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FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15109 Date November 19 8.6. THIS CERTIFIES that the building ..... Qx3~..~.aSrgj.~l.~...dW.~.l. 1. ~.t2~t..' ................... Location of Property ...... 3.75. R.ay. ctor~ .I~r, ........ S.Q~3.t.h.ql..d. House No. Street ................. County Tax Map No. 1000 Section 079 .Block 05 ...... Lot 23.1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. Ju./.1~. 15 .......... , 19 8.6. pursuant to which Building Permit No... 1. .5.1.0.8..Z ............ dated ....J.u.l.y...1.9 ................. 19..8.6, 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. The certificate is issued to . JOSEPH CASSIDY .................... ?o;;,n'o'r ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... .8.6.-.S. Q7.8.4. ........................... 31777865 UNDERWRITERS CERTIFICATE NO ................................................ . . PLUMBERS CERTIFICATE 11/19/86 ~// Building Inspector Rev. 1/81 ]FOB~ NO. I TQWN OF SQUTHQLD IHLjlLDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDit~IG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N'? 1510~ Z Permission is hereby granted to: ........ ~......~....~.,....!.!..~.! ............. ,o at premise* located at ...~..~..,,,~ ........ ~ ............................... County Tax Map No. lO00 Section ..... ,,0...~....~. ....... Block ...... ,~.....~.~.. ....... Lot No ..... ..~-...~.!..J ....... Building Inspector, approved by the Building Insgector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted I~ 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 e~ectrical installation from Board of Fire Underwriters. 4. Co~rc-i~'l b~'ildings, 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 pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 · 00 3. Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 5. Updated .... C .O. $15.00 Date.. ,/~..--7../. J.'.~.~. ~,. ....... ~ld or Pre New ~,P,n~P~ '.~.u ~, -existing Building ........ Vacant Land Location.of P~r~operty .,. ,.,..~..ri .~. ..... ~.r~. V..~.o. ,k ....I.~ ~_ ......... .~.o..c,.~--.~ p. Zq¢. ........ :,,*~'~,~,.~-.~%'~m'~-..~=4'louse No. Street Ham/at Owner or Owners of Property .. _'..~.% ~'~).~....~.o-..~.%; d ~. ................................. ......... Block., . .~..~¥ ....... Lot.. ~.~. ~../ ...... Subdivision-. ;,; ~.,. 7;¢ ..-, ...................... Filed Map No ........... Lot No .............. Permit No../..~./P.~. Date of Permit .~.~,/;-~<../ZApplicant ...... /? .¢~'../.. ,' .~.' ,~. ,~. ~.',~.'.'~. .... Health Dept. Approval /~..~.. ~. .......... Labor Dept Approval "- -- Underwriters Approval ·.. .~ ~ .. ........,....Planning Board Approval ...'...'~T'rT. ,. '~ ................ Request for Temporary Certificate ..................... Final Certificate .. y ~ ............. Fee Submitted $ ..... Construction on above described building an~~ app~c~le codes and regulations. 1001071 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY IE~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.t~ ~ove~x~r 6, 1,986 417024/~6 No.o.S,,e N 77'7865 THIS CERTIFIES THAT JoseF~h C~sidy, 375 Reydon D/~LVe, Southold, N.Y. in ,hefollowlng IocatJon; ~ I~asement ~ Ist FI. ~ 2nd FL Section Block Lot tt~s exart~ined on ~0~ ~0 ~ ]~ arid found to be in complionee u'itl~ the req~:iretnents qf th s Board FIXTOE$ ~ FIXTOEES RANGES ~KING DE~K$ ] OVENS ]DISH WASHERS DRYERS ~ FURNACE MOTORS FUTURE A~LIANCE FEEDERS SPECIALREC'PT SERVICE Di~ONNECT OTHER APPARATUS: NO. OF METER · OF CC, COND 2/0 R V I C NO OF HI-LEG EXHAUST FANS MULTI-OUTLET SYSTEMS NO. OF FEET E 2/0 Ton A/C Unit ]-G.F.C.I..g--Sr~ Detecto~ G&S Elec'~ic Bo~ 215 Southold~ N,Y. 11971 IAc. 578E GENERAL MANAGER 11 This ce~t_~ifi¢ote must not be oltered in ony manner return to the off ce of the Boor~ f incorrect Inspectors ~UPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST N * TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date //~/~--~ Building Permit No. / Owner .~.