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Home My WebLink About9886-z1~,!~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. Z9/~20 Date J~'lu~'~ ~'t ... ........................................ ,19.79 THIS CERTIFIES that the building located at . .2.~..~..D.e.e .~' p.~..~...R...0.; .W..... ~ Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. J.u.~.y....2.8. .......... , 19 .?8. pursuant to which Building Permit No..9886~.. dated .. August..5 ........... , 19.78., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... .P.r.i.~.,.a.t.e:..0.n.e...F.a~..i.l.y. ~.v .e.ll..l.n.g. ................................... The certificate is issued to ....... L..e.e..a...B.a?.b.a..~.a..S.i..~.o.i.s .......................... (owner, ~~aa:~ of the aforesaid building. Suffolk County Department of Health Approval · .. Januar~r..24,..1979...8.-$.0-.90... Robert A, Villa UNDERWRITERS CERTIFICATE No...N~.~93.3 .................................. HOUSE NUMBER ...2~ ........ Street .... .D.~r..P.~$h .~.~.d,..(1~, O.,.~[.~ ) ........... .......................................... ~a~.~uck~..Ne~..York .............. .................. Building Inspector County Tex Number 1000-106-10-Par% 28 BUiLDIN~ PERMIT ?HIS PERMIT MUS3' RE ,'KEPT o~ THE PREMJSE~ UhTIL FULL COMPLETION OF THE ~0RK AUTHORIZED) N? 9886 Permission is hereby granted to: FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 featu res. 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 instatla* tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certfficate of occupancy $1.00 $5.00 Date .... /./.'~..~_~.,~..~.... ......... New Building .... . .~.,,.,, Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~...~..~..~, .',~,~.-/?...I,~,~77.~.., ./.~.~?..~.. ................. ~ ,/.~. ~. ~.~. ~, .~..~-/-'C~"'' House No, Street Hamlet Owner or Owners of Property . .~. ,~..~..~...~..J-'~. )..~i.-~. ~.~....~./.~,/.-~......~.~. ).~..~?-.?~ .................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Map No ............... Lot No ............... Permit No. ~.~..~.~.. ~ Date of Permit .9//_'~./~.~.Applicant..~..~.~-~.~?-~.. ,~./.~./.~.'?..~./.~.').~./..~...?./ Health Dept. Approval.. ~'/.C,~'.~). ~'.(~. ....... Labor Dept. Approval ........................ Underwriters Approval..~C,~, .~,..~.~..~D ...... Planning Board Approval ...................... Request for Tempora~ Certificate ..................... Final Certificate ..... ~ ............ Fee Submitted $....'..~/...(~..~. ................ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy. 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CE~IFIES THAT Bay T~m~er Bu~ld~s, M~Zle~R~ht of Way, Deer Path Rd., R~ Ma~t~uck, L.I. ~.~..i~o. December ~1 ~9~8 a~fou~tobeincomp[~n~withtherequiremen~ofth~. DRYEI/~ FURNACE MOTOI~ [ R~TUm A~'UANCE ~NI~ uT. K.w. O~L ,. P. O*S ,. P. ~T. ,O. ~ W. O, EANGES Il'EClAt BEC'PT SERV1CE DISCOHNECT I NO. OF $ it V I C ~ c~c~co. ~w.G. .o.o~ .~o A.w.O. ~'. ~'~, ~'~ mu~P. ,~,~,w Ho, D, ~cc, c~o. 1 150 P x 1 2/0 Elec. Room Heat~B: 1- 2.0~, 1-1.5~, 2-1.25KW ~anelboard/s:l-eclr. 12~p,l-3cir. 10amp,l-~clr. 8a~. Motor/s: ~-O.F.C.I. 1-Smoke 1-~.5~ Hot Water ~eater EXHAUST FAHS AMT. H, P, Rober~ Marmion 22 Appel Dr. 8hlrley, 11967 2/0 Llc. 130g E eme~ m~eea 11 " This certificate must not be altered in any maormr;, re~urn to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING THIS COPy OF CERT!F!CA~ NOT ~Bi ALTERED ,[~l_Ai,rg. J~,~ ~R. TOWN DF SDUTHDLD OFFICE OF BLIILDIN61 INSPECTOR ~ TOWN CLERK'S OFFICE SE]UTH~LD, N. Y. 11~71 "~- FO~M NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. o. This application must be completely filled in by typewriter aC 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 plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o 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 shell 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, or for removal or demolition, as herein described. The appiicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and i~ buildings for necessary inspections. (,~nature of applicant~, or n~ne, if a cc~pbrotion) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ot premises .................. ~ ...................................................................................................................... If app~za~t is a~,corp~rote~ s~ignature,of duly author~.~ officer. ........ ....... ......... d Builder's License No ..................................................... Plumber's License No. /,.~.,/'Z 7-~ /~/_~ //~,~t-~-_/~/'--/~ _ Electrician's License No.../. ......!~.. ................................. Other Trade's License No ............................................... 1. Location of land on which proposed_,_.,,,~;.~cz~/z~,,.,~.,~.~_.7~,_z~_~_?~_~.::~....m..,/~/_p~..~work will be don~'~. M,a.,p No~ ......... :. ............................. Lot N.~.~ ............. .~ ...... Street and Number ...................~...~..C..~.5...c5..£..~-..~..~.4~..~:f-.....¢:~/..,ff.....~......~...