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Home My WebLink About16404-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. Z17016 Date June 22,1988 THIS CERTIFIES that tile building One family dwel 1 lng Location of Property 2010 The Strand East Marion County Tax Map No. 1000 Section . . .3.0 ........ Block 2 .Lot 55 Subdivision PebbLe Beach Farms FiledMapNo 6266 .LotNo. 113 conforms substantially to the Application for Building Permit heretofore filed in this office dated Aug., 28, 1987 pursuant to whicb Building Permit No. ] 6404 Z dated.....Au g. .... 30. ·........' ' 1987 ..... .... was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... O..n.e..f.a..m~.l.~...d.~.e.l.l.~.ng.,. deck and one car garage Tile certificate is issued to ROBERT & MIRIAM KLOTZ ..................... ..................... of tile aforesaid building. Suffolk County Department of Health Approval 87-S0- 164 Mar, 28, 988 UNDERWRITERS CERTIFICATE NO.. NO 16859 June 6, 1988 PLUMBERS CERTIFICATION DATED: Constantinos Zervos 6/13/88 ............. l~u)fllin~ Inspector ............. Rev. 1/81 I~OBM NO, ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOLD, No ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 16404 z Permission is hereby granted to: .......................... ..................... .....o...~......~..:..2., ...... !..L~.2 ........... at premises located at ...~..c:~...! ......... ~.....~..~.....~.... .......... ~...~:~. ......... .~.~ ........ Count7 Tax Map No. 1000 Section ....... .0.....~....~. ..... Block ...... ,,~,..,,,L~,. ...... Lot No....~'.,.~.... ........... pursuant to application dated ..... ~..~a.,.~,,....,,~...~. ...... 0 19~.,~.., and approved by the Building Inspector, Fee~ Building Inspector Rev. 6/30/80 APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in Wpewriter oR ink. and submitted m ~ 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 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 3ertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New DwellS:rig.S25.00, Accessor¥'¢10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5 .Updated C.O. $' 50,00 Date .... ~t~,~_. ~.) .i.~..~.. New C on s % r u c t i on, ,~.., Old or Pre-existing Building ............ Vacant Land ............. Location of Property..~..(~. J.O. ......... . .--~.. ~,. House No. Street /Yam/et Owner or Owners of Property County Tax Map No. 1000 Section ...0.-~..O. ....... Block ...~.~ ......... Lot...-~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ].~.~.~..~.'.ZDate of Permit :~ .~.~o:~.O.).~.~.Applicant..I~--~ .~9~(~. 2~.~.~.0.% ............ Health Dept. ApprovalS.tI 'SO~lf~ .~.~.~.~.~ .~..~.. Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ¥. ................ Fee Submitted $..~-,~ ".(~.0 ................... Construction on above described building and permit meets all applicable codes and regulations. Applicant.. ~.~).~.~ .~ 2 ~._~O ........................... C~O, z. /?