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Home My WebLink About10846-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. , Certificate O~ Occupancy No .... ;Tfi.0 .'45[-;. ...... Date ..... ,,T,~.r~.u..a.r~..~ 3, ............... 19.8.t. THIS CERTIFIES that the building ................................................ Location of Property ..... 5fl.0..-T.h.~; .C,ro~.aw.ey., ............. E.*. ~..M~.~.l.o.n. ,.. N.Y, .. House No. Street Ham/et Connty Tax Map No. 1000 Section . .0.~0. ....... Block . 07 .Lot 105 Subdivision..P.e.b.)]:?. ~.~1.~ ................ Fded Map No. 6966 .Lot No. 38 conforms substantially to the Application for Building Permit heretofore filed in this office dated .....................gUgllst 18~ , 19..8.0pursuant to which Building Permit No ..................... , '108/46 Z dated .... % .u~.nl..~., ,.9.5, ............. 19.8.9, was issued, and conform~ to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is issued is ......... Priv,~te One F,qmily Dwelling The certificate ~s issued to T.G.M. Construction Coz~p. ..................... ?o¥.'~;,~'.Z~') ...................... of the aforesaid building. Suffolk County Department of Health Approval 't0 - 80-~5/4 'I/'t?/8'J Robert ^o Villa UNDERWRITERS CERTIFICATE NO .... .~. ~.Q39.0.8. ' . .............. ........ ~'.~ .~..r. :~..~. ~.: .~4~.4-_~t~.~. .... Building Inspector Rev 4/79 (THIS PERMIT MUST BE KEPT ON 'tritE PRE~IS~-S UNTIL ~ULL COMPLETION OF THE WORK AUTH6RIZED) N? ~0~ Z Date ,,~/~,'-......,,~,, .............. , 1',.,,,~,, Permission is hereby granted to: / ........................................ ~..,.~~...~ ~ .............. ~0 .... ~ ....................................................... ~ ............ ~ ........... ~..~ .................. ? ........................................ Coun~ T~x ~op ~o. 1000 S*ction ..~.~..;..;. BIoek ~ ........... ~t ~o. ~..~ ........ ~ .......... ~ ...... ~ ... '1 ~ d opprov~ by tho pUrsUant to ~pplic*t[on:doted ...... Build, no I~spoctor. Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall · ~}outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-J~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 ownel: 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. Fees: 1. Certificate of occupancy $5.00 / land use 2. Certificate of occupancy on pre-existing d~vv~ling 3. Copy of certificate of occupancy ~ --Pre-Existing C.O. $15,00 Vacant land C.O. $ 5.00 ..... .... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... ;.. '~. &'~£' ~- /Z'~/)~/2/~3 Hou~ No, ~treet Ham/et Owner or Owners of Prope~ .... /~ ~.~...~.~ ~ .~ .......................... CountyTax MapNo. 1000Section .~.~.~.%~... Block .~.~,..~ .... Lot.~.~.~.~.. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. ~pproval ........................ Labor Dept. Approval ........................ Unde~rJters Approval ........................ Planning Board Approval ...................... Request for Tempora~ Certificate ..................... Final Certificate ............... Fee Submitted $ ..................... Construct[on ~n above described building and permit meets all ap~icable c~s an regula ' ns ~ ~0~ . Applicant .... ' .... ~. ~ ..... d. ~~ _ . ...... ........... FROM : Panasonic FAX SYSTEM PHONE NO, ; Mar. FORM NO. 4 TOWN OF SOUTHOLD BUILDING D~PARTMENT Town Clerk's Office Southold, N,Y.. Certificale Of Occupancy No .... ~1.03./*.5 ..... Date .. , ~anua.ry fi. 5, ........... ............... 198~1 THIS CERTIFIES that the building ............................................. · East Location of Property .. ..... 5.'I.Q .~2lq, e. Cro~s.~W~Y., ................ gg¥~-Pg ~. ~.,X, .... , , , ~OU~ NO, ~tree~ H~ml~t Co,inty Tax Map No,'10O0 Section 0~0 .. ,Block O~ .Lot 105 SubdiH~on .~.~ ~ ............ Filed Map No. ~?~ .Lo* No. ~S conf~ms' substanti~ly to ~e App~cation for Building Permit her~ofore filed in ~s office dated A~st 18~ 19 ~pursuant to w~ch Buddin~P~it No, ~0~6 Z dated .... 4~. ~, ............. 19 .~P, w~ issued, and conforms to afl ?[t~ [equiremen*s orthe app~cabl* provisions of the law. ~%e occupancy*for which *his certificate is issued is ....... d T.O.M. Co~st~ction ~o~. ~ow~e~~ o~ ~he a~oresa~d Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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- lions, 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. 