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Home My WebLink About10639-zFORM NO. 4 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. ZI0297 Date December 11 ....... 19..80 THIS CERTIFIES that the building ............................................... Location of Property ,..9.95. Glen. C. our.t ........................ .C.u.t..c.h.°.g~3.e .......... ~touee No. Street Hamlet County Tax Map No. 1000 Section ...QS~ ...... Block .. QI .......... Lot .. 010 ........... Subdivision.. Y.:[.8.~. 9..~.l. 13.~.f ............... Filed Map No. 5.0.6.Q...Lot No .... ./4 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~p~.l.. ?fl., ...... , 19 ~30. pursuant to which Building Permit No .... '~ 065.9. Z .......... dated .. ,fiplti~..28, ............... 1980., 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 ......... ....... .P.~. SY.~te. One .F~mily. D~ell.iaqg ....................................... The certificate is issued to ~, ~' i .~.~.~..D..y,n?... ' ....... ~' ' ............ (owner, 'l~ ................. of the aforesaid building. Suffolk County Department of Health Approval 10~S0-56 ~ 2/'I 1/80 Rob~irt ).. Villa UNDERWRITERS CERTIFICATE NO...I~...~.0.'[~..'1 ./4... i~ .,.).../ ............. ..... Build Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPART/~ENT TOWN CLERK'S OFFICE SOUTH'OLD, I~. Y. BUILDING PER/V~IT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10639 Z Permission is hereby granted to: ..... ~.,.~.~.~.~.~....~,.,,~z~...~o~ · ..z~.z~.....~. .~,3....,~....: ....... .../. ....... Fo ..... ~ ~.~. .r'-~ r,z. c ~. . . . . . . . .~,,,~ / /~ ~ ....... ~.,'~ . :. . .o z ~'. . . .~. .,o/,,z. ,¢. ~.'7'. . . ~. . -¢. ,~.. . .... ...... ~,~r,._ ....... ~... . . . .c. . .~. ,~. . . . . . .~. .~ (~,./ ~ ~ .................................................................... at premises located at .~... ...... .~..~.'-~'" .~.../~..~(". -~..~..~-~'"'/' (~/¢~'?' /~ ~ ~'~ ~-,~"~"'~'~'" pursuant to application dated ~.~..(m.....Z/. .................... , 1~...~..., a d pp y Building Inspector. ~...~~ Fee $./,/.,~,..,~,... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apptication 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 ali buildings, property lines, streets, and unusual natural or topographic featu res. 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. ~ ~ ~./.o../.~. Q ........... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Local:ion Of vroperw .............................................. ¢ ....... x', · · House Ne. . .~. .~, /~ ~.~.,.../ / ~z~] Street Hamlet Owner or Owners of Property .... . .~ ./~ .~,,. ,~./.~.~,..4~../~-~4!4~. · .......................... County Tax Map No. 1000 Section 083 Block 01 Lot. 010 Subdivision .¥~.s.~a...~.~.~..~'.~ ................... F,led Map No.. ~. ?,~. ?...Lot No.. ,.~.~ ........ Permit No. ~..~..~..~...~ Date of Permit . . .~.,.~.~.¢.~. .Applicant .... .~../?../'~...~..~....~.~.'~'~..~....~..~.. · Health Dept. Approval , .1.0. ?.~.0.-:~..~..1.2,/..1.1/8.0.,. Labor Dept. Approval Robert A. Villa Underwriters Approval . .N.. 5.0.!8..1./+. ........... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.5.00. ....................... ~ .. ,- _ ,: ~'~ ~. , ~ Construction on above de.r,bed bulld,ng and perm,t~eets ~H ~-¢~Ecodes .n~regulatlo~. . Applicant., ......................................... .... FOUNDATION (~st) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY cope 4. FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ~,~: ~.. ~9~ 8s Jo.. ST.EET, .EW YO.K. ~f.K ,OO~ Date Application No. on file N ~ ,%/~ ~ ~ THIS CERTIFIES THAT ~ ~ only the electrical equipment as described below and introduced by the applicant named on the above application number itt the premises of Walte~~ C. V~'t Dyne, N/S f~l¢~ ~yart~ 4~0' E/O Visga Place Cut~ ...... N v was exa.