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Home My WebLink About10292-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z9735 Date October 30 1979 THIS CERTIFIES that the building ................................................ 770 Elijah..L.a}.le. :..M.a. ,t.t.i.t.u.c..k.,, .?.e.w..Y.o..r.k.. Location of Property l:t[~[ts~, ~}oi ..... Street ............. County Tax Map No. 1000 Section .... 1. 0..8 ..... Block ..... 3. ......... Lot ....5.9. ........... Subdivision..G.r.e.e.n..b.r.i.a.r.. '.A.qr.e..~ ........... Filed Map No..6.6.0.9....Lot No .... .5 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .,July .......... 3, ...., 197..9. pursuant to which Building Permit No. t.0.292.-Z ............. dated J.u.ly. ................... 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 ......... one-family dwelling with attached garage a~d deck. The certificate is issued to Greenbrier Homes Inc. ..................... ...................... of the aforesaid building. Robert A, Villa Suffolk County Department of Health Approval .Qq.tP.b.e..r..2.9. ~ . .1.9.7..9.. 89.2. ... ~.9.-~ 5..0.-.5.8. ..... UNDERWRITERS CERTIFICATE NO...~..4.5.3.1,.* .9 .... , ................ .._/ ........... / Rev 4/79 NOTE: Installation of wood-burning stove must meet all fire standards applicable to installation. Amended to include deck & garage on 8/12/88. safety FORM NO. 2 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? 10292 Z Permission is hereby granted to: ....~.~..4~z~...~L..- ......................... ............. to ........ (~. ~..~Z~.~Z......~z~.~.......~.,c~ ...~....~,~.Z ./z ................................. ................................................................. zz ........ . , / ,~'~ .......................... *Z ....................... ~ .................. at premises located at .~...~..~.~.?...~.~...~..4~..~.~...~.../~..-~..~./3.~.~`~'~'~ ,~..'~-~...~Z~.~.~ ....................... :.....: .......... ~.~ ............ ~.::- .......... ~ ............... ~ ............. ~...~..-.'.zz ............. ....... ......... ..-.. ......... ~/.......~. .................. pursuant to application dated ................. ~ ........ ~ ...................... , 19..Z.~,~and approved by the Building Inspector. Fee $.., .~..~.....~ .-J. .... FORM NO. 6 TOWN OF SOUTHOLD 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 6r 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 .......... ./ New Building ............. Old or Pre-existing Building ............ Vacant I.and Lo0at~on of Property ..'7. ?~.. ~¢?./.~.r.~.d...~.~. ~'~ ......... .~.~ r-.r× .r.~..~./.¥...~.. House No. Street Hamlet GREEHBRI R ttO ES lNG. Owner or Owners of Property ............................................................ County Tax Map No. ~eee Section .... /..~.¢:. ....... Bloc~ .... ~ ......... Cot... ~.~ ......... Subdivision. ~.~'~'~/.~.~.. ,/~..'/?.~.'~.~.' ........ Map No....~,~.' .O?. ...... Lot No.., ~.'~ ......... Permit No./.~.~,~,'..~.. Date of Permit ?~..&l?.~, ..Applicant G~[[~B~!~R Ho~rcs ~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ..................... Plann ng Board Approval ...................... Request for Temporary Certificate Final Certificate Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Appl /. GREHBRIAR HOME . ............. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY Ocl:ober 17 1 19~JOHN STREET. NEW YORK, I~E~'~K 1OO3S THIS CE~IFIES THAT [] 2nd FI. Section Block and found to be in compliance with the requirements of this Board. X DRYERS FURNACE MOTORS FUTURE AEqqJANCE FEEDERS AMT, K.W. O~L H.P. GAS H.P. '~ AMT. NO. A.W.G. TIMEOOCKS BELL UNIT HEATERS MULTI4FUTI-~T SYSTEMS AMT. AMP~. TR;~TNS.HO. OF FEET V I C 5 RAHGES ~ECIAL REC'P1 SERVICE O~SCONNECT IO. Of S NO. OF CC. COND. A.W.G. NO. OF HI-LEG ~t~e~-~eeea heaters: 3-2.0, 3-1.5, 5-1.0, 3-.75, 2-SKNs. GFZ smoke deteators Future Appliance Feedera: 1-2~12, 2-3~10, 1-3#6. EXHAUST FANS D~MMERS Joseph Crocombe Box 1175 Center Moriches,N.Y. 11934 lie. 746E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors be identified credentials. COPY FOR DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY lJl'OJl,~ l~i'O. ! TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. ::::::::::::::::::::::: ..... Disapproved o/c ..................... .