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Home My WebLink About11737-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15201 Date January 14, 1987 , THIS CERTIFIES that the building P o o 1 Location of Property 1170 WILLOW TERRACE LANE ORIENT County Tax Map No. 1000 Section 26 ·Block 2 . .Lot 23 Subdivision..¥IL.LOlf. ~rX~RRA£,R ............ Filed Map No...5.4.0.7...Lot No. .4 ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... M..ay..1.8.: . .1.9.8. 2. ...... pursuant to which Building Permit No...! .1.7. 3. .73 ............. dated.....................·..June 22, 1982 .... .,wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Inground pool and fence. The certificate is issued to WILLIAM AND LOUISE SEGALLIS of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO... N579261 PLUMBERS CERTIFICATION DATED: N/A Rev, 1/81 (THIS PERMIT MUST BE KEPT ON AUTH6RIZED) COMPLETION OF THE WORK N°. 11737Z "' .~...~, uo~e ,........~ ................ ~ ........................... , ]9. Permissio~ ~ is hereby groh~ted to: ' .............. .......... ~ ~..,..~..~ ................ ~. ............... ~ . ~ .~ :~.~..,~..... ,~ ? .......... ~: .......... Z~ .. . } ........... ,..:...~.....,..:....L,: ............ ;:¢: ........................................ ................................. - ............... ' " at premises located at ...; ........... ~. / 7 ~ '~2: ~.&~ ............ ...; .................................. ,.~ .......... 7... ... ~ : Coun~ TOx Mop No. ]900 Soctio~ . ~ .~ ~. Lot N0.....-~-~ ......... .. pu~suont ~0 epplicefion doted ...... ~ .......... . .~..,, .. ...... opproved by the Buil~lng I~pector., FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplvicate~o A. This application must be filled in typewriter OR ink, and submitted ,: ~:he Building Inspec- tor with the following; for new buildings or new use: I. 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 survev of p~operty 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 $ 3. Copy of certificate of occupancy $1.00 Date ................. New Building ............. Old or Pre-existin, g B,~uilding ..... ~ .... Vacant Land ............. Location of Property /[. Hou~ No. ' ' Str,~t ......... i~'~ie'~/ Owner or Owners of Property ................................ ~ ~."~0~.-;~-~ Block Lot County Tax Map No, 1000 Section ................................... S~ubdiVisiOn...~;, ......... ;, ...... ., ,'. ,, ,-~, ;,;-Fired MapNo:- v';-;~, ,.; · ;'~,Lot No;,--; :, ;;; v;; ~,, · 7 J ~'~ Dte of Permit Applicant Permit No.. J../. ...... a ...................... ~ ..................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate . ~ ................. Fee Submitted $...-~,-.~! .~. ..................... Construction on above described building and permit meets a~pplicable codes and regulations. ~ ~511l ].001071 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ ~--~ft 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 THIS CERTIFIES THAT only the electrical equipment as describ, ed below and introduced by the applicant nan~ed on the able application nurnber in the premises of William Segallis ,Willow Terrace,Cast $o~th House On Bay, Orient,N.Y. ~.~.~em~,~18~9'~t2F~' [] ~nd ri. O~tside Sec,lo. ,,oc~ Lot in the following location; was eJ~,nined on September ~ 0 , and found to be in complia~ce with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS DRYERS SYSTEMS NO, OF FEET E R V OF CC, COND C OF Hi-LEG NO. OF NEUTRALS AWG OF NEUTRAL 2-G.F.~. ($wimm~n~ Pool) Thi~ certi£icate covers oomplia~ce aC ~he date of inspection only. Because of unusual enviro~en~ l~ ia advisable ~o have frequent ~es~ G&S Elec. ~ox 215. 11971 ANY MANNER, ~E~D INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE BUILDING DEPT, INSPECTION i [ ] FOUNDATION 1ST [ ] ROUGH pL~BG. 'FOUNDATION 2ND [ ] INSULATION ..u.s.,. ] FRAMING ~ [~~, INAL i, FORM ~'JO. 1 ..... F-= SOUT:qOLD BUILDING DEPARTMENT ~=.xmmg use and occupancy, TOWN HALL , ', ',' ,,~',i ~, , '~''- SOUTHOLD, NY,'l'J971 ~"" "' ' ' ' TEL.:765'l~02' Disapproved a/c ...~ , , ,-~ ........ : ............. ;'. ~ ,~ ' ~~ ~ (Building Inspectoi)~( APPLICATION FOR BUILDING PERMIT a. This application ~ust be 'complctcl) filled ih'=by {ypewriter 0r in ink'and submitted in triplicate to the Build Inspector ,with 3 sets of plans, accurate plot plan to scale. Fee accordii~g to ~chcdule. ' ~ b. Plot plan showing location of lot and 'of buildings on premises, r~lationship to adjoining p~mises or public sire o~ areas, and givii~g a detailed description of layout of property mus~ be drawn ou tlze diagram which is part offthis ap' cation. , ' , c. The Work c0vered by this application may not be commenced b{:fore issuance of Building Pe~it. d. Upon apprc.ml of this application,, tile, Building Inspector will i~ue aBuilding Pe~nit to the applicant. Such pen shall be kep~ on the prennses available for mspectmn throughout tim w,ork., ' ~: e. No buioldh~g'~hal] b~ occupied or used in whole or, in pan for a0y purpose whatever until a Cgrtificate of Ccc-par shall have be.n granted b5 th~ Building Inspector,,. ' ,: ' ' APPLICATION IS H~REBY MADE to,~he Bnddlng Department for tg~ issuance ora Building Pe~it pursuant Building Zqne Ordinance of"the Town ~f SOt thOld, Suffolk County, New York, and other applicable Laws, Ordinances Regulat~gm,',for the construction of buildings, additions or alteratiohs, or Dr removal or demolition, as herein descri~ The ~appli~an~'agre~i to comply with all applicable laws, ordinances, building code, housing code, ~d }egulations, ~d admit auth'orizcd inspectors on prenfises and in buildings for necessaw inspections. . . ' (Signature.of applicant, or name, if ~. corporation) .... : ' (Mailing address of applic t) State wheth*r; ~pp!icant is owner, lessee, agent,' architect,).~ngineer}.general contractor, electrician,', p}umber or butte ~ . ; ., ,~ ........ . ...... N~nc of owner 0f prcm~scs ... ...... ..... ' ......... . ' .' e 7 ' (ason the tax rolt or latest deed) If applicant is a corporation, signature of duly attthorized officer.. Bt r censeNo ....... ,..'. · ~ :, .', Plumbe{'~ ~i¢ No .... ''El¢¢t'" ' ~" L' e No' : ' Other TrCd6's Licm~ge o .................... : ,, ~ ,,[ .... , 1. Location':of land on which.propose, J6~. ' Street '.' '? ~' "5' ~ ' Hamlet '; County Tax Map No. 1000 Section ........ ...... .... '/.;...'; mock ... ..... .. Lot'.':, q bdNi ' No~ .... · · · · SU Si Il "' L' ' ' ' ',,' * , ' , ,', (N ) amc . , V, 2. State exJidng use and occupancy of premise*and iatended ney of proposed co;strhc[ion: ' ' ' P: Od~er Wor~ , , , ,, ......... , .... ~,~ ,:,,; ~ ( o be ua ~ on fi n~ this application) fi., Ifdwcllml. munbe~ of dw~lll~'unit~ .. ~ ~..., Number of dwelling units on each floor., ~ ..... 'If garage numberofcars ~ , ' ' ' ~.. If,Susiness,. , , commercial. . 'or;,?i~ix ed, occupancy, specify haft re,, and ~ exD ~t Of cae, ~ type of use .~ ..... h ,Dmlensions orexlstmg stalCtums, ff any: Front ...~ ;...'. ,Rear . .~.~ ...... Depth . ~. '1 ..... H eight ..../.~ .I ..... Ntlm,bcr o f Storie's, , ...... ~,} ..... , .... , -~,. .... . ............................ ... Dimensions of same stmcmm with alterations or additlon~': Front ,?. ;: ek,.....; ..... Rear ~ ..... Depth.. ~ Itei~t .......... ~ ~N robe of Stol ; .... - ................ . ...... ,..?.. u r r es '~ Rea~'(,,,,.~.~ . Depth .~ ~ ~. Dimensions of entir6 ~cw'constructi0n: Front .... ~, .., ............. Height~,~~, ~ . Number of Stories ..... ..,......,.~ .~..;. ... ;,.. ..... ~ ....... , ......... .. 9: SizeofIot~'Front .... .~/~'.,~ . .... ) Re~r~ ;5~.(~J.~...~,.. ~ Depth ../~. /0. Date. drPur6 a~e, ....,,..,,......,~ '~ ..~.." .. :...-N~me'ofFdmmrOwner ~..~.~.~. ~1. Zon~ o'~ usa' district in whidi promises'are s,mated .:' ~, .,~ ~ ~ ~ .., '. ~l.' Does,Proposed consiructi0i~ v~o~te any zoning law ordinance'o? regt iafi0n , ( ....... ~ .... ....... . .... ,~. ,Will lot be re-faded · ' ' Y~ ..Wil!excess fill b~.rem0ved from premises ~ t4. Name of Ow'not of premises ~~/~.'~dr=ss , . . ~'..:,.... ; .. .... Phone No. ), ..... Nam~ or Architect ~~. 1'.,~O.&'...... ~dress~:~ ~. ~.. ~Phone No...: ............ [,.,- ~LOcatecearh'Nnddistnc't :M btiklh, whether~Do. ~ ¢' ' ' "' ;' ' . -; . ; ' · ...:. : ' . . ,, Y ' .'=~, !-0.~.. ;P 9POS~? an~,mmcate ~1 set back ~=ns,ons fro property'i~ngS..~N,e~reet and block number 0x'de~cnptmn acco.rding, to~deeg, 3nd ~how ~treet names and ~ndicate coux~r¥ oP, ,~.~'.,~. ~ ~:~.,, ,'. '. o.o ' c, ",' ' ' ; :, ¢?~'~ J ' ~ bei i rn s S n says that ~ is the applic=n , ':' ,-'(Name_.. 9fmdividual signing contract) . abov.~ named;.? .,..~ ~ ' / , ' ~ '2 ~ '.} .. .... ...,~.,]~,.. smd m~?C, or.oWnCm, and.m d~dy au tli~ Said work and td' n~e and file applicati0n,,~lat ~11 Statemg~ts co~tained [s ~beSt 0fhis kn6Medge and be ief; and that th h~ork >zfll be performed ~n the manner set forth fil tli~:a ~otaw Public, (Si1 of appIica~,