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Home My WebLink About13121-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No .... ~. ~-2.7.7. 6 .... Date .............. .S e.~ .%':...1..3 ........ 19~. THIS CERTIFIES that the building Tennis Court Location of Property ................... .Og.e.a.n...V'.i.e.w...Ay.e.: ................. F....I.. ..... House No. Street Hamlet County Tax Map No. 1000 Section . . O..0.9 ....... Block .,..1.1 .......... Lot .. Q D .6 ............ Subdivision ........ X. ...................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 30 , 19 8.4. pursuant to which Building Permit No. 13121Z dated ....M.a.7. .... 1.2. ............... 19 .Sfi., 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 ......... .............. ................................................... The certificate is issued to ......... I~..A~.B.Q .R.I~..G.E..O.R.G.I~. ................................ (owner, lessee o~tecra.t) of the aforesaid building. Suffolk County Department of Health Approval ..... .N/.A. ................................. UNDERWRITERS CERTIFICATE NO ............. .N/.A. ................................. Building Inspector Rev. 1/81 FOB~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOI.D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13121 Z Permission is hereby grante~d~to.~ Q,.I~... ~; ..... ~ ~ ............. .~..~...,~:~¥;.~.~..~.~.,~:./~..~.~,.~ ~;~ ~: ... ~,.~:. ¢~, .. ................................................................................. ......... ~ ........ ~ ...... ~-~ ........... :.. ~ ~ ~. County Tax Map No. 1000 Section ....... %)..~,~, ......... Block ......... J..! ......... Lot No....,~.~.,~. .......... "~V*~ [.~ .~.~. . 19.~..~1:., and approved by the pursuant to application dated ........... .~ .................................... , Building Inspector. Fee ,..!~.:...:~.. Buildlng In.q~:tor Rev, 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ,~;outhold, 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 Inspec- tor with the following; for new buildings or new use: 14 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. Comrnercial 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. B. 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 ! land use 3. Copy of certificate of occupancy $1.00 / ~Buil-d' g ...... Old or Pre~existing Building . --~re-E×isting C.O. $15.00 Vacan~ ~nd/ C.O.~/~ ~/ $ 5..00 Date .... /¢..-. ~...,. .......... Vacant Land ............. Location of Property ................................................................... HouseNo.~ ~. ~ '. %~ Hamlat Owner or Owners of Property ..................................................... Cou.tyT.xMapNo. 000Sect o. ..... q.? ....... . ock ..... !! ........ Lot. Subdivision ........................ 7 ........ Filed Map No ........... Lot No .............. Permit No.I .~.[ ~.! .~... Date of Perm,t ./...;;~..~..Appl cant .~.~.. ~.~t'~.......: .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Request for Temporary Certificate ..................... Final Certificate ..... ' .~'/. · ·. ' ' ' ' ' Fee Submitted $ · .~.'. [.'~ ....................... .onstruction on above described building and p~rmit meets all aoplicable codes and regulations. ~ ,~ppnca t .............. ,~;,;.~,r.,z '~!~'~,aI ........................ F~se~r s I~:~{, N.Y. 053~0 FIELD I;ISi'ECTION 1. tOUNDATIOII (lsd,) ( 2nd ) FRAME & ?LUMBING COFI,ILNT~ ~ JtlSU[,ATION PER N. STATE EN EP, GY C,ODE ADDITIONAL COHMEN.T,_S~: ........... - : FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ..~.~llx~.l ~- , Examined Approved .~.~ .~; .' '.~.': , 1 ~'.~ . Permit No.( .~ .~J. '.&.].~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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 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 bfiildings for necessary inspections. (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. ..................... Co~trac.t.or ............................................................... Name of owner of premises .... Geo,'ge. Lamborr~ ..................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... It. Z3 2 9 ................. Plumber's License No .... 2. 3. .2 .-? ................ Electrician's License No... 2. .11.5.5.-.E. ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ................................................ ..................... .... .... ............. House Number Street Hamlet County Tax Map No. 1000 Section .... .~. ........... Block ...4. !.......;'7.~.... Lot...~...~/..~.~ ........ Subdivision ............................................. Filed Map No .... '.. .~. Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupan~cy of p~oposed construction: a. Existing use and occupancy Lawn : b. Intended use and occupancy Tennis Court i Nature of work (check which apphcable): Ne uilding .......... Addition .......... Alteration .......... i Repair .............. Removal .............. Demolition .............. Other Work.~.enni s ........~ o.ur t. . (Description) 4.1EstimatedCost..$..q0a000.~0 Fee. $ 15.:00 (to be paid on filing this application) .1~ 5. i If dwelling, numbe[ of dwelling chits ............... Number of dwelling units on each floor ................ ' I If garage, number of cars'.... ' ...,: .................... ' '6. If business, commercial or mixed occupant3/; specify nature and extent of each type of use ...................... 7. Dimensions of existing structure~, if any: R, ront ............... Rear .............. Depth ............... : Height ............... Number of Stories ........................................................ ~ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dmaensmns of enUre new constr¢ctmn: Front .. ~.:L.0. ......... Rear ...6.0. .......... Depth .. 6. .0 ........... Height ............... Number of Stories ........................................................ 9. Size of lot: Front .... Rear Depth . ,, 10. ! Date of Purchase . I~.-¢~..... .................. Name of Former Owner ..... , ....... ~, ::: ............ 11. Zone or use district in which premises are situated ...... H.esidential .................................. 12. ' Does proposed construction violate any zoning law, ordinance or regulation: .. NO ............................ 13. ' Will lot be regraded ...Ye~,.. i ................... Will excess fill be removed from premises: _ Yes_ No 14.: Name of Owner of premises i .G~O~'g$. ~glllbor.n.. Address Fishers Island . Phone No 516-.788'~6 NameofContractor Robertl El Wal.1 Address PhoneNo.~'l~-~gSL?~ PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. Permit appilication is to install a all weather court as located oni attached survey map complete with 10' fence aroun~ cou~t. STATE OF NEW ¥O1~I~. n ~ COUNTY ~~ "~]~/~C0._~:S'S being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;~ that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this Notary Public, ................. ?-' N;. s~.,)s09~s :, (Signature of applicant) KEY SCALE~. NOTES- I.'Coordlnote distances ere measured from U.S. Coast and Geodetic Survey Triangulation Station "PROS" 2. TOTAL AREA = Z85-",4cre$ LEGEND- [] sprinkler e electrical outlet ~ water faucet ~- sprinkler and electrical outlet Q control valve ,, ~ boulder underground utility retaining wall stone wall maple pine i~on Ripe dry well ~# // ~ron pipe ELIZABETH HUSBAND N 56°11'00"W dwatlin~ 625.65~ boul~,ra c~rrg ~e e 0 ,,? GEORGE D.F LAMBORN OCEAN VIEWAVE AND, BEACH AVE. SCALE : I = 40 CHANDLER ,PALMER ~ iKIiNG