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Home My WebLink About13178-zFOflM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zq359o Date rulV 5 19a..5 THIS CERTIFIES that the building new one-£amily dwelling. 90 The Greenway East Marion Location of Property ............................................................... House No. Street /dam/et County Tax Map No. 1000 Section 30 .Block 2 .Lot 52 Subdivision l:>ebble Beach ~arms .Filed Map No. 6266 .Lot No. ~10 conforms substantially to the Application for Building Permit heretofore filed in this office dated Flarch 26 198.~ pursuant to which Building Permit No. ~q 37 78Z dated ........ .FI.a.y....3.~ .............19.8/[,., 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 ......... .... ~..e.w..qn..e.-.~.~.m..i.~F..d..w?.~.~.5..~.~.. ................................................ The certificate is issued to ............ gfi2q~O~R]) P~NAIJ~R of the aforesaid building. Suffolk County Department of Health Approval .......... .~.-:S..0.-.~.9.~. ..................... 1~678~q 8 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 lrOB~ NO. B TOWH 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? 13178 Z at premis?s ~ocated at..?..~......,.~'~......~), ......~..~.....,-,~. ~ ~ .~ .... ~~ ........................... c~ T~ ~p ~o. moo ~t~o~ .... .0.~.~ ...... ~ ..... ~ ............. Lot ~o ..... ~.~ ........ ~ ~ ~.~ ~..~. pu~uont to a~lication dat~ ........... ~ ................ , 19. , and approv~ by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Bo This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the fol~owing; 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 sirri]lar 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 3, Copy of certificate of occupancy $1,00 use --Pre-Existing C.O. $15.00 Vac_~mt'land C.O. $ 5.00 Date ....:.q ...... New Building .... ¥:'. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property..C{' ~! .... . .~....e._.¢..~.<.~..~.~.O.~J....4~. ~ ..... '~"(:~'~'~' '~ ~? } ¢[~ ....... ~;~ie~ Hou~ No, ~ Street Owner or Owners of Property ':~(~ ~ C ~ ~ ~M~ ~ County Tax Map ~o. 1000 Section 0 ~0 Block .{ kot .... ' ~.. ~.~[~ ...... Fded Map No ........... Lot No .............. PermitNo.~[.~.~.. Date of Permit . ~...Applicant~in. ....~,~'~:,. Health Dept. Approval ~' . Labor Dept. Approval Und itersAppro al ....... PI ni g B rd Approval ..... e~r v ................. an n oa ......... . ........ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~ ~.. ~.~ ~.~ .... Construction on above described building and P~rmit meets all applicable codes and regulations. ~'0 ,~) Applicant(~.~ .&.~. "C~.'..~....~' '~'. ,,...~! '..~.' ....... Rev. 10-10-78 FIELD INSPECT_ION DATE COMMENTS ~OUNDATION ( 2nd ) ~ m ROUGH FRAME & , ,. FLUMBiNG ?1~ O~ ~C- .......... iNSULATION FER N.Y. ~'/7/~ O~c STATE ENERGY ADDITIONAL COMMENTS: HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--3690 Inc, CERTIFICATION Date October 22, 1984 Building Permit No. / ~J~ Owner Sanfnrd ff~nm,tar Plumber Henry J. Smith & Son~ I system certify that the solder used in the water supply of 1% leadx~ ~ contains less than 2/10 Sworn to before me this 2A,~.~day of f~ , 19 ~ Notary Public, /~/L,./f~. ~3~f~/ County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICIT~ STREET, NEW YORK, NEW 'YORK 1OO3~' ~Yl~ l~eb~oJ~Ty 1~ 198~5JOHN Apptic~ionNo. onyile .~,~ N 678418 THIS CERTIFIES THAT only the electrical equipment ~ described below and introduced by the applicant ~med on the ebo~e application number in the premises H~uer ~ley, ~e Str~d S/W ~ ~ ~c, ~ ~ion, N.Y. i~ ,~ yo.o~i.~ ~o~.,io,. ~ ..