~itted on ~O~;f~l'~r 24s 1,980 and found to be in compliance w, th tbe requirements of th,s Board. FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS FLUORESCENT DRYERS SYSTEMS NO OF FEET S E R AWG OF CC COND 5OO~M I C AWG OF HI LEG NO OF ~UTRALS AWG Ruland glec. b~ttit~'t;.~ N. Y, 10952 in ~¥ manner, return to the off~ce Board if COPY BUILDI IN ANY April 29~1980 Chet Van Dyne 300 East 40 St. New York~ N.Y, 10016 Windsway Building Corp. 1020 Glen.Road Southhold, N.Y. 11971 Gentlemen: This is to notify the town of $outhhold Building Dept that I will not hold them liable for building my house at Vista Bluff, I will take full responsibilityr at this site. SinoerelY~ ~ /,/ /~5 State of New York ) :SS.: County of New York) Sworn to before me this 30th day of April, 19 80 ROBERT TISCHLER Notary Pubhc, State of New ¥o~ No 30-3989860 Qualified In Nassau County Commission Expires Ma~'o~l 30, ~, 08/t0/80 ZCS IPNMTZZ CBP NYAE~ MGM TDNT CUTCHOGUE NY 17 08-tO Itt~A EST 80UTMOLD BLDG DEPT ATTN GEORGE FISHER MAIN RD DEAR MR FISHER IN REFERENCE TO MY HOUSE BEING BUILT ON GLEN COURT ROAD ! AM ~U!TE CONCERNED ABOUT THE PLACEMENT OF THE SEPTIC TANK DUE TO THE'PROBLEM OF EROSION OF THE CLIFF I FEEL IT SHOULD BE ~ACEO FURTHER FROM THE CLIFF THEREFORE IF YOU APPROVE IT ! FEEL THE TOWN OF $OUTHOLO WILL THEN TAKE FULL RESPONSIBILITY VERY TRULY YOURS CHET VAN DYNE MOMCOMR MGM · TO REPLY BY MAILGRAM, SEE REVERSE SIDE FOR W, ESTERN~ [ ~ '~ UNION'S~TOLL- FREE PHONE NUMBERS · · [JIM (fOLL )-RI:F) 808 257-22~1 (EXI, EF f ifil I~,lE~fit d EHSLY 811[;-632.22 l I ) dIAL WFS{ [:RE] UI~iO~]'S II~]FOIV1ASTER SYSTEE~I D{REG] L¥: ':' ,.. F,qONI I'WX' 0 · 0 0 0 0 0 0 0 0 0 0 ... 9i0470 1212 , · 0 0 0 0 0 0 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL~: 765-1803 Examined .X JS Application No /e,': INSTRUCTIONS a. ~is apphcation must be completely filled in by typewriter or in ink and submitted in t~plicate 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 desc~ption of layout of property must be drown 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 Pe~it. d. Upon ~approv~ of this application, the Building Inspector w~l issue a Building Pe~it 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 Ce~ificate of Occupancy sh~l have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Depa~ment for the issuance of a Building Pe~it 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 ~teratmns, or for remov~ or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~d to admit authorized inspectors on premises and in buildings for necessa~ inspections. ........ (Signature of }p~icant, or nag if a ~poration) ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder. ............... .~ ; 74'k'. ./4-~'.. . ........................................................ Name of owner of premises . ~. ........................................ (as fin the tax roll or latest deed) If app~corporation, signature of,dl~y authorized officer. Builder's License No ....... (}~ ................ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. .... ....................... ....................... House Number Street /Hamlet County Tax Map No. t000 ~,e, ction .... (~J...