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Home My WebLink About11865-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g .~ .1.5.5. 7 ......... Date ......... ~.a?.c.h...2.2 ............... 19 .3.3. THIS CERTIFIES that the I~uflOing .. P 9.o.1. ......................................... Location of Property . .6.7.8..5 .5 ................... C.q u..n .~.y.. ~ .o.a.d.. 4. .8 ........ G.~..e .e.n.p.o..p .t... House No. Street Ham/et County Tax Map No. 1000 Section .. 9.3.3, ...... Block ...0.3. .......... Lot 0 18 Subdivision...X ............................ Filed Map No..X ....... Lot No..X. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · ..A..u g.u.a. ~...5 ......... , 198..2. pursuant t o which Building Permit No...1.1..8 .6.5.Z. ............ dated ...A.u. ~.u.s.~. ! .7 ............... 198..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 is ......... .... .a.n..i.n. ggp. u.n..d..s. EJ:..m.m.J_.n. g' p.qo. 1.: ............................................. The certificate is issued to ...... C. 9B.iq.E..L .I.A' .C.....K.E.O..O.H...&... B..Ey.E.R..L.Y..H.A..L .L.0.C.K. ......... (owner, te~ee-o~ ~enar~) ' of the aforesaid building. Suffolk County Department of Health Approval ... ;q./.~ ................................... UNDERWRITERS CERTIFICATE NO ........... .N..5. .7.6.1.3. 4. ............................. Building Inspector Rev. 1/81 N°. 11865 FORM NO, 2 TOWN OF $OU~HOL~D :~ BUILDING DEP~RTMI~N~ TOWN HALL SOUTHOLD, N~ Y. BUILDING P,ERMIT~ (THIS PERMIT MUST BE KEPT ON THE P~,EMIsES UNTIL EULL COMPLETION OF THE WORK AUTHORIZED) Z Date .. ~.. ~C,-~ 5. ~.... · ./.~..'. ............ , Permission is hereby granted to: ~"~ ..::::~.~.? ....... ...... ,o .,...c~.~z,~.~....~ ~......~%~..~~:=m ...... ~........,.~,, ...~,...~~~ ........... ~,,,~,,.,,~,,~ ~,.~,~ ....... ~~,..~.,.....~..~~ .......... ~.. .................. .................................................................... pursuant to opplicetlon dated ....... ~ ,~ .............. ~ ...... , ]gO..~.~nd Opprov~ by the ..........~ zsu~am '""?""~'--~-~'" ................... ~ ................. Rev. 6/30/80 FORM NO. 6 TOWN OF ~OUTHOLD 13uiiding D epa r~m.e.n.~ Town Hail Southold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Th~s aoafication must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor ;.z~:,~ the following; for new buildings or new usa: ' 1. F~nat r. un.'ey of property with accurate location of all buildings, property lines, streets, and unusual n~;ural or tooograoh[c features. 2. Fin.*l aooroval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Acatoval of electrical installation from Board of Fire Unde~rwriters. 4. Con:mercia[ buildings, industrial buildings, Multiple Residences and similar building~ 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. Fcr existing buildings (prior to April 1957), Non-conforming uses, or buildings ahd "pre-existing" land 1. Accurate ~n/ey of peoperty showing all prooerty Pines, streets, buildings and unusual natural or tO~O.~ ~Dh,c features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. D3~a of 3ny housing code or safety inspection of buildings or premises, or other pertinent informa. tion required to prepare a ce~ificate. / Fee~: 1. Carthqca~e of occupancy $5.00 2. Caruficate of occupancy on pre-existing dwelling or land use $5.00 3, Cc2,/of certificate of occupancy $1.00 Swimming pool Date. 9/20/_82 , .. ~,.~.v Bu,dir, g ............. Old or Pre-existing Building(X) ........ ~ /Vacant Land ............. 65255 North Ad G~eenport LccadonofPrcperty .,, ............... '~ . Hou~ /VD, S(ree~ Ham/et Owner or Owners of Property Cornelia 0. Ee~h and Beverly Jj Hallock County Tax MaD NO..1000 Section .. ~3 ........... Block .. ~. ........... Lot.. 18 ~ Subdiwsio~ ........ ......................... Flied Map No ........... Lot No .............. PermitNo.~¢~, · Date of Perm[t~/~¢~ *- · .... Skinny Dip Pools, 'Nattituck ' ' ' · ,,~phu¢,~ ........................... Hea~[h Dept Approval ......................... Labor Dept. Approval .................... ,.. Unde¢.'/rhers Approval ........................ Planning Board Approqal .................. Request for Temporary Certificate ..................... Final Certificate ........ - ......... Fee Submitted S .~..~¢. ~/' ~)~'~' , Cons[ruc,~on on above described buildin~ and ~e¢~i*'--~ ........ , ~ ~,,, ~ ,,,u~ a. ap~Kcao~odes~nd regulations. * Th~r~ ~ill be ag additional 4,/~olosing/~elf-10cking gate installed across the 2e~ o~ the pier-between the existing fences when work around ..~..pool itself (~hioh i8 fully completed and in use~ is completed. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: ooo66 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~[~C~C ..[4, ]-9~S JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ~ ~, ~e ~65255 ~ ~.~r~ ~.