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Home My WebLink About11028-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. zJ.0.860 .......... Date ..... .J.a. I1U~.v.y. 2.6 ................ 19.8.2. THIS CERTIFIES that the,building ................................................ 185 Stony Shore Drive Location of Property . .80 ............ W;Lld. Che~.~Y..W~Y ................. SP.u.~h. 9~-.d... House No. Street Hamlet County Tax Map No. 1000 Section 9.52 ........ Block . .0.3 ........... Lot . .0.~9 ............ Subdivision. S.hore..C.P. es.t. ......... , .......Filed Map No. 5.5.~ .4:..Lot No...1.8 .......... conforms substantially to the Application for Building Permit heretofore fried 'in this office dated ... F~.h~.uar.7.. 7 ....... 19 8.1. pursuant to which Building Permit No..'[ 192.8..$ ............ dated ... Fe,h~.uar.y.. / 0 ............ 19 8.1., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupaucy for which this certificate is issued is ......... · .. a..p~. ;[vat, e. o~ao-,fa~t.l¥..d~ml,l.l, ng .......................................... The certificate is issued to .... $al~ak. O~demi~.d J i. & .wife.. ( Sub.an ) '(owner,~t~i~ " ................. af the aforesaid building. Suffolk County Department of Health Approval . .1.1-.$.0.-.04 ,..1./.2. 5/.8.~ ~..R.o.b.e. ?.~..A.:. y.:[.~.l..a UNDERWRITERS CERTIFICATE NO.. .N5322.53 ........................ .~ ............ PeEo Rev. 1/81 Building Inspector (THIS PERMIT MUST BE KEPT ON THE PREN SE~S'UNTIL FbLL COMPLETION OF THE WORK- AUTHORIZED) :'- N? llo2s z [~at. ',.-.~..~.~.~F.....z~ ....... , Permission is hereby granted to: ; : ...... ~ ...... ~ ......... ..... ~.5.~ ...... ,~xzo.~,~ to ....~.q~ ~.....~ .... at p~emises located ~ Builaing I~spector. ~ -~ ' ~ffmlding~ln.ector Rev. 6/30~80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hail Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subr~itted 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. 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. Co 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 New Building .... . .~.. i .,. Old or Pre-existing Building(X);._ ........ ~/Vacant Land ............. ocat on of PropertY..o.;; ' .. Owner or Owners of Property . ~..~dCJ/~. ]~ Q~.,L~ ~_//~/~,, j). J / County Tax Map No. 1000 Section .. ~.,57.~'~. ....... Block .... ~. ......... Lot....c~, ~ ~. ........ Subdivision ..... .~..O./.~ .j~..~.~./.~.~..~.. ....... Filed Map No..,,(.'5-'x~-.~.. ,Lot No....X/..~. ....... ...... ..... Permit No./.[0.~>~,. Date of Permit ,~/0/~.1 .Applicant ..... Health Dept. Approval .... //~.T-~'.~.. :-..~Tff ..... Labor Dept. Approval ...................... ,.. .~.... ~'~'--%~,~,-,q'~,. g B App ' Underwriters Approval ................. Plannin oard roval .................. '' Request for Temporary Certificate ..................... Final Certificate ............ ', v/ Fee Submitted $. ~'~' Construction on above described building and permit"meets all appl~cable~co_des and regulations. o,o,' :- . ..O..¢,..~. c., .............. Applicant ...... ,¢ ...... : ......... . . . . Fm.V~ ~NSPECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME& PLUMBING (2~) INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: ~N 1o0006o THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-6gJ~ as JOHN STREET, NEW YORK, NEW YORK 10038 O.,e A~,~ 2.0, 1981 ~..,~,~. ~o. ~,,~.~ ~algl-~ N 5 3 2 ~ 5 3 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the able application nu~er in the premises of in tbe following location; ~B.sement ~ Ist FI. ~ 2nd FI. Section Block Lot was examined on ~ 17, 1981 ..a fo..d to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 22 30 25 22 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHE~ A~A T US: 1-4,$~ 1 Smoke Detector NO. O~E ND. OF CC, COND, NO OF HI-LEO A, WG OF HI LEG NO OF NEUTRALS 1 AWG, OF NEUTRAL 2/0 Fwd Bars& 356 ~len Dr. ~irlq, N. Y. 11967 L:Lmt2$~5 GENERAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspector~ may be identified by their COPY ~OR BILflLDING O£PART/~I~NT. THIS COPy, OF ~?NOT,~ ~!BEALTER"D IN ANY MANNI~R. DESIGN FOR TRUSS SPANS up to 35' - g" SPACED 2'-j~c. DATE: July 8, 1963 F~U~ NO. PGM- 34 - 5- 55 - N · a -- ' DESIGN LOADING Do not com bbeTypeA& TypeB ~ ~~ j - ess than tnos e,,sfed ...... er L }/4' 5uft JointJ ~1/8,, ~Butt Joint . J 312 (3x4) Grip-Master G-M ' ' ALT~NAT[ JOINT ~ ~ G-~ ~ 1 --: ~ -- ~-1/2" 327 ~ Hemlock~5, - 0' ~1 Equal ar~s J Z 535 30'-8" 31~ C~BER ~/2"AT PANEL POIN[~ 318 26'-4" 23'-0'J LUMBER: M~. 2x4Jop 2x4B~. LUMBER, M~. 2x4 T~ 2x4Btm. LUMBER: Max. 2 ~ 2x4B~ ...................................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined '.~,,,e~cf-...[rY. ..... , 19 .~./' ^pproved ...... 197/. Permit No. f Disapproved a/c ...... ~....~ ........................ ./ (Buildh~g Inspector) APPLICATION FOR BUILDING PERMIT Application No. Z~d~..~:. ~ · .~..~. ..... Date .ff, d;X~. ~ ......... 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 diago'am 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 promises 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 iegulations, and to admit authorized inspectors on promises and in buildings for necessary inspections. .... .-?.c/.4d..--,~R t,..¢:cr.~.$'77../,,~.c.. ............ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. /~.v .r .~.*-.~ X~..~. ............................................................... Name of owner of premises .... .~..' .~c../'/.'~..~ .... ~...~..D. ".F-d?./..~,.,~. d./. ........................................ (as on the tax roll or latest deed) If applicant is a ,ooxb, oi-at~.$igllg.[~of duly authorized officer. ---/~e &nd title of co~;raie officer) Builder's License No ...... ...~..%"... f-~ ........ Plumber's License No.../..d..../.~.~.. ~)&. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..,5/o..~?./.~..tlS?-.. House Number Street Hamlet County Tax Map No. 1000 Section ...rO.~: .~ ........ Block ...~. ............. Lot.. ~ .¢~/. ............ Subdivision ....... ~5'th/.0./.{[ .<g£$.( ............... Filed Map No.. ~"57&.~. ..... Lot. }.~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~?./.~. ,4e'/Zf-. .... .~..'~.4q~. J.). .................................... b. Intended use and occupancy .(-ff .J . J~ . . . [-~J~/D. J ....J~.{~/.~...~/.q.~./.~. ....................... 3. Nature of work (cheek which applicable): New Building J Addition Alteration Repair .............. Remoyal .............. Demolition .............. Other Work ............... ' a ?. ~ e~ o (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 ..... o~..~..c...,,?../~ ....................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each.,tyl~e of use ..................... 7. Dimensions of existing structure~, if any: Front...~ ...... Rear ... ~ ..... Depth . .~ ....... Height: ...~ ...... Number of Stories ...... ~ ............................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth: ................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .. :~.~. ...... Rear ...~..~.. Depth .,,-~..~. ..... Height .... '.~'.~. ....... Number of Stories .... .~..,~d..P-~ .................................... 9. Size of lot: Front ,,., ,,~,.~.~ .......... Rear ..... ~. d.~.. ......... Depth ...~..~.-.~'.. ........... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. 11.: Zone o~ use district in which premises are situated ..................................................... 12. Does proposed construction vlol~tte any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ....... \/. ;~,~ ............... Will excess f!~ll be removed from premises: Yes ~__~ 14. Name of Owner of premises f..4'.. ~.~.t2£~4/,~/).4 [. ~ddress .. ;FOa.~.~,~.. t~..x2.,... Phone No ................ Name of Architect .... .~.... ?..O.T./~/~.~ ....... Address .... f~ ~. ~2g~.-rT'.. Phone No ................ Name of Contractor ... ~' .c~/~'..-:,d. ~/~ ........ Address .... ~7~,,~ . Phone No. 77~. ?.. ~'~... PLOT DIAGRAM .Locate clearly and distinctly all lbuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YDlttK, ,~ ~ ~ : ( ing contract) above named. He is the ..........................~..; ~ .................................................. i ~( (Contrac~ent, co~orate officer, etc.) of said owner or owners, ~d is duly [ut~erform or have peffomed the said work and to m~e ~d file this application; that all statements cont~ne~ this appiication are true to the best ofhi~ knowledge and belief; and that work will be perfomed in the m~n~r set fo~h in the application filed therewith. Sworn to before me this N0taryPu~lic, . ..... ~...~ ..... ~.~.. County ~ NOTARY flUBtlC~tat0 Of flew Ygk -- ~ (Signature of applicant) ~ NO. 52-8125850, Suffolk Co~ Term [xpires March 30, 19~ being duly sworn, deposes and says that he is the applicant LOT ~ ~ D~'~[na~e i -.4 =-. - ,../ .5bOo" t q 40%1" a~% 225 RODERICK VAN TEYL, P.~. GR~ENPORT NEW YORK SUFFOLK CO. HEALTH DEPT APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISFOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK ~.O. DEPT OF Hi~ALTH SERVICES APPLICANT SUFFOLK COUNTY DEPT. of HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY DATE: ".S. REF..O.: APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST: ' SECT; ~ BLOCK - PCL OWNERS ADDRESS: DEED: L ,~/~::~ TEST HOLE STAMP SEAL ' L. OT' 2 L. OT ~ ~T aun-~lll{ COnstl~cfio., la~ -~ SUFFOLK CO. HEALTH DEPT. APPROVAL 333A Calverton. Westhampton Road H.S. NO. CalveKon,, New York 1193.~ __ STATEMENT OF INTENT !~:}~/,,,,/~ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL t(~.r..2..i~.y. CONFORM TO THE STANDARDS OF THE APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL Of ffl'~, ,V CONSTRUCTION ONLY ' DATE: H. S. REF. NO.: APPROVED? · SUFFOLK CO. TAX MAP DESIGNATION: . mST, _s~_ct: · eLQCK POE OWNERS ADDRESS': ~[~ : 40 ~ I l' TEST HOLE STAMP /" ~.~. SEAL .5orv'e.~jed .'via.. 1~, RODERICK VAN TUXL, P.C. LICENSED LAND SUR~YORS GREENPORT NEW YORK LOT [...OT ~ Town c~' Eg:~~, N.Y. SL.J~ FOL~', 'CO ;'iEAL ~ ;-t~jDEPT THE WATER ~d.J~Y AND SEWAGE DIE4~O~AL SYSTEMS FO~ THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF T~ SUFFOLK CO. D~T. ~ ~ALTH ~RVlC~. ~NT ~' ' ' SUFFOLK COUNTY D~PT. OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: · . . H. s. RJr. ~o.: ,//- ,~.,s~ '- 4- .... APPROVED: SUFFOLK CO. TAX MAP' DESIGNATION: DIST. ~CT. llLOCK ~L. DEED: TEST RC)DJrRI(.~K VAN TJ&YL. P.C. LICENM:D LAND $UR'~'Y'ORS GREENPORT N~W YORK SEAL