~..~. ....... Block .... .O..~ ........... Lot...O.(.O. ............ Subdivision . ~r~. ~ ~...~/.'.~.~.(N a~m/~e~ .~. ............ Filed Map No..~..O..~.~. ....... Lot ..¢ ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... -- "' .*'.~./~...(~- ./~.../~.'~'. ............................................... b. Intended use and occupancy ......... ~./~f'& ................................................... I 3. Nature of work (check which applicable): New Building .. ~ .... Addition .......... Alteration .......... Repair Removal ' Demolition Other Work i., ..~///.~ ~ (Description) 4. Estimated Cost ....t.~ ... 9~ ...................... Fee .¥.~ ............................. (to be paid on filing this application) 5. If dwelling, number of dwellingi units ..... ~...M.~..~. ..... Number of dwelling units on each floor ................ If garage, number of cars .... , ..... o.g.~.-~.. ......................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing strnctur~s, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. i .. Height ...................... Number of Stories ...................... 8. Dimensions of ent, i~;e new construction: Front .. I~ 0. ~ ........ Rear ... t~.~. o ....... Depth .,~ ........... Height .... ~} ........ Number of Stones...,,~. ............................................... ... · 9. Size of lot: Front .... /..o .~.. i ............ Rear ....... /. q74.. ........... Depth .. ~. ~. ),~../e .......... 10. Date of Purchase ...].~.,).¢.. I ................... Name of Former Owner . ~.--o. j ~.. .............. 1 1. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ...... &/.tO. ...................... 13. Will lot be regraded ... O/~'~i .......... , ......... Will excess fill be removed from premises;,, __ (~ No 14. Name of Owner of premiSees~q. O1(~0 f~.~.-.r ~./~.~. 07.O.-~'. Address ~o? .~: ~1} ?. ~.../(,{ ~,.. Phone No. ~'~".).. ~'~9 ') .... Name of Ar hltect ............................. Address ................... Phone No ............ Name of Contractor ~],~t~d. . .~.v:/0~. . . Address/.~..J~..~./e.~. .~?~ ...... Phone No. >ac} .:--i~214 .... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, an& 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 YORK, ., being duly sworn, deposes and says that he is the applicant (~a-mc°ne of individual signing co tract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will be performed ~n the man,er set forth m the application filed therewith. Sworn to before me this Z: LICENSED LAND SURVEYORS GREENPORT nEW YOrk SUFFOLK CO. HEALTH DEPT. APP~ROVAL H S NO STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS rESIDENCE WILL CONFORM~T/z~Tt~ ST~ND~.F~DSp OF THE SUFFOLK CQ~D E PT'.~ I~L~H ~VJ CES, sUFFOL~' COUNTY dEP~' OF HEALTH SERVICES FOR APPROVAL Of CONSTRUCTION ONLY -- ~ APPROVED ~ SUffOLkCO TAX MaP DESIGNATION: dlST SECT. BLOCK PCL OWNERS ADDRESS DEED L ~,';~ P TEST HOLE STAMP SEAL ~,~E~RTME~j: OF HEAL,'fM 0 .O %, 6 .0 RgJ~ZqlqK VAN_.,.~YL. P..¢: LIcENsED LAND SUR~'EYORS GREENPORT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAG~ DISPOSAL SYSTEMS FOR THIS RESIDENCE WtLL CONFORM TO THE STANDARDS OF THE: SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: APPROVED: SUFFOLK CO TAX MAP DESIGNATION: DIST. SECT BLOCK PCL. ;'oco o:~"B [ lO OWNERS ADDRESS: , '~,,. ;O0l~ DEED L ~'/~ P. TEST HOLE ° " E L E ",,/'ATIO N~ I I I l~ LLc OND · FL OOR PLA No 3 I D 7_ ' ~. L ~ V A i 0 N