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Home My WebLink About9246-zirO~t~ NO. · TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...~he. Loni~ igay ........... Street l~ap No. Pel~l~le. ~oal~l~ck No .......... Lot No...2.1 ........ Eaai, .ll~.iori ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... }la.y. t6 19..?? pursuant to which Building Pen~it No..9~t+6Z.. dated ......... ~ay .... ~6.., 19. ?~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P!'..$~.~.~;a, orte..f.a~nil.~ .d~-1-': in~ ..................................... The certificate is issued to ~ohn ~. l~aI~i~. Iloole.y .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .3~.t; 3~-497~'. · .by..ri o · V,f.l. la. · · UNDERWRITERS CERTIFICATE No..~3~6~t7. .... ae~.t;..a0...1.977 ............... HOUSE NUMBER ...$.16~ .... Street .... ~;h¢~ · Lon~. ~:~y ...... ~.,..i..;aI';~.o~ ...... '£,'e Ll~ore Building Inspector FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE $OUTNOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WoRK AU:FHC~RIZED) , 9246 Z Date .................. : ........... ~ ......... t6 .....19'~j1~" Permission is hereby granted to: ~o .~..~...~..~..~v~ ................................................................................... ................................ ~ .... ~,~ .~,..~..,.L~ ................ ~t premises located ................................. , ...... :'~'~e7"a"aa~ t'~r ......... ~"~t~: .......... ................................... >~...: ................ ~.~ ...... : ..... 4::..,~.,:,,~:;;~,.~;.~.,.~.~.:~ ....... :...:...:.:~:~: ........... : ......... pumuant,,to application det~ .................. ~'""1~ ..................;, ]~...., and approved by the Building Insp~tor. ~" FORM NO, 8 TOWN OF $OUTHOLD , Building Department 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: I. 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-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, 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 ....../.. ............. New BI4ilding ..~., ....... Addition .............. .~ J/OJd-°r/Pre'existing Building ................ Vacant Land L ation Of Pro ert : __ -, .... Owner Or Owners Of Propertyt-~/~...~......~....~..~., ,.~.......~...~ ................................. '-t"o //. I kNo ouse o Subdivision ............................................ ...... .............. u~ ~-~ ............ I~ ac .............,id N ............. Permit No.~.~.~'...~..... Date Of Permit ...'~.?../...~'?.~?.~.Applicont~ ~~...~~ ........... Health Dept. Approval Z/..~...~../..~.~.. .................... Labor Dept. Approval ................................................ Underwriters Approval .7/.~..~../..~..~. ..................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Finctl Certificate ..~....,.. ..................... Fee Submitted $ ~"~'~'~- , Construction on above described building and, permit meets all applicable codes and regulations. Applicant ~.~ ................. .~ ................................... Sworn to before me this ..... o, Nota~ Public ..~~~ .... Coun~ :38§ Lot 12 (voconH TITLE NO. 77-S-01249 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM ~I~[D OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND 5EWAG~ DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTME OF HEALTH SERVICES APPLICANT ADDRESS TEL ______ = = Lot It ~,~ Areo=24,418 sq f! sptOF?7- \~ EL=385 I,YlI-HIN I00' NOTE ·:MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE 11,1975 AS FILE NO 6266 REVISIONS MAY 3, 1977 JULY 1,1977 SEPT. 28~ 1977 YOUNG & YOUNG 400 OSrRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUNG SURVEY FOR: JOHN S. DOOLEY & MARIA V DOOLEY LOT II "PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHOLD , SUFFOLK CO., N Y. SCALE GUARANTEED ro ~ CHICAGO TITLE INSURANCE CO SOUTHOLD SAVINGS BANK Lot 12 (~ocant) Lot II l~e~--24,415 sq f! E1.;59-I THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE W.~TER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTME OF HEALTH SERVICES APPLICANT ADDRESS TEL SUFFOLK COUNTY DEPARTMENT OF HEALTH 5Ei~I~ FOR APPROVAL OF CONSTRUCTION ONLY 7 .s .,..o.. 00' ~ O~VKLLINGS 'THIN I00' NOTE' · = MONUMENT SUBDIVISION MAP FILED INTHE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE II, 1975 AS FILE NO 62[66 REVISIONS MAY 3, 1977 YOUNG & YOUNG 400 OSTRANDER AVENUE, RtVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUNG SURVEY FOR: JOHN S DOOLEY 8, MARIA V DOOLEY LOT Ii "PEBBLE BEACH FARMS" !AT EAST MARION TOWN O~ SOUTHOLD ,~. SUFFOLK CO, N Y, GUARANTEED TO CHICAGO YITLE INSURANCE CO SOUthOLD SAVINGS BANK SCALE OCT 28,1976 i rI t APPROVED AS NOTED excepl by d Licensed Pr~;fes~ sioncd Enmneer, Section 7209, Subdluslor, N. Y. State [duc,~li(m J..(,~ Oiiice Oi Gc;rd,.:.n K. Ahl..~s, P. E. ri-- L1 ~i,;r ~1] Eqglhleer, is ill,ga!". :,~,:; cn 71209, 5ubdlvlsir~r~ ~,