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Home My WebLink About13125-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N.Y. Certificate Of Occupancy No. Z14260 Date March 6 .................................................. 19 86 THIS CERTIFIES that the building .. · .0.n.e...~.a.m.i. 1. y..d.w.e..3_.l.i.n, g ...................... Location of Property ..... ! .2.9.5...T.h.e..C..r ?.s.qe..n.~ ................ East Marion Hou$o ~7o. Stroot Hom/ot County Tax Map No. 1000 Section , . .0.3.0. ...... Block ........ .0.2. .... Lot ....... .0.2.~ ....... Subdivision ..... P.e..~p.l.e.. ,B?.a.c.h., .F.a.v.m..s ..... Filed Map No. 6266 .Lot No. 20 conforms substantially to the Application for Building Permit heretofore filed in this office dated Jt.t2v. %%... 2D ........... 19 8.4. pursuant to which Building Permit No .... .q .3J. 2. 5. ~Z ........... dated .... .MB.y.. 3 .4 ................. 19..8.4, was issued, and conforms to all of thc requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... · 0n.e..fam.%].¥. ~l.w.~ l%j-.r~g, ¢.e.q~;. over garage The certificate is issued to . E. vere. tt L . .G..r.a.n.t...I.I..&...R.o.s.a. 1. y.n..H.: ................... [owner,/~t~,~ of the aforesaid building. Suffolk County Department of Health Approval .... ] .4 .-.S.O. r ~3.4 ............................. UNDERWRITERS CERTIFICATE NO ............ ~ 7.3.7.~.4 J .............................. Plumbers Certificate 2/26/86 Building Inspector Rev, 1/81 TOWN OF $OUTHOLD 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? 13125 Z Permission is hereby granted to: ~ .~ ..~.~z~.Z2.¢.~:.~..z...~.~..,,~ ~,~/~ . Z ~.... ~. ~...~ ........................ / ..~~.¢~.....~..~...../~J¢ ,o ...,~.~:~~..~.....~.....~~......~-~....~ ..... : ......................... ~ .................. ~_. ................................................................................ ~.....;.........~ ...... ..~=5~.~....~~.~.¢ .......... 4z~.4 ................... ~.~...~...~.~... Co.n~ ~ a~. No. ~000 S~¢t~o...~.~ ............ m~ ...~..~ ....... ~ot ~o...~.~..~ ........ Building Inspector. Fee $..Z~.~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted i ~ 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all propertv 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. C, Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling $ :15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5°00 Date ...... ~ .~ ..~, ,~':. ?..~, ~. .... New Building ~/~ Old or Pre-existing Building Vacant Land Location of Property ./...~.. '~..z~.'.. ~~< ...... ff~.~.-~.~. , ~ ...... House No. Street Ham/et qwner or Owners of Property ~M~' ./~.:. ~Cd~-~ ~ ~ ¢:.~:,.~L,~ ~.,. County Tax Map No. 1000 Section '. ~ ........ Block ...q~ ........ Lot.. ~ ~ / Subdivision/AD~ ..... (~ ......... ~ ...... Filed Map No.~ ~.~..~..Lot No. ~ ~ Health ~ept. Aporoval ........................ kabor Dopt. ACproval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ /-~ ~ Construction on above described building and permit meets all appJicable codes and regulations EVERETT Lo GRANT II 182 Nassau Avenue Manhasset, New York 11030 February 26, 1986 To~ Town of Southold BuildingDepartment Town Hall Southold, New York Re: Building Permit No. 13125 Z Date: May 14, 1984 1295 The Crescent East Marion. New York I, the builder, certify that the solder used in the water system, of She above structure, contains less than 1/10th of 1 per-cent lead. NOTARY PUBi ICi .te:~e of New Yo k ~L. Grant II Qua f ed in Nosscu Countv ? THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITM 8.5 ,JOHN STREET, NEW YORK, NEW YORK 10038 Date , ApplicationNo. onfile , : N 737641 THiS CERTIFIES THAT only the electrica{ equipment ~ described belo*v and introduced by t~ applicant named on the above application number in the premises of ~as exam~d o~r ~] ;~4[ ~ ~&~3 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS 14 DRYERS SWITCHES SYSTEMS NO. OF FEET E E R V I C 2/0 ~. 2/0 OTHER APPARATUS! 