¢,b TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ~(oqO[~--- Owner ~ ~'~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (pluf~ber's signature) Sworn to before me this 19 ~ Notary Public Notary Public, . ~~, ... County HELEN K, DE VOE NOTARY PUBLIC, State of ~w York ~ 4707878, Suffolk County ~, ~ Term Expires t~rch 30, t~,~ ~' .FIELD INSPECTION COHMEN'I'S FOUNDATION (ls~~) FOUNDATION (2nd) 2. FRAME&/ ROUGH PLUMBI G~/ INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. FOUNDATION 1ST INSPECTION ~ ]~ROUGH PLBG. [ ~/~OUNDATION 2ND [] INSULATION [,/] FRAMING [ ]FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [~]//FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR THE .NEW YORK BOARD OF FIRE UNDER~ITERS 1~95099 IBUR~AU OF "~L.~CTRICITY 8~ ~HN ST~. NEW YO~ NEW YO~ 10038 ~ 16,1~ '~ a~,~o.o.~ 5207~387187 ~ 016859 ~IS GE~F~ ~T ROB~RT K~TZ~ THg ~TR~ND, ~ST ~RTON, m exami~ ~ e~nd ~o ~ in ~m~ian~ wilh t~e ~gs e~ t~ ~. 4O 38 51 40 200 SMOKg Dg"I'KC'I"O~: -1 TRACK [.IGRYING: -20 519 5'I~RLING PLACE GRggNPOR?, NY, 11944 the offk~oftheJ 1'1 SORVEY FOR ROBERT KLOTZ 8, MIRIAM KLOTZ OCT. I ,1987 LOT 113, "MAP OF PEBBLE BEACH FARMS" SEPT 8,1987 JULY8 1987 AT EAST MARION D~T[= OCT. , 980 ~WN OF SOUTHOLD SCALE' SUFFOLK COUNTY, NEW YORK NO. 8o-522 [_ YOUNG s YOUNG RIVER~AD~ NEW YORK BOARD OF HEALTH ..¥... .... $ORVEY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CAL~ ................ MAIL TO: (Building In spector) APPLICATION FOR BUILDING PERNIlT Date ................... 19 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 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 pai~ 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) · .?,..o, o. eJ .9 t9.,.¥,..t,t.?.s..'7. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner o f premises ]'J.l.~./.~. ] .~. .... . ................................... e x t If applicant is a corporation, signature of duly authorized officer. . / (Name and title of co,orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No... P~.~. v..1~.~ ......... Plumber's License No....o~.3.q.~....~. ........... Electrician's License No ....................... Other Trade's License No ...................... House Number Street . Hamlet County Tax Map No. I000 Section · · ..C~:~'C2 ............ Block .... ~ ........... Lot...~.~ ............ Subdivision ..................................... Filed Map No.' .............. Lot . [j.~ .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing dsc and occupancy ............ ~..v3q ~.'~ .~. ..... {.c>.~. ....... ..... : ...... ............... ~ ..... b. Intended use and occupancy .......... ~ .' 9,-~ [ .~ .... t : ........................... Nature of work (check which applicable): New Building . .'d.' ..... Addition .......... Alteration .......... Repair .............. Removal ..... , ........ Demolition .............. Othes~orl~ ~ .............. .i .... "(Descrip~tion) 4. Estimated Cost. ° ..................... Fee ...................................... ~' (to be paid on filing this application) 5. If dwelling, number of dwellingiunits . .[ .-~.or. ~,~ ! .... Number of dwelling units on each floor ...... : ......... If garage, hum her o f ca~ .... l ~ ......................... · ...................................... 6. If business, commercial or mixer occupancy, specify nature and extent of each type o/'use ...... '. .... .'. ......... 