The URL can be used to link to this page

Home My WebLink About9680-zFORM NO, ,S TOWN OF SOUTBOLD BUILDINC, DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate of Occupancy No..Z.9.3..4.8. ..... Date ...D.c..c.e.~.b..e.r .... 1..9 .........., 19..7.8. THIS CERTIFIES that the building located at . .1.6.5....T.h..e..S.t.r..ap.d. ........ ~ Map No... 6.2.6..6 ..... Block No ........... Lot No ..... 7..6 ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .. At~.r. ll ....~8 ........ , 19.. 7.8 pursuant to which Building Permit No .... 96.8.QZ dated .. April .... 18 ......... , lg. 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 Private One Family Dwelling The certificate is issued to Edwin Hudson of the aforesaid building. Suffolk County Department of Health Approval ..... Dctoher.23~.~9~8.....8~-.$0r~7 Robert A. Villa UNDERWRITERS CERTIFICATE No .... N402~8~ ................................. County Tax Map Number 1000-30-2-90 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? 9680 Z Permission is hereby granted to: .: ~. ...... ~.. ~.~,:. L .bJ. ....... L )..~/..~.e..5.~.~ ............... pursuant to application dated .......................... ~.t~ ......... -"Z.~....., 19.(~...,~" and approved by the Building Inspector. Fee $...~....~....~ ....... ......... ~../. ...... ~~: ........ Building Inspector l~Ol~l NO. 6 TOWN OF $OUTHOLD Building Delmrtmeut 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 triplicate to the Building Inspector with the following; for new buildings ar 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-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 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 3. Copy of certificate of occupancy $1.00 New Building ..... .~ ......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ........ ./..~..'~...~'~'. ...... ..7./~..~...~. ...... ,..~..~'~..'~'..z~./?~.........~.~.:...~ ..~.'./....c~...'~....~. .................. Owner Or Owners Of Property ............... : .............. ' ~. ...... ~..~ .................................................... Subdivision ...~.....~.~/.~.~.?.....~..~...~.~.~'..~../. ,~.~.~.~¢.~.. Lot No ............. Black No ............. House No ............. Permit No..~,~;,~.'.~..... Date Of Permit ...~.,/¢~:~.~.~.Applican, ...,Z~.~...~,~,~.~......~.(?...~,,~.~:./.~,,..~..,~,..~.,~:'- 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 permit.. ~. me~es and regulations. Sworn to before me this Applicant ....... ~..~.._.,¢w.,~.~,,~m,,,~/. ............................................... ................ day of ............................................ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ ~ep~embec 19, ~'*~ 978507 N4023 2 THIS CE~IFIES THAT o~y t~ ~t~ ~t ~ ~sc~b~ ~ i~ ~y ~ ~ ~n t~ ~ ~ num~r ~ t~ p~m~es o~ in the following location; ~ Ba~ement ~ 1st Fl. [] 2nd Fl. S~ction Block Lot ~ 6 was examined on ,o~ 0 ~) ~ e~b ~. ~ ~ ~{ ~ 1 ~ 7 '~ and found to be in compliance with the requlremen ts of this Board. RXTUR~ RXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS SWITCHES 22 ~7 25 )2 DRYERS FURNACE MOTORS FUTURE APFtlANCE FEEDERS TIME CLOCKS ~JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R V · I ' C E Detector Hot ~el- NO. OF CC. COND. A.W.G. ~_/u NO. OF HI-LEG O~e HI-LEG C OZ'a~a Elect. Llc. 733~: This certificate must not be altered in any mannerr return to the office of the Board if incorrect. Inspectors may be identified by COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF ...~OUTHOLD OFFICE OF BUILDING INSPEOTOR TOWN i-:LERK'S OFFICE SDUTHOLD, N. Y. 11971 TEL. 765-2660 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Disapproved a/c .................... ~~i ........... ................ '~ .................... ~""~ '" '/"':"'U ............................... (Building inspector) Application No ................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 151an showing IocatJor~ of Jot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and-giving a detailed description of layout ofproperty must be drawh 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 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 ~r~'buildingS for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicanf)~'~u~.~'r~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... .~.u.~ ...... ,~...~...~- .......................................................................................................................................................... Name of owner of premises ...~/~'.~..tff~.i.~.~ ........ H..,, ...... ~.U ....................................................................... If ap~glicant is a corporate, signature of duly authorized officer. ....... ............. (Name and title of corporate officer) Builder's License No ....... ".~3..~...~.