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HomeMy WebLinkAbout15592-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z-16103 Date August 27, 1987 THIS CERTIFIES that the building ...O.N.E...F.A.M.I..L.Y..D.W..E.L.L.I.N..G ....................... Location ~" ~ 2870 The Long Way East Marion, New York ct rropeny ~Ss~ ~V'ol ....................... ~}/o~t' ....................... County Tax Map No. 1000 Section 030 .Block 02 .Lot 116 Subdivision M/o Pebble Beach Farms .Filed Map No. 6266 .Lot No. 57 conforms substantially to the Application for Building Permit heretofore filed in this office dated December 18, 1986 15592Z ...................... pursuant to which Building Permit No ...................... dated........,............December 23, 1986 ....... 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 WITH ATTACHED WOOD DECKS The certificate is issued to C H R I S L 0 L I S ..................... k;~r;e'r,'ig.~d~X~X .................... of the aforesaid building. Suffolk County Department of Health Approval 86 - 8 O- 2 ~ 7 UNDERWRITERS CERTIFICATE NO. ~ 000006 PLUMBERS CERTIFICATION DATED: July 1, 1987 Building Inspector Rev. 1/81 ~0~ NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~'-~5592, Z Date ....~~ .......................... , Permission is hereby granted to: a , ,o o~r~,~,~o~ o~...~..~...~.~. ......... ~.....*...~...~.~. ....... z~......m~.. ...................... ~ .... ~ Coun~ Tox ~op ~o. 1000 Section ~ ~ Bilk ..... ~ ............ Lot ~o ................... Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 TOW \~ O; ~X)UTk~'iL~ ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate 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 disposel-(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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-e,xisting" land uses: 1, Accurate survey of peoperty 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 pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling ~r 3. Copy of certificate of occupancy $1.00 land use $/s'/$5.00 Date .. July- 31, 1987 . · New Building _~'~ .......... Old or Pre-existing Building(X) ........... ~ ~Vacant Land 'i ............ Location of Property . .,,~.~?.0..".~.~¢..~,,qng. ,~, .a,7.~. ~. ~9~ .~.,..~. ~,~...~¢~. Beach Hou~ No. Street Hamlet Owner or Owners of Property ~. ~[~...:: .~ ..................................... County Tax Map No. 1000 Section .... 30 ......... Block ...02 .......... Lot .... ~,6 ........ Subdivision Pebble Beach ~arms .Filed Map No. 6266 .......................................... Lot No .............. Permit No. 3,,5.5.~2..~, .. Date,of Permit ]=.2..z/.~./.8..6.Applicant ]~':[~L[~]:) .~.O~[~E~ Health Dept. Approval .?./.~. 02/.8.?. ............... Labor Dept. Approval ...................... ,.. ~'0.O000z~ d App Underwriters Approval ...................... Planning Boar roval .................. Request for Temporary Certificate ..................... Final Certificate ........ - ......... Fee Submitted ~ ~2~o00 Construction on above described building an~Lf~it' meets all apl~cj~16code~ and regulations. ,.~. ~o-,o-ya Rober~ ~.. Hil~z - ~_~I~D H0~ES, IRC. 0 I/,, TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CE RTI F I.C AT I ON - Date July 1 ~ 198g Building Permit No. 15592Z Owner ~h~ L~I~ (please print) Plumber Fr-n~ p.z~enz~td/h/.prim) B~v Plumbing & Heating (please - I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this )~>. day of~~ , Notary Public, ~ ~k3 County (plumber' ign~ure) Frank Pazie~z~aig~ ,o, Term Exp*res Decelnbe~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. IN/SULATION ~FINAL DATE .... INSPECTOR 765-z8~2 BUILDING DEPT. INSPECTION ~~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS-. ~ ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATE INSPECTOR ~ ~v~ ,~ ~"ILO[~G DEPT, % iNSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION I- ] FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [//J/INSULATION FRAMING FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [i/]~RAMING [ ] FINAL REMARKS: DATE ~/~/~ ~ OUNDATION ~(lst) OUNDATION (2nd) RAME & :NSULATION ?ER N. STATE ENERGY CODE . ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approv~~..~..~.., 19~.b.. Permit NoJ. ~.$~. ~.,,~. ~ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date Decembe~l 5 19 86 INSTRUCTIONS a. This application must be completely filled in by bdpewriter'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 ~ Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAI)E 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. INLAND HOMES, INC. (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N. Y. 11952 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or 1 er. .................... ~.eneral..Con.trac ~zar ...................................................... Name of owner of premises . .C..h.r.i.s...LQ.l.i.s. ........................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .t.z.,..e.r..e.s.i.d.e..n.t ............ (Name and title of corporate officer) Builder's License No ..... .- .................... 517-P Plumber's License No ......................... 2816 Electrician's License No ....................... 0ther Trade's License No ...................... ~'~<~ '-~ O x~ ~ ~j~ 1. Location of land on which proposed work will be done...'.U?ehblO. Beach..Earl~ts.'! .L~tt .No,..57, ......... House Number Street Hamlet County Tax Map No. I000 Section ...... .~..O. ........ Block .... .~ ........... Lot..fi./..~. ............. (Name) 2. State existing use and ~ccu~ancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ..................................................................... 1 family dwellin9 b. Intended use and occupancy .- ................................................................... Nature of work (check which applicable): New Building X.X. Addition Alteration Repair .............. Removal .............. Demolition .............. Other Work ................ ~[[g ~ ~ (Description) Estimated Cost ..................................... Fee ...................................... (to be paid on filing this application) If dwelling, number of dwellin units ... 1 Number of dwelling units on each floor... If garage, number of cars ........ .1 .............................................................. 6. If business, ' ' ' . .................... commermai or maxed occupancy, specify nature and extent of each type of use 7 Dimensions of existing structufres if any: Front Rear ' Depth Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. i · · · Height ...................... Number of Stories ...................... 'truction: Front Rear Depth 8. Dimensions of entire new cons, . ............................................ Height ............... Number of Stories ....................................................... 9 Size of lot: Front ' Rear Depth 10. Date of Purchase ............................. Name of Former Owner ............................ 11. Zone or use district in which plremises are situated ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ ione~remiseS:No..7.1.8.- 13. Will lOto be regraded ....... · Chrls~''" ................. Lolls Addres~r~.~ ¢th' N~'~'~...Will excess fill be removed frOmp] .~'~,._~o ,N,,o~..~y .~.o.~..~. 14. Name fOwnerofprem~ses .! .................. Name of Architect ~ Address PI ~one No Name of Contractor IN...L-Pct.-D,. H.O.~.I~..Ss. I.N..C:. AddressBg.x. ~7.,/~t.tituc.kp] ~one No~gOr.9.~96. 15. Is this property located within 1100 feet of a tidal wetland? * Yes . .. No ..... · If yes, Southold Town T~ustees Permit may be required. J PLOT DIAGRAM ]Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate set-back dimensions from property lines. Give street and block number or description according to deed, and show stre: names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY:OF..~.I$..~F.O~:..K. ...... S.S ......... R.o.b..e.~.t..E.:..H.i..1.t.~ ....................... being duly sworn, deposes an( says that he is the applicant (Name of individual signing contract) above named. He is the Contractor (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file this application;that all statements cootained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man~er set forth in the application filed therewith. Sworn to before me this 17th ' D~¢~mb~r 198..6 ........................ day Of ..................... , · Notary Public, .... ..SUFFOLK Countl .. CO~FORM TO THE STANDARDS OF THE SUFFOLK COUNTY D~PARTM~NT O~ HEALTH SERVICES APPLICANT ADDRESS -- -- TEL - - GRASS Lot 58 i. ot 56 vocO~t REV|$1ON$ JAN. 5 ~ 1987 JULY 8,1987 Lot 57 . $0. F1: AREA; 21657' Ur/ENO. 7GS-05085 NOTE.: : · = MONUME.NT A =STAKE ~USOIVI$10N MAP F/LEO IN tHE. OFFICE. OF TNE C£E.RK OF SUFFO£K COUNT~ ON dUNE II, 19Y5 AS FILL'NO. 6~GG. SUFFOLK COUNTY TAX MAP DIST. IO00 SECT. :~0 BLK. 02 LOT 116 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG~ HOWARD W. YOUNG SURVEY FOR: THE LOCATION Of WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELO OBSERVATIONS ~ND/OR F~OM DATA OBTAINED FROM OTHERS THE WATERSUPPL'Y AND SEWAGE DISPO~J~,L SYSTEMS FOR THIS RESIDENCE WiLL CONFORM TO THE STANDARDS OF THE SUFEOLK COUNTY DEPARTMENT O~HEALTH SERVICES APPLICANT ADDRESS · TEL REVISIONS · -' MONUMENT' SUBDIVISION MAP FILED IN TNE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON UUNE II, AS FILE NO. 6266. YOUNG & YOUNG' 4~00 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SURVEY FOR: CHHIS LO~IS LO T NO. 5~ "PEBBLE BEACH 'FA~ TOWN oF SOuTHOLD . C~ SUFFOLK CO., N.Y. SCALE: '/'~ 40' ] DATE: OC~. 19, 1'9~'~, SUFFOLK COUNTY '- . RW~H~qO 4.Y. 11901 mR APPROVAl. O[ CONS~CTIO~ ~ . ~ ' ~in~Family R~dence Only SUBDIVISION MAP F/LEO IN THE OFFICE OF THE As F~NO. ~.  _,~ * 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK A~ICANT: '~ .... ~ ~ ~_ j ALDEN W. YOUNG Box 117 + Mattituck, N.Y. 11952 HOWARD W, YOUNG SURVEY FOR: CHRIS LOLLS LOT NO,. 57 "PEBBLE BEACH ?ow.o, SO~.'HOLO c0., ,.,. ,1, :PLUMBER CERTtFi~ TION : . , K/F/CATE:OF OC~'~UP~'I~CY ' '