The URL can be used to link to this page

Home My WebLink About16668-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17316 Date SEPT. 20, 1988 THIS CERTIFIES that the building. ONE FAMILY DWELLING Location of Propert~ 365 RYDER FARM LANE ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 08 Lot 03 Subdivision ORIENT BY THE SEA Filed Map No. 3444 Lot No. 64 conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 1, 1987 pursuant to which Building Permit No. 16668Z dated DEC. 9~ 1987 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 ONE FAMILY DWELLING~ DECK. The certificate is issued to JOANNA STURM (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT'OF HEALTH APPROVAL 87-SO-200 UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED AUG. 31~ 1988 N017463 JUNE 17~ 1988 MATTITUCK PLUMBING & HEATING 9/8/88 Inspector Rev. 1/81 TO%YH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: _.~ / /~~ ~, ~...Z- ..... .,~~,~.~ ............. · /~ .&,...~...,¢.~....~..~, ............................. ~. ,~/,' ,,/,~- ? . _. to ......... ~....~.' ~ ............ ~' ~ '~ ................... ~-~"" '"'"'"'"""~'"'''~"i""~ at premises located at ..... .~.....~..~.....~.o~.......~.~ ..~..~ ................ pursuant to application dated ~ .............. ..~... ................. , 19~...~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Receipt No. 03571_8 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Southold, New York 11971 Date ....... ~../]..~./..~...~.. ....................... , ~ ~. ~,..~.:.-~,- ¢- /1~ "~ . ........... /100 Dolla~ For .... ~¢' ~'t ' ' ~* ' '" ~ ~ "'~"' ' ' ' ~"'"~"" '~';"" "~';~~ ~,eor .................... ~al Fee for ~ Fee for ~tificate ~ YardS~le ~Fee for ~ ~ H.I.C. ~~Building Permit ~4~. ~o°f Occupancy ~ Misc. ¢ ...... ............. ,.,.'""' $ ............ ~t..~.~. ....................... ~ /~ ~ ~ ~ Building Department .... ~.,..~ ~vuy or p~pe~y s~owing all properW lines, ~reets, buildings and unu~al na~raf or topograph ic featu res. 2.Sworn statement of owner or previous owner as to use. occupan~ and condition of buildings. 3. Date of any housing code or safew inspection of buildings or premises, or other pe~inent informa- tion required to prepare a ce~ificate. C. Fees: AddLtLons $25.00 200~S ~25.00AL~RA~OR $25.00 1. Ce~ificate of occupancy New D~e~ag,~25.Q0, Accessory ~10.00 ~us~aess ~50.00 2. Ce~ificate of occupancy on pre-existing dwelling ~ 50.00 3. Copy of certificate of occupancy $ 5.00, ove~ 5 yea~s ~]0.00 5.Up~ate~ C,O. $ 50.00 Date ................ ..... existing Building ......... Vacant Land ............. NewC°ns ~uc~°n , Old or Pre- Location of ProperW ................ , ...... Hou~ No, ~ A Street Nam/et .... ~.---~ .............................. CounW Tax Map No, 1000 Section .... ~ ~,~ .... Block ..... ~, ........ Lot,..~ ........... u v s on, · · r -~, Fil ............. ed Map No ........... Lot No .............. ,~m,, ~o. ~. ~.~. ....¢ ~,o o~ ~,, Z~r2~,,~, ..- ~.~' .~.5~. ~.~ ' ........ Health Dept. Approval ...................... · · Labor Dept, Approval ........................ Unde~riters Approval ..................... · · , Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ..... ~ ............... Fee Submitted $ TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~ /~ ~ Owner ~/~ ~F~ (please print) ~ Plumber~ ~.,~ ~oo~ ~_~:~ ~. ' (please p~t) ~ I certify that the solder used in the water.supply system contains less than 2/10 of 1% lead. Sworn to before me ~his 19~>- . Notary Public, ~o~[~ County (plumber's signatur~ 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST ~ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CE~IFIE$ THAT S'~H~.~, OR~,ENT BY ?H~ S~A~ POLE PN-.~7 RXTW OUTLITS SWITCHES 4 I EXTUI~S IIANG~ OVENS S~RVI(~ [X$CONNLiO' S E R V i C E O~ CC. CON{). I,l ~'t,; E1,ECTR]~C 1 7 FOREST t~I'DGE, NY, 11 This certificate must not be altered in any manner) return to the office of the Board if incorrect. Inspectors may be identified by their credentials, COPY F(X~ BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY MANNER. FEB 1610088 · ~NNIN$ BOARB , ~_-~--~_ 9r 19~B DE IC~ VA UYL, . LICENSED LAND SURVEYORS, GREEN~RT NEW YORK SUFFOLK CO. HEALTH DEPT APPROVAL H.S, NO STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE ~I~L CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF DATE' APPROVED: SUFFOLK CO. TAX MAP DESIGNATION' DIST. SECT. ' BLOCK PCL. Iooo 15' ~ ~ OWNERS ADDRESS: ~'e'l. 283 - gR 99 TEST HOLE STAMP ;,'kg SEAL Examined. 0 .~:5....~. .... , 19~.7 Approved .D,~-~.. ff .... 'FORM NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ ., l .7. Pc=it No. Z Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ., 19 .K.7. INSTRUCTIONS a. TbJs application must be completely filled in by Wpewriter 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 inspections. ....... ......... (Signature of applicant, or name, if a corporation) ... ~. ,r ~. ? ?. . . C_/~. .~¢ ~. ~ , ~. . /.¢.~. (Mailing address of~' applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Name of owner of premises ..... 'x/. ~9. .. .~../':.~'d ........................................... (as on the tax roll or latest deed) If ap/p~t is a co, rTm,~,~turTf dul~uthorized officer. · :7.