~.t ~ ~ r~. ~ ~na ~, S~,~o,. mo~ rot was examined on Feb~ry 4~ ~985 and flound to be in compliance with the rdquirements of this Board. FIXTURE OUTLETS DRYERS ~ECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT MULTI-OUTLET SYSTEMS NO. OF FEET 1-G.F.C.I. 2.~Smoke Detectors. E R V , I C OF CC, COND NO, OF HI-LEG NO OF NEUTRALS 1 2 Box 215 I~ic. 578 This certificate must not be altered in any monner: retorn to the office of the 8oard ff incorrect inspectors may be dent~ed by 1hm~ ~edentlals,~'~ ~ 76S-'~80:~ BUILDING DEPT. INSPECTION FOUNDATION '~ST [c-]//ROUGH~ · PLBG. I' ] FOUNDATION 2ND [ ] INSULATION [~/FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 76S.'1802 BUILDING DEPT. ~ INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [~ FOUNDATION ZND [ ] INSULATION [ ] FRAMIN~ , [ ]FINAL REMARKs: 76S-1802 BUILDING DEPT.~ INSPECTION FOUNDATION' ~,ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ~]/~NSULATiON [ ] F ,RAMING [ ] FINAL RE:MARKS; ~/~/~ DATE INSPECTOR "FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 E×amined .... ~' ~ ~./. 19~.~. Pe~it No. .t.~. ~ ~.~ 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 to the Building Inspector, with 3 sets of plans, accurate plot plan to scale· Fee according to schedule· b. Plot, plan ~howing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and:giv'm, g 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 inspections. · (Signature of applicant, or name, if a corporation) · d0&~.~..~..., .~..o., ~. ~~..//.e..7/... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... 6o . o ,z ............................................................................... Name of owner of premises . .. ~....~d. ~.. J~Vg14.J~g~d~ ........................................ (as on the tax roll or latest deed) If applicaht is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... /.o~./ .................. Plumber's License No.. ~. · .~ . .~..~ .t.~ .~. · .~· .~. i)(j Electrician's License No. ~.~. ~... Other Trade's License No ..... 1. Location of land on which proposed work will be done .................................................. ................ ?.0. ......... '.-fi&. ~e.~.~. ~.~y ............ ~mr. ~./or .............. House Number Street Hamlet ' Tax Map No. 1000 Section ..... ~)..~..('-fl ......Block .... ~.. ........... Lot .... .~. ~ ......... Subdivision.. ~.'~.~.~.../~/4~/....~ .... Filed Map No ............... Lot .... .~./../~. ...... (Name) g use and occupancy of premises and intended use and occupancy of proposed construction: use and occupancy .......... i/fl..~..~P/A/.~. ................................................ and occupancy ......... ~/d~ ................................ i I property lines. Give street and blocklnumber or interior or corner lot. 3. Nature of work (check which a plicable): New Building ...... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition . Other Work ~ (Description) 4. Estimated Cost ..... ~[~.1.0'~ ......................... Fee ................................... i '~' (to be paid on filing this application) 5. ~f dwelling, number of dwelling units ............... Number o f 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. Dimensin~ structures, if any: Front .... ~ ..... Rear ..... ~ ..... l~;;t'h' ::~ ::: ...... Height-~ ..... Number of Stories-. ....... .~T~,,,l~.. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i · · Height ...................... Number of Stories ...................... 8. Dimensions of entj, l'9 new consffUction: Front ........ _ ..4~..~ . Rear....'~.'~. ....... Depth..~..~ ., , · ; :-' ......... Height ..... :~..~. ...... Number of Stones ........... 9. Size of lot: Front ....... i.'?D, ........... i~'.'~, ii... i i i i i 'b;~it~' i~..' i i i i ......... 