~Z..4~.Z~..-~...~../-Z~..-...~ZC....kZ~,.~. .... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of propos~constructian: a. Exisiting use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building..'L.¢~...... ........ Addition .................. AlteraHon ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................ ,,. (Description) ;=7000 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 ................ ~J~/.. ...................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type 'of use ............................ 7. Dimensions of existing structures, Jf 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 ....... '~...~.. ............. · ....... Rear ...... ~..~.. .............. Depth ..~...~.......Y~.. ......... Height ......... ~.~.. .... Number of Stories .......................... ../..../.~...~ ..................................................................... ~z.'" 9. Size of lot: Front ........................................................ Rear ................~. ........................ Dep h ............... ~ ............. 10. Date of Purchase ........................................................Nome of Former Owner ........................................................ ,./... 1 1. Zone or use district in which premises are situated .................................. ~....~. ............... ~:; ........................ 12. Does proposed construction violate or~v zoning Iow, ordinance or regulation: ........................................................ 13. Will lot be regraded . ........ /~. ....... ~ ...... Will excess fill be removed from premises: (~)"-Yes ( ) No 14. Name of Owner of premises .~...~...~T..~:./~'~}~ .~../~?..~.....~'/../.~...~/..~.. Address .~'..~...~'.~:....IZ[~'.../.~.....~hone No. Name of Architect ............ ..~..f..J..~....~..~....~?..~...~.. .................. Address .?.../~..~/~......~'....6(.~..~. Phone No..~..~ .~..~..~..'~...~..7 Nome of Contractor ~. ......................................................... Address ................................P~one No..7. ................... PLOT DIAGRAM Locate dearly 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 shaw street names and indicate whether interior or corner lot. STATE OF NEW YORK, lc ~ COUNTY OF ................................ f~'~ ................................................................................................. being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) obove nomed, ~ ~,~ ~ ~ /l~_ (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 all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn t~b~fore me this .~ ..... day of ...~..~. ....................... , 19.~r ~/~ ~ ~l~~ .... No,o ................... ....... Co., ......... ......... ....... ................. ~ , ~ ~ ~ /~ (Signature or applic~ ~otary Public, Stato of ~oW ~ ~ualffied In Suffolk Couat~ ~o. 52--4528113 O~mlB~i~n Ex~ires Mar~h ~O, ~gS~ "MILLE'RS '?9 JAN 2't AM II ' 51 igDt -0.0' sand gravel ........ IZO' HEALTH DEPARTMENT- DATA FOR APPROVAL TO CONSTRUCT ADDRESS SURVEY FOR LEE SIROIS ~ BARBARA SIt?OIS AT MATTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK ~ UNAUTHORIZED ALTERATION OR AOOIT~ON TO THIS SURVEY I~ A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW ~-DOPiES OF THIS SURVEY NOT BEARING THE LAND SURVEYOR'S ~NKED SEAL OR EMBOSSED SEAL SHALL NOT SE CONSIDERED TO BE A VALID TRUE COPY YOUNG 8' YOUNG · --MONUMENT SET ALi)EN W YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.%S. LICENSE NO J2845 HOWARD W. YOUNG, LAND SURVEYOR -.~THELOCATIONOFWELL(W),$EPT~C TANK(ST)BCF-8$POOLS(CP)SHOWN HEREON N.YS LICENSE NO 45893 A__RE FROM ,FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS, DATE . JULY 5, SCALE' NO ~ 78 - SEE GUARANTEED TO: LEE & B,,~BARA SIROIS RIVERH~ --- SURVEY FOR SUFFOLK COUN~ DEPARTMENT OF HEALTH SERVICES L~' S/~O/S ~ BARBARA S/RO/S HS R~E. NO. SUFFOLK gOUN~Y NEW YORK NO : ~UNAUTHOR~Z~D ALTERATION OR ADDITION TO THIS APPROVED , ,. SURVEY i~ 'A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCA'TION LAW SURVEYOr'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO,BE A VALID TRUE COPY ~GUARAN~EES INOICAT~D HEREON SHALL RUN ONLY TO H~LTH DEPARTMENT-DATAFOR APPROVAL TOCONSTRUCT AND ON HIS ~EHALF TOTHE TITLE COMPANY, GOVERN- OTHER THAN THOSE SHO ER O , TO ADDITIONAL INSTtTUTIONS OR SUBSEQUENT / /i~ / ~ERT~'L NES O~F~R TiE ERECT ON OFFENCES _I~UUI~ ~ IUUI~ R~VERHEAD, NEW YORK m =MONUMENF S~F o = ~FAKE P~AC~O X~DE~ H~WARB W. YOUNG, LANO SURVEYOR B APPROVEEI AS NOTED 765-2660 9AM fo 4PM FOR REQUIR- ED INSP~CTIONS~ 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMJJg~ 2, FRAMING INSPECTION 3. BEFORE COVERING PlP£S OF ANY KIND 4, FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y. STATE CODE AND TOWN HOUSING CODE & ZONING PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY REGRADING LOT DRIVEWAY CONSTRUCTION CESSPOOL CONSTRUCTION CELLAR CONSTRUCTION OTHER REVISIONS DRAWN BY, 4 8 NUMBER DRAWING NO. bJN, P t L~IK, .PLAhl DRAWING NO,