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Home My WebLink About11606-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Zl112.7. ......... Date .. g.ugus.t..12 .................... 1982. THIS CERTIFIES that the building ................................................ LocationofProperty2000 Brigantine Drive~ Southofd House tVo. Street Ham/et County Tax Map No. 1000 Section ClX9 ......... Block . .0zJr .......... Lot .C123 ............. Subdivision .~ar b.o.n .Lights ............... Filed Map No. 51~7 .... Lot No. 2£. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Iq~r.ch../~ _., ...... , 19~.2. pursuant to w~ich Building Permit No.. ~-J-.6.Q6g ............. dated ........ A.p.~.5. $. 1 ........... 19g.A., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .............................. 0n.e..~'am~ly. D.w.e 1 l£r~g ........................... The certificate is issued to . ',.,. l~.o. be r.t;..H.. ~IAll ...................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~ug~t:. 9.,..3.9~2...~12.-.S0~-.1.7. .......... UNDERWRITERS CERTIFICATE NO.. 5.7. $ 9.6.7. ........................................ · tgi," ..... ~' · ./' ;~'. ...................... Bui~ing Inspector Rev. 1/81 TOW~N OF[$OUTHQLI~ ~ BUILDING DEPARTMENT: TOWN HALL SOUTH'OLD, N~ Y; BUILDIHG ~FE~IT: (THIS PERMIT MUST BE KEPT ON THE PREM, IS $ UN~IL F LL COMPLETION 0F THE WORK AUTHORIZED) , Permission'is hereby granted to: to .~ 7 at premises located at ....... ~..Z~ County Ta~ Map No. 1000 Section ....~,.iZ~.~...., Block Building InSpector. No. i(,.:'Z2 .......... ' approved by the 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 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 topograph[c features. 2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equat). 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. ; 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 .. New Building ............. Old or Pre-existing Bui~ding(:~) ......... ~ ~Vacant Land - . ........ ¢.oe ¢ .......... Location of Property ........... ~;~ · [ ................. ,0.4~'./. ~. E .............. House No, Street Ham/et Owner or Owners of Property ~'~---0 z'~ ~'f~,~--~ ,~O.(... ~4~' County Tax Map No. 1000 Section . ..~. ,~..(~' ....... Block ............... Lot...~, ' ,~... ...... Subd v s on .~0..';~....~?..¢~.....~%.l..~-...~. ........ Filed Map No..~.l ,Q.(..~..Lot No .............. Permit No, ././. , ~(~ ~ ~ate of Permit .......... Applicant ..... /-/~ ...... .............. Health bept. Approval t ~- '~ ,~ ¢?..,.-/~ Labor Dept Approval * Underwriters Approval...............,...,...f--'// .Planning Board Approval . .V~/.. ............ , , .~ Request for Temporary Certificate - Final Certificat~ Fee Submitted $ ............................. Construction o n above described bu ilding and permir meets all apP~cable~codes and regu lations. luoo3oo THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~'~ ,~ ~, 1~ .~ Jo.. ~.~,.~w ~o.~, ~[~ff~,oo~ ..,~ ~,,~.,,o.~o.o.~,,~ N 571947 THIS CERTIFIES THAT B1116~6-2 in the following tocqtion; ~ Ba~ar~nt ~ 1st FI. [] 2nd Fl. Section Block Lot was exarnined on ~ '~ ~ 1~'~ and found to be in compliance wlth the rqquirements of this Board FIXTURE OUTLETS 22 RECEPTACLES SWITCHES 67 28 DRYERS FURNACE FIXTURES RANGES COOKING DECKS OVENS FLUORESCENT SYSTEMS E EXHAUST FANS E R I C OF CC COND pER ,~' AW, G, OE CC, COND OF HI-LEG NO. OF NEUTRALS AWG, OF NEUTRAL 4 Four-Way Electric, P.O. ~ 38.5, Boh~mlLa, ~qoY. 11716 FIELD INSYECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY q. ODE FINAL ADDITIONAL COMMENTS: . FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .~..~.~./......./. ............... , 1 .~..,c~.... Application No.../../..(.~...~.. ................ Approved ~I/f/~.L.....Z ............... , l~....c~.. Permit No ..... ././...