~ & ~ ~., Cre~, N.Y. in thefollowing Iocati~; ~ Base,aents~ 1st Fl, ~ end FI. ~Si~ Section Block Lot FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS NO. OF FEET E R I C NO, COND. OF CC COND, OF HI-LEG OTHER APPARATUS: ~ by a q~ed p~son, Gleam R. ~radley 169 ~rton Ave. ~acClCuc~, N.Y. 11952 Itc. 1227 This ce/tificate must not be altered in any manner; return to the office o( thee Board if incorrect. Inspectc~?s may be identifie COPY, FQR BUII~DING DEPARTM~NT. THIS ANY .MANNER. FORM NO, 1 TCWNCFSOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, f'LY. 11971 TEL.: 765-1802 ..................... ....... .54./... 1/.// (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No/~.d~..~. ....... INST RUCTIONS Date a. This application mast be completely filled iu by typewriter or in ink and ~ubmitted 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 buildings on premises, relationship to adjoining promises or public or areas, and giving a detailed description of layout of property must be drawn dn the diagram which is part o¢this apl cation. c. The work covered by this application may uot be commenced before issuance of Buikling Pem~it. d. Upon apprc.'al of this application, thc Building Inspector will issue a Bui!dmg Permit to the apvlicant. Such pen; sbalI be kept on the premises avadable for inspecfion throughout the work. e. No buildh~g shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shMl have been granted by the Btnhling Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of thc Town ~f Southold, Suffolk County, New ~, and other applicable Laws, Ordinance: Regulations, for tho construction oUMdldings, additions or alterations,~ for/emoval ordemo~ion, ashereSndescriM The applicant al;(ecs to comply with all applicable laws, ordinances, bu~, lng/code, housing ~e, and regulations, and admit authonzcd nlspcctors on plcnusc's and in buildings for necessary il~s[ ~ // ' ~ nature ofapp~n~q:~e, if~oration) (MMling address of applicant) State x~hvthcr applic:m~ is owner, lcsse~arc'dtect, engineer, general contractor, electrician, plumber or bmld (as on the tax roller latest deed) 1[ applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... I'lumber's Licens'.' No ......................... Electrician's License No. I~...C~.? ........ ~ .~/~k{(l....,. Oil or Trade s License No .................. I. Location of land on xvhicb proposed work w~ll be (lone.. ~ ........... ~ ....... ..................... ..... ..... ......... ........... ' Honse Number Street tlamlet County Tax,lap No.!000 Section ~.'3 ~ / g ............ Block .................. Lot ................ Subdivision .... Filed Map No. ~ Lot . .". .......... (Name) 2. State existing nsc and occupancy of premises and intended ns~and occnpancy of proposed construction: a. Existing use and occupancy .......................................... b. Intended use ~d occupancy .... ~O~.. ~.~~ ......................... Es r~atedCost ''~['~ (] ' ' w I N , f(to be ppid on fiIing this a ,ptication) Ifd,velling;ntunberofdw~ ~ gt 1 s kr. ~ ~ . , ' If g ~r.,gc, numLer of cars ' / . . · rca ~smess, co~mnerc~al or:m xed occupancy,¥ecH'B nature and extent ore'neb typd of use ......... Din ensions of existing stmctiures, if any: Front ..... ' Rear ..... ' Depth .. let ht ............... Number ol Stor es , ' ' ' Dimensionsofsamestmct~r~w taterar ...... ~, ~""'~'''2 ............. .............. ~ ........ Denlt~ , . _... ....., .... Rear ......... ~. ]. · ................. , .... Nt ~berofStorles ......... ~ .... ~lnlcnslons ol enllrc ne'.','~oQstructiom Froa~ ............... Rcar. . ] ...... ) ....... Height ............... -Niunlbcr of Sto~es .......... ~ . ,Depth .... '. ....... ' Dat¢orP*rc ase . . I ~ .................. Depth ..~,~ ......... ' ' ', .................... t~ame of Fom~er Owner .......... f . aoa'e or use district n xv ~ ch premises are ' u I s~t ated D e ro sc c , '~ ' ~ ~ . · ' .......................... .... ~,~ p . po d pn,strt.cti~n}~l,.te any Zoning lasv, ordhlance or re~t lation: .. Nan{e of Ow e of nremise~ ~ ¢ ~.~ .... / .~ cas f~Lbejemoved .from premises. o, Arc[utcct ........ . , ., ~ ~ .............. '. · Address ................... Phone No ........... i;" PLOT DIAGRAM Loc~t~ c~i>, =~d distincSy ~l buikli,:gs, whether exis=ing or proposed, and, indicat~ aU set-b~ck dim=ns~on~ ~'ro;.~erty lines. Gh'e s~reet and bIock number or desc~ption according ~o deed, and show street names and indicato whatho tenor or corner lot. ATE 0 , being duly s~vorn, deposes : ' [ (Contrkctor ' , ., , r ~:!, i . , ,~ge,~corporate officer, etc ) .! .T.,,¢~ .mvi, er or owneps and IS duly authorized to per'o~or ' ' ~ , .' . / )phfiaUon tJtat all st te ncnts co ~ai ed i~ t ..... .... nave permrmcd ,the said' work and to na~e and orklw Ibh~o~r~, .... ,'-q ~ ,o -v},ncauon are true tot ebcstof sknowlergeandbelielf, and ~ ' ~r t- ....... tcu u t.le ma nor sot Forth hi tle ap ~licatio '- , ,, · ' ~' ~ort~ to b~/'ore n e riffs~ I n mcd t: ercw~th. ~ j t .:..: ..... ....