7. Dimensions of ex~ting structures, if any: Front ......... , ..:... Rear .............. Depth ............... Height ............... Number of Stories ...... :... .... ...................... ': ................... D~ens~ons of same stmcture.~th alterations or additions: Front ................. Rear .................. Depth ................... [.. HeiSt ...................... Number of Stories ...................... D~mensmns of entire new const~ctmn Front ...~D, ~. ' Rear ~ .~. Depth 3~ ....... . t .~ ~ . ..... , .................... Height . .~. m ........ Number of Stones ..... ~. ~.~';~5 .......................... ~ ............. Size of lot Front ..~B,~G.t .... '..... Rear ...... .¢~ . DeCth ~J~l ........ ~ate of Purchase .......... ~ ................... Name ~f Fome[ Owner . ............................ Zone c~' use district ;n which px~m~ses ac(; si :un:ed ..... :~,.~.~.~[.., ............................... Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ......................... Will lot be regraded ...... ~O ................. Will exce~s f[l[~ remaved ~om .~emises' Yes 14. Nme of Owner of premises ~.q ~ ~qT~ ...... A d dress ~gga~t. ~,.~*~one No.' ...... . .... Nme of Architect .~N~. ~..¢9.~.~ ¢.~ ...... Address . .~.~..~a.,.~r~,. Phone No.. Nme of Contractor ~l~. ~.K~ ......... Address .~,~.,~oX ~a~ , . Phone No ~ZT':/.Zg~ . .. 15, Is this propar~y loeatedlw~th~n 300 feet of a t~dal ~etland? *Yes ..... No ..... · If yes, 8outhold Tom TrCsCees PermSt maybe required. PLOT DIAG~M . Lpcate clearly ~d distinctly ~l bulldogs, whether existing or proposed, end. indicate ~1 set-back d~ensions from prgperty ~nes. Give street ~d bloc~ number or description according to deed, and show street names and indicate whether in~efi0r or corner lot. ~ ~O~ ~¢~ ~ ~O O M ~ 11I. 12. 13. STATE OF NEW YORK, ~ COUNTY OF ................. ~ S.S - ~. 470787~, $?a~ ~,i1~ (Signature of applicant) Term £xpims ~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the i ' ,' (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is dt~ly authorized to perform or have performed the said work and to make and file this application; that all statements ~on~ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann,bt set forth in the application filed therewith. Sworn to before me this i · · ......... day' ~f...~,~, ...... Notary Public, . . i . ./~.~....~..t~. ....County Sr GLE FAM?LY LLING ON UN~ DEpARTM SU~Y FOR. - --PRovAL OF CONST~ ION ONLY LOT I 3, "MAP OF PEBBLE BEACH FARMS~"' )SUFFOLK COUNTY, NEW YORK ~ppROV~D N U~UTH~IZED ALTERATION OR ADDITION ~ mis SUnVEY · A VtO~ATI~ ~ SEC~IOH ~200 ~ ~HE CHICAGO TITLE INSURANCE C~ H~w YORK ~TATE E~CATION LAW N COp~IES ~ ~lS S~VEY NOT .~RWS THE LARD ROBER SU~vE~R~ IRKED ~Ak OR EMBOSSED ~EAL SHALL NOT BE CONSiDE~O ~O BE A VALID TRUE DOPY N~ARANT~I (NDI~TEO HE~ON ~L/RUN ~LY ~ ~ ~R WHOM THE $U~EY I~ PREPARED HE~TH DEPARTMENT-DATA F~ APPRO~L TO C~STRUCT N N~RE~TW~ IA~N--MI. ~ N SOURCE ~ WATER* ~I~TE ~UBLIC ~ M~NTAL A~NCY AND ~ENDING INSTITUTION LIS~D OTHER THAN THO~E ~HOWN ~EREON. ~ ~I~ONAL INST~UT~$ OR SUBSEQUENT ~ , WI~ C~FORM ~ T~ ST~N~R~ OF THE ~K COUNTY D~TMENT TO'EXlITIN~ ITRUC~R~ ~E FOR A SPECIFIC OF H~LTH S~ CES; ~- ~ n ~ 1~*~ P~POSE AND ARE NOT TO BE USEQ TO ESTABLISH YOUNG S YOUNG RIVER<AO, NEW YORK 8UBDIVI~ION~PFILE~THE~FI~ECCERK~8~FOLK~TY ALDEN W, YOUNG~PROFESSIONAL ENGINEER ON J~E II, 1975 A8 PILE ~. 