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Home My WebLink About10973-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date ........ ~g~[.l~ ................. 1~.1.. THIS CERTIFIES that the building ................................................ 1760 The Strand East Mar:Ion, New York Location of Property ............................................................... House No. Street Ham/et County Tax Map No, I000 Section ...0.~lO ...... Block ..... (~ ........ Lot ....... ~.6.Q ...... Subdivision ~'9. b. 1;~..e..B.~. $9.h..F..$¥.mp. ......... Filed Map No ......... Lot No. l, lO .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated November 13 t . pursuant to which Building Permit No, 10973Z dated November 19 80 . ............................ 19..., 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 The certificate is issued to ..... .J 9.a.n...M:..V..o. ,rg.a.~a. .................................... (owner, of the aforesaid building. Suffolk County Department of ttealth Approval . 7/.7./.8. J..1.0.-..S9.-.8.3...~.o.~.?r.% .~. :. ?...E. UNDERWRITERS CERTIFICATE NO ..... N..5~ .2~.2.8. Q .................................... Rev. 1/81 Building Inspector TOW. O~ SO~T.0'~' TOWN HALL SOUTH'OLD, N; Y. (THIS PERMIT MUST BE KEPT ON THE COMPLETION OF THE WORK AUTHORIZED) 10973 Z : ~ISES UNTIL ' !ULL Permission is hereby granted toj. ~ ~, !~ ~ . ., ._ ~ ~.I / '~. t /~_. _ - ~o .. ....... .~.~ ~.~ z.~.~c.~ ........ oz~.~ ....... ~ ~.?~....tC~~c~ ................... ~ ...... ............... .... , ....................................... c~h~ ,~ ~ ~o ~ooo so~t,o~ ..... ~.~.0.~ ..... ~k ~..~. ........... ~b~ Uo..~.~c~ ........... p~r~,o~t to ,pp~,,~t~o~ d,t,a ~.~,~.~ ...... ~.~..., ~¢ ........ , ~d ~pp~o~od by tho Building Ihspector. //~ ~---~_7 Fee ~$../.~.~..~.....x..~,.. :i Build!rig :?nspector Rev. 6/30/80 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 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 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- tion;required to prepare a certificate, C. Fees: I. 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 land ............. Location of Property I '7~O '~'[x~ House No, Street Hamlet Owner or Owners of Property .. ~).~ .~..I ,? .... !,~, !.~. ~ .~. ,~,.,, .~... ~...~.~ ?.~,..~...,., .~,~. ~: ~..~ .~ ~. ~_.. County Tax Map No. 1000 Section O ~ O Block O ~_. Lot .... /. ~ ~'. ...... Subdivision..~ ~. ~. ~.~ ~... ~ ~. ~2;; .... ~.~ .Filed Map No ........... Lot No. Permit ~o. I 0~ ~Date of ~armit ..I.~ .I.~ ...Applicant. .~.. J... ~~... Health Dept. A~proval .'~.i ~ ~ ~. ~ { .Cabot Dept. Approval Unde~riters Approval . ~- 2 ~ ~ ~ ~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ................ Fee Submitted $ ...... Construction on above described building and permit meets all applicable codes and regulations. App cant ..... · ................................. [000434 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THiS CERTIFIE~ THAT onlytheelectr' aleq i mentasde r~be ciera in ~d ed b, t e ~ I~ca nam on~h bo eappl' ti nu~ber~nthepre~ises 030 2 60 ~n the~o~ow~e~g ~ocut~on; ~ Base.~e~t ~ 1st f'l. ~ 2nd FI. Section Block Lot was exa.dned on J~ 2~ , ~ and found to be i~t colnpllance with the requirements of tkis Board, FOC~URE EIXTURES RANGES COOKINGDECKS OYEHS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES INCANDESCENT FLUORESCENT 18 2~ 18 DRYERS MULTI-OUTLET SYSTEMS NO. OF FEET C E Gooc~le ~lec, O[~%C. inc, 11 Th~s certificate must not be ahered ~n uny manner; return to the office of the Board if )ncQrrect. Inspectors may be identif ed by COP~ ~OR B~ILOINe DEPARTMENT. THiS coPy o~ C.E%T,~C~' p~T.~0[~BE~AL~,RED. IN ANY MANN~ : ~ FIE~D I~PECTION FOUNDATION (~st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~.~.O. ~....../. ,~. ....,192.~ Approved ,~?...~..../. ?. ..... 1~.~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No../.0..~..~. ........ Date .[ ['l' ( 3 ........... 19 ~ 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 the diagram 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 in buildings for necessal~ inspections. (Signature of applicant, or name, if a corporation) . t ?. . ¢.,, ¢. po,u'( ¢..& ,. , ,_, , l l (Mailing address of applicant) i I '~ '~ 9 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .~..&.%..~...}.~.,...~..~. ~..~]. *{..tr.~k~. ........................................... las 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. ~ :..L). ( .