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Home My WebLink About10201-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate Of Occupancy Z16975 Date June 13, 1988 THIS CERTIFIES that the building .... O..n.c..f..a.mj.l.y...d.w.e. 1. 1. .~.n.g. ..................... Location of Property 965 The Strand East Marion h~'~ ~io~ ....................... 's'do3i ....................... h3~/'o~ County Tax Map No. 1000 Section ....3.0. ...... Block .... .2 .......... Lot ..... 7.9. .......... Subdivision ...P.e.b.b. 1. 9..B.e.a..c.h..F.a..r.m.s ........ Filed Map No. 6266 .Lot No. 83 conforms substantially to the Application for Building Permit heretofore filed in this office dated .~.p.r.i..1..2.4. ~, .1.9.7.9. .... pursuant to which Building Permit No...19.2.0. ! .Z ............. dated . . .A.p.r..~.1..2. 5. :..1.9. 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 ......... One farnily d'welling and attached garage. The certificate is issued to ...E.l.e.f.[ .h.e.r.~.a...C... ?. 99.t.e.s.. 5..A.n. ~.e.l.~.k..i..~.r.e.$9.r.~.o.u' ........ (owner, Xt~(~t'~XXXXXX of the aforesaid building. Suffolk County Department of Health Approval ....... 9.-~ .S 9.-.3....A.p.r.i..1..1.7. ,..1.9.7.9. .......... UNDERWRITERS CERTIFICATE NO ............... Iq4...47.7. 1. 3. ........................... PLUMBERS CERTIFICATION DATED: Original C.O. Z9711 N/A Rev 1/81 FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE ,KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10 01 z Permission is hereby granted to: L: ~:x~.~-~ 4~ L~ .C,.-: ............................................ , ...... /~....&... ......... L~..~. ~ ......... t..5 ...... .>.Z~. .......... ~O~.....L ~ ~ tv. . .......................................................................... .~ ~ o ~ ~/ ' at premises located at ...................... ./..~.~4.......1....t. 1..1:. .......... ..'~....%[.?.~...~...*~). .................................... ................................................................................. £~.~.. ......... ,54. ,~.~.~..o...~. .............................. .h. o 7' ~ ~. .... '.b~..~.,~,L~ ....... :~ ~C. O. .U,9 ~. ~.~ E!.~ ~ ../.:~.~. pursuant to application dated ................................ .~...~.~.~.~.......c~...~., 1~.7.~..., and approved by the Building Inspector. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT Towa Clerk's Office SoutltoM, N.Y. Map No, 1;0oo Sectioa :~0 .mock 2 .... Lot ..7~, . P.ebble Bea. c.h. F~ F~No 626~ ~ ~ ..... ~ m ~e ~ for~~t ~~~ Spril 2~ ., 197~ p~nt to ~b ~ ~ ~ 1020~Z ~ll 2~ z~ ~ ap~ p~ ~ ~ ~w. ~ ~y ~or w~ ~ ~ ~ ~ ~ ......... ................. ~. ~ ,~XI~ ........................................ ~ ~t ~ ~h Ap~ .... ~ ..... ~. ~,. ~ ........ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation 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 sewer.a, ge'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 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 Date New Budding .. ,¢..~.. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .?~.? ...... JA~.~. ~/.*'.' .~..~....~...~.~..~.~, ............. ,...;. Owner or Owners of Property ~[~'~..~'. ~..~~'~{..~~¢J. C ountyTaxM~No,,1000Section .'~ .......... Block ...... ,~ ....... L ot..,~¢.,.~, ...... Subdivision./~.~.~'% ~ .... Map No..~ ...... Lot No...g~... Permit No.~ ..... Date ................................ Health Dept. Approval. ~* S¢.-. ~ / ........... Labor Dept. Approval ........................ H / Unde~riters Approval ........................ Planning Board Approval ...................... Reque~ for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~. ;~,, ' ......... Construction on above described building and permit meets all,applieable codes and regulations. A ¢io .t. .... ................... AD D ITtOt,,J /-\ L_ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 "t ' L, 19~.). Permit No/ ( -7 (5 t ~7_ ~ Examined ... Approved ... Disapproved a/c ....... '] .~. · -.~=-:- ....................... APPLICATION FOR BUILDING PERM IT INSTRUCTIONS Application No.././.':~).(! ./i ........ 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 the dia~am 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 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 ~n buildings for necessary~dnspections. (Signature of applicanjf(or name, ifa c~fporation) .. (Mailing address o/f applicant~ State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ................. ........................................................... Nmne of owner of premises g, 4~--g~. '(-~ .~...q. t~r, .4'~0..~:{ ~.O .................................. (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 Trad¢'s License No ...................... 1. Location of land on which proposed~g~.r~i~one O...INc-. ~ ~_p.w~../~.A.~. ..... House Number Street Hamlet County Tax Map No. 1000 Section ........ ~:... ...... Block .~ ......... Lot.. ~. Subdivision. I .,: ......................... : ....... Filed Map No. ~k?. ~. ~ ..... Lot.. ~' -~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~P. U ................................................... b. Intended use and occupancy ..... ~5. ~G~ ................................................ 3. Nature of work (check which applicable): New Building . .~. ..... Addition .......... Alteration .......... Repair .............. Remloval .............. Demolition ... ............ Other Work ............... 4. Estimated Cost... ~.&~2ffff~..~. ........................ Fee ... ~ ''~ ''~ '~ (Description) ! (to be paid on filing this application) 5. If dwelling, number of dwelling units ... ~./~.~- ..... Number of dwelling units on each floor. ~9. M.~. ........ If garage, number of cars .... i .... ~ tM.F~ ........................................................... 6. If business, commercial or mixed occupancy, specify nature and extenti of each type of use '. .... '; ............... 7. Dimensions of existing structures, if any: Front.... ......... -:... Rear .. ~ ........... Depth ~ .............. Height .............. '- ~ Numbet of Stories ................... '-'--- ~ ' ..................................... Dimensions of same structure with alterations or additions: Front ,. i ............. Rear ~... ~ ............ Depth ............ : .......... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ... ~,./ ........ Rea[ .... ~/ ........ Depth .~/.'.-~f ......... Height ...... Ib~.I ...... Number of Stories . .. O ~.~.. ......... ~ ..................................... 9. Size of lot: Front ..... ~ ,~67 ! ......... Rear ... ~.e~t .~7 ./...~ ........ Depth Ac/~ff'~ 7o~'acf. .......... 10. Date of Purchase .......... , ................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ...................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulhtion: ./~. ........................... 13. Will lot be regraded ...... '1~5 .................. Will excess fill! be removed from premises: ~ No 14. Name of Owner of premises ...... A-~'~O~to~. · · Address $.q-~.a4~..Q~T,~2/~a'z~'Phone No.~/g.~.~g~.7... Name of Architect ............................ Address ...... , ............. Phone No ................ Name of Contractor .......................... Address ...... I ............. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block number or description according to de6d, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COU'NTY OF...~.L)~.C-OL.~... S.S ....... .~. 0..t~.C)O t,-)...b<5,.. ~/lr ./:4.L. ~J~ ................. being duly &worn, deposes and says that he is the applicant -- (Name of individual sig~ing contract) above named, i (Contractor, agent, corporate 6fficer, etc.) of said owner or owners, and is duly authorized to perform or have perfgrmed the said work and to make and file this application; that all statements contained in this application are true to th~ best of his knowledge and belief; and that the work will be performed in the mann'er set forth in the application filed ther6with. Sworn to before me this APPt_tCANT ............................ ADDRESS ....................... FEL tn~pected by this deT)artm~$ Op¢° ,~Ut7 8 , 1979 NOTE W = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE II, 1975 AS MAPNO 62~ WA TER SUPP~ Y - PUB£1C WATER YOUNG & YOUNG SURVEY FOR ~. G~OT~S ~ ,4. G/?~GONIOU LOT A/O. 83, "PEBBLE BEACH FAt~MS" EAST MARION ,~ ........ TOWN o~ SOUTHOLD ..... ''' SUFFOLK C(,) N Y ,, ,,, J ............ ,~ /-' //...~ '~,-~-(7 -- - '~' ......... : ...... " t ; I = O0 , : - SEPT/6, 1976