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Home My WebLink About12702-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate 01: Occupancy No. Z12802 Date Sept. 21 84 THIS CERTIFIES that the building... ~.e.~$9~1...D.w.e. 1.1..i.n.~ ........................ Location of Property 260 Great Peconic Bay Blvd. Laurel h i d 'e 'tv'o l ....................... 'S'tie i ............................ Ham/et County Tax Map No. ]000 Section ...1.4..5 ...... Block 02 .Lot P/O 1 Subdivision....~.c.~...u.i.'q.;2..(.m.:[.n. qr.) .......... Filed Map No. 200 .Lot No. "A" conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................April 16 .... 19 81 pursuant to which Building Permit No. 12702 r. dated ......... 0¢.~ .... 2.6 .......... 19 ~.3., 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 ......... Seasonal Dwelling as applied for The certificate is issued to ........D.I.L..L.E.R.,.JOHN C. ..... ...................... of the aforesaid building. Suffolk County Department of Health Approval .... ]~ ~ .-~.qr Q .1 ............................. UNDERWRITERS CERTIFICATE NO ............ Eela~l. ir~g .............................. Rev. 1/81 Building Inspector FOB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12702 Z Permission is hereby granted ~: (~-~ · ..... ............................. .... ~ ...... ,o ....~.:~..~.....~.,~.&...~......~~.....~.:~J-~.%,....~ ............ .~.~.~:~ %,_ ... ~_, . ~" .............. "~' .......... '7",'""~'~ .......... : ...... ~ ......... ~ .... ; ........... Y~ .........'X ......... at premises located at .....~.,,.~...~..~:~(..~'~/~,~..'.,~*......~..~..~......~...~...~,.~.4~.. ...... County Tax Map No. 1000 Section ..................... Block ...................... Lot No ....... 9..0.. .... pursuant to application dated ............ ,~¢_~.~,~1 ...~...I ........................ , 191~;~, and approved by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~-'p, Hcct; 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 featu res. 2.Sworn statement of owner or previous owne~ 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 dwe ing/landuse --Fre-Existing C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C.O. $ 5.00 Date .......................... New Building ............. Old or Pre-existing Building Vacant Land Location of Property ~/26.0. Great Peconic Bay Boulevard, Laurel House No. Street Ham/et Owner or Owners of Property John C. D i 11 e r CountyTax Map No. 1000Section 145 2. P/O 1 ............... Block .............. Lot ................ & "A" SubdivisJon.~D.~U... He. len McNulty (Mino-~)_.A.ppr.~°ved 10/16/80 ...................... rhea t~qap IMO ...... ; .... Lot No ........... PermitNo..~.7. Q;~.7.. Date of Perm t 10/26/83~ ..... , Lew±s E. Eaetwood Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~-. .................... Construction on above described building and permi~~ S qq and regulations. ~.,.,,~-~-~r ql~ Apphcant ......... ~ I :k~o'~_ ..................... Rev. 10-10-78 FIELD INSFECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY CODE FINAL o~ cdc FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE -'SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ~'~4".,'~..~.... ~Z~.,~.~7'~?O~. ........ .v~..~/~..9..~ ....... PLEASE TAKE NOTICE that your application dated., ~.Z~.. ...... , for permit to const~ct...~g?~C~ . .~ ................................. ;... at House No. Streo~ ~ ~ Hamlet No. ~c00 S~tion . .~.~ ...... ~o~ . .~.~. ....... Lot . ~.. Count~ ~ax Map Subdivision ..... ~.~. ....... Filed Map No ................. Lot No.. ~J..' ........... ... ~-~.~ .... ~-~..~ ~.~...~..~..~~... ~ ......... R¥ 1/80 TOWN OF SOUTHOLD Board of ~ssessors M~In Road Southold, New York 11971 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'~[~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW yORK 10038 THI~ CERTIFIES THAT only the electrical equipment as ~scribed below and introduced by t~ applicant ~omed on the ob~e application number in the p~mlses of in the followlng loc.~ion; ~ Bas~men~ ~ 1st ri. ~ 2nd FL SecHon Block Lot was ~xaminod on and found to be in compliance with the requirements of this Board. 3 i 3 DRYERS IRNACE MOTORS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: .o.% aND oF~¢co.o 2/0 NO, OF HI-LEG A.W.G. NO. OF NEUTRALS A W, G OF HI-LEG OF NEUTRAt GENERAL MANAGER / ~ il This certificate must not be a[tered i~ any manner; return to the office of the Board if !nco[rect. Inspectors may be identified by COPY FOR BUILDING DEPARTMENT. THIS COP'~ ~J ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT . TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×omined ....... Approved ....~...~....~..(~ ...... , ;9.~...~.. Pemit No..J.....~t...~...~.....~r...._~. ....... Disapproved a/c ............................................................................................ Application No ................................. .................................... (Building Inspector) APP'ICATION FOR BreeDING PERMIT ................... i~ .................... ~9 6/ Dote' ' /-'~ /~' ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 diagram which is part of this application. c. The work covered by this application may net 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 permit shall be kept on the premises avs[lable 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 shatl 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 inspections. --'"'[-- // (~tgnature of applicant, or name, if a corporation) .