~....~.~....~... ......... Disapproved a/c ...................... ]]]..~'.....]]...'. ......................................... /.......~... , ' (SuJl~t~ Inspector) ' APPLICATIONI FOR BUILI:~ING PEI~MIT ,,, Date .......................... ....., 19.~.... ...... ' . INSTRUCTIONS a. This 6pplication mus~ be completely filled in by typewriter aP in ink and submitted in' triplicate to the Building Inspector, with 3 sere 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 )remises or public streets o~ areas, and giving a 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 b'efor~'issuance of Building Permit. d. Upon approval of this application, the Building Inspector x?ill 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 in buildings for necessary in~sj~ections. ~/r~.cYc) (~7~/cY/ ~-~'~~:~_~:'_~::; ................. ::'"'¢ ........ :, - ,~ ./ ~gna~ure or appucanr, or name, it o corpororlon~ / c N:.Y... i. I..s..i .... (Address of applicant) State whether opplicon¢ is owner, lessee, agent, architect, engineer, general contractor, eJectrician, plumber or builder. ............... ................................................................................................................................................................. Name of owner of premises.... .... '.~b~r~......j.~..-' .......... ........... I.~lJ ........... - = .............. . ...................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. i¢,~'--'P Electrician's License No...~.I..~....~...~...~'.Z ........................ PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY / REGRADING LOT DRIVEWAY CONSTRUCTION -- CESSPOOL CONSTRUCTION -- CELLAR CONSTRUCTION -. OTHER Other Trode's License No ............................................... Location of land on which proposed work will be done. M~p No.: ...~.,/..~.~.../'.."-"'/~' ........................ Lot No...~. ................ Street and Number ............ ~.'~.~..~. ..................... ~q'~"~ ~~-~../.~7~7~-~..,~.~..'. .................................... .. Municipality State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a, Exisiting use and occupancy ,,,,.V,,~J,~'~l-,f,'),~,~,, b. ,ntended use and occupancy ........................................................................ 3. Nature of work (check whichlapplicab;le): New Building ; .......... Addition .................. Alteration .................. Repair .................. Removal ............. i ..... Demolition .................... Other Work ~ ~,., ~..~].- (Description) 4. Estimated Cost ..... ..~J.....~.~..i..(~..~.....~.. ................Fee ~.~;~7.. .............................................................. ~ (to be paid on filing this appli~o~ 5. If dwelling number of dwelling units~D.~fi~.~.b)~J. Number of dwelling units on each fl~r~x~...i.tt~. garage, number of ~rs ..... .....~.,}....%1~.~.;.~ ............................................................................................... If 6. If business, commerc,ol or re,xed oCcupancy, specify nature and extent of each ~e of use ~,~A.~.l... 7. ~o.~ of ~x~,.~,,,u~u,~,, ~f o~: ~on~ _~_..~., .... ~ ....~ ........... ~p~ ...~.~. Height ..~.:... Nu~er of St )ries ....~ ...................................................................................................... Dimensions of same structure with alt ~rations or additions: Front .................................... Rear ............................ Depth ................................Height ........................... Number of Stories ................................ Dimensions of entire new construction Front ....~.~.....~.., ........... Rear ....~3..~: ....... D~th ...~.~.: ..... 8. ,Height .;.[.~,... Numbe;i _q/- .eL°f Stori ,s ..