 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~/,~ ~ TOWN CLERK'S 19~.~... pr*ed ..................... , 19~ . ~emit No .~.~...~.~ .......................... APPLICATION FOR BUILDING PERMIT Lr] *,e .................. ............ INSTRUCTIONS ~'~i a. This application must be completelv filled in by typewriter or 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. P~ot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, an giving a detailed description of layout of property must be drawn on 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 CerUficate of Occupancy shall have beene- 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, Ordinanges 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 applicant, or name, if*a corporation) ................... ~ ......... ,.~.,....../~....~.../...;z...~.. .......... (kddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu(ider. ........ :- ................." ' ........................ .......... :......'.....,...'...' ...................... ........................ Name of owner~'of premiSes ...~...~..9;.~..~....~/..~.......V....~...~,....~ ........ ..~....'~....~../. ...................... ...,..:.....i ....................... ...... '" -i~;~'~';~'a"i~~;'~i ..................... Builder's LicenSe No .......................................................... Plumber's License NO ....... ./....~...~......~.. ............................... Electrician's LicenSe No; . ,~....~.....-~......~... .................... Other Trade's License. No ................................................... 1. Location of land on which propOsed work will be done. Map No ........ ~----/..~?...~t....~..~. ............. '..'....LOt· No.....~--/ ............ Street and Number ................... ~ ...... Zd?..,.,.,.,~.~ ...... ~.~. .............................. ~.! ..... .................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... b. Intended uSe and occupancy Alteration ............... 3. Nature of ~o~k (check which applicable): New Building ....................... Addition ..................... " Repair ......................... Removal ................. Demolition ........................ Other Work .................................... ........ (Description) 4. Estimated Cost .........~ .................................. 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 ................ /. .......................................................................................................................... 6. If business, commercial or mixed occuoancy, 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 ............ He ght ~. y ..... Number of Stories ....................................... · ......................... ' ~'- // / '~ 8. D~mens one of ant re new construct on. Front ..... ~..'.~.. ............ Rear ...... ~ ................. p ................................. Height ................................................. Number of Stories ............. ~... ....................................................................... Size of lot: Front ........ ~...~...~ ................... Rear ............. .~..~..../. ................... Depth ....... c~..~...~......,. .......................... 9. Date of Purchase ......~' --?~......o~l~...~ ...... Name of Former Owner ....../..~.~.~.../'..~.......~...~.~......4~..~..~/~"~ ~ /~ -- ............ 10. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ Will lot be rearaded ....... xa~....~.. .............. WiLl excess fill be removed from pr.amices: [ ] Yes [~] No 13. _ ~' 14. Name of Owner of premises ....¥~'~.~.....~....~'..~, ............~.~...~..~... ...... ,~.~[.~3.~. ........................................................ j ~, , / / .~ (Address) ,~ ~ ~.bone No.) Name of Architect ....~.~..~..~/%..~..;......~...~.../~..zf~. ............... .~...'.o..~...~...~..../'7.....,L...~....~.. ....... ../~..~..~..~.../~..p...n3.....¢~. .......... {Phone No.) ~ ,, (Address) · Name of Contractor: /~/~--..~......~-~x/,?...~.......~....~......~......~.~ ..~.,4~.X:.V. ~ ~ ....... .~.~.~'~.'.~/~.v. ~..~... .............. (Address) {Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from properW lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YO[:{I~ , COUNTY OF ....... . men ~zpi~a March 30~ 1 ~ . .......................... ~..~..~.~.....~.~..(../~.~ ................. being duly sworn, deposes and says that he is [~e ~phcant above named. ........................ ................................................................................................................................................... (Contractor, aEent, corporate o[~cer, etc.) of said owner or owners, and is duly authorized to ~rform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ~ormed in the ~nner set forth in ...................................... ................... ....... ................ ..... ............................ LI' -9~2~30 TOMARK CONSTRUCTION INC. Buildin$ -- Construction 5250 SUNRISE HIGHWAY SAYVILLE, NEW YORK t RIGHT ELEVATION ~-/~O'OF 3- /, ALL PA~RTtTION5 5HOin/N tN A"ITIC~ /~RE UNFI~I,SHE.D EXPO3E~) STUDS, TOMARK CONSTRUCTION INC. Building -- Construction 5250 SUNRISE HIGHWAY SAYVILLE, NEW YORK t 5ECT[ON THE cROSS ~.ot~ AREA '- :BI611 50. sUHDI V/SION MAP FILEO IN THE OFFIC~ Or rN£ C~mK OF SUFFOLK COUNTY ON YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. SURV~ FOR: / /~g ~ ~, TH~ODOHE H STAHL ~ JOAAr H./~HL / ~- ' ~ LO~ NO 54 PEBBLE BEAC~ ~H~ ~ ~ ~ THE cROSS / ARE~ 21611 So' Lot 55 UNAUTHO,~tZED ALTERATION OR ADDITION TO THIS SURVEY I$ A ViOLATiON OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THI$SURVEY MAP NOT OEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT 8E CONSlDEREO TO BE A VALID TRUE COP~ GUARANTEES INB~CATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHO~ THE SURVEY I$ PREPARED, AND ON HIS aEHALF TO THE TITLE COMPANY~ GOVERNMENTAL AGENCY AND LENDING iNSTiTUTION LISTED REVISIONS DEC. 12, 1975 APR. $0, SEPT. I$, SEPT. NOTE: · -- MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE II, 19 7§ AS FILE NO. 6266 T,:~' ~.'~ '? 7'r';: .--* ~"ELL$ AND $I10~;'~; :H'" -: ,"?. '207.1 F/ELD YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: THEODORE H. STAHI ~ JOAN H. ETAHI LOT NO 54 "PEBBLE BEACH FARMS" AT EAST MAR/ON TOWN OF SOUTHOID SUFFOLK CO., N.Y. GUARANTEED TO: I HOME TI T£E D/W/SION OF CHICAEO I T.IT.£E INSURANCE CO. I SUFFOLKCOUNTYFEDEI?ALSAVlNG& I