~..~..~/..~;;~.,....~.... ............................ ?,:;~.~.......~./ {Bu~ldi~ Inspector) APPLICATION FOR BUILDING PERMIT Date ............ INSTRUCTIONS o. 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 t? schedule. b. Plot plan showing location of iot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and 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 premises and ir~ buildings on for necessary in~ections. ........... ~7 ' (Signature of applicant, or name,~/'a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... .......................................................... : ........................................................................ Name of owner of premises ...... ..................................................... If oppligant/is a corporate, s~g~natcJ~,'~//" ,'~_ of duly a~thorized officer. ....... (Name and title of corporate ~ficer) Builder's License No ..................................................... Plumber's License No ......... ~,../,..~......'~.,..~.., ................ Electrician's License No ..... .~....~....~.....,~.~.~.. ................ Other Trade's License No ............................................... Locot,on of land on wh,ch ro osed work w, II be done Ma No ('~' ~... Lot · ' p .p ' . p .: ...................................... IN ......................... Street and Number ....--" ~ -- -- ---- ..~'./..,~......~....~.i./....~//~..~.~.......~.~...~..~'..~ ....... ~..~Z..~./....~....c~......~. ...................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... .,~/.~,~.~,,~...~.O...~,.., ...... ,. ............................................................ b. Intended useandoccupancy .~..~,~;..~...~..r.~ ~'~/~'~/ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ..... .~.~..,~¢'~4...~....~....O.. ...................... Fee .~..,.....~....~.....'~...,?:.. .......................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~...,~...,..~.. ....... Number of dwelling units on each floor ............................ garage, aumber of aais ............... ....................... : ....................................................................................... 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or'additions: Front ....................................Rear ............................ De th ................................ Height ............................ Number of Stories .................. ,.., ........... ~ , 8. D'mens~ons' of entire new construction. Front ..~T...~..,. .......... C~' Rear ... ~..~, Depth .~... .o... Height ............... ~/,..~....~.../ .N..~..m. ~ ~ i?. ~ .~.~,.S;~ ~: ................................................... ~ , ................................................................... 9. Size of I~t:Front ................. '"""... Rear .......... ,~.."X~...Z../.. ............... Depth .....~..../....'~....~ ............. 10. Date of Purchase ............... /(.~...?..~.. ........................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ ~..../~..~.~..~...~-.~-. ........................................................... t2. Does proposed construction violate any zoning law, ordinance or regulation: ......... ,,,~, O.. ...................................... 13. Will lot be regraded. ...... ..~.....