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 requ ~red 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. Copv of certificate of occupancy $1,00 ?./ V~ Date ................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~.O?...~'..~..~...~' .~...~....&~..~..~', ....... ~,~,, ,?~,, ,f~, ,~..~.1 ,~..1~. ............ House No, Street Ham/et Owner or Owners of Property'.-. ,~..'..~., .~I~..1~..~ .'~,... ..... .~.. J~.~'~,'. ......................... County Tax Map No. 1000 Section .~,~ ........... Block .,..~. ......... Lot .~.~..~ .......... PermitNo/.O.~.~.~...~... DateofPermit~..~.~/.~?..Apphcant .1~...~'...~. ~,~J'~l'l~- Health Dept. Approval~O......... °~O'~.,............LaborDept.Approval ........................ Underwriters Approval ..~.. ~..~..~.~.~..~. ........ Planning Board Approval ...................... Request for Temporary Certificate. .Final Certificate Fee Submitted $...~.~ ~ Construction on above described building and permit meets all ~ es and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 89 JOHN STREET, NEW YORK, NEW Y~ORK 10038 ~),,te Decerab~r 1~, 1~ 096211 THIS CERTIFIES THAT lice ~.~ve ~ldera, n/~ *me tzcoz~way ~/:o~ cio t,'rescer~c, ~tt~c ~ ~ff~ [] 2nd FI. Section Block Lot 98 and found to be in comphance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS FLUORE$C~NT 14 DRYERS SYSTEMS NO OF FEET E S E OTHER APPARATUS, 1-S~aoke Do~ecCc~ R V ~ C AWG OF CC COND 4 AWG OF HI LEG NO OF NB{TRAL$ AWG OF NEUTRAL Wa~.c,~a Scott Elec. P.O. Box 907 GmNmRAt ~ ~ ~~, N.Y. 11779 ~c. 4~ E 11 This cerfificote must not be oltered in ony monner, return to the off~ce of the Boord m~ Dco¢?ct Inspector} moy be identified by their FOR ,THIS IN ANY MANNER. F~i~LD~ INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL COMMENTS ADDITTONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examine .0~&.~..' ~,~ Z.~..~. ...... 19...~ Approve~..O./-~. Z.'~~. ....... 19 .~.. Permit No./(ff.~...~...~.~ / Disapproved a/c ...... ~--~---~'. ...... .... APPLICATION FOR BUILDING PEBM[T~ Application No..~.~.~...~. ........ 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 th~s 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 Pen-nit 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 apphcable laws, ordinan(es, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necess, ary inspections. ,. ............. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engin~eer, general contractor, electrician, plumber or builder. Name of owner o~premises . .'~. · .~..~ .... ~ ~.~: . .~ ~: ....................................... (as on the tax roll or latest deed) ~. If applicant is a corporation, signature of duly authorized officer. (Name and tiF~ co,orate officer) Builder's L~cense No ......................... Plumber's License No. 7.~.~....~. ............ Electrician's License No. q[ ~...~ ............ Other Trade's License No ...................... ~[ ,tl 1. Location of land on which proposed work will be done~.'.~"z'~. (~,~-~..~.~1~..~..'.~.F~.O...~.~/~ z/l .... ..... ..... .......................... House Number Street Hamlet County Tax Map No. 1000 Section . 3' ~? ........... Block .... ~ .......... Lot. ~.O. J~%~.'. .......... Subdivision ~Jl~.~l~,. ~...~-~.~[7.~. ~,~: ...... Filed Map No. ~.~: .~.~.~. ..... Lo~ ~.~ ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy..q.~,.C-~..',.~.~...'~.' ...... ~.".' .~. .......................................... b. Intended use and occupancy O ~ ~" ~'~'~!/~1) ~" ~J~ '~ ~"' /~ ............ .................................... 3. Nature 0fwork (check which applicable): New Building ~ Addition Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost .............................. Fee .... .~..~. ......................... (to be paid on filing this application) ' 0.~ Number of dwelling units on each floor 5 If dwelling ' ' ' · , number of dwelhng un/~.s ........................ If garage, number of cars ................................... 6. If business, commercial or mixedl occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmctum~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...... . .............. I. Height ....... [! .............. Numbly[ of Stories ........... ~ .......... 