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Home My WebLink About16035-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate 01: Occupancy No Z-16541 Date December 28, 1987 CONSTRUCT ONE FAMILY DWELLING WITH ATTACHED GARAGE THIS CERTIFIES that the bmldmg . & ATTACItED'hVOOD'DECK ............ 340 Orange Road Southold, New York Location of Property House No Street Hamlet County Tax Map No 1000 Section 078 . .Block 0I .Lot 02 Subdivision .............. Fried Map No .Lot No ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated 16035 Z · M.~j.o,, 1.,.,9 .1987 pursuant to winch Building Permit No ................ dated June 8,.I 987 .... .. . . was issued, and conforms to all of the requirements of the applicable prommons of the law The occupancy for which tlus certificate is issued is ... ONE FAMILY DWELLING WITH ATTACHED GARAGE & ATTACHED WOOD DECK RICHARD & JEANETTE MARINESE The certificate ts issued to ~,w' ' of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO . PLUMBERS CERTIFICATION DATED: 87-S0-64 PENDING - December 22, 1987 Dec. li, 1987 - O'Connor & Son Contracting Building Inspector Rev 1/81 IFOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~_ 1 ~035 7. Permiss:on is hereby granted to: ..~..~......~....g.... ................. at premises located at ....~.~...0. ....... ..~..~%,.......~......: ........ ...~..~.~ ............... ................................................ Coun~ Tox Map No I000 Sect,on .... ~ .~..~.. ...... Block ....... ..~....~ ........ Lot No ......~ .~ ..... Building Inspector. Building In.q>ector Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OC Instructions A Th~s apphcat~on must be filled ~n typewriter OR ink, and submitted m duphcate to the Budding Inspec- tor w~th the following; for new buddings or new use' 1. Final survey of property w~th accurate location of all braidings, property lines, streets, and unusual natural or topographic featu res. 2. F~nal approval of Health Dept of water supply and sewerage disposal-(S-9 form or equal) 3. Approval of electrical installation from Board of F~re Underwriters. 4 Commercial buddings, Industrial buddings, Multiple Residences and s~milar buddings and installa- tions, a certificate of Code comphance from the Architect or Engineer responsible for the braiding. 5 Submit Planmng Board approval of completed s~te plan reqmrements where applicable. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-exist~ng" land uses' 1. Accurate survey of peoperty showing all property hnes, streets, buddings and unusual natural or topographic featu res 2. Sworn statement of owner or prewous owner as to use, occupancy and cond~Bon of buildings. 3. Date of any housing code or safety ~nspect~on of buddings or premises, or other pertinent mforma- t~on required to prepare a certificate. C Fees' 1 Certificate of occupancy $5.00 2. Certificate of occupancy on pre-ex~stmg dwelhng or land use 3 Copy of certificate of occupancy $1 O0 New Budding Local,on of Proper Hour' B o. ? a Owner or Owners of ProperW ~ [ ~ ~ ~ County Tax Map No. 1000 Section . O~ ~ PermitNo. ~3J Date of Perm,t .~////~ ....V~. . OldorPre-ex~st~ngBudd~ng $5.00 Vacant Land ......... ........ Block ~ J ........ Lot..~ ......... Health Dept Approval ..................... Labor Dept. Approval ................... Underwriters Approval ......... Planmng Board Approval ..................... Request for Temporary Certificate.. .... Final Certificate ..................... Fee Submitted $ described budding and perm~rre'~al~pphcab~e,co, d~s ~d reg~lationsv /'2 Construct,on on above Apphcant ~ ~''//. .~..~..'~'.. ;~//.