[~ .~. e.O...rd... ~.~'.0 Electrician's License No. ~..l-J.[. ~....~ ~ .~.~.e..~...~./~ ~ f' Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ~..~..~. ¢. l~.-..~).t.~.c..~...-7/'.~..w.~.,.S ............... ............. 3. .................. .h,., ........................ House Number Street Hamlet County Tax Map No. 1000 Section . .~.: .~..O ........... Block ....~. ............ Lot .... ~.~. ............ Subdivision. ~..~ ¢. ~ ~.*-~.. ~'~ ~ t[e~.~..~ ~..*~..$ ........ Filed Map No ............... Lot.. ! ! .~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of prpposed construction: a. Existing use and occupancy ...... .~..~ .¢2 ...... G~ [q)../. ....... '.. ' ' :: ................. b. Intended use and occupancy .... ~..~. ~1 ~'.t~ .~.~.. %..<,.,....O..~. ~..~ .... ~.~ ~.. ~',.~ r;v...- ............ 3. Nature of work (check which applicable): New Building ...... ~... Addition .......... Alteration .......... Repair. ............. RemOVal .............. Demolition .............. Other Work ............... , .~.(,). ~ .oT.~' (Description) ' 4. Estimated Cost .................... Fee .................................... .(to be paid on filing this application) 5. If dwelling, number of dwelling Units ............... Number of dwelling units on each floor ................ If garage number of cars ~.. ~ .~ [ ~, ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front...~. t} .~..'~. ..... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth .................... :.. Height .............. ; ....... Number of Stories ...................... 8. Dimensions of. entire new construction: Front ,~.'L,~. .~...~..*~.t.u. ,~ .i Rear ............... Depth ............... Height i . ~ .~..'. ........ Number of Stories .... ~ .................................................. Size ofilot: Front . .,. :], ~./, .0.,O.~ ......... Rear....'7..~.~ .I,..t'7(. .......... Depth . .~.{ .~...0.'.~. .......... Date of Purchase . .(~. [ .3..~../. ~.o. .............. Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ......... i ................... Will excess fill be removed from premises: Yes No Name of Owner of praises ..... ~ ............... Address ......... ~ ......... Phone No ................ Name of Architect .??.~.~ .~.. ~. ~?. ~/.% ......... Address 1'.~'.~..z/.O....r,. ~. ~.....Phone $o.~ ~..: ~.~: .7..~.'.7. $' Name Of Contractor ¢.. ~,../~..o?.~.~ ........... Address I.ct .lt. ~ 1 .u~ ~. ~? ~ ~.{.t~hone No.~ .'7 .l, .~.q IL .~..~.. PLOT DIAGRAM Locate cleariy and distinctly all lbuildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether 10. 11. 12. 13. 14. property lines. Give street and block interior or corner lot. STATE OF NEW Y~'RK~ '- S covey OF ' '---'----~u~si~'~~ ...... being duly sworn, deposes and says that he is the applicant abOve named. {,/ He is the ...................... ~ ................................................................... (Contractor, agent, of s~d owner or owners, ~d is du!y authorized to perform or have perfomed the said work and to m~e and file this application; that ~1 statements conthined ~ this application ~e true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner set for~ ~ the application filed therewith. Sworn to before me this ........ Notaw Pub~ .... ~....~~ ........ County { MURI~L TOtMAN, ~Y ~[[1[ ~ ~ ~ ~e~ .... ~ '~ ............... ' ~, ,2.1522~11.$,1l.~ ~ ~(/ . (Signature of applic~t) ,ri 7%o0 SURVEY FOR LO~ 116 "PEBBLE 8EACH ~WN OF ~OUTHOLD SCALE. /"= 50' SUFFOLK COUNTY, NEW YORK ~o. 80- ~E~ ~OR~ STATE E~UCAT~O~ ~W CHICAGO TIT~E I~SUB~NC~ CO, HEA~TH DEPARTMeNT-DATA FOR APPROVAL TO C~ST~UCT ~ ~ H~S ~E~F m ~E ~LE C~, eOV~N- ON JUNE II, 1975 AS FILE NO. a~a. ~/ AND LAND SURVEYOR N Y.S. UCENSE NO. a I/ HOWARD W. YOUNG, LAND SURVEYOR *T~ L~T~ W~L(WI, SEPTtC TANK(STIR CESS~OLS(CP) SN~N HERE~ ~ I~ N.Y S. LICENSE N0.45893 SUFFOUC COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION DATE , HS REF. NO. APPROVED__ C:NL¥ . HF_ALTH OEPARTMENT-OAT~, FOR APPROVAL TO CONSTRU£ T TEL MONUMENT BUBDIVISION MAP FILEB IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY / //,4'".,,? SURVEY FOR JEAN M. VERGARA LOT 116 "PEBBLE BEACH FARMS" AT EAST MAR/ON TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DArE AUG. 12, 1980 SCALE I''= 50' NO EO- 426 YOUNG a YOUNG AL DEN W YOUNG,PROFESSIONAL ANO LAND SURVEYOR N YS HOWARD W YOUNG, LAND SURVEYOR N Y S L~CENSE NO -II AVENUE EW YORK GUARANTEED TO Ct~ICAGO TITLE INSURANCE CO. dEAN M VEtEGARA