~ .............................................................................................................I~W.a 9. :~ of ~o,: F~on, ....... ,.~.~...,.~., ............................. R~or ....... ,..,..,...,..~., ................ g~,h....~..=., ......... 10. J Date of Purchase ................. . ..................................... Name of Former ~ner ........................................................ 11. Zone or use district in which premis~Jare situated ................................................... ~ ................................................ 12. Does proposed construction violate an zoning law, ordinance or regulation: .... ~ ............................................. 14. Name of Owner of premises ...~.~ C...~:.J~.[J ........... Addre~.~.~.~ Phone No. ~LT~J ..... Name of Architect -,~,!'~,,..~ ~}~. ................. A~ro~ .~..~b.~..~: Phono No, .~.~ PLOT DIAGRAM Locate clearly and distinctly all buildin s, whether existing or proposed, and indicate all set~ck dimensions from prope~ lines. Give street and block hum'er or description according to de~, and show street nam~ and indicate whether interior or corner lot. STATE OF NEW ~(~RK,/! ,,~1~ lSS ...................... ~~ ....... b~ing duly swath, deposes and says that he is the applicant 'r (Name of individUal signing ~on ,rocf) obove named. He is the ................................ ~ ~~...:=...'.~,,,.~ .................................................................................................................. of sa d owner or owners, an~ is ~ly a~ed to perform or have performed the said work and to make and file this application; that all statue.s conta~i~ed iD this application gte 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.~ef~e me this .~_ _ ) ] No~ ~ub ic, . ...................... ~oun~ ..~.~ ....... ~....~ ............................................. C~ ~~ (Signatureofapplicant) ~ ; ~ ' ~ ~lC, ~a~ ~f New Y~ ~ No. 5~-8~25850, Suffolk ~ ' Term]~pire, March ~0, tg~ :',1 EXCAVATION IHSPECTION REQUIRED: LICENSED .LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONI~Y_2. L~ ~ ~ DATE'_._ ,_/-- ~ ' H.S..Er. NO.: la¢>o'---~ . / / ~FOLK CO. TAX MAP ~ATION: DIST. ~CT. BL~K ~L. OEEO: L. N/~ P. "' TEST HOLE STAMP SEAL ~ ' ~ COreM TO THE ~AND~ OF THE ~ ~,~ ~FF~K CO, ~. OF HEALTH ~EVICES. .~ ~ - ~ - , ,,, . ' ' : ~ ' . '~,' '.'.' ' ROD~K VAN TUYL, P,C. LAND SURVEY~S , ~EN~R~ NEW YORK , l L~kL~=~C, kVATLD 4, :FILL PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY/ FEE:¢ iF?L 4 "Y: CX , NOTIFY BUILUING DEPAR~'-~ENFT' AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAM]NG & PLUMBING 5. INSULATION 4. FINAL - CO~STRIJCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. ,..HVJMC-,- Ro0¼ :-' z"J/~,~ L,'~L.L¥ ~-.Z:' F-l P-.ST T LOOP~ PLAN &a. ~: _ _~.. ~ ~"q' Il'&" .~ ',~' ~ ~I.~". "~-~" :~r~ ' . ~,. II ' ' ; 4: I % ~:'~ ' ' , . ,,- ,, X~ ~ ~1 H ," :, ~ ::~-~ ~11~ /~ , ~.:~,~'::~--~' - ~ , ' ' ' x]'~ ~ ~ ~ ..... . ' ' * i~ 0 :Ilt~~-:~'~" - ~ ~' 'm" ' H'I ~ ~" ~'-~ ' ' ~ '~ ' [~[[I ' :~' ' ': ' ; . ' ._ ~,~.~ . ~ ' ~ '~. ~ , .. ,~ · . . , ~ .... 3LCO~D ~LOOE -- ~ --~: .... ~: .I/~!'~ t~'~" i ..... LLF-r 5rD,P_ LLg,,VA"TtOt,-I tjx" * ¢-o' 4 I TOTAL. ~LQ012..: USE [,~ ~LAWFUL WITI{~ CERTIFIC,~;i'~ OF OCCUPANCY PERMIT INCLUDES APPROVAL ,TO REMOVE EXCESS FILL FROM ABOVE PREMISES REGRADING LOT -- DRIVEWAY CONSTRUCTION CESSPOOL CONSI RUCTION CELLAR CONSTRUCTION OTHER 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION 4, FINAL - CO~TRUCTION MUST BE COMPLETE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, i t~00¼ .... -:F--IP--DT T. LOOP-_ PL~ -- 3LCOf~DBLOOP.. ..... .11~ . -[ F.~OMT' p~4~cL ~L~WAT~O~ CALcuLkTjO~S ~0~ OVEg_kLL CO~FFtGI~T o/14D/~T 'Z, FF/o 14.~-.~'{'1J'--4~- ~EC=P..E.~ E:::,~¥~, ~,¥. G. Uo.t~ ..