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Home My WebLink About11910-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.1.1.4..4.7 .......... Date ... J. qo¢.a.r.7...2.5 .................. 198..3. THIS CERTIFIES that the 1~rfil-dirrg . J~.QQ.]- .......................................... Location of Property .. 1 72.6.... R.O.W. of£.. Ar.%h.a..mg.m.a,q.u.e..A.y.e.n.u.e. ........ .S.qu..t.hp.J:d... House No. Street Ham/et County Tax Map No. 1000 Section . . . .0 .6.6 ...... Block . .q 2. ........... Lot ... 0..4.5 ........... Subdivision .... B..e.i.x.e..dg.n..E..s .t.a.t.e..s ........ Filed Map No.. 1. 4. 7.2...Lot No...5 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · $ e p.t.e .m.b.e.r.. ~ 2 ....... 19.8.2. pursuant to which Building Permit No.. 1. J pti. 0...g ............ dated ....S.e~.gera~.e.~..1.5 ........... 19 .8.2., 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 ......... ·...c%Fl. ~LTig. E. QUll~. Swimr~i~g..pQO.1 ................................................ The certificate is issued to .... M~r.qNQN..S. ~. ka.M..Q~.T.E ................................... (owner, le,~ee er-terming- of the aforesaid building. Suffolk County Department of Health Approval ...n../.a .................................... UNDERWRITERS CERTIFICATE NO ........... N...5.8.Q2. 0..3 ............................... Building Inspector Rev. 1/81 FOF, I~ NO; ~ TOWN OF $~U :HOLD ~: BUILDING DEPARTMENT TOWN HALL SOUTH'OLD, N~ y. pERMIT BUILDING (THIS PERMIT MUST BE KEPT ON THE PREMISES uNTIL ~ULL COMPLETION OF THE woRK' AUTHORIZED) 1:1910 Z Date ...... j~ ............. , .......................... , ....... Permission is hereby granted to:~--~7~ ~ ~ ,:, · ....... ~.~...~./.....~ ...... ; ......... ~. ......... ~~.~:..- ........ ....i · · ........ , ..~ ........ ~.~.....: .............. ~~~...~....~,Z~.~~f.~ ........... [; p~mise' located o, ...~.Z~.~..[ ...... ~~..~~~....-~[~.-:.. cou,. ~ M~, ~o. ,oo0 ~s.~,o. [ ....... ... ~,% ...~.d. ........ ~o, ~o..~.~ ........ Building 16spector. ~.e ,..?;~ ....... Rev. 6/30/80 Inspecto~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instruotions 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 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 unusua~ natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of anv housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5,00 3. Copv of certificate of occupancy $1.00 Date .,g~f3~/....3~.j../~.~. ........ New Building ,..~4~....~-*. .... Old or Pre-existing Building ............Vacant Land ............. Location of Property., ,/7.. House No. Street Ham/et Owner or O wnars of Property . ............................... County Tax Map No. 1000 Section .... ~.~. ..... Block .... ,~).;~ ....... Lot...~,~-~.~. ...... Subdivision, ,~./X~¢'~ .~...~, ,~.~¢2~.~;~. ........ Filed Map No.../, ~,7..~, .Lot No..45..'~. ........ Permit No. /l ,~,/.~ .... Date of Permit ~,/,~5//~.. ,~.Applicant, Health Dept. Approval .... ./~//A. ................. Labor Dept, Approval , ,, ,A/./~, ................. Underwriters Approval ./~/'~/$'. ~d....~"~.~...~). ~...Planning Board Approval...~. ................ Request for Temporary Certificate ..................... Final Certificate .... ~c-. ................ Fee Submitted $..-,~ ...................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .... ~ .~.~ .... ~ ............. 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 Wpewriter 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposal-IS-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. C, Fees: 1. Certificate of occupancy $5,00 / 2. Certificate of occupancv on pre-existing dwelling/ land 3. Copv of certificate of occupancy $1,00 use--Pre-Existing C.0o $15.00 Vacant land C.O. $ 5.00 Oate . ,H.~.~. 2. ];, ~. ?.8,4. New Building ............. Old or Pre-existing Building . .:~ ......... Vacant [.and ............. Location of Property · .];.7.2/~..A.~:~a.m. qm.a. qq~ .4~'e;~q~ .~gq.~;hq:~ .~(~/.~9~;~; ..................... House No. Street Hamlet Owner or Owners of Property .... H~,gqo. q .~j ~..~a~q~;t;e, ...................................... County Tax Map No. t000 Section ..... 6..~ ........ Block . .~ ............ Lot .... Subdivision..~e.~x. eAqq ?.s.t;a,t~s. ............... Piled Map No. ::L/~7~ ...... Lot No.. ,5 .~0¢~. 