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Home My WebLink About10571-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Date AU~S~ 28 19 80 THIS CERTIFIES that the building ................................................ Location of Property 6060 Main Bayview Road, Southold .............. hz,21 z~6.1 County Tax Map No. 1000 Section ...0..7.8 ...... Block /t .Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in th/s office dated .Fehr:uary..27, ...... 19..~l~ursuant to which Building Permit No ....... 1.0.~..7.~..Z. ....... dated .... F.e.¥.ru..a.~... 2...7., .......... 19 .8.0., was issued, and conforms to an of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ....... ?r.i.v.a.t.e..Qn..~TE~.m. $.ly...~.,p.l.l.~..ag. ........................................ The certificate is issued to .... .I:I.e.n..~...dr.,..? .r.o.m.~% .ay ................................... (owner, ~I]~J~D~X. of the aforesaid building. Suffolk County Department of Health Approval .... ~. 97.8.0.-..~9. ............................ UNDERWRITERS CERTIFICATE NO ............ hl .~.8.~.6.2. ~ .............................. Rev 4/79 FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~.EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 10571 Z go¢~ ..... .7. ........... , Permission is hereby granted to: ....... /zb'~ ~.,~/~.~...~.~.~.~..57 ......... ~.c~...zz~ .............................. ........ ~/~.z~.c/~.~.~.~.., ......... · ~o ~.~c~.c~.....~.. .~z~z,~ ...... ~//~G ....................... ..... ~ ......... ~.~.~....~..~~.~ ................. ~ .......................... .............................. ............................................................................................................. ~~...:' --~. Building Inspector, Fee $ ~.,.....f, ........ ~'~'"'"'"""'' ' ~ Building Inspector FORM NO. 6 TOWN OF 8OUTHOLD auUd~ Dqx~m~nt Town Hdl ,~x~thoicl,~ 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 Inepac- tor with the following; for new buildings or new urn: 1. Final ~urvey of property with accurate location of all buildings, property line% ~ ~nd unumal natural or topographic feature~ 2. Final approval of Health Dept. of water supply and sewerage d~.mpoml-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Undmwritm~ 4. Commercial buildings, Industrial buildings, Multiple Re~ioncas and similar buildings and in~alla- tions, a certificate of Code c~mpliance from the Amhitact or Engineer reepomible for the buiMing. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1967), Non-conforming uses, or buildings and "pra-mdsting" 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 buildingl. 3. Date of any housing code or safety inR~ction of building~ or premises, or other pertinent informa- tion required to prepare a certificate. C. Feas: 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~u, gU~.'c..4 ,. ,~9.~9 .......... New Building .~c~. ×. .. ........ Old or Pra-existing Building ........... . Vacant Land ............. Location of Property 6060 Main Bavview Rq~d $oytt~o~d N,~ House No. ,S'treat Hamlet Owner or Owners of Property.H.enry ..... .~,...T..~.e.m.b.~..~.y ....................................... . County Tax Map No. 1000 Section ....0.7.8. ........ Block .. ,4. ........... Lot ?.~.c., .4.4.:~......46.1 Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. 10571 Z Date of Permit .2/.2..7~'.8.0..AppliCant Inland Ho.m.e.s.a.~n.c, 7/.2.8/..80 .- .IO.-S.O.-.1.O Dapt App ~/.~ Health Dept. Approval .............. Labor . roval .................... Underwriters Approval. .7/22./89.... . .-..~.4.8.6...6.2.~...Planning Board Approval ...y.e. ? ................ Request for Temporary Certificate r~ Final Certificate Yes Fee Submitted $ .5;.0.0. ........................ Construction on above described building ~~ and it mas all epplica codes and regulations. Applicant .............................. ~~ Rober~ E. Hil~z~- Inl~d Homes~ In . FIELD INSPECTION COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (en ) INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY J~ [..~R SE, JOHN STREET, NEW YORK, NEW YpRK 10038 THIS CERTIFIES THAT only the electrical equipment as described belo~ and introduced by the applicant ~m~d on the above application nu~nber in the premlses of ~.,~..,,,..do. ..1'~1y 17, 1980 and fouad to be i,, compl,ance w,th the requ~rements of this noard. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 18 22 18 DRYERS SYSTEMS NO. OF FEET E E R OTHER APPARATUS V I C w G NO OF NEUTRALS A W G NO OF HI-tEG OFA HI LEG OF NEUTRAL /0 Richard Relyea Yotv~gs Pt. /I%0. Box 372 Laurel, M Y. 11948 Lie. 2148 E FOR THIS IN ANY NEW YORK STATE DEPART~2NT OF ENVIROI~ENTAL CONSERVATION Regulatory Affairs Building 40, S~Y Stony Brook, NY 11794 15t6) 751-7900 Robert F. Flacke Commissioner COPY OF TRIS ~U_~T~_,.O?_IZAT~ON MUS_T_~BE A~VAILA~_LE ON P. ROJECT S~TE Mr. & Mrs. Henry Tremblay 22 M~rlboro Dr±v~ I-tuntJngton, ~ 11743 TWNL # 15276-0338 TIDAL ~¢ETLA~DS NOTIFICATION LETTER APPROVAL. Dear Mr, & Mrs. Tremblay: This is to inform you that we have reviewed the notification letter (or permit application) ~iled on 1/30/ !9 80 and have determined that it will not ba necessary to file a permit application (or secure a tidal wetlands permit) to cons~uct a one family c~mll±Dp on lots 44.1 and 46.1 of District 1000, SectLon 78~ Block 4~ on~Z~iD Ba_~±ewRoad, ~7~gNec2{, ~bwnof Southold, Suffo~ C~unty~ ~PI. Assuming you have obtained all other necessary permits, you may proceed with your project adher~n~ to the special condigions (if amy) found oz~ this letter~ and septic syskem a~e to be at ~st 100' frc~ mean high water .mark, Regioaal Permi~ Administrator ............. Data Issued Expira~io~ cc: U.S. Army Corps of Enstneers NYSDEC Law Enforcement - Region TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19.. [.~... Perm,t No...../....d.. Z. Application No..(...~.Z../.. ............ Disapproved a/c ........ ~ ............................ ",>n ................................................. .......................... : ......... ...... .................. : .................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by ~pewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according f0 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 ofpraperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commence4J before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl 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 necessary inspections. IL~T~NO IIOivl}~S~ INC. (Signature of applicant, or name, if 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 ....}:'S?.~;;r2/....~[.'....??..?;?.~?..'[.'.a.~.~ ....................................................................................................... If applicant ~s a corporate, signature of duly authorized officer. ....... ~Zob. ez.~....l~ ~..,LLi.].Zz...=..~?.t: f¢.~ ........................... (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. 5]7-? Electrician's License No. Other Trade's License No. :; ............................................ Location of land on which proposed work will be done. Map No .......................................... Lot No .......................... Street and Number .J'.4~.~..rL. f;)~CV..:!¥~.w...T..~..o..a..d..,....:.o..~.z.~t.~..o..]..L[~...N...,.~., ................................................................. Municipality State existing use and occupancy of premises and infended use and occupancy of proposed construction: a. Exisiting use and occupancy Vacaz~t ] T,'a ' ~ ,,,~x~- b. Intended use and occupancy ........... u...':] ....... ~..z..];..¥. .......... ~.~.~ ....................................................... 3. Nature of work (check whicE applicable): New Buildmg, ....x.~.x.. ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolmor, .................... Oth~ Work ................................................... ' ~ / ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwel!ing units ;1 .......................... Number of dwelling units on each floor ........................... If g,orage, number of cars , 6. If business, commercial or] mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Nurqber of Stories ................................................................................................................. Dimensions of same structuie with alterations or additions: Front ....................................Rear ........................... Depth ................................ ]Height ........................... Number of Stories ................................ 8. Dimensions of entire new cdnstruction: Front ............ 6.:a ................... Rear 65 Depth ...~.8, ................. Height ....t.[J ............. Number of Stories .......... ~l ......................................................................................................... Rear See ourvey. . .. Depth ...~.f~.~...~.U.~.V.~Y ..... 9. Size of lot: Front ...............! ............................................................................ 10L Dote of Purchase ............... 4 ........................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .................................................................................................... 12, Does proposed construction violate any zoning law, ordinance or regulation: ...,n.,o. ................................................ ' yes l 13. Will' lot be regraded' . ............ l ...............Will excess fill be removed from premises: ( ) Yes (×) No ~ . : Henry J. Trembla. y 14, Name of owner ox premises '"i ................; ............................... Address ................................ Phone No ....................... Name of Architect ............ ~ ............................................... Address ................................ Phon* No ....................... Nome of Controctor Inland Homes, Inc .... Bo.~ ]17 a~.tt~l¢ ,. 298-9606 ........................................................... /~odress ................................ t'none mo..; ........... ; ........ PLOT DIAGRAM Locate clearly and distinctly 611 buildings whether existing or proposed and indicate all set-back dimensions from property lines. Give street b ack number or description according to deed, and show street names and indicate whelher interior or corner lot SI'ATE OF NEW YORK, ~tobert E, Hiltz ........................................................ i ........................................ being duly sworn, deposes and soys that he is the applJcam (Nome of individual sJ~nJng c~nt~ocf) above nemed. (Contractor, agent, corporate officer, etc.) of said owner or owners and is d~uly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this app icotion are true to the'best of hfs knowledge and belief; and thor the work will be performed in }he manner set forth in the application filed therewith, Sworn to before me this I ~ ~,.~~-- Inlanct I-[O/TL~nattTaC'of applicant) JUDITH T. TERRY Note%' Public, St'ate of New York gemmissioo E,xp~re¢ March SUFFOLK CO. HEALTH DEPT. APPROVAL /%A' H.S. NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DIS~SAL SYSTE~ FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE .... ~ 117 e ~Jtuck~ N. Y. 1195 .... ~.__ SUFFOLK COUNTY DEPT, OF HEALTH ....... S'ERVICES -- FOR APPROVAL OF ~ CONSTRUETIQN ONLY -- ~ -- ~.' ~ re~'~ b~_ ~T~: ~ , ~ , ..~ ~o~ ~., SUF-~K CO. TAX ~P DES ........ " VAN T~L, SUFFOLK CO. HEALTH DEPT. APPROVAL ~ H.S. NO. THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL ..... ,. r.:~",,~-c.,.~L.,~ . . SUFFOLK COUNTY DEPT. OF HEALTH CONSTRUCTION ONLY DATE: /, VAN TUYL, P.O. B.T.O,~ T~u ES.T. L). ii. ~'oTKL ~:'Ti O,~4,; 2% '7. - ~ES~DENCE OuTDooR / N~I~ ~UJL~G D~P~RT~ENT AT 7~5-T~2 9 ~M TO 4 PM FOR THE 1. ~U~DATIO~,I - ~/0 REQUIRED ~ ~U~D CONCR~E 2, ~C~ - F~MING & PLUMBING ~ F~ - COh~ST~UCTION MUST ~ ~ FOR C. O. A~ ~N~CTION SHALL ME~T ~[ ~g~[~[NTS OF THE N, Y, ~A~ ~DION & ENERGY ~. ~T RESPONSIBLE FOR ~ ~ ~RU~ION ERRORS. 2