~.. .......... Will excess fill be removed from premises: ( ) Yes ~ No 14. Name of Owner of premises ....~.~.l../~....~.0...~...l~.......~l...~.:""r"'"'"''" ,,~,re ~,m ...... Address ....~.~....~...~..~...... Phone No. Name of Architect ...~.,."~..../..~....~..'(..'~....'~...~...~..~.~. .............. Address ...~.~..~.~...~....~..~.....~one No.~...~....~..~...~.~'.~ ............................................................ :~-~ --/~-~ ~ ,om~ of Contro~tor GREENBRIAR HOMES INC. Address ..,,~?~.-~....~.~...~.. ...... Phone No. ~ .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shaw street names and indicate whether interior or corner lot. ¢'I'ATE OF NEW¥OR~,~ ~OUNTY OF ...~.~4'.e~..'~.......J~'' ..... .'.~....~..~'..~...~,,.......~...:.~.~....~...~.%....~ .................. be ng duly sworn, deposes and says that he is the applicant (Name of individual signing contracO above named. He is the ..... ~~.~ ...................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 that the work will be performed Jn the manner set fo~h in the application Sw~to ~fore me this ...... ....... .......... z~~~~ ~/ (Signature of applicant) ~ ~, ~,4 I/V Lot bo! HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ~ NEAREST WATER I~AIH~:.MI, ~ N SOURCE OF WATER, pRIVATE J~."PUBLIC RSUFFCO. TAXMAP OlST?ooo SECTION/~'~' IILOCK-~-LOT ~.9 ~-THEf~ ARE NO DWELLINGS WITHIN IO0 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON N THE WATER SUPPLY AND SEWAGE DISPOSAL SYS EM FOR THIS R $1DENCE WILLCONFORId TO THE STAN~RDS O~ THE SUFF LK COUNTY A TMENT ~0~: S~A/W~/ON ~ F/L~ /~ ~NE ~/~ O~ ~N~ ROAD ( A/YS. fi'/e 25) SURVEY ',FOR GREENBRIAt? HOI~ES , /NC. LOT IVO. § . Gt?EEtVBRIAR ACRES ' A? MATTITUCK TOWN OF SOUTHOLD suFFOLK COUNTy, NEW YORK DATE: SCALE: NO. OCi~ 24, 1979 AUG. 27, 1979 JUNE 5, 1979 I" = 40 79 - $1~ ~ UNAUT, HOR~,IZED ALTERAtIOR OR ADDITION TO THIS GUARANTEED TO SURVEY: IS · VIOLATION O~SECTION 7209 OF THE NEW YORK STATE EOUCA r~gN LA w US£1FE TITLEINSURANC6 TO AOOItlONAL INSTITUTI~S OR SUBSEQUENT / OWNERS / I , I/ YOUNG a YOUNG DEN W YOUNG, PROFESSIONAL ENGINEER Lot .ft. 4 LOt M,~ IN SUFFOLK COUNTY DEPARTMENT Of: HEALTH SERVICES FOR ArP~OVAL OF CONSTRUCTION ONLY OF ~UFFOLK COUNTY ON OCK ~ 1977 ~ ~PNO. ROp D ( N. yS. R/e ~5 ) SURVEY FOR AT MATT/TUCK OATE. dUN£ 5, 1979 TOWN OF' SOUTHOID SCALE /" = 40' SUF~)LLK COUNTY~ NEW YORK NO 79 -$16 ~GNAUTH~R1ZED ALTERATION OR ADD~TIO~ ~CO~ES ~ TH~S SUrVeY HOT BEARING THE LANO SU~V~S ~KEO SEAL OR~BOSS~ S~L SH4~C MENTAL AOENCY ANO'L[~O~N6 ~NS~TUTmON OSTEO INSTIT,UTI~, GUARANTEES ARE NOT TE~SFERABLE / lB: ) V~I IM~ ~ V~I IMC ~OSTRA~DER,~VENL ~[~ ~ / /UUI~ u /UUI~U RIVERHEAD, NEW YORK ., ~ ~ NYS LICENSE NO 45893 4000STRANO~'~AVENUE ' PEt~,,AIT INCLUDEs Ap'pROVA/, To ,~.E~,~OVE eXCESS FiLL FROM aBOVE PREMISE$~B REGRADING LOT' ,,~ DRIVEWAY CONSTRUCTION CESSPOOL CONSTRUCTION . CEL~R CONSTRUCTION OTHER / / ~ I .! ~ --4 ~ I APPROVED AS NOTED ~E/l~ FLEVAT ON /LEFT SIDE ELEVATIOM/ DATE, '7-~"'~C~ ~ ,< FE E:~~ " NOTIFY BUILDING DEP,~RTMENT AT.' ,' 765-2660 9AM to 4P,¢6 F E L E'~'/~T I O N- -FRONT OR REQUIR. ' "' ED INSPECTIONS: '-- , 1. BEFORE BACKFILLING FOUNDA- TION OR START R~,AMJNG 2. FRAMING INSPECTION: 3. BEFORE CQ~ERING PIP,iS OFANY 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLg ,EOR,.DESli~I ' OR CONSTRUCTION EI~J~OR~;,"~ - S, ALL CONSTRUCTION MUSTJ REQUIREMENTS OF H.Y, r- 5 T 0 $ .$ H I K.I G LE 5 ,, COC. _.HIAR A R C: HtT g ,~t~., bI['ST BB INSTALLED 1'0 CODE PROVISIONS M 9t~'' 9-CD -r '~ 0 U P. I kJ O PLA~-.J' IQ:lo PL '0 f - ,4" ~. t 'Z" woo ~ (1¢5of) 7' o T GL.. __ "/'--/" 7i 7" . ,Two __ 4-"x12," H&ADt.~/ i- ,~'O"x'TO"O,H.TYp~. Dr~i , 9 '-I 0" -- · I. 4"9't 5'-3' "~ 7:~" 2:Eh" ROOM:- ,! I 4'- 10" 30,3~ ,1~ I: D R.O OK4 9~- 0" . B E pl~%N4¢~ u' 9 '- ~O" 7'-T' ~r~ T-7" L. FirST FLOOE P L& N - 5~CONI~ FLOOR. pLAN-