62~ -- AND LAND suRvEYOR N.Y.S. UCENSE NO. 12845 HOWARO W. YOUNG~ LAND SURVEYOR N~ L~T~ ~ W~(W),~IC TANK(ST)aCES~(~)~N H~E~ N.~S. LICENSE N0.45893 ~E ~ FIELO ~ATI~S ~D OR DATA O~TNNEO F~ OTHERS " ' ,5 / / / / HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUC¥ N STIFF CO, TAX MAP ~S~/-I'g99 SECTION 030 BLOCK ~-.~.--- LOT 55 )(-THERE ARE NO DWELLIHg$ WITHIN I00 FEET OF THIS PROPERTY WILL DO~FORM TO THE STANOARDS OF THE SUFFOCK COUNTY DEPARTMENT SUBDIVISION UAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ~ TH( LOCATION OF WELL(W}, SEPTIC TANK($T)t~ CESSPOOLS(CP) SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FR'OM OTHERS TDY POS! E0494 \ \ SURVEY FOR ROBERT KLOTZ I~ MIRIAM KLOTZ LOT 113', "MAP OF PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHOLD ,SUFFOLK COUNTY, NEW YORK FEI3.18~ 1988 OCT. I , 1987 SEPT. 8 ~ 1987 JULY 8, 1987 OATE: OCT. ~ ,[gGO SCALE: 1"=40' 'NO. 80-52;~ NUNAUTHOR1ZEO ,~LTERATIOH OR ADDITION TO TTIIS SURVEY IS A VlOLATIQN OF SECTION 7209 OF THE GUARANTEED TO: CHICAGO TITLE INSURANCE CO, AM KLOTZ ~TRANDER AVENUE YOUNG 8, YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N,Y,S. UCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR N.Y.S. LICENSE N0.4§89:~ RIVERHEAD, NEW YORK SURVEY FOR ROBERT KLOTZ ~ MIRIAM KLOTZ OCT. I ,1987 LOT 115, "MAP OF PEBBLE BEACH FARMS" SEPT. 8,1987 JULY 8~ 1987 AT EAST MARION DATE: OCT. ~ ,~980 TOWN OF SOUTHOLD SCALE, 1"-'40' SUFFOLK COUNTY, NEW YORK NO. 80-522 N UtMUTHORiEED ALTERATION OR AOOmOa ~ m~S ~ GUARANTEED SURVEY · A VIOLATION ~ SECTION 7209 OF THE CHICAGO~I~NS~ANCE CO. NOT BE CONSIOE~EDTO 8EAVALID TRUE CORY HEALTH DEPARTMENT-DA+A FOR APPROVAL TO C~STRUCT ~HD ~ HIS BEHALF ~ 7HE TITLE C~P~Y, GOV~N- N $~F CO, TAX MAP ~S~Q0 SECTION Q~O,. BLOCK ~ ,,,. LOT 55 HEREON~ AND TO ~E ASSIGNEES OF THE LENDING NTHE~ ARE ~ ~ELLI~ WITHIN IOO FEET OF THIS PROPERTY INSTITUTI~, GUARANTEE~ ARE NOT TR~SFERABLE ADDRESS ' ' ,,, YOUNG YOUNG RIVER AO, NEW YORK SUBDIVISION MAP FILED ~THE~FICE OF~E CLERK OFf. FOLK CO~TY ALDEN W. YOUNG~ PROFESSIONAL ENGINEER ON dUNE Il, 1975 AS FILE N0.62~6 AND LAND SURVEYOR N.Y.S. MCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR ~ L~T~ W~L(W),SEPTIC TANK(ST)a CESS~OLS(CP)SH~N HERE~ N.Y.S. LICENSE N0.45893 TDY POST E0494 ,,,~ ~$ U~LtIWFUL '~?~!gHOUT CERTIFICATE pLUMBER CERTIFICATION oN LEAD CONTENT BEFORE cERTIFIcATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/I0 of 1% LEAD. c ! J il C 'C .{ ~ " ENEP, Y' CODE CALCOLA.TION5 ..,~ O,~$ YS T£ A\ .2o 003 1) HEATING EQUIPMEAT2 TO MEET 7813.23 - 75% EFF. 2) HEATING CONTROLS TO MEET 7813.13 RANGE 45 TO 75 DEG~EH FAHRENHEIT. 3) WATER HEATING P~ 7813.31 THRU .38. 6'70o II. do° TO THE BEST OF MY KNC~EDGE, BELZE~, AND PROFESSIONAL 3UDGEMENT THESE PLANS ARE IN COMPLIANCE WITH THE CODE. 4) PIPE INSULATION 7813.19 5) WINDOWS - DOUBLE GLASS. 6) CONSTRUCTION TO MEET N.Y.S. E~ERGY CODE. i- c-cs GREENPORT, N.Y. 11944 Phoae 47%0400 .I - · Phone 477-0400 Mai ~ Road L , ,,GRErEN, PORT' N',Y' I 1944 ,,