~~ db4.~ '..-~, ....... (Name and title of corporate/aSfficer) Builder's License No ....... ~.,~.,~..~..~./'/. ~... Plumber's License No ..... z~,~. ~ d..~. ...... Electrician's License No ...... /.Z/. ~..~.7...'~. · . . . Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ........... .:. :.. .... ..... .......... ,:... .............. ttouse Number Street Hamlet County Tax M~E)No. 1000 Section ...... ./.~..~. ....... Block ..... ~. ........... Lot...~ ............... Subdivision .(d,/..~:L~..~..~.." ' ~/g Z~.. de..Y~i ........ Filed Map No...~.y~. ~t. ..... Lot. ~. ~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... '' '/~/. ,'SttO.,~-47. .r'7. .............. ..... '-.' ............................. b. Intended use and occupancy ...... .~''.~. .x/.~.~, .a~.)o.'.t'?./. ............................................... 3. Nature of work (check which applicable): New Building , . .~, Addition ...i.. ..... Alteration .......... Repair .............. Removal ...... ........ Demolition .;,;/ ......... i.. Other Work ............... ~ i (Descrip'tion) (to be p~id on filing this application) 5. If dwelling, number of dwelling units ....... /. ....... Number of dwelling units: on each floor .... .* ........... If garage, number of cars ............................................. ! ........................... 6. If business, commerciai or mixed occupancy, specify nature and extent of each typ{ of use ..................... 7. Dimensions of existing structures, if any: Front Rear ~ Depth Height Number of Stories i Rear Dimensions of same structure with alterations or additions: Front . .' .................................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ~...~.. Rear . .~~.~'.. Height ...... /.,5.' ......Number of Stories . .. ! ......................... i ........................... 10. Date of Purchase ....... ~.,~.~.f~ .............. Name of Former Owner . .! ...................... II. Zone or use district in which pre' mises are situated ..... /:q~./~ ................ i .................... 1 2. Does proposed construction viol.at~ any zoning law, ordinance or regulation: ... ~.' .~.' .... ' ..... ... . 13. Will lot be regraded ........ /[/.t9 ................ Wilt excess fill be removed!from pre~n'i~e'sl .... 14. Name of Owner of premises .................... Address ................ i... Phone No ................ Name of Architect Address ~ ' ............................................... Phone No ................ Name of Contractor Address i Phone No. /~.~...~'.Z4F..~(~.. PLOT DIAGRAM ' Locate clearly and distinctly ail buildings, whether existing or proposed, and~ indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and showlstreet names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. He is the .............................................................. ! ........................... (Contractor, agent, corporate officer, etc.) *f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that ~11 statements contained/n this application are true to the best of his knowledge and belief; and that the ~vork will be performed in the manner set forth in the application filed therewith. ~worn to before me this ' . NOTARY I,UIIL C, Stateef NewYork ~"-'P-' '~" ....... ! .................. ,' · · 78 uffelk County · ! , , . Np.~4707~ S. ~ .^ ~ (./ ; (Signature of applic,mt) " SINGLE FAMILY DWELLING ONLY EXPIRES TWO YEARS FROM DATE OF APPRO~ LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. ^eeaOVAL H S. NO. STATEMENT OF INTENT THE WATER SUMaI-Y AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE ST~DARDS OF THE ~LiCANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY ./- /- APPROVED: . . , DIST. SECT. BLOCK PCL. Iooo /~ b~ .? TE~I' HOLE STAMP SEAL SUFFO~ COUNT~ DEP~?MLINT HEALTH ~RV1CE~ ~.NG~, F~L¥ DW£LdNG oU~r ~c~ and ~q~d :h ~ ~eJ~a~. j LIC£NSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO HEALTH DEPT. APPROVAL H S NO ~'7-50-.~OO STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT OF HEALTH SERVICES. APt~ICANT SUFFOLK COUNTY DEPT, OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCT ION ONLY DATE: H. $. R[F. NO.: APff~OVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST· SECT BLOCK PCL. ¥ ¢' C' :i. STAMP S~Ak SUFFOLK CO. H~ALTH D~PT. AJ'I~ROYAL H' S' NO' ~'~r~ ~"~, '~' ~AT~NT ~ ~NT~T THE WA~ ~Y A~ ~WA~ DI~ ~ F~ THru R~I~NCE WILL ~F~ ~. ~. ~ HEALTH LJo~,V~/A ~ T~ A4 ' ' '~ ~ ~RVIC~6 -- FOR APPROVAL OF ~.,cm/~ ~0' =/" ' ] ' ." ~ ~ ~we~ ~ ; ,. ,,~,..~,.~,,,~,,,~ ~.~ .. The ~wage dis~ and wa~r ~up~y ~iti~ ~ ~b ' ~- -~,',~. ~',, · ~tion have ~n i~ected by ~hB D~a~t~t a~lM ; c~-,.~. ~..-,~ ~.,-..~ .... ~T ~ Y~K SUFFOLK CO- HEALTH DEPT. APPROVAL STATEMENT OF INTENT THE WATER SU~LY AND ~WAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WJ~L [ CONFORM TO THE STANDARDS OF THE ~~ ~ SUFFOLK CO. DEPT. OF HEALTH SERVICES. J SUFFOLK COUNTY DEPT. OF HEALTH [~ J SERVICES -- FOR APPROVAL OF ) H.S. REF. NO.: i j SUrr~K' CO. TAX MAP DESIGNATION: ~DERICK VAN TUYL, P.C. LAND SURVEYORS ~' ':*'"',o'.-' ~" --?~/-~ ~q' '~ ~ ~' GR. EEN~RT NEW YORK '~'-' L.A~.~[~ ~ i 7