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Home My WebLink About10393-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificafe Of Occupancy June 20 80 Date ................................. 19 ... THIS CERTIFIES that the buildmg ............................................... Location of Property 950 The Crescent House No, Street ~-7 Ham/et .... County Tax Map No. 1000 Section . . .0..~.0 ..... Block ............... Lot ............. Subdivision..P.e.l~.~..1.a..B.e..8.a.h..F..a.r~. ........ Filed Map No ......... Lot No. 26 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .~?.p..t:..~. ........ , 19 7.9. pursuant to which Building Permit No ..... .1.0?.??.Z .......... dated . S..e?.~.....6 .................. 19..7.9, 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 ......... Private One-Family Dwelling with attached garage. Pebble Beach Realty ~ The certificate is issued to ........................................................... (owner, le$$ea or tenant] of the aforesaid building. Suffolk County Department of Health Approval 98076 Nt~81703 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev 4/79 FOI~NI NO. ~ TOWbi OF SOUT8OLD BUILD[biG DEPARTMENT TOWH CLERK'S OFFICE SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10393 Z Date ..... ~ ............ , Permission is hereby granted to: ......... [~.~z~ ...,~ ..:~.~ ...... ~x.....~~..~~ ............................... ~ .............. ~..~ ...... ~.~ .................................................. ~~:~ ...... at premises I~ated at ..~.~....~....~~.~ ........ ~.~~.?.~..-' pursuant to application dated ........................................................ , ]9 ......... and approved by the Building Inspector. Fee $~.~ ...... ...... FORM NO. 6 TOWN OF $OUTHOLD 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 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. Bo 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- t~on required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ~a~ 27th,. 1980 New Building ....... X ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....~5..0...~..~. ¢...C.~'. ~.s.c.~z~ ............................ Ea,s.t House No. Street Hamlet Owner or Owners of Property .... ?~_.e..~.o.~;~.~.. ~.~.~.~:~; .]~8~. ............................ County Tax Map No. 000 Seet on ....0.3.0 ........ B ock ........... Lot .... ..... Subdivision. ?..e.b~.];..e..~.e.a..c~. ?..~ .37~..s .......... Map No ............... Lot No ....... 26 ...... Permit No.~.0.9..3. .Z.... Date of Permit e~.l;.; .-~6.t;.~.Applicant . .~'¢]~.e3.. ~.e. ac~-..~..a~s.,..Inc. ..... Health Dept. Approval . ~.S.O.. 7,6. ............... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ,~ .................... Fee Submitted $..5., 00 ....................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 Applicant...~l~±~.a~d.~,e;3~.so[[~.[~c ...................... 350 Vanderbzlt Motor Parkway Hauppauge, NeW York *Future applzance-' feeders: 1-2 14., ~1 Z 12,1,3 ~07I 1'3~ _ .. -~ ~ .,'::~,.i ....... ',. 2-GFI ' ~ ' .......... ' ........ TOWN OF $OUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned .. ? ^ . ./~./.~i ................................. ~ pplication No ................................ Approved ..+..~.......~.. .............. , 19...~..~.. Permit No..../...~..,,,ff...?,..'~.~. ........... D~sapproved ................................. a/c .............. ::~..;~.~'~'~;...........~:~.~. ~.~ ............. -~ (B,~i Id~g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 oF areas, end 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 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 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 o 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. {.Address o~ oppJi~:ont) 356 Fulton ~venue, urooKmyn, New York State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises ........ Rebble..I)each .F.~tzm~, [.0~; ................................ If applicant is a corporate, signature of duly authorized officer. Jack B. Peters (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No....Y..O~.k....M..e..c...h.a..n..l.'c..a..1. ................ 1577P Electrician's License No ..... Wa~.~.~.$.co. tt.£l.ect~Jc Co. 498 E Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No ....... 1~.;~.6. ........................... Lot No ........ .2..~. ............ Street and Number ...... .T..h..e....C.~.e..s..e..n..'~. .......................................................................... .E..a..s..t...~.a.~,i.,o~..: ..................... \ o -4~ <~.~ O Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction' a Exisiting use and occupancy Vacant Land b. Intended use and occupancy ami.l ..r, es.i. Le c.e, ........................................................... 