~ Rev 10-10 78 OU~DATIO:~ ~[lst) OUNDATION (2nd) OUGH FRAME PLUMBIN~ NSULATION PER N. Y. STATE ENERGY CODE FI~.AL ADDITIOn[AL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Buildi~ Permit NoZ (please print) {please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's slgnature) Sworn to before me this /~ day of 0C~ , 1 g7 County Notary Public 'o 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [/'~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: /~' ~,/~"~ "'~'F V'~/' / - DATE INSPECT~_~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL / ,,, INSPECTOR ~/°/~~ 765-1802 BUILDING DEPT. INSPEC N FOUNDATION 1ST [~]' ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ~JGH PLBG. FOUNDATION 2ND [~ INSULATION FRAMING FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [.~UGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE Examined '~ .A..t.,~.~. ~. Approved 1 4"13k"~' ' ~' Disapproved a/c ., 193.'7 , 19~'~ Permit No BOARD OF HEALTH ~--. 3 SETS OF PLA~.Sz ...... FORM NO I ' ' SURVEY .... ~_ ..... TOWN OFSOUTHOLD CHECK -~-~-~'- · BUILDING DEPARTMENT SEPTIC FORM (7. ~ ....... TOWN HALL $OUTHOLD, N.Y 11971 NOTIFY TEL.. 765-1802 CAUL · 7~5" MAIL TO' (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ...... 19 ~. a. Tins application must be completely filled in by typewriter orzn ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relatmnshlp to adjoining premises or pubhc stree or areas, and giving a detmled descmptmn of layout of property must be drawn on the dmgram which is part of this appl cation c. The work covered by tlns application may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Bufldmg Permit to the applicant. Such perm shall be kept on the premises avadable for inspection throug.hout the work e No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bmldzng Department for the ~ssuance of a Bmldlng Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construchon of bmldmgs, addmons or alterahons, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and admit authomzed inspectors on premises and m bmldmg for necessary insp/c~it~ns · .... (Slonature of apphca~t, or name, zf a corporangn) (Mad~ng address of applicant) State whether apphcant ~owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde ...... ............................................. Name of owner of premises. /~.,~...~a/,{~ ,t., ~1~,//,~' /'~'./~.t~{?~-a' ~ (as on the tax roll or latest deed) If apphcanp~~n/~~g,~ran , ~ duly. t ed cer. · /' ' (Name'a~c~ t;tle of corpor'at~ officer') ' ' ' ALL CONTRACTOR'S MIJST BE SUFFOLK COUNTY LICENSED Budder's License No Electrician's Llcense No /~.~...~'~.'~ Other Trade's License No 1. Location of land on which proposed work will be done ttouse Number County Tax Map No 1000 Section Street 2 (Name) State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction Block .../ .. Lot. a Exishng use and occupancy b Intended use and occupancy Nature of work (check which applicable) New Budding ~ Ad&tlon Alteranon Repmr .......... Removal ..... Demolition ..... Other Work ....... f (Descnptmn) Esnmated Cost . ..// (~/ .1:> ~ ~... Fee .................... ' (to be prod on filing th,s apphcatmn) If dwelling, number of dwelling umts ~ Number of dwelling units on each floor .... If garage, number of cars . . ..,2~ ............................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ........ Dimensions of existing structures, if any Front . Rear .. . Depth .. Height ... Number of Stories ..................... Dunens~ons of same structure w~th alterations or addltlons Front ...... Rear ....... Number of Stones Depth ............ Height .... t .... t ' ' ' Dimensions of enti[e new construction' Front. ."~.'1,~... Rear . .").~.l. ..... Depth . i~..~ ...... Height ... ]d}.~.~ .. . Number of Stones . ~ .... Size of lot Front . ~/~. o ....... Rear. ]..q'~. ............. Depth ...] Ot"~ o i~"-~ .. Date of Purchase ~ ........... Name of Former Owner ....~----~. ................. Zone or use district in which premises are situated ...... Does proposed construction violate any zoning law, ordinance or regulatlo'n'''' i i ' ./~.' i' i. iiiii'i. Wall lot be regraded .... ~ ~-~3 ......... Will excess fill be removed from premises' ,Yes Nd. me of Owner ofpremlses /i~tt~k~'~,~ ~.~'~.~.1~... Address ~/g~: ,~'t,(,~ ~,,... Phone No ........... Name of Architect ........ ~ O..~:*/?t. 6~'.. Address ./~'m~. ~.'r'~..~'~ i'j,,,I,,~'9_ Phone No. . N~e of Contractor ~, ;~. ~ta//~ &,~,~ ~ Address t..~.~.~ C/..~.t~/: .l?*~'J0gtmne No ~.~..~.-.l ~ .~ .~77 .. · Is this property located w~thin 300 feet of a tidal wetland? *Yes ..... No ..~-... *If yes, Southold Town Trustees Permxt maybe required. PLOY DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and ~ndmate all set-back dimensions from ~perty lines Give street and block number or descnphon according to deed, and show street names and indicate whether enor or corner lot. ATE OF NEW--K, )UNTY OF . ,]W''/ .... S S. · ...... /'~. ~'~.&.-~."~ .~.: .t~. '~..~ O..~. I [ .... being duly sworn, deposes and says that he is the apphcant (Name of lndwidual slgnmg contract) eve named /j is the * ' ~ ~ (Contractor, agent, corporate officer, etc.) said owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and file ti'as '~hcation, that all statements contmned in this application are true to the best of his knowledge and belief, and that the ,rk will be performed In the manner set forth m the apphcanon filed therewith. om to before me this day of. . .'~ .~ tary Public, · ..... ~ ....... ? Not~ ~ub[io, ~t® of N~,~t~_~x~P/ Term Expires December 31, 19 "~ ~ (Signature of applicant) o .¢- N, 8.5 °3g-40"E- lOO.O ¢- er.e, , I '~ SINGLE FANI[¥ t)WEI.UN~ ONt. Y OAT~~H S. REF NO The sewage d~sposal and water supply facilities for ~m Iocahon have been respected by th(s Department and/or ',~ ChJefof ,B,u, reau of W, ast.ewater Ma. nagement RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREEN~RT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM~T~I~- S/T~.~,AF~OS OF THE '.,APPLICANT · n . SUFFOLK COUNTY DEPT/tfb~If HEALTH SERVICES -- FOR APPROVAL OF CO,STeUCTION ONLY DATE H s REF NO 5o-~.t .... APPROVED' .... ' SUFFOLK CO TAX MAP DESIGNATION LIST SECT BLOCK PCL OWNERS ADDRESS , DEED L.,i/, TEST HOLE SEAL -t ROOERICN YAN TUYL. P.C. LICEN~D LAND ~RVEYORS GREEN~RT NEW YORK H S NO 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. (si .... APPLICANT SUFFOLK SERVICES -- FOR CONSTRUCTION ONLY DATE , H S REF NO APPROVED COUNTY DEPT OF HEALTH APPROVAL OF SUFFOLK CO TAX MAP DESIGNATION DIST. SECT BLOCK PCL 1 ~,O f..3 0'7,.g [ , o- )WNERS ADDRE . DEED L t4/~% P. TES~i' HdLE "STAMP" ' SEAL -p S. ~5 °o~ -'~,O"~ v.-tO0.O r ~) t '1 RODERICK VAN TUYL, P,C. LICENSED LAND SURVEYORS GREEN~RT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL OF THE SUFFOLK CO~'f~II' O.F HE~TH SERV~ES _ ~ICANT . ~ SUFFOLK COUNTY DEPT OF HEALTH CONSTRUCTION ONLY ~FFOLK CO TAX MAP DESiGNATiON DIST. ~CT aLOCK ~L OWNERS ADDRESS F~,MIL¥ DWr-LL!NG ONLY rEARS FROM DATE :ED. L t ~/~ P, TEST HOLE STAMP SEAL WITHOUT CERTiFlcA:TE,:,, < OF OCCtlPANC¥ ~' d~ibUNng SOLDER USED IN WATER SUPPLY SY,~TEM CANNOT EXCEED 2/10 of I~ lEAD. PLUMBER CERTIFICATION , ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY C-EL L/A ~, , 0 Ix! T t~