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Home My WebLink About11090-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... Z3.0.680 ........ Date ...... S.e. ptemher..1.1 ............ , 19 8.1. THIS CERTIFIES that the building ................................................ Location of Property . t1....0 ,..W., . Of/'..,~ain .Boa.r[ ~ .... O~len.t,. N~,~ ,Yo~k ........... House No. Street Hamlet County Tax Map No. 1000 Section .... 0.1.8. ..... Block ........ .05 .....Lot ...0.0.9.-..2 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated · . Apl'il. 1 .......... , 19 .B.lpursuant to which Building Permit No ...... 1.1.0.[10. Z ........ dated .......... Ap~'i.1. ? .......... 19.81, 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 Dwellin(~ The certificate is issued to ...... J..a.n.e.~...R :..T.a..bp?. .................................... of the aforesaid building. UNDERWRITERS CERTIFICATE NO ...... .N.5.2. 9 .19.3. ................................... Buriding Inspector Rev. 1/81 FOEM~ NO. ~ TOWN ~OF $OUTHOLD BUILDING ~8PARTMI~NT TOWN HALL SOUTHOLD, N!. Y. BUILDING P,ERARIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) , 11090 Z Permission is hereby granted to: ....... .~.~.~.~.....~.~...,l,~.c,-....~ · .~a..~' ././ . ......... ~.~z/.-~-~./.~.&-.....~ ...j .~.. .......... zz:~.~ ~o. ~..7...x/&~...~,..Z.. 2./.~ ..~.~.~..z.~..~.i....~Z,2~,,~.Z..Z'.z.~...~. ......................... ............ ~...,......~ ............ ~~....~..z~..;~.,~. ............. ~ ......... /.... .................. County Tax Map No. 1000 Section ..~..*~.~... ........ Block ...,0.~.~ .......~Lot No....~.~...m...~.. pursuant to application dated ~./...~. ..................... ....., 194, and approved by the BUilding Inspector. Fee $--~.~... ......... Building }Inspector Rev. 6/30~'80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 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 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. 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 9/11/81 Data .......................... New Building .. ~ ........ Old or Pre-existing Building ............ Vacant Land ............. Village Lane Location of Propert~,~.S. R, Qule..Norih .Road. ............. Oriant,. N,Y .................. House No. Street Ham/et Owner or Owners of Property Janet Tabor County Tax Map No. 1000 Section .0:[8 ........... Block . ~5. ............ Lot .... p.t;....(~i..9... Subdiwsion ................................. Filed Map No ........... Lot No .............. / Permit No. ff.~.~.~. . Date of Permg .~gpplicant ............................... Unde~riters Approval. N834174 .... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .~ ........ Construction on ~bove described bu ildin~it meets all applicable c~es and regulations. ~pplican THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equiptnent as ~scrlbed below and i~troduc~ by the appllcattt na~d on $he above application n~mber in the premises of wasexamlnedon ,JO:]5' 23, /9~JJ. and found to beln complianc, withtherequire,nentsofthlsBoa~d. FIXTURE FIXTURES 13 Z7 L~ t3 RANGES COOKING DECKS OVENS DISH WASHERS FANS DRYERS FURNACE MOTORS UTURE APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT S E R V q C OTHER APPARATUS: NO OF CC COND pER ~' A W G NO OF HI-LEG OF CC COND AWG Q~ HI tEO E jNOONEUTRAL$oWG NEUTRAL Th~s certificate must not be altered in any manner, return to the office of the Board if ~nco lic. 214~~g Inspectors may be identl~lec~l~y their credentials. COPY F, OR BU~ILDING OEPAR~TMENT. THIS ~COPY OF CERTIFICAT,E ~/IU~ST NOT BE;ALTERED IN ANY MANNER. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~z~...7..., 19~./. Approved ,. ".. ..,l .Permit No. Disapproved a/c .... __. .... ".~...~ ~/~' ~ '~ (}ilding~nspecto;~ ...... ~"" ~F~ /~f/7~ APPLICATION FOR BUILDING PER~IT [~TEUCT[O~ Application No..ff.( .(~..0 ........ Date_April..1 ........... 19.8.1 a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w~th 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, relationsh,p 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 ~ssuance 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 ~n whole or ~n part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance 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. ..I..Nk,..AI~I..D. HOMES, INC. (Signature of applicant, or name, if a corporation) BOX 117, Mattituck~ N.Y. 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or builder. ..................... G.e..n.e.r.a. 1...Cp.n.t..r .a.c.t. 9 .r .................................................... Name of owner of premises . .J..a.n.et...R.o..T.a..b.o.r. ....................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....... .ap.b.c..r.t ~....H.i.~.t.z. ...................... (Name and title of corporate officer) Builder's License No .... .- ..................... 517-P Plumber's License No ....................... Electrician's License No....2.1.4..8.-.E. ............ Other Trade's License No..H/. I...~.6.3. ............ 1. Location of land on which proposed work will be done..1.5..f.q .o.t..r.i.g.h.t..o..f..w.a?...M.a.i.n...R.o.a.d.: ............ Village Lane, Orient. House Number Street Hamtet County Tax Map No. 1000 Section . . .O..1.8 ............ Block ...5. .............. Lot ................... Subdiwsion ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacant b. Intended use and occupancy 1 Family Dwelling . .~?: .?~, ~,.~ .~.j., ,, ,,, ~, ............... 3. Nature of work (check which applicable): New Building . .x.x. ...... Addition .......... Alteration .......... Repair '. ............. Removal .............. Demolition .............. Other Work ............... ~ ~,--j, c,,~-) (Description) 4. Estimated Cost .$.4.5.~Q0.O.,.O. 0 ......................... Fee .-~....~../... 77. ........................ (to be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor ................ 1' If garage, number of cars ........................................................................ 6. If business, commercial or mixed, occupancy, specify nature and ex,tent of each type of use ..................... 7. Dimensions of existing structures, 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 ...... 4..8 ........ Rear ...,~{I .......... Depth .128 ............ Height 18 Number of Storie~ ~ 1" '., .x.., ......... 9. Size of lot: Front 294 Rear 329 Depth . ~.O.5. 10. Date of Purchase ............................. Name of Former Owner ............................. 1 h Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .n.o. ............................ 13. Will lot be regraded .... ¥.os. ~ .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .J~.D.e.'~. 1~,..Ta. lc.o.r... Address ................... Phone No ................ Name of Architect .......... , ................ Address ................... Phone No ................ Name of Contractor .. ~['o.l.e~rLd~ .H. qm..e~.,..I..rig.,... Address .Bp.x.. 1..17.,..M..a.t.t.:.. Phone N~9..8.-.9.6.9.6. ....... PLOT DIAGRAM Locate clearly and distinctly all .buildings, 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 l?t. STATE OF NEW YORK, COUNTY OF . . . $1af.~O].[<. ..... $.S ............... Robe~;'~ · go..tti.1 .t,a ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) above named· Con~rac~or He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 1St . ~ April .~ 81 · . ~ ..................... oay oI ..................... , iv... Notary Public, ....... SU~fg.o. lk....C~A~..., f.' ....... Co,,-,~'v'--'-""~ ~ I~ $O?FObK OOLrNT'( RT,AT'TH DZPAR?MF-~ ~, SUFFOLK CO. HEALTH DEPT. A~ROVAL The sewa&o d~poaal and ~a~er suppl~ I. facilities for this location have been ~nspeeted by this de~me~t mid found [ -. ' ,~ STATEMENT OF INTENT Chief of General Engineerin, " d~[~' 7-- ~. ~ ~ O~ I THE WATER SU~Y AND SEWAGE D,S~AL Settees ' ~ SYSTEMS F~ THIS RESIDENCE WILL ~ ~ ............. SUFFOL~ COUNTY DEPT. ~ HEALTH ~ .............................. CONSTRUCT ION ONLY . 0 ~ ~ ~f'~ ~FFOLK CO. TAX MAP ~SIGNATION: ~ OWNERS ADDRE~: I SUFFOLK CO. HEALTH DEPT. APPROVAL H~S. NO. "It should be noted that since this property is Jocated in an agricultural oma, the possibility exists that the ~ppleYs c~daeYs contain trace :~toe~ntsS ti arAl or nitrates. SpecioJ analysis required. Contract th~s Oeportme~l~i~:~ s~mp~i~' . GREENPORT NEW YORK .S~,ATEI~ENT OF', INTENT . THE *tNATER ~LY AND SEWAGE 01~OSAL SYSTEMS FOR THIS RE~DENCE WILL CO~IF'~M TO TH:E STANDAR~ O~' THE '~ M~tht~ SERVICES -- FOR AlaPROVAL OF. DEED: Lv SEAL N75554 Vfli~;;~,r CF. RT~FICATE OF O URANCY :APPnOV~. ~,s .OTEO, NOTIEY BUILDIN6 DEPARTMENT AT 76~-1802 ~ A~ TO 4 ~M FOR THE ~LLOWING INSPECTIONS: I, FOUNDATION . ~VO REQUIRED FOR POURED CONCRETE ~. ROUGH - F~MING & PLUMBING 3. INSU~TION ~, FINAL - CONSTRUCTION MUS~ BE COMPL~E FOR C. O. ALL CONSTRUCTION SHALL ~E REQUIREMENTS OF THE N. Y, ~ATE CON'RUCTION & ENERGy COD~. NOT RESPONSIBLE FOR D~IGN OR CONSTRUCTION ERRORS. :? ,j %0 ' I il- 5LAD :CONST~OC'¥10N HO-FL'O :- ,' -' H~ALTH ~-,~ DO NOT SOAL~ 2NERGY TTP. ROOFD~_TAIL NO ATTIO 0.17 O. 4-4. 0.4-7 I ,OO ICi .00 0.6i T'r'?. ~.OOF YV I q- rd ATTIC, 2_2.07 U = ! ~ ,. WALt._ DETAIL. 0.~2 Iq,O0 I,,/,¢. ,, i~L.fVV. D AiR 5"PAC E GODE U : -i ' FLOOR, GARA*z,_ DETAIL ~ASZMENT T'r'~