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Home My WebLink About11530-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.1.1.5. 6. .6 .......... Date ........... ~q~Oh. ~5 ............ 19 8.3. THIS CERTIFIES that the building ... l~.w., d~r~:l.:].:i_~ .............................. Location of Property ,...~.q 5. ~e. G~.~enw~.y .&..q.Sq-5..~;.he. ~.~;.~a~d~... ~.a~;. Ha~2±or~. House No. Street Hamlet County Tax Map No. 1000 Section . .. D.30 ..... Block . .. 02. ......... Lot ..... (3~7 ......... Subdivision., Pebble Beach Farms .Filed Map No. ~266 .Lot No. 93 conforms substantially to the Application for Building Permit heretofore filed in this office dated December 30 ,19~.?. pursuant to which Building Permit No. 'l'1530Z dated . ~.~.n.~.~. ~.~..5 ................ 19 .~..2, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued i's ......... New one family dwelling The certificate is issued to Peter & Dolores Walsh (owne~tessee-~r~em~t) of the aforesaid building. Suffolk County Department of Health Approval ...#..'l.q.T.s.°.~ .?~.0.,..5./.~.2./.~. 3 .............. UNDERWRITERS ¢ RT FICATE ...... ..................................... Rev. 1/81 Building In~pectoy TOWN BUILDINI TOWN sOUTH'OLD, :N~ Y. BUILDING I~E R~IITI {THIS PERMIT MUST BE KEPT ON ~H,E PRE~IS~S COMPLETION OF THE WORK AUTHORIZED) . UNTIL F[ULL 4 N°. 11530 Z ~ate ..~,C7..(~.~;~'~ ...... Perrhission is hereby granted to: ........ .... ,, ..m~.~ ...,~,~*~.., ~ ,..~/~ ...................... ...... ~ ......... ~ ................... ,...~ ............ ~..~.~.~......~,..~~.....~.~,~.~ ................. ...... ~ ......... : .................... z~.d ...... ~.....~~ ............ ~. ....................................... ....... ~ ......... ~ .................................................................... ,....> ........ ~ ................ ~ ....... ,.....' .......................... COUg~ lON~op NO. ]000 S~ctlon ..... ~.~ ..... pubs0ant fo ~pplication dated ~ ;~,: , 19 and approv~ by the Bulldlng 10spector. Fee ~.Z,~;¢ ............. ~r FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and sub~i~ted 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 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 installa- 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. B. 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 dweIHng or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ..b, New Building .... /,~ ....... Old or Pre-existing Building(Z) .......... ~/Vacant Land i ........ Location of Property . House, o, g Street .................. Ham/et Owner or Owners of Propert ........... _.. ~, ................................... CountyTax Map No, 1000Section ..C~. ~ O. .. Bock O ~ Lot O ~''~ Subdivision ~ n n~ ~. n ~ ....... ~' ~(i,' ........ ' ........ · ~ ~ ..... [~/~'~Filed Map N~.Lot No. ~. ~ ......... Permit No. ( f~ ~. Date of Permit .~N~ ~ ~ cant ~- ~,,~' Health Dept. Approval .~. ~ ~.~/~ ...... Labor Dept. Approval .... ~'. ~ ............... ................ l~ing Board Approval . ./~,/~ ........... ~ .., Request, for Temporary Certificate ...... '- . ..... Final Certificate . ~ .......... , Fee Submitted $. ,~. ,. ~ ..................... Construction on above described building and permit'meets all apP~cable_,codes and regulations. Rev. 10-10-78 loolo?i THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT only the electrical equipment ~ described below and int~duced by t~ applicant ~amed on the above appllca~ion number in the premises of thefollowing locat~; ~Basemeet...,~ 1st Fl. was examined on FIXTURE OUTLETS IECEPTACLES 40 ~] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS OTHE A T S: 2--~noke Detectors Tz~ck Ligk;ing; 8' -'0" 8 lites. I C AW, G A. WO' PER ,~/ OF HI-LEG OF NEUTRAL S g~ec. 215 ~)u~hold, N.Y. 11971 This certificate must not be altered ' return to of the Board if GENERAL MANAGER Per~ THIS , FIELD ~N SP~,~C T I ON FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL DATE COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined Approved . .~.~. ,/?.... ~ ..... 19~.T'. Permit No. t/~..~.. ?..O. .~ Application No. (/~..7 .~. .~. ...... Disapproved a/c ....... ; ....... : ........... 5~ ........ /" ' ,, (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ , 19. INSTRUCTIONS a. This application must be completely filled in 'by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bnildings on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn oil the diagram which is part of this apt? cation. c. The work covered by this application may not b~ commenced before issuance of Building Permit. d. Upon apprc':al of this application, the Building Inspector will issne a Building Permit to the applicant. Such peru shall be kept on the premises available for inspection througbont tile work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by lhe Bnilding Inspector. APPLICATION IS tlEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Bnilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, honsing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary iuspections. (Signature of applicant, or name, if a corporation) (Mailin=O~lddress of applifant) State whether applicant is owner, lessee, agent, architect, engiueer, general contractor, electrician, plumber or bnild, ............................... , a,neofownerofpre,, ,, s .................