182 Nassau Ave. r~ue This certificate must not be altered in any manner; return to the office of the Board if i~correct. Inspectm COPY, FOR BUILDING DEPARTMENT. THIS COPY 01~ CE RJtl ;ICATjEM~T N 0[~ E~, GENEI~AL MANAGER Per_ / 'L ~ s may be identified by their cred~ti¥~i FIELD I~SPE~LTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N, Y~ STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This May C~ncern, We are unable~to complete your Certificate of Occupancy because .of the following reasons. _/ /~/An application for Certificate of Occupancy is not fi e. ~/ No Underwriters Certificate on file. /_~/The check is(outdated/not_on file..} /~_ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~ ~ ~ ~ ~Z Building Dept. ***/~No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 Memorandum from... BUILDING INSPECTORS OFFICE TO'¢~ OF SOUTHOLD TOWN .MALL, BOX 728, SOUTHOLD, N.Y. ! 1971 765-1802 coNTINUATION 0t~ bz:ARCH~$ .~"~ ~' ~' tl,4 VE 1. Effective date: 3/3/B4 2. Policy or Policies to be issued: (al XX , ~, .......... Ow~ er ~lohcy, NYBIU, IOOD (b). SCIIEI)ULE A redated; Proposed Insured: Loan Policy, NYBTU, I OOD Proposed Insured; Grant by (c) Policy $ Proposed Insured: 3, Tide lo Iht FEE SIHPLE estate or interest iu the land described or referred to in this commitment is at the effective date bereof vested in: ALAN CtlIET AND OOANN CHIET, HIS WIFE, by deed dated 12/13/78~ in Liber 8~59 cp 572, made by Pebble Beach Realty Inc. 4. The land rol~rred to in this Commitment is described on the description shoot attached. recorded 12/29/78 SCHF[ ti F [~, -- RF¢;TION 1 ' MORTGAGES .............. .',...'~',, ,-,,,~., ,. ~',a,..o lu~..'u otJt,., uOUoUU I.)IOtJF. U4.,UU LO'I; Uff, loUgO BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: ~,~, FINAL INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y, 11971 :~xamincd ..... //. ........ ,19 .... ~ kpproved ......... , 1 Permit No. . )isapproved a/c .... :'~ . . .-7. .-777. .......... ~ .... ;.. · V . ~ ........... (Building Inspector) --""" ' .... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts 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 ,r areas, and giving a detailed description of layout of property must be draon on the diagram which is part of this appli- 'ation. 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 hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or (egulations, for the construction of buildings, additions or alterations, or, for removal or demolition, as herein described. "he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to .dmit authorized inspectors on premises and in building for necessary inspections. '"i~ig t crflfVplican,lt~ol~n-ameTff~Fc~tp ratio'ri') .... (Mailing address of applicant) 5tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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. ' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done .... ~ .~... ~ d9 ....:5- ..... .......... .... /.....7.. ........... ..... House Number Street ~-~ ,9-5o7'/~x-/¢/~ /a~ , County Tax Map No. 1000 Section .~t~ Block 2. Lot. ~' J Subdivision .~ ~...~... f~:....,~.. ~q, .m. 2-~ .... ap No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ?..,~...~:..~%-...s~..~.. ................................................ b. Intended use and occupar, .......... /(.....~.~. ~ .~'f..~...tw.~..'. ..../~...Z?...,p~...~. ................... 3. Nature of work (check which applicable): New Building 0. 1. 2. 3. Addition Alteration Repair .............. Removal .............. Demolition .... ....... i" Other Work ............... 17~" -- .. (Deseription)n *-. (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................ number of cars ./ ~ If garage, · .................................................................... If business, commercial or mixed occupancy, specify ngt~re and extent of each type o use ..................... Dimensions of existing structures, if any: Front ..... ~... Rear . .~ .... Depth .. ,~ ...... Height ....................................................... Dimensions of same structure with alterations or additions: Front ............ i ..... Rear.. ................. Depth ...................... Height ..... ~->_.~ .............. Nu~_~b,e r oflStories ..................... Dimensions of entire new construction: Front ........... Rear . o~-~.. ! ....... Depth ...27.. ~ ....... tteight ............... Number of Stories ........... ~ .............. i .............. ~ ........... Zone or use district in which premises are situated...'