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Home My WebLink About14828-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy bio Z15301 Date Feb. 24~ 1987 THIS CERTIFIES that the building...O.n.e...f .an).il. y..dw..e .1.1 .i .ns: ......................... Location of Property .... 325. EA!4S. LAI~$ ............ c. u. T. C. H. 9 .G.U.E ..... i ................... House No. Street Hamlet County Tax Map No. 1000 Section . . J 93. ....... Block . . 4. ............ Lot . ...2.1 ............ Subdivision .~0C)S.E..C.O.V.E..E..8%: ............... Filed Map No.3.2.3.0 ..... Lot No..4.3 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ,..April.2g,. 19~6 ...... pursuant to which Building Permit No....l.~gg~3~ ............. dated .... ~...ay..3 ,..1.9.8.6 ............... 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, including 2 car garage, deck and covered porch. The certificate is issued to DONALD H. & LYNN K. MONTGOMERY ..................... /o7n¢;, 'Fag'~a~R~k ..................... of the aforesaid building. Suffolk County Department of Health Approval .. g5:-80~.1.47 ............................... UNDERWRITERS CERTIFICATE NO. N783471 PLUMBERS CERTIFICATION DA~ED: 2/23/87 ' Building Inspector ...... Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERt~IT (THIS PERMZT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1~828 Z Permission is hereby granted to: .....~b..~.L.~..~.~ ..... .... ~.~..~.~. ,..~,,~.:....!.!.~..~.~ .......... , -~ .................... ........... et premises located at ....................................... County Tax Map No. lO00 Section ....... l...O...~ ....... Block ...... .g...Oj. ........ Lot No.....--~.! .............. pursuant to application doted ........ ,.~..~.. ...................... , 19..~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR 198/ BLDG. OEPT, TOWN OF SOUTHOLD Instructions This application must be filled in typewriter OR ink, and submitted .- ~ 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. Bo 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. 1. Certificate of occupancy New Dwelling~$25.00, Accessory i$ ]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copv of certificate of occupancy $ 5,00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~.c~.'.., ./~../~. ~.x~.~.. x%/.(~.../~..~_/y., .~.~ ~. ~.~ ~ .............. House No. ~treet ~ Ham/et Count TaxMa No 1000Sectio~ ~ . Block . ~. ~. Y P .......................... Lot... Subdivision .... ~ ..... ~ .............. Filed Map No.~...Lot No...~ ....... Health Dept. Approval ....................... .Labor Dept. Approval ..................... . 2/ .......... .oa. ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... COMMENTS FOUNDATION FOUNDATION (2nd) CODE FINAL ADDITIONAL CO~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING REMARKS: [ ] ROUGH PLBG. ] INSULATION [ ] FINAL DATE INSPECTOR,,/~~ 76S-1802 BUILDING DEPT. INSPECTION [/--~OUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: i 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION DATE INSPECTOR ,,,, ~ 765-t~02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECrOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date c~/~/~y (please print) ~ (please prin~) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Public, HEI,EN IL DE VOE No. 4707878, r ~// Term E~l~re~ I~h 30,1~.- \ (plumber ' s signature/ 'Notary P~blic} loom'n THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW yORK 1'0038 ..,e :u, .,ppi,e.,,o. No.o. i,. N 783471 THIS CERTIFIES THAT only the electrical equipment ~ ~scribed belo~ a~ int~duced by t~ applicant ~med on the a~ve application number in the p~mlses of FIXTURES RANGES OVENS EXHAUST FANS FIXTUR 2~ 57 37 25 DRYERS APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS IULTI*OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: 1-G.F.C.I. l~r~ko DeteCtor NC) OF Hi-LEG NO, OF NEUTRALS OF NEUTRAL 2/0 C4~ Electric BOx '~1:5 Southotd, N.Y. llF~I GENERAL MANAGER I1 ~ This certificate must notbe altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BLJLDING DEPARTMENT, THIS COPY OF CERTIFICATE MUSTi~NOT BE ALTERED IN ANY I,~ANNER. ~, ~ ;: . : 'FORM NO, 1 · ~: ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined....."~...~.'~..,19~. Approved..· . .~. · .~ .~..., 19~. Pe~it NO. ~9.~.~ . . Disapproved a/c ..................................... (Building Inspector) ~PPEIC~TIO~ FO~ BOIkDI~G 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 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 pumuant 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 ins/f0ctions. .... d .................. (Signature of applicant, o~am/e, if a corporation) .... ,. . . .'z. , . . . ew. . . . .Z. . y. . . (Mailing address of applicant) I IClqt'.{ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... .~.o. ? .~.c.3... ~. .... .~-.... ~. ~.M'. :d.. K ..... ~ &'q'. ~....6Z2~ ~.~. ................... (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 .................................................. ·-23 .5T ................ .F ..read.& ................... ................ House Number Street Hamlet Map No. I000 Section /dP ~ Block ..... .~... Lot ' ~1 County Tax ' ' 'f~ ....i .................................... Subdivision... ~.~..~.~ ......... Filed Map No. ~.~)--'~Q> Lot /~'~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~./0. ~7. ~... ~4/.~-z3/.~..O.....z~...5~.. .......................... . ...... b. Intended use and occupancy .... ~'/~.~.C/7 ................................................. 3. Nature of work (check which applicable): New Building ..... Addition . i Alteration Repair .............. Removal .............. Demolition .........i... Other Work .............. 4. Estimated