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... .~....~: .i,./.'. ............ Plumber's License No .... 47. ~ ;2 /O.~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be don~.~,~_V.~.~N-~.../.~ ~g ............ .................... ,-. House Number U Street Hamle{ Corn:tv Tax ~ap ~o, moo sectio~ .,. ~. B.9 ......... mock .... '~ ............ Lot~..~.-.~./... ~ (N~m~) 2. State existing use and occupanc7 of premises and intended use and occupancy of proposed construction: .. a. Ex~stmg use and occupancy ................................ . B""''''"'""' .... b, Intended use and occupancy ........... ,: ........... L Nature of work (check which applicable): New Building ....4 ..... Addition .......... Alteration .......... ' Other Work Repair .............. Remgval ......... Demolition ............................. E ' dC F ~ stllnate ost .................... ee ........................ ¢ ........... ~ (to be paid on filing this application) ;. If dwelling, number ofdwellingunits ... ~ ..... Number ofdwelling units on each floor..~ ........ Ir garage number of cars L If business, commercial or m xed occupancy, specify hature and extent of each type of use ...'7. ................. Dimensions of existing structures if any: Front ...' ......... Rear '- Depth " Ileight - Number of Stories Dimensions of same structure w'itb alterations or additions: Front .. . .-., ............ Rear .. r .............. Depth - : Height -- Nmnber of Stories .~. L Dimensionsofentirenewconsti'uction:Front...Z-/. ....... ~...... Rear....~..~ ...... Depth .~.,STA. ....... Height .. '4 '~' .t ...... NunCber of Stories ....... .~:~.. ....................................... Size orlot: Front ..... //. ~'.i ............ Rear ...... "7.0 ...... ' ....... Depth ~;1, ,~, ~ .~".7~ ........ Date df Purchase . . ,0~. 2. '~ .[ ?. ~ ........ ;,. Name of Former Owner ./?x~. ~ f)t'o,~,~..~.. Zone or use rhstnct ~n wtuch prpm~ses are situated. :". ....... ' .................. Does proposed construct o ~ v olate any zonino~, law, ordinance or regnlatio ................. . Will lot be regraded ........ ~ .............. Will excess fill be removed fr, om premises: Yes )~ No Nane of Owner ofpr~,mises{~f-l){<.l~.~ ..Address ~.~ NaneofArc tcct ~:~ .' ~.:..~-'~... .... Address .~.*,~..,r,.~-~ l~,.~.~ PhoneNo . . Name of Contractor ~ .~.~ ..... Address--u~--~'~ '/~ P~"' Phone No. 6.1r~... PLOT DIAGRAM Locate dearly and distinctly all buiklings, whether existing or proposed, and. indicate all set-back dimensions fi'om nun:her or descriptio_.n according to ~leed. nn4 shC'.v ~-t~eet names and indicate whether ). 1. 2. I. roperty lines. Give street and block terior or corner lot. T^T~ OF NEW YORK, . S.S OUNTY OF..~. e..~.P'-, e .z: .~. .... ,? ! · ..~.~4~..7~.~./'6. .... ~)/'/~Wfl. ~;. / .................... being drily sworn, deposes and says that he is the apblicant (Name of individual sig~ ng contract) ~ove name~d. e is the ..................... : .... ' ............................................................... (Contractor , agent , corpmate' officer , etc . ) f said owner or owne~, and is du~y authorized to perform or have performed the said work and to make and file this >plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth h~ the application filed therewith. worn to before me this - L~NDA E RO ' Qualihed ~ ~.. ,. ~ ,, (Signature of a lica~t TITLE NO. 102-S-9017 HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT N NEAREST W~TER IAI ~MI. -~ N SOURCE OF WATER: PRIVATE__PUBLIC HTH[~ ARE ~ ~[LLJ~S WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE ~HOWN HEREON. H ~HE WATE~ SUP~Y,~ SEWAGE D S~AL SYSTEM F~ THIS R~ I DElE wri[~ ~FORH ~O TH~T~N~ROS OF THE SUFF~K COUNTY DEPARTMEHT OF H~kTH ~ICES. TEL MAP FILED IN THE OFFICE OF THE OLERK OF SUFFOLK COUNTY SURVEY FOR PETER K. WALSH E~ DOLORES WALSH LOT 93, "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK NOV. 16, 1982 NOV. 3 , 1980 DATE* OCT. 2, 1980 SCALE: I" =40' NO, 80-524 GUARANTEED TO: AMERICAN TITLE INSURANCE CO. PETER K WALSH ~ DOLORES WALSH BOWERY SAVINGS BANK YOUNG e, YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. MCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR N.Y.S. LICENSE N0.4§893 tVENUE NEW YORK TITLE NO, I0;~-S-9017 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FO~ ApprOVAL C'~F CONSTRUCTION ONLY HEALTH DEPARTMENT-DATA FOR APP.OV~L TO C~STRUCT N NEAREST WAT lAIN MI. ~ ~ SOURCE OF WATER: ~I~TE ~PUBLIC ~ ~F CO. TAX~P ~OO SECTION O~O e~CK g LOT ~,7, WTHE~ A~ ~ ~ELLI~I WITHIN IOO FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON, }~ TH~ LOC&TEmPI OF WELL(W)~ SEPTIC TANK(ST)D CESSPOOLS(CP) SHOWN HEREON ARE FROM FIELD OB~RVATIONS ~lO OR DATA OBTAINED FR'OM OTHERS SURVEY FOR PETER K. WALSH ~ DOLORES WALsH LOT 9:5, "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK NOV. :~, 1980 DATE: OCT. 2, t980 SCALE: I" =40' NO. 80- 524 GUARANTEED TO: AMERICAN ~TLEINSURANCE CO. PETER K, WALSH & DOLORES WALSH BOWERY SAVINGS BANK I YOUNG YOUNG ALDEN W.YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N,Y.S. UCENSE NO. 12845 HOWARD W, YOUNG~ LAND SURVEYOR N.Y.S. LICENSE NO.4§ScJ~ YORK