7.. Permit No ........... Date of Permit .......... Applicant .M~,gr~qq, A...I~e,I~qz;t;~ ............... Health Dept, Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ..................... Copies of C.O.s (2): Request for Temporary Certificate ..................... Final Certificate ~-l.z[zt7, .~,n,d~ Ai.~4.4t~ ..... Fee Submitted $..2...0,0. ....................... Construction on above described building and ,~f~meets all appl,c(~~t'ons. Rudolph Ho Bruer, attorney for Applicant Rev. 10-10-78 1001071 m THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~J 0~'~Obt~' 30, 1~ 8S JOHN STREET, NEW YORK, I'~t~OO3~ ~.te .~ppli,,.t,o. No. o.~,le N 580203 THiS CERTIFIES THAT only the electrical equipment as described belotv and i~trod~ced by the applicant ~amed on the above application ~utnber ir~ the premises of ~&tgnon La~orte~ pry1;. ~d. on Bay, Bte~[edow Esl;ates, Soutl~ld, ~.Y. FIXTURE FIXTURES OUTLETS SWITCHES INCANDESCENT FLUORESCENT I 2 1 O~side [~ 2nd FI. Section Block Lot and found to be in compliance with the r~quirements of this Board. RANGES OVENS DISH WASHERS EXHAUST E R V C E AWG A. WG OF HI-LEG NO OF NEUTRALS OF NEUTRAL made by a qualified person. G. ~ S.EElec. Box 215 So~thold, N.Y. 11971 Lic. §78-E This cej-ti_fic_gte~ must not be altered in any manner; return to the office of the Board if incqrrect. Inspectoks may be 'heir credentials. COPY THIS ANY MANNER. N~ YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Building 40, SUNY--Room 219 Stony Brook, NY 11794 (516) 751-7900 RE: Permit No. Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore. the permit is amended to authorize: ~s letter is an amendment to the original pe~t and as such, shall be posted at the ~ob site. All other te~m- and conditions remain as written in the original permit, Very truly yours, [ m. Daniel J, Larkin Regional Permit Administrator FIELD~INSP~ECTION ~ QOMMENTS ~ ~ FOUNDATION (~st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: N.~0'20 W<iY'~. - 7t 0 L' N [ ~ ""~ .... ~TO FILTER · BOTTO ~ 2'- 4" S AND '~'~ ~£L~D FOAM ~ET..EEN o-;'b_3C BOND ,---FROM~SKIMMERS / -- SEE TYPICAL ~wALL SECTION FI~.TERonN PUMP ~'-'/"--~- TO RETURNS FROM FILTER PIPING ARRANGEMENT SECTION B-B -T='.'.ELED ~' EACH F C= ~C~CRE~E B~G3K WA ~NOTES.. WA LKS TO AWAy FROM WATER PROPERTy TO 'S~ T LOC,",.. ~EGULATION~ r2 4 4 ' 512 ~B,500 36' E '36~2 8 r2 ~ 4 cC 23 4C 2 :C '2 6 F,BEROLA~' ~ £'ULDED PIECE ,, ,~_~_~ OPTIONAL STEP ...... TYPE I. __'T_Y PI¢'A L__ V,'A L L SECTION ,_ o --r - ~ I_._ '~_, _, ~ , -I ,- - ' OPTIONAL STEP ~ = ~ ~ TYPE 2. : ~ o o FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................ ,19 ... Approved ................ ,19... Permit No ............ Disapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 building for necefisary inspections. (Signature 6f applicant, or narffe, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . P.~/~..fl....~.~. bT.~.g..T./~ ..................................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy../..~_~...~~ .................................................. b. Intended use and occupancy ~ ( 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............... Other Work.. ~"~,~-A~....~.... : (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 ................ If garage, number of cars ........................................................................ 6. If business, comnlercial 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 ...................... Number of Stories ...................... 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. r)ate of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... : ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premisesO~.~.:..A.,q.~. ~fl. 7'/~ ...... Address ................... Phone No ................ Name Of Architect ........................... Address ................... Phone No ................ Name of Contractor . .~.t?.g..~..~ 1./~/~'~..~..,y! ........Address ................... Phone No ............ ..... PLOT DIAGRAM Locate clearly and distinctly ali 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 show street names and indicate whether interior or corner lot. lift STATE OF NEW YORK, COUNTY OF ................. S.S ............................. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign!ng contract) above named. He is the ...................... i ............................. ~ ..................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul$ 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 forth in the application filed therewith. Sworn to before me this ........................ day of. ................... ,19... Notary Public, ................. ................ County (Signature of applicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or.in ink and submittedX, t_.2pii~J.~ to the Buildin~ 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 street: or areas, and giving a detailed ~lescription of layout of property must be drawn on the diagrmn which is part of this appli- cation. 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 per~ni: 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 Occupan% 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 o~ 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 tc admit authorized inspectors on premises and in buildings for necessary inspections. · ....... ..................... ~c~/t~ ( '~ ~p' , or name, if a corporation) t~V[, ' ' , s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises... ,:~fi~-'-, ~-i/~. ~t~e. ~~.~t.~e.d.).~./~..&..~.~. .......... If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ¢./.. Plumber's License No ..... . ./~./~t. ............... Electrician's License No..//~...~..~. ............. · Other Trade's License No ...... : ............. 1. Location of land on which proposed work will be done .................................................. ...... zTz .... ........ .............. House Number Street Hamlet County Tax Map No, 1000 Section ....(~.(,t~ .¢ ........ Block ....(~. ~ .......... Lot..0..~, .~.~ ......... Subdivision. ~).~.].)~-~../~. ~.~J/~F~'.~. Filed Map No.. ,/.d//f.,~.. . Lot..~.. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....~ ~..~...(-~.. b. Intended use and occupancy' l~'./~.~..[ .. . .~...~.l .~../.~....'~. '...z~..-~. ..... 3. Nature of work (check which applicable): New Building .......... Addition .~'~' ...... Alteration .......... Repair .............. Removal .............. Demolition ......... ..... Other Work ............... 0-0 (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 ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specil'y 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 ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Storie~ ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase .............................. Name of Former Owner ...................... ~ ...... I 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded .. ~/.--~. '.; ....... ,...,.~ ....... Will excess fill be removed from premises: ¢.~J~-~) No 14. Name .of Owner of pren{is, es f~2,.¢./2.~...~./) ./u/~..f../~..Address ./~.~'?~.4~..~..~ .~./7. PhoneNo .. ' ..~.~-.'. Name bf Architect ~U'~/~. ~. - . ... Address .. ~.. i~ i i" ' m.~ ~a~' "~ .... PLOT DIAGRAM {J ' Locate clearly and distinctly al! 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 show street names and indicate whether interior or comer lot. STATE OF NE~ YORK 'S.S COUNTY OF~4~'d~.. ,.~.. ' .......... -'.-'.].fi./. ................... being duly sworn, deposes and says that he is the applicant (Nhme of individualtsigning contract) above named. (Contraogr .................... e'tc" ' ' , agent, corporate.officer, . 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 forth in the application filed therewith. Sworn to before me this~ ....................... . ay 19 x, ~ ~.~gnature of applicant) / -FO SUFFOLK CO. HEALTH DE'P~T. ~ro~: I, STATEMENT OF ~r~T, , ~ L...~ .~ vt( Y/ / , · ; THE WATERSUPPLY ANDSEWAGEDi~L SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS. OF' THE ~"~M~~ SUFFOLK CO. DEPT. OF I-IEALTH .5OOT~OLO, bd.'~. (s) APPLN=ANT SUFFOLK COUNTY DEPT. OF ~ALTH ' SERVICES -- FOR APPRO~A~ ~OF~ CO~TRUCTION DATE: ,, , H,. ~, REF. NO., ., , ,,, ~OVED= -~,, , , ~ · , ,, ,~ ,, I SUFFOLK CO. TAX M'A~P c~,l~ -' .<iD -_ ; " : .... · ~ , " & = -~c~t hob ..... , -... OEED: L.~tltt la. ~74: ,. L TEST ~OLE STA~ , ~:TION 7209 OF THE NEW YOPJ( ,- . -' , ,, ~./~:J4~, ~OPIE5 O,~ THIS SURV[Y MAP NOT W~ARiNG ............ ~[HE LAND $[JRVEYOR'$ INKED S~AL OR ' , -{~aee SEAL .... to RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK