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Home My WebLink About13075-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..z.l.3. Q 97 .......... Date ..... ~o..v.e.m.b.e.r..2.1 ............... ,198.4., THIS CERTIFIES that the building ...O.n.e.. [.a.m. $ .17..d. ¥ ?.1.1. ~..n g ....................... Location of Property .... 5.6.0.. 9.P.e.~. 9 .n..C.q u. r.~ ..................... .M.afl.~. ~..~ .u.c.k. ........ House No. Street Hamlet County Tax Map No. 1000 Section . .. 1. .0.7 ...... Block ..... .2 ......... Lot ..... .3...3. ........ Subdivision..G.p.e..~.o.n..E..s.~.a.~.e..s .............Filed Map No..6. ti .~.7. . .Lot No..6 ............ conforms substantially to the Application for Building Permit heretofore Cried in this office dated · ...~p.~.$ .1. ,2.q ......... 19.8fi. pursuant to which Building Permit No. !2..0YS. z. .............. dated ... ~.ay... ] ................... 19.8.~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whic~,h, this,,! certificate is issued is ......... ....0n~.. r.~.m.~..~y..q~.? .1.~.~.~. g.....¢.h..~.t.t??.h.~.a..a.~??.., i.'.} ............................ The 'certificate is issued to G. S T R/~ Iiq (owner, IB ~t~.~ X X X of the aforesaid building. Suffolk County Department of Health Approval ... ~N663200 UNDERWRITERS CERTIFICATE NO ................................................. Rev, 1/81 Building Inspector l~OR,11g NO, ,ti TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13075 Z Permission is hereby granted to:/) .... ............. ....... ........ .~..q.~. ....... .>..:./..~:~z..~ ./..~.c,~. ............ ,...,, ......... ,a ...... ~.q>..( .~Z.,~f..TC~.....~..~.... ~,~ .f.~,.'.Y.......D...~.f./z ~...~......~r?..~,,,~... ................ -C7..~.~i.~ ........ ~...f;.<,:~. z,~. ............................................................................ at premises located at ...... ~...~I~...Q ............... .~../~..~t~.. ....... ~....~..'(~...~...~.~.~.~.l ........................... ................................ ; .......................................................................... Z~..,~.~./..~.../~/.~; .~....-..:~.. ~-~-~,~/ ,~--~ ~,~ Z~/...~......M.... ..., ........... /.~. ......... ~,~./.~-,.....~,~ ............. ..:.. ................................ ~ ............... County Tax Map No. 1000 Section ,,../.(~l...~.. .......... Block ...~...t~. ......... Lot No ......~...~...:..~..: ..... pursuant to application dated ..... ~.~.'~,;~.~....~.~.~...~...~.. ........... , 19 '~....~ and approved by the Building Inspector. 17/ ~~ Fee $.t...~..~ .............. Rev. 6~30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted~'pllcctc 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 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/ land use 3. Copy of certificate of occupancy $1,00 --Pre-Existing C.Oo $15.00 Vacant land C.O. $ 5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of PropertyHouse .......................No, 'Z~'~' ' '~' ' ' 'Street'?' ~' ' ' ................. Owner or Owners of Property ........................................... County Tax Map No. 1000Section ..~.~.~. ...... Block .. ~ Lot. Subdivision .... ~ ~.~ .... ~~, .Filed Map No ........... Lot No ...... ~.: .... PermitNo./~.~.~.~. Date of Permit ~.~Applicant ...~Z.~..~J~.' ..... Health Dept. Approval...~/~, ~ .~.. ~ ...... Labor Dept. Approval ........................ Unde~riters Approval . . ~.~. ~ ~ ..... Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ...... ~..~ ............. Construction on above described building and permit m~ ~ pplicable codes and regulations. App lican t .-~..¢-'~'~.. .......................... / o.7 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~ ~7--~/~} ~/ (please print) Plumber ~, .J~ /~ ~please prin~) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. vv - - (Plu~ber,s sig~TM Sworn to before me this 19 ~. Notary Notary Public ~ JUOITH T. TER.~y P.u_blle,, State ~ New York THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW yORK 1OO3B .a,e O~'~O~'l~, la~4 .'~p,,,"c.t'onNo, onS, b, 27m.~V~ N 663200 THIS CERTIFIES THAT o~dy the electrical equipment as described below and introduced by the applicant named on the above application nuntber in the premises of George Strain, ~/S Greton Oou~ 600' S/O Grm~d Averts, Mattituek~ N.Y. Plot ~3 in tke followlng location; [] Basement [] 1st Fl. [] 2nd FI. Section Block Lot was exan~ined on 0~'~0~%D7~ 4 ~ 19~°~ and found to be i~ co~npliance with the r~quiretnents of this Board. FIXTURE OUTLETS 23 RECEPTACLES 41 SWITCHES FIXTURES RANGES OVENS EXHAUST 21 23 FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK! MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E NO, OF CC, COND A,W G pER ~' OF CC, CONO i 2/0 R V I C E NO, OF HI-LE~ AW, G, OF HI-LEG OF NEUTRAL Rulaad Electric Cb. P. O. Box 143 ~,~ttttttmk, N.Y. 11952 lac. ~~,.'~',1~-~,j~ This certificate must not be altered in nny manner; return to the office of the' Board f ncorrect Inspecto~rs may be identif ed by their credentlals. ~i~ UPY~FOR B ILDING DEPARTMENT. THIS COPY OFCER JFICATE ' U TNOT. BE ~L~E~ED N ANY MANNER. ' FIE~LD I{{SPECTION COMMENTS ............ __~ -~--~'__~ FOUNDATION FOUNDATION 2. (2nd)' ROUGH FRAME &C~ FLUMBING ~< INSULATION PER N. STATE ENERGY 2ODE FINAL ADDITIONAL COMMENTS: 7GS-1802 BUILDING DEPT. SPECTION ]FOUNDATION IST [ ] ROUGH PLBG, FOUNDATION ;ZND [ ] INSULATION FRAMING ~FiNAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ]FOUNDATION 1ST [ ] ROUGH PLBG.. ] FOUNDATION 2ND !.~ INSULATION FRAMING [ ] FINAL REMARKS: ~ ~ss 18o2: BUILDING DEPT, INSPECTION FOUNDATION ].ST [ ] ROUGH pLBG, FOUNDATION 2ND ~]~ INSULATION FRAMING [ J FINAL DATE: '~//c~/~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST ~ ROUGH' PLBG. FOUNDATION 2ND [ ] INSULATION I~] FRAMING [ ]FINAL REMARKS; ~ ~.~ ~,o~ ]7 DATE,r INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.../.~ ./~. !,.*~.../..., 19c.~.~. ./~<&:~ .,19.~ Permit No../~747. Approved ~.. ~... ~? Disapproved a/c .... :-:'~ ..................... ................. ...... ........ (Building InspectoO APPklCATIO~ FOB B~IkDI~G INSTRUCTIONS Application No./.?~. ~..~.~ ....... a. This application must be completely filled in by typewriter or in ink and submitted 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 this application may not be commenced before issuance of Building Permit· d. Upon approval of this application, the Building Inspector will issued 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 building for necessary i ,n,~ections .... (Signature of applicant, or name, if a corporation) · .o.' ~'....~54 ./.... ~ .~.....7~. :.. (Mailing address of applicant) State whether applicant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder· .............................. ./~..ez~. ~..e~ .................................................. Name of owner of premises ~' ~ ..7~..~..~.. ?./.~] ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· .............. (Name and title of corporate olfficer) Builder's License No .... /.' .~... ~ ................ Plumber's License No ......................... Electrician's License No. j.?...1~..~].&,.tJ,. .......... Other Trade's License No ...................... I. Location of land on which proposed work will be done. . . .~!./~. . .~. ~.~. .O. .A"i . . ( .O. .~. t~','~'. . ,. .... ~./5 .......... .~-.~ ................ . ./~.. ~..~. 7-../. :~.o..~./.<. ..... ~../: ..... House Number Street Hamlet County Tax Map No. 1000 Section . ./.0..~'~. .......... Block ..... ~..~. .......... Lot. -~' ~'~ ' Subdivision .... .6(.<..c.-..~..q... E.,.~..,~..~.,... ~iled Map No.. ~.~Z ?. .... Lot. ~, ............ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................. '~',;.~ ~t~v! :,4~;~,','~ ,,.,., ........... b. Intended use and occupancy /~',Z]/~9 //-- /,t/~ ,-.- ,.,~ . .................................. ~ ,¢?,. k&~ .~o..:..;. ,... .................. 3. Nature of work (check which applicable): New Building .. ~...... Addition ' Alteration .......... Repair .............. Rembval .............. Demolition ............ ...' Other Work ............... c~. ! (Description) 4. Estimated Cost ~0, o e~ O , ?. <~ Fee .~.FZ/. .....; (to be paid on filing this application) 5. If dwelling, number of dwellingi units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent 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 ............... Rear ............... Depth ............... Height ............... Number of Stories ............................................... 9. raze of lot. Front ....... ./.q.~. ......... Rear A ~..~ ........... Depth . ~ ~'; ~ 10. Date of Purchase .......... ; .................. 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: ................................ 13. Will lot be regraded .../~r?., ........ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~. ~ i~.~.' .~.' ~rl/.' .~.... Address ................... Phone No ................ Name of Architect ................ ~ ......... Address ................... Phone No ................ Name of Contractor .~./~</.~..t-.t/Z'....J.~..~.~.r.. Address ./f~.~..~..;~.: ..... Phone No...--~.'.fi~. :~..al>fi..~..-~---. PLOT DIAGRAM Locate icleariy and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~W~01~K..//..~/~ S S COUNTY O~.. ~ ,' ' , ...... · ,~..~..~ .~.~ ~.~.. ~.: .!,~.~..,%.%z: ...... being drily sworn, deposes and says that he is the applicant (Name of individual signling contract) above named. He is the /~...q. I . ...... /..~..~.e./g ~ ................................................................ (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 manne'r set forth in the application filed therewith. Sworn to before me this ........ ..... Notary Publ4~. ~.'~.~. .~....'7~. ~ ...... County __ ~ ~,~52 - No. ~,.Q~lSe8 ~olk~ou~t: ...,~., ............................. ;/. · .: .... i CommINioa Exgir# SINGLE FAMILY DWELI, JNG ONLY GEORGE STRAIN COUNTY D~PARTMENT OF H~LIH SERVICE5 LOT NO. 6,"GRETON ESTATES" ~WN ~ SOUTflOLD SCALE: /'= ~0' ~( ~YT--HS t~. NO._~2~ SUFFOLK COUNTY, NEW ~RK NO. NEW YORK STATE E~CATtON LAW ...... ~COPIES ~ ~IS S~VEY NOT ~AR~ THE LAND DEPARTMeNT-DATA F~ APPRO~ TO C~STRUC T ,,o ~ H, ~,A,F ~ THE, ,CE C~,,Y. ~ ~E~LI~$ WITHIN I00 FEET OF T~ PROPE~Tf TO A~ITIONAL INSTITUTj~S OR SUBSEQUENT ~' ~7[- ?~7~ rffi I Vml IM~ ~ V~l IM~ ~OS~DER AVE~E ~! /MMIXg I ~IXO RIVER~AD, NEW YORK NOTE,.=MONUM, NT / ~=~rAKE~ 1 B ALDEN W. YOUNG, PROFESS,ONAL ENG,NEER ~UB~/VI~N M~P ~1~ IN ~ ~1~ ~F ~ SURVEYOR UCENSE 12845 ~ ~ HOWARD W. YOUNG. LAND SURVEYOR ' ~L~T~JW),~ICTANK(~T)~CE~OL~(~)~N~ ~. ~ , I, N.Y.~,LICENSE N0.4589~ BRANDIS & SONS INC, 2046 ~_~ \ .76o41'00 ' LOt ~ B~O~K C,O~TY ~ALTH DEPARTmEnT ' fao]~; ~ ~ '~-~e ' ,~ ' ...... ~ ~.,- a:kd found Chiof of SURLY FOR GEO~G~ STRAIN LOT NO. 6,"GRETON ~S~TFS" JUL Y ~4, 1984 AT MATTITUCF ~ ~: AP~IA 5, 1984 ~WN ~ SOUTHOAD Sca~5: SUFFOLK COUNTY, NEW ~RK NO. 84-254 ~E ~R~ FOR WHOM THE SU~EY IS PaEPA~ED ~ ~0:.~.~ '~ HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ~No ~ HIS ~EHALF ~ TH$ TITLE C~Y, GOV~.- /~ "' YOUNG & YOUNG SUBD/V/~/O~ MAP F/~ED /~ TH~ OF~/C~ ~ Tff~ ~ffK AND ~AND SURVEYOR N,Y.S. UCENSE NO. OF SUFFO~ff COUNTY ON SFPr ~0, 1976, AS FILF NO. 6447 HOWA~D ~YOUNG, LAND SURVEYOR ~ ~ L~ ~ ~L(~i,~P~C Ta~K(ST~m C[~OLS(~) ~ ~ N.Y. ~. LICENSE NO. 4589~ 8RANOIS & SONS INC. 1046