~...~.-T~ ............ P~umber's Ucense ~o ............. ~...~...~..,,t',. ............... Electrician's License No ........ ,~.,~.~,,...,~ ............. Other Trade's License No ............................................... /~.~ '--~ ..... ,.- ~(, , Location of land on which.proposed work w!ll be done. Map No .~..~.~;.~.~.~'. Street and Number -. ..;- ;-;..-_..- --------.-. / ~/ ((o~ ~1 Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExJsiting use ondoccupancy ...... i~....~..~.~..:.~.~.J.~t.~,.~ ...... , .L4...0...Z.i ............................................................................. b. Intended use and occupancy ....~....~...~ ......... ~.m.i...~j. ......... .~. ...................................... 3. Nature of work (check which applicable): New Building,...,J~, ......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................. ... c. (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.... ,.J}..J~.....~.. ....... If garage, number of cars ..... ..'~..~"LO. ......................................................... ~ .......... '. .................................................... 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 ............................ --,reNumber of Stories ..................... 8. Dimensions of entire new construction: Front ...... .~...~..: ..................... Rear .......~..~..' ............ Depth ....~....~,......~ ...... Height ..,../...~.. ........ Number of Stories ...... ~ ....... I~. ............................ ~' ...................................................... '1 ............. 9. Size of lot: Front ......... ~...'~...'~,,...~. ................ Rear ...... ,~..i~.. ............................ Depth ...~1'~..~.,,,~,. ....... 10. Date of Purchase ...................... .~,...~.~:t~...... ............ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... i2. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~)..~. ........................................ 13. Will lot be regraded .....~....~....-~.. .......... Will excess fill be removed from premises: ( ) Yes (~) No t4. Name of Owner of premises..~*,~.,~....~......,.'.~.;~.~...-m.. Addre~ .~'..~.:.'.,.~..¢ ..... Phone No..*.,.,.'...'...'.?...~ Name of Architect ,.,~),,l~..g..,~. ....... .'..~..~.~...~....L'J~ .................. Address ..~..,.~.~/t~.~.. ........... Phone No.'~.~...~..,~'.~.~..J~ ~om~ of Contractor ,~.~..~....~../~t~.L¢.....C:.e..~..,~>,Addres~.~.~.f.~ ...... Phone No.~.~.'...S;.~ PLOT DIAGRAM L.ocQte clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines· Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. /~ STATE OF NEW~Y~[I~- l/r/ ~c c .................. ~...~.~.[..~ ....... ~........[....(~.~..~,.... .......... bein~ du~v sworn, doposos ond s~ys that he is the ~pplicom (M,mo of individual si~mn~ ~ controcf) nQmed. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or how 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 tha~' the work will be performed in the manner set fo~h in the application flied therewith. Sworn to before me this ~t~' ~?,. ................... ~....~.~/~~' ~- co.~ ~.~ ....... ~......~~ ......................... ~[r~ ~xpire~ March 30, l~ ~0 '.00 open THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIOENCE WILL CONFORm ?O THE STANDARDS OF THE SUFFOLK COUNTY DEPARTM OF HEALTH SERVICES THERE ARE NO DWELLING ~ITH/N IOO' OF TNI$ PROPERTY OTHER THAN FHO~E ~HOWN HE~EON. NOTE: I:MONUMENT [2 = ~T/N[&~ SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE 11~1975 AS FILE NO. 6266 TITLE NO. 76S-02623 REVISIONS AP~.. !~, tg?e AP~..~I, IgF8 AUG. 23,1978 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: EDWIN H. HUDSON & AASE A. HUDSON LOT 76 "PEBBLE BEACH FARMS" AT EAST MARION TOWN OF' SOUTHOLD SUFFOLK CO., N.Y. SCALE I" : 40' j DATE' OCT. GUARANTEED TO: CHICAGO TITLE INSURANCE CO. 28, 1976 76-919 NOTE= I= MONUMENT SUBDIVISION MAP FILED IN THE[ OFFICE OF THE CLERK OF SUFFOLK C~3UNTY ON dUNE Ii, 1975,AS FILE NO. 6266 TITLE NO, 76S-02623 PI4 3 -:' THE LOCATION OF WELL~ AND CESSPOOLS SHOWN HEREON ARE FROM FIELD SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES V open` Space FOR APPROVAL OF CONSTRUCTION ONLY P~OP~R~Y O~H~ ~HAN THOS~ SHOWN ~E~EON. REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK HOWARD W. YOUNG SORVEY FOR: EDWIN H. HUDSON ~ AASE A. HUDSON LOT 76 "PEBBLE BEACH FARMS" AT EAST MARION +OWNO~ SOUTHOLD GUARANTEED TO: CHICAGO TITLE INSURANCE CO. SUFFOLK CO., N.Y. I'i: 40' DATE: OCT. 28, 1976 76-919 'APPROVEg AS NOTED DATE~~'~f~ ...... ~~L-'~'~*~L~ ............ ~ 765-2660 9AM to 4PM FOR " ~ ~'~ - '~" ' - ....... ED INSPECTIONS: ................... 1. BEFORE BAC~FtLLIHG FOUNDA' PA~JL' J, STBBEL A::H!TECT ~79 ' ' ' ' M~c~e. Co~.m~"y Road Corem, New York 479 A'~iddl~. Co-am, New York 11727 4 t 7I- O -i '+%