=.=..; (Address of applicant)""//'c/~/''''''- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................. ......................................... an, e o, owner o, pr misL .iiTZ;/" **' iiiii Z Z - ZZZZii ........ Z .......... iii.i ................. Z.....Z If applicant Js a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on whic,~proposed work will be done. Map No.: ..................................................... Lot No ............. Street and Number .....,~,~...~....c~...~../...~....~, ..~../....../~...~.....'..~_.: ....... .,~..~..,.~.....0~...(~.. ............................. ..~..,.,~,,.,~.,.,~.,.;~,.,~.. ................ Municipality 2. State existing use and occupancy of premises,~intended use and occupancy of proposed construction: a Exstn useandoccu anc ,.~.......~?.,~...,/~.'~.,.~.~.. ? ^. __.~..~..~'/~'/~'/~ · g P Y .......... ~ ................................................................................................... b ntended use and occunancv .~~~ ~~ 3. Nature"of work (check which ap'plicable): New Building ....................... Addition ..................... Alteration ............... Repa r .............. RemoVe ...... .Demo t on . Other Work ................................... 4. Estimate~ uost ............................................... ~ee ..~.~ ...................................................................................... (~o be paid on filing thi~ application) 5. If dwelling, number of dwelling~unit~ .................Number of dwelling units on each floor ............... ~ ......................... If garage, number of cars ............................................................................................................................................ 6. If business commercial or mixed occupancy, specify nature and exten~ of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ~Z ' Rear ........................... Depth '. ..................................... , ..................... 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 ................................. , ~. ~ ~. ~ De~th ~' 9. Size of lot: Front ................... ~ .................. Rear .......................................... ~ .................................................. 11, Zone or use district in which p~emises are situated ..................................................................................................... 12. ~oes proposad construction viOlat~ an~ zon[nfl ~aw, ordinance or regulation: ............................................................ 13. Wtll I~t be re~aded ~.~,. ................... (Address) (Phone No.) Name~ of Architect ' ~ /./ t ~ (Address) -- (Phone NO.) (Address) (Phone No,) PLOT DIAGRAM Eocate clearly and distinctl, all buildings, whether existing or proposed, and indicate all set-hack dimensions from property li~es. Give street and b[ocl., number or description according to deed, and show street names and indicate wheth- er interior or corner lot, ,.-. STATE OF NEW YORK, ~ ) COUNTY OF ................ ,.~. ' ..,~..,~,~7/.~.,.,: ............ ) (Name of individual si~ning contract) Heisthe.. ;/~"~'.~.~..'~"'i ..... ..................................................................................... .. ' '" ""r {Contractor, agent, corporate officer, etc.) of said owner or owners, and is du~y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application a~re true to the best of his knowledge and belief; and th~ the wq~k will be performed in the manner ~ ~ .... ~4~r~ ~RIE 'YOUNG set forth in the application filed therewith. ~- 4~5077 ti' ~Uvv,,.~ Q ~L,'~i'ARy PUBLIC. S~te o~ New Yer~ .................................... day of ......... ,..~, ..................... lO ............ Notary Pubhc .......... ~ ........ ..~..~ .~.. ....................... Court y //"~.~.....'.'.'.'.'.'.'.'~..~~~ .................. / oo 0 SURVEYED SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY NTHE~ ARE ~ OWELLI~S WITHIN IO0 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON, WICLC~FORM TO THE STAN~RDS OF THE SUFFOLK COUNTY DEPARTMENT NOtg : ~ = MONUMENT ~ = STAKE WELL(W) SEPTIC TANK ST 8~ CESSPOOLS CPI SHOWN' ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINI~D FROM OTHERS SURVEY FOR ,JO~IA~ C. R/Al_ER AT L /I U, CeEL TOWN OF SOUT/IOLD SUFFOLK COUNTY, NEW YORK 0C77 2/, 1980 DATE, 0C77 2, 1980 SCALE. /" ~- 50' NO. 80 -483 N UNAUTHORIZED ALTERATfON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW YOUNG. 6 !YOUNG ALDEN W. YOUNG~;PR6FESSIONAL ENGINEER AND LAND SURVEYOR N.Y~s[UCENSE NO. 12845 HOWARD W. YOUNG, LAND sURvEYOR N.Y.S. LICENSE N0.4589~ 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK u ,,,, C HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT NOTE : · = MONUk. IENT C~-- STAKE SURVEY FOR JOHN C. DILLER AT L~UR£L TOWN OF SOUTHO£D SUFFOLK COUNTY, NEW YORK ' ,aPR. /4, 1.98/ MAR. 25, /98/ OCF 21, I~0 O,~TE: OC~ 2, 19~0 SCALE: I" ~ 50' ~o. ~0 N UNAUTHORIZED ALTERATION OR ROOITlON TO TI'HS SURVEY IS A VIOLATION OF'SECTION 7209 OF THE NEW YORK STATE EOUCATION LAW YOUNG & YOUNG ALDEN W.¥OUNG~, PROFESSIONAL ENGINE. ER ANO LAND SURVEYOR N.Y.$. LICENSE NO. 12845 HOWARD W YOUNG., LAND SURVE. YOR N*Y~ S. LICENSE N0.45893 400 OSTRANDER AVENUE RIVERNEAD, NEW YORK