3. Natgre of work (check which applicable): New Building ........ X ........ Addition ~2..~..~Alteration ................ Repair .................. Removal .................. Demolition.. Other Work .--~. ,..'~.. ........................................ ~ ~ ~ (Description) 4. Estimated Cost .........ZZ,,O0.O ....................................... Fee .......... 7...~). ............. ~ .......................................................... (to be paid on filing this application) 5. Ifidwelling, number of dwelling units ............. .2. ............. Number of dweIling units on each floor ........................... If garage, number of cars ....T. wo..C&~$ ....................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height .............. ~..8. ...... Number of Stories ............... ]. .............................................................................................. D~mensions of same structure with alterations or additions: Front ....................................Rear ........................ Depth ................................ Height ............................ Number of Stories ................................ 8 Dh-nensions of enhre new construchon: Front ....... .~¢.:.~.~ ................... Rear ............................ Depth 30.00 Height 18' Number of Stories 1 88.00" 202 ' 50' 9. Size of lot: Front ................; ....................................... Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....... }te.s.l.rte~.t,.t,~.l ........................................................................ No 12 Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ............ NO ............ Will excess fill be removed from premises: ( ) Yes Brool~l~}~,Nfi.y. 14. Name of Owner of premises ........... Address .......3.,5.,6...F..U..1..t..g.r)..,S,..t"Phone No. 2..1..2..'L8..2..~..'..8,.0..0..0 Name of Architect ........ .a..e...r..o.!..d..,AX.e.!.r..q.d. ........................ Address .... 2/.5 .B.r..qad .H.o.!.!P.~t~' bio ........... "' ~"~'" a ....... 1' Motor Pkway a pp Nome of Contractor ........... I~l.ei.k~..akld..F.v. er. so.).) .............. Address ........ J~.U...~l~lF).q.0~..l~.l F~one No. 23.1-4~ ...... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions frorn 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 NEW YORK, ~./' . its COUNTY OF · ........................................................ ~ ........................................ being duly sworn, deposes and says that he ~s the applicam (Nam'e of individual signing contract9 above named. He is the ............................ .~.,.,~..,._.._. ..... ~.~ ......................................................................................... ~ (Contractor, ~gent, corporate off cer, etc.) of said owner or owners, and is doly authorized to perform or have performed the said work and to make and file this application; that all statemen}s contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the mannar set fo~h in the application filed therewith, Sworn to before me this . ...... .............. , ub ic ..... '~, ', / / (S~gnature of appiicdn~ ..... Nof~ry Pub~ic~tet~ ~ New Yo~k ~ Ce~.'filed in K~ngs ~unfv Y ~ommi~lon ~xp;ras M~rch Ki~J R = 399 O0 ' Lot SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY HEALTH DEP~RTMENT-D~TA FOB ~PPROV~L TO C~STRUC N THEWATEI~ SUPPLY AND SEWAGE OIS .PQ~L SYSTEM FOR THIS RI[SIDENCE WILL CGNFO M TO THE STANI)ARDS OF HE SUFF~K COUNTY DEPARTMENT NOTE ~: MONUMENT O: STAKE SUBDIVISION MAP FILED IN THE OFF/CE OF THE CLERK OFSUFFOLK COUNTY ON dUNE II, 1975 ,~S FILENO 626G SURVEY FOR KLE//V EVERSOLL, //VC. LOI~ NO 26, . PEBBLE BEACH FARMS" AT EI~ST MARION ~OWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK AL~EN W YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y_S LJCENSE NO 128.45 NYs LICENSE NO 45893 OATE SEPT. 4, 1979 SCALE / "= 50' NO 79- 461 AVENUE RIVERHEAD, NEW YORK THE Lot Lot 7 The sewage disposal e~{d water supply facilities for this location hav~ been inspected by this departmont and found HEALTH DEPARTMENT-DATA F,OR APPROVAL TO CONSTRUCT ADDRESS TEL SUBOIVI$10N Mx1p FI/ £D IN TH~' OF, c/CE' OF THE OPSUFFO~K COUNT)' ON JUNE II , 1975 AS £1£ENO 6266 SURVEY FOR MILD/C?ED DZIM/ANI LOT NO. 26, "PEBBLE BEACH FAF?MS" AT EAST M,4F?ION TOWN OF SOUTHOID SUFFOLK coUNTy, NEW YORK DATE JAN $~ 1980 SCALE 1%50' NO 80-52 GUARANTEED TO- CHICAGO TITLE iNSURANCE CO EQUITABLE SAVINGS ~ LOAN ASSN ~ TNE LOC,a,T/(~ OF WELL(W),SEPTIC TANK(ST)~, CESSPOOLS(CP) ~}'IOWN HEREON YOUNG s YOUNG ALDEN W YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y-S UCENSE NO 1284§ HOWARD W, YOUNG~ LAND SURVEYOR NYS LICENSE NO ~§89S AVENUE RIVEF ~D, NEW YORK