8. Dimensi6ns of~ntire new construction: Front .~.~,~1~!'.~ ..... Rear ~'~{.~ .~'[. ..... Depth ~.~i ~ ......... Height '..~...t ....... Number of Stories.. OK[~! ........................ ~,'-' "~ 1 ............... 9. Size of lot: Front . .'~!,~.~ .............. Rear . .7--. ~...'~. .............. Depth .~{I~..-~ .............. 10. Date of Purchase . .J~]~ .~. ~ ................ ~ __ ____Name of Former Owner ............................. 1 1. Zone or use district ~wl~ich Premises are situated..~]~1~.~-~.%~,11~..., .......................... 12. Does proposed construction violate any zoning law, ordinance':: or regulation: .... ~,~ ................... 13. Will lot be regraded . ~,~.,~.. 2 .................. Will excess ill[be remQved from premises:~ Y.es _ ~ 14. Name of Owner of p~remises~...~'~.~..~ ~.. Address"~l~..l~/.~(gt~!~..... Phone No. ~.-.~n~[[ ..... Name of Architect~l]B~.~%'~.~'f; ...... Address ]~.~.~.[./~t,d~"~. ...... Phone No ................ Name of Contractor . ...2.~,~:~ ............. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW' COUNTY ......... q , . being duly sworn, deposes and says that he is the applicant igning co~tr~(ct)r above named. He is the .......... t .................................................. .i ~ , (Contractorl agent, corporate officer, etc.) of said owner or owners, and is dulg 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 in the manner set forth in the application filed therewith. Sworn to before me this . ............. c~./.~....day of .... ,.. ~~ ~...., 19Q~-). Notary ~.~t,blic, ............ .~ .... :'. ~.. ~County NOTARY PUBtIC,~ate of New York No, 52-8125850, Suffolk CoU0~I'~ Term £xl~lies March 3il, 19...~-~ open Spoce Lot 38 AREA=20,776 ~ 66 cROSS SUFFOLK COUNTY DEPARTMENT' OF NEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY HEALTH DEPART M ENT- DATA FOR APPROVAL TO CONSTRUCT * NEAREST WATER MAIN__Mt -+ *X-SOURSE OF WATER, PRIVATE__ PUBLIC ¥~SUFF. CO TAXMAP DISTJooOSECTION .~O BLOCK Z LOT ~'THERE ARE NO DWELLINGSWITHIN I00 F'EET OF THIS PROP~Y OTHER THAN THOSE BHOWN HERF..~I ~ THE WATER RUPPLY AND SEWAGE OIEPOSAL $YSTEM FOR THiS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES W= MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE I1~ 1975 AS FILE NO. 6266. THE LOCATION OF WELL(W),SEPTIC TANK(ST)I~ CESSPOOLS (CP) BHOW1N HEREON AI~E FROM FIELD OBSERVATIONS AND OR DATA OBTAIN£D FROM OT~IERS~ SURVEY, FOR T,G/M CONSTR, UCTION CORP. LOT 38' "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TOWN OF $OUTHOLB SUFFOLA COUNTY, NEW YORK YOUNG YOUNG AND LAND SURVEYOR NY.S LICENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR NYS ~-ICENSE NO 45893 DATE AUG 8, 1980 SCALE 1":40' NO 80 - 407 400I AVENUE RIVERHEAD,NEW YORK JAN 12. AH opon $po¢~ ,¢. Lot ~8 AREA~20,776 $.~' c 'moss TEL,' ~ : MONUi~IEN T m , .~.'t'~.KP. .',-2. SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE I1~ 1~75 ASFILE NO. 6266. ~E ~AT~ WELL~W),SE~IC T~K(S~ a C~SP~S (CP)SHO~ HERE~ ~RE FRpM P~D OB~RVAT ~S ANp OR DATA OBYA ~, E O FRqM, OTHE ~S~t SURVE YC~, FOR MICHAEL GARONE LOT 38 "MAP OF PEBBLE BEACH FARMS" AT E~,ST MARION TOWNr O,F SOUTHOLD SUFFOLK COUNTY, NEW YORK ~UNAU~HO~IZED ALTERATION OR ADO~TION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YO~K ~TATE EDUCATI~NLAW ~ COPIE~ O~ THIS SURVEY NOT SEARING THE LAND SURVEYOR'S NKED SEAL OR EMBOSSED SEAL SHALL NOT SE~CO~StDERED TO SE A VALID TRUE COPY ~GUARANTEES INDICATED,iHEREON SHALL RUN ONLY TO THE P~SO~ FOR WHOM T~E SURVEY IS PREPARED, AND ONiH!S~OEHALF TO THE TITLE COMPANY, GOVERN MENTA[i A~ENCYAND LE~DING INSTITUTION LISTED HERE~[AN'D TO THE ASSIGNEES OF THE LENDING tNSTITUTIO~ GUARANTEES ARE NOT TRANSFERABLE TO ADDtTIO~NAL INSTITUTIONS OR SUBSEQUENT OwN£R~. ~t-DISTA'~N_CE~ SHOWN HEREON FROM PROP~TY LINES TO EX~TIN~ S~RUCTtJRE~S ARE FOR A SPE'CIFIC pUrPOSE A~ND ARE NOT to SE USED TO ESTABLISH PROPEI~T¥ LINES OR FOR ThlE ERECTION OF FENCES YOUNG e, YOUNG ALD~ W. Y~)UNG, PROFESSIONAL ENGINEER ANDiLAND SURVEYOR NYS LICENSE NO 12845 HOWARD W YOUNG, LAND SURVEYOR N.Y. Si~ICENSE NO 45893 JAN. 5, 1981 DEC 19, 1980 DATE ' OCT 17, [980 SCALE I": 40' NO 80-554 GUARANTEED TO* CHICAGO TITLE INSURANCE CO. MICHAEL GARONE Rl¥