~, (please -PriHt) (tp~lease pr i~nt) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this / ? d~y of ~-- , z9~¢ Notary Public, ~ County Notary Public HELEN K. DE VOE I/OTARY PUBLIC, State of New York No. 4707878, Suffolk Count~ ~ Term F. xp/res i~mh 30,19 ~/ FORM NO. $ TOWN OF SOUTHOLD Building Department . . Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF QCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and sub~ :tad in duplicate to the Building Inspec- tor ~vith the following; for new buildings or new use: ' 1, Final survey of property with accurate location of a{l buildings, property lines, streets, and unusual natural or tooograohic 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 ,building~ 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 a~.d "pre-existing" land uses: 1. Accurate survey of peoperty showing all prooerty 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. Dare of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. , ! . C. Fees: 1. Certificate of occupancy $5.00 /land ' ~' ~' ' 2, Certificate of occupancy on pre-existing dwelling use /3/$5.00 3. Copy of certificate of occupancy $1.00 Da~e ..~ove.m~..er 2, 1983 ' ' -....x New Building .......... Old or Pre-existing Buiidin ......... = ... · ' ' ZVacant Land Location of Property .......... Reydon Drive . ' _ Sou 'ld House No. $~reer ........... Ham/et OwnerorO~ rs of Property Georg B Aks in & Opal R Aksci ' County Tax Map No. 1000 Section 079 ' 5 ' ' ......... :-- Block ............... Lot SubDivision .......................... Filed Map No ........... Lot No .............. Permit No Date of Permit ' ^ pplican' ' Health Dept Approval · La~bor Dept Approval ....................... Planning Board Approval .................. Underwriters Approval . Request for Temporary Certificate Final Certificate' .%..o.o. Fee Submitted S ' ,;,ila.la. Ta - _ ~cnara ~'. L~r~/( 'a'ttor~ey for' applicant' 785~XSOZ BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL 765-180Z BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ] ROUGH PLBQ. FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING REMARKS: DATE '7/~//~&/' INSPECTOR.,/~C:~(~ 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ;ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE 7GS-'~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE,,, '~/~/ I'GS-:LS02 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE FIELD FOUNDATION ~' (~lst FOUNDATION (2nd/ ROUGH FRAME & t!DATE !t PLUMBING INSULATION PER N. STATE ENERGY CODE Ye ADDZTZONA'L COMHENTS: . 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 ., 19~. ¢. ., 19~¢. Permit No../. h--J.O...~. ,~ Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,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 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 shail 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 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~,~afFd~ther applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for,femoj/al or demolitio~ as herein described. The applicant agrees to comply with all applicable laws, ordinan6es, buildin~'cod, e/, housing code,End regulations, and to admit authorized inspectors on premises and in building for necessary inspecffon~r" __ / ........ /' ~' '~'~' · '~'~Vo;;; ·; ...... (SignOre ofapplicant,~name, ifa o p at'on) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... . .~:>.~,~ ~.~/....c2o ~ ~.~:,~ ~ .~. ......................................................... Name of owner ofpremises'~te~,~../~-.'..k.Z.~.t'% ~..~.r~.~ *.~,'}t. - (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ ~...~..< .......... Plumber's License No ..... .~. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ........ 3-~ ................. ~ .J.o.~...~.o..~ ........ ~'r~.~. ................... House Number'~ 7~treet Hamlet County Tax Map No. 1000 Section .... ~ .rT..~. ...... Block ..... .~. .......... Lot... o~.~.'/ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~.~.c.-r4~..'T~.. .................................................... b. Intended use and occupancy ..... ~.~. ·. <~ t. .... ~q ~.~ ~,o¥ .~,.%%, · .~,: ,~ ~.~ ,e~.;~ .~ ......... 3 } Natu e ofgvork*(check {4~ich ~ pplicable): New Building Addition Alteration [ Repair ............ ~..~.~¢r royal .............. Demolition ............ Other Work .. [ ' ~ ~ I I~. {'~!i~ ! (Description) 4 ~ Estimate ~._~_;t~ ~ ~ ~o o ..... ......................... ...................................... [ ~ , i~ :.~, ~ , _ (to be prod on fihng th~s apphcat~on) 5~f'dwelling 7num'b¢~.6~ing unit s ....... ~. ...... Number of dwelling units on each floor; ...... 77 ....... If garage, number of c~s ... J.. ~ .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7 D' ' s o~~--~-*~ ~*~,~*"~- :~ ..... ~-~-* Rea Depth Height ............... Number of Stores ....................................................... D~ensions of same structure ~ith alterations or additions: Front ................. Rear Depth .................. ~ . HeiSt Number of Sto~es .8. Dime:nsions of entire new construction: Front ... ~ ~ ~.~.t .... Rear ~9.'.~. Depth ~,. ~.. ~..~'. .........~..'"" ..... ..y/~: ............ '. ...... . ........ 11. Zone or use district in which p~emises are situated .... .~.~ .~. ................................. .. . ... ... 12. DoesproposedconstructionviOlateanyzoninglaw, ordinance or re~lation: ...~. ......................... 13. Will 10t be regraded ..... ~ .................... Will excess fill be removed from premises: Yes ~ 14. Nme of Owner of premises . ~ ~ .~ ~5.1~ .... Address ................... Phone No.~ ~-~7~. Nme of Architect ......... ~ .................. Address ................... Phone No.' ............... Nme of Contractor . .~. ~bm* .~a ........... Address ~.V~gt~ ..... Phone No. ~ .~.-~g~.~.. PLOT DIAGRAM . Locate clearly ~d dis~cflg ~1 bufld~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from property ~nes. Give street ~d bloc c number or description accord~g to deed, ~d show street nines and indicate whether interior or comer lot. ./~oo - o7,?_ %_ 9.:31 ~~~(S~nature of applicanti~ ..... ~. ~.../-7~ ........... day o:f... ~ ........... 19 .~.. Not i' Term STATE OF NEW YORK, COU.NTY ~ ..~(~ .... S.S ........ Im.~. ee 1....-1~ ~.e .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ........ ~. .............................................................. (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;that all statements con[ained in this application are true to the best of his knowledge and belief., and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this SUFFOLK COUNTY HEALTH DEPARTMENT ...-'2, H.D. REF. DATE ... THE SEWAGI l, LOCATION SINGLE FAMILY DWELLING ONLY O, · DISPOSAL AND WAT~ I SUPPLY-FACtLITJ~O~Ta~}~ [/~VE BEEN iNSPECTED BY THIS ~~t~( Management ~ti~ TELEDYNE ~DST LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H. S: NO. '~' :'©~S4 STATEMENT OF INTENT THE WATER SUPPLY A~I~SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM T,O THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPL I CANT SUFFOLK cOUnTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO. ~'~.~ ,-.~ APPROVED :~UFFOLK CO TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL OWNERS ADDRESS:~ DEED: L. P. TEST HOLE STAMP SEAL PLEASE NOTE -~,My and sewage FOOt.. ' RJ~OE:R ICK V,A~bL.TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK .I SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLI~'(~. DEPT. ~V~E (st APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE:. H. S. REF. NO.. APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. tO00 079 ' 5 ~ 'OWNERS ADDRESS: DEED: IL. TEST HOLE I STAMP SEAL k~ATC-z.,e6 Il ~ t-bln~ I~ ual ~,,,,,., ,~,,,,'",""" OCCUPANCY OR ~y~te~t; piping ,,hall be ,,,,,.,-~ USE IS UNLAWFUL WITHOUT CERTIFICATE ^..ova. EXCEED 21tO of I~ ~D. : ~, ~ ' ' ' - le5-1 PLUMBER CERTIFICA T/ON 2 ROUGH ON LE~D COA~T.CN7 : : 3. INSU~T~RUCTION MUST SOUTHOLO _ _U~41~_~.INC. 2 7'0 7'0 I I 1131 SOUTHOLD LUMBER CO,, INC, YOUNG~ AVENUE 12. p./-. ~,-:; OUTHOLD LUMB~J! I:O., INC. YOUNG,~ A~IEIIUI[ $OUTHOLD, Ili.Y. '1'1~1 7e5-2.662 7~,,44 ,I SOUTHOLD LUMBER CO., INC. YOUNG8 AVENUE SOUTHOLD, N.Y, 11971 765-2552 765-E~.~*.