10. Date of Purchase ' . ..... Name of Former Owner ............................. 11. Zone or use district in which prbmises are situated ..................................................... 12. Does proposed constructmn violate any zoning law, ordinance or regulation: .......... /,~.'O. ................. 13. Will lot be regraded .... ~,d O, ................... Will excess fill be removed from premises: Yes ~* No 14. Name of Owner of premises . 5,4~'*q~0-~. b~tffg,q~&Address ~. ~.i~.~ t~OPhone No ................ Name of Archit_ect ......... [ ................. Address .... - ...... ,.. N, Phone No ................ Name 'of Contractor ~i'~,~l~g ~-~1. ~.14.~ ~ Address .~4 t ~ll~..~. .... Phone No..Y&~..vl~'.rf.~.... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether STATE OF NEW YORK, country OF ..... S.S ........... ,..~.~,.r. ~-.-.-.-.-.-.-.-~1.I .................... being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the ... ~,Ot.r'~...i. .................................................................. . i (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 l 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 mannir set forth in the application filed therewith. Sworn to before me this .................. ~.~.,..day o; .... ~/~J~. .......... 19 ~.~/ , No. 52-0344963 Suffolk County Comml.~ion Ex~ir~ M~mh ~0, 15,f~ ', ~gnature 0~ DEPARTMENT OF H~:~AL.I'H '83 OOV I A~ I I'OZ i0~ EXCAVATION- ~iUFF©LK COUNTY DEPARTMENT OF HEALTH SERVICI~ FOR. APpEOVAL OF CONSTRUCTION Ot',~.Y .,,...o,. tC '-q o- tqo¢ HEALTH OEPARTMI[NT-OATA FOR APPROVAL TO CONSTRUCT N NEAREST WAT~J~ IIIAiN4MI. ~' N SOURCE OF WATER: PRIVATE __PUBLIC N SUFF CO, TAX MAP Dl~T I000 SECTION OSO STOCK N, THERE ARE NO DWiLLINOS WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON, N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE WILL CONFORM TO THE STANDAROE OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. .PR.c,,., k//e~,~,/~;/.u/,~ NOTE ~ m · MONUMENT i'1 = STAKE SUBDIVISION MAP FILED IN THE OFFI~*E OF 1HE CLERK CF SUFFOLK OOUNTYON JUNE 11~IST5 AS PILE NO. ~r THE LOCATION OF WELL(W)~ SEPTIC TANK($T)B CESSFOOLS(CP) SHOWN HEREON ARE FROM FIELD O~SERVATIONS AND OR DATA OBTAINED FROM OTHERS TOY POST E0494 INSPECTION REQUIRED SURVEY FOR SAIVFORD NANAUEt~ £OT IVO, II0, ' PEBB£E BEACH FARMS A? EAST .MABIOIV TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK OATE: SEPT. 22, 1985 SCALE: /' " ~' UNAU THOI~(1Z E O N ALTERATION OR AOOITION TO THIS SURVEY I~ A VIOLATION O~ SECTION 7~09 NEW YO~K S~T[ EDUCATION L4W NCOPIE$ ~ THIS SURVEy NOT BEAR~G THE LAND SURVE~R'S iNKED SEAL~,OR EMBOSSED SEAL SHALL NOT BE CO SIO~RED TO BE A VALIO TRUE COPY GUABANT~D 7'0: Of NEW ~. INDICATED HEREON RUN ONLY 1~ THE F~RSON FOR WHOM THE SURVEY' IS PREPAREO ANO ON HIS BEHALF TO T~IE TITLE COMPANY~ DOVERN- MENTAL AGENCY AND LENDING INSTITUTION LISTEO HEREOR~ AN0 TO THE AS$1ONEES OF THE LENDING INSTITUTION. GUARANTEE~ ARE HOT TRANSFERABLE TO ADOITIONAL INSTITUTIONS OR SUBSEOUENT YOUNG 8 YOUNG' ALDEN W. YOUNG,, PROFESS IONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 1284,5 ~DER AVENUE ~,D, NEW YORK S~ ~Y.~TH DEPARTM~I SURLY FOR ., SANFO~O HA~AUE~ facilities for this ideation ~ve been ~WN OF ~L~ SCALE: ' ~," = ~ ' tnspeeto~ by this de~r[ment ~d f~nd SUFFOLK COUNTY, NEW YORK ~o. HEATH DEPARTMENT ANO ~ HIS BEHALF ~ Ti E TITLE C~P~Y, N ~F CO, TA~MAP ~T I~O SECTION O~ ~CK ~ LOT BE ~ERE~ AND TO ~E ASSI ;HEES OF THE LENDING . ' ~OS~NOER AVENUE ~ s MOHU~NT D · STAKE , ALDEN W.Y~NG, PROFESSIONAL ENGINEER SU~lWS;Oa MAP R~ ;N mE OF~ ~ ~E ~K ~ ANO ~ND SURVEYOR N.Y.S. UCENSE NO. ~2845 9U~O~ ~O~ ~UNE Il, Ig?~ AS Fl~ NO. e~ ' HOWARD W. YO"NG~ LAND SURVEYOR