. ~ ' Does proposed construction violate any zoning law, ordinance or regulation: . ~.~. ........................ Will lot be regraded ............................ Will excess fill be remove~ from premises: Yes Name of Owner of pre~nises ,~, ~ ~z_~ . Address ...:. . Phone No. Name of Architect ..: ........................ Address ............... .... Phone No ................ Nm fContracto ~D~A-...~. Address ~ Phc No roperty lines. Give street and block number or description according to deed, and show atedor or corner lot. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, inldicate all set-back dimensions from street names and indicate whether ....................... 27 , V, 2 'rATE OF NEW YORK, S.S OUNTY OF ................. i ~ ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) [)ove named. is the ............................................................ , ............................. (Contractor, agent, corporate officer, etd.) said owner or owners, and is duly authorized to perform or have performed thelsaid work and to make and file this pplication; that all statements contained in this application are true to the best of his~ knowledge and belief; and that the ,ork will be performed in tl~e manner set tbrth in tho application filed therewith, i' ' worn to before me this ..... ~ }IEL[N ~. Ilk NqTARY PUBLIC, Stats ~ New Term ~xp,es Mmch 30, ~- ~ignature of applicant) N ?O~f,P~°Nf' ~13FFOLK COUNTY HEALT~ DEPART~ .'OCT 23 t.q~ ~. ~. ~. #~¢ ["nB mewage dis~o~al snd water zuppl~ ,~,,~ faeilit!os for th~ !oc~f~Lon havo boon tnspected by %his dop~Cmont ~d found ' O~ef of ~eneral Enginee~n~ J HEALTH DEPARTMENT- DATA FOR APPRO~/AL TO CONSTRUCT ~NEAREST WATER MAIN__MI +- )+$OURSE OFWATER, PRIVATE__ PUBLIC I"= MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE II, 1975 AS FILE NO. 6266. ~ THE LOCATION OF WELL (W),$EPTIC TANK($ T) ~ CE~ SPOOLS (CP)$HOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINEO FROM OTNENS[ giliOCJe SURVEY FOR EVERETT GRANT LOT ED "PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHO~D SUFFOLK COUNTY, NEW YORK DATE SCALE: NO. : SEPT ~t~, 1985 AUG. 29, 1985 APRIL 20, 1984 I": 40' 84- 378 GUARANTEED T .~.,~ CHICAGO ~~ YOUNG a YOUNG ALDEN W YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR NY~S. LICENSE NO J2845 HOWARD W. YOUNG, LAND SURVEYOR NYS LICENSE NO 45893 400 OSTRANDER AVENUE RWERHEAD, NEW YORK ~ 5.6 ~0.00 · ~_ of ~/illOcJe SIN~GLE FAMILY DWELLING ONLY 6ree P°rt IIUI:FOLJK CouNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION, ONLY HEALTH DEPARTMENT- DATA FOR APPRO~/AL TO CONSTRUCT '~ NEAREST WATER MAIN__MI.-+ ~4- SOURSE OF WATER* PRIVATE__PUBLIC ~ ~'SUFF CO, TAX MAP DIST, IO00 SECTION 030 BLOCK Og LOT ~l 'K-THERE ARE NO DWELLINGS WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON. · ~'THE WATER SUPPLY AND SEWAGE DISPO3AL SYSTEM FORT/IlS RESIDENCE WILL CONFORM TO THESTANOARDSOFTHE SUFFOLK COUNTY DEPARTMENT OF /lEALTH SERVICES APPLICANT. m= MONUMENT SUBDIVISION MAP FILED tN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON dUNE I1~ 1975 AS FILE NO. 6266. · Y~T/IELOCATIONOFWELL(W),3EPTICTA~JK(ST)PJCESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OE~SER,VATIONS AND OR DATA OBTAINED FROM OTHEHS,t SURVEY FOR EVERETT GRANT LOT 20 '*PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHO~D SUFFOLK COUNTy, NEW YORK DATE SCALE: NO, APRIL 20, 1984 I" = 40' 84- :578 ~ UNAUTHORIZED ALTERJ~TION OR ADDITION TO THIS SURVEY tS A VIOLATION OF SECTION 7209 OF THE NEW YOR~( STATE EDUCATION LAW ~ COPIES OF THIS SURVEY NOT 8EARING THE LAND GUARANTEED TO: CHICAGO TITLE JNSURAN( YOUNG YOUNG' ALDI['N W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. LICENSE NO 12845 HOWARD W. ~OUNG, LAND SURVEYOR N.Y. SJ LICENSE NO. 45893, 400 OSTRANDER AVENUE RIVERHEAD,NEW YORK II ~API~RO~D AS NOTED L i SOLDER USED fN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD.~ - PLUMBER CERTiFiGATiO~V~''- ON LEAD CONTENT' BEFOR~, CERTIFICATE QF OCCUPANCY OF OCCUPANCY ~ ~: : ~ ' I:forCOpper ' water distributing- ' sys em p!pirfg shall be · : . :.. _ , : ,, APP~.~¥~D AS NOTED ..... FOLLOWI~,G IN?ECYIONS: 1. FOUNDATION - 2. ROUGH ':' ~ATE CONSTRUC?ION' - , , CODES. NOT R~SPO~rBLE' ' r , , DESIGN OR CON~RUCT , '~ : ~030 -~LCoN'f Phone 477.0400 iI C A Phone 47%0400 ~./ blain GIiIf'ENPORT, N Y. t 19,14