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Home My WebLink About10204-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... :~9775. ........ Date 9eeembe=' 6 19 79 THIS CERTIFIES that the building ................................................ Location of Property ~0 ~he G~eellw.Sy. EaS~ 12/ ~ ~s'e 'IV'o: .................................................. Street County Tax Map No. 1000 Section .... .~.0. ..... Block .... .~ .......... Lot Subdivision ?.~.b..b.J..o..B..~.~.o.h...F.8..1~.~. ......... Filed Map No...61~.~.6..Lot No ...... ! .0.8. .... conforms substantially to the Application for Building Permit heretofore fried in this office dated ....... ~la~.. ] ......... 19.7.9 pursuant to which Building Permit No ....... '!.0~.0.~.2; ........ dated .Iialr..5 ..................... 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 ......... ......... Prt.v. ate..fine. Pamil.~. D~elling ....................................... The certificate is issued to Eq~.i'l;tlfl~.~..~ Fe~97.8.~ ~.~.in.$.~ .~.~ .~.o.~..n ~esoola~:ion ................. (owner, ~ .......... of the aforesaid building. Suffolk County Department of Health Approval ..... 9.-~.0~../4.'t .... ~/3./.?9 .................. UNDERWRITERS CERTIFICATE NO ............. ~1..6.~.?.0¢.'I ............................ Building Inspector Rev 4/79 FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT COMPLETIOH OF 'THE WORK AUTHO. R~ZED) N? 1020~ Z Permission is hereby granted to: .... ~.~.,~.~.....~.~...~z~y..,.~e. to ..~.~=..4..~.~.d....,x. ....... ~x.~Z~.....~.~....~r.~ ...~.~x ............... at premises bcoted at .~.....~;..~}~x.~.: .... ~......~Z...~Z¢~f.~. ,...~' , ~. ..... ,.....~.~'z.~.. ~z~.~. ~~ ............................... ~,~n, ,o ~,c~,,o, do,~d ................. ~.Z .......................... . ~Z.~., ~d ~o~d ~ th~ .... ..... ~i~;~[;'i ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy ~ ~o~,-,~: ~,~ :~.~{~ ~o.. ~T.~?, .~W ~o.~, .~W ~.~ ,oo~ THIS ~RTI~IHS THAT Section Block Lot was examined on attd found to be in co,nplia~ce with the requirements of th~s Board. FIXTURE OUTLETS DRYERS IECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS FLUORESCENT SYSTEMS NO OF FEET E R V I NO %~Vo,o 2/0 A W G NO OF HI LEG fned~:~:c~:l~2 12~1~3 10~ I~3 8 C AWG OF HI LEG NO OF NEUTRALS AWG OF NEUTRAL Wa~'Ten Scott El. Co~ Inc. Box 907 L~e Konkonkoma,N~YL t. 1779 'L[c.498 GENF~R~L MANAGER This cerhflcate must not be altered n any,manner return to the office of the Board if'incdrrect Ins~e-t ...... ~.- .~--..z. ~ ~ .[ . , ~J FO~ NO. 6 TOWN OF $OUTHOLD ~ I~uilding Department Town Clerks Office Lot # Southald, 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 Inspector 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 topographm features. 2 Final approval of Health Dept. of water supply and sewerage dlsposal--(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 installations, a certificate of Code comphance 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: l. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn Statement of owner or previous owner as to use, occupancy <~nd condition of buildings. 3 Date of any housing code or safety inspection of buildings or premises, or other pertinent formation 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 Dote November 15th, 1979 New Bqilding ...~ ........... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~/.S the Greenway 240.97' S/O The Strand Owner Or Owners Of Property E.o, uitable Federal Savinqs and Loan Association Subdivision Pebble Beach Farms ,, , 108 ................................................................ Lot mo ............. Block No ............. House No ........... 3..10 PermitNo ..... ~..0..~.0..4. ..... DateOfPermJt.....~.a~...9..t..h..ApplJcant . Klein and £versoll, Inc Health Dept. Approval ............. .9.?..S..0.T.,4..1.; ................ Labor Dept. Approval ................................. Underwriters Approval .............................................. Planning Board 'Approval ............................ Request For Temporary Certificate ........................................ Final Certificate ..... Cer. t4.f.~.cate..0f...0ccupanc~v Fee Submitted $ ........... .5.:..0..0. ................. // . Construction on above described building bio codes end regulations ~ ~ el ~/~a ng~ ~.y,~F~r~ · Sworn to before me this 0nald M. Evers011, President 15 da.-f November, 1979 ................ Y ~ ....................................... (stomp or se~l) Notary Publ~ '~ ....... County / x' yEANETI'[ M. ooMFTOtt N0.52-5774760 , Q~ml~fmd [n suffolk County ~mms~0~ ~res ~rch 30, ~O fl - FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......................................... ]9. Approved ...... ...~..~....?. .................. , 19~.~..f.. Permit No....~..~....~..~a...~... ............ Disapproved a/c ..................... ~ .................. . ............................................. .................................. ......................................................... · ........ ..... ...... Application No...~...~....~[.~....~. ............ APPLICATION FOR BUILDING PERMIT Date ...~a~..~.,..3~.~.~.~ ....................... , 19 ............ INSTRUCTIONS o. 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 dn premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drown on the diagram which is part of this application. c. The work covered by this application may not be commenc, ed before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit ta 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 buildings for necessary ir~mections. ~ F~LL INC. ........ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder. Name of owner of premises ...t~EBB~...~A~H...E.~t~..t. NO~. ............................................................................................... If applicant is a corporate, signature of duly authorized officer. ................... ~.~C.[C ~,...P.E~E~o..~., .......................... (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No...Y.c~J~.Maahanic~l ................ Electrician's License No.~i~w...~r. Lc].~m.~,~., .............. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No. ~r2~. ............................... Lot No ...TO8 .............. Street and Number ................Dhe..Gr.e~nw~c .......................................................................................................... Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: o Exisiting use and occupancy ...... ,~c~,JDand ..................................................................... b. Intended use and occupancy ...... S~t~i'e"F'~'i'i~' ~'~i'~.'~'~'~' ........................................................................... ~. Nature of work (check whichlapplicable): New Building.......X .......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................... .,~/. _ ,o (Description) . 4. Estimated Cost .................................................... rea ..... (to .................. 5. If dwelling, number of dwelli'ng units ........ .1 ................. Number of dwelling units on each floor ..... 1 ..................... If garage, number of cars ............................ 9 .............................................................................................................. 6. If business, commercial or ]mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of ex~stmg structures, if any: Front '"'N'~A' ................. Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................ Dimensions of same structure with alterations or additions: Front ....................................Rear .......................... De'pth ................................ Height ............................ Number of Stories ................................ 8 Dimensions of entire new construction: Front ...~24 ............................ Rear ..~(~.~..~. ................ Depth ...6C).~.8~.~ ........... kleight ...1.8 ............. Numbei of Stories 9. Size of lot: Front ' ............................. .... .'j'.7. · .0.0. ........................................ Rear ............. 7.?.,.0.(~ ................... Depth2~.O'~.2'/.2.90'94' 10. Date of Purchase ................. [ ....................................... Name of Former Owner ........................................................ 11. Zone or use distr~ct in whichlpremises are situated ....... ~..~e,s'icl.~tdk{~ ................................................................... 12. Does proposed construction v!olate any zoning law, ordinance or regulation: ........ N~ ............................................ 0 ' 13. Will lot be regraded ...~ ........................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises~]~BJ~E...~AC~..~.~0,L~.Y.,...~C.... Address~...~L~,o~..~., ..... Phone I Me ~il Name of Architect .$.ero~cl..IAxe~od ................................. Address2Z..5..;~.e~e.Zlow..REhone No2ft3,,4.~Z.B ........ , Hra~ uge N.Y. Nome of Contractor .JC~[.!.~..~)f]B~.0~,,~..I~.(~., ................ Address~.~.6..e.~..~ ..... ~)hone No23;].r:~)0 ........ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot SZA-I'E OF NEW YORK, COUNTY~ OF .~.~...~.~q'..A~.. ............ S S ................. ?.f~t~z:..Klei~ ......................................................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. He is the .................................. ~$de-~es&6e~.¢ .................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and s drily 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 tha~ the work will be performed Jn ~he manner set fo~h in the application filed therewith. Sworn to before me this '~> ~ J 7~ ~ ~ /~ KLEIN ~ ~ERSOLL INC. ...... ............ ....... ................................... MARY R. HENDRICKSON (Signature of applicant) Notary Public, State of New iYork No. 52-45 t ~O38 ~Qualified .3 Suffolk County ' Ce~ffmate F~led m Suffoll~ COunty Commmslon Expires Marc~ ?/HE NO. /09~1- lOB bot ~ 1,01 R~s~t~t~o~ for this location ha~e been lnsp~t~d b'? thts departmont ~d found H~LTH DEPARTMENT- DATA FOR A~PROVAL TO CONSTRUCT ~THERE ARE NO DWELLInGS'WITHIN I0~ FEET OF T~S PRO~TY OTHER THAN THOSE ~HOWN HEREON. ~ THE WAT~ SUPPLY AND SEWAGE DtSPO8~L SYSTEM FOR THIS RESIDENCE WiLL CONFORM TOTHESTANDARDSOFT~E SUFFOLK COUNTY DEPARTMENT OF HEALTH S~RViCES, APPLiCANT~ NO~' ' · ~ MONUM~#~' SUBDIVI$10N M,,4P F/LED IN T~O~FIC~ OP ~ CLERK OP NOV. 15. 197'9 SURV£Y?FOR FR~IVK~ G. VEDDER ~ DOROTHY J. VEDDER LOT NO. lOB ,." PEBBLE BEACH FARMS AT EA~T MARION TOWN~ oF SOUTHO£D suFF~L~ COUNTY, NEW YORK DATE SCALE NO NOV, I$~ 1979 JULY 25t 1979 MAY $0, 1979 APR 26, 1979 OCT. 24, I "= 40' 78 - ~* UNAU~JMO~IZE~) ALTEBAi'~ON OR ADD T~ON TO TM S SURVEY~IS ~ V)OLAT'(ON OF SECTION 7'209 OFTHE ~.~I~EW YOI~'K S~ATE EDUCATmON ~COP{E~ O~CTM)S SURVE~NOT BEARING THE LAND SURVEYOR'~ INKED SEAL ~R EMBOSSED SEAL SHALL NOT 8E ~CO~StDERED TO BEA VAL{D TRUE COPY ~GUARA~E~S INoICATED[~EREON SHALL RUN ONLY THE PEr,SON, FOR WHOM THE SURVEY ~S PEEPARE~, AND ONe'S BEHALF TO THE TITLE COMPANY. GOVERN~ MENTAL~. A~ENCYAND LENDING NST TUT ON LISTED TO ~OD~:T~O~L iNST'TUTIONS O" SUBSEQUENT PU~PbSE A~D ARE NOT ~0 8E USED TO ESTABLISH PROPER~Y ~INES OR FOR ~HE ERECTION OF GUARANTEEO TO. E OUG, PROFESSIONAL ENGINEER AND LAND SURVEYOR NYS LICENSE NO 128,45 HOWARD W YOUNG, LAND SURVEYOR NYS LICENSE NO 4589;5 CO. ,/NC. 400 AVENUE RWERHEAD, NEW YORK SU~gEY FO~ FBAN~ G. VEOD~R ~ DOROTHY d. SUFFOLK COUN~ DEPARTMENT OF HEALTH SERVICES LO~ ~. I0~ ~ "P~BBLE BEACH AT FOR APPROVAL OF CONSTRUCTION ONlY TOWN OF ~0~0~ SCALE' APPROVED ~ ~~ ~ COp~S ~F THIS SURV~Y NOT BEARING THE LAND SU.VE~OmS mN~[O S[~ OR EMBOSSED SEAL SHALL F~NK H~LTH DEPARTMENT-DATA FOR ~PPROVAL TO CONSTRUCT rE[ P~,R9~ ,N FOR WHOM ~HE SURVEY ~S PREPARED, AND O~ HI~ BEHALF TO,HE TITLE COMPANY, GOVERN- OF HEALTH ~ERVtCES .' '~-'~ -~ TO EX;~TI~G STRUCTURES ARE FOR A SPECIFIC [ ' ; ~~ m/,ow,,o w.~ou,e~ ~AND SURVEYOR WTHE~ATION~WELL(W),BE~ICTANK{ST)aC~BP~LS(CP)SHO~HER~ON [~ ;~ ~ N.~S LICENSE NO 45893 ARE FROM EIELD OB~RVATION8 ANO OR D&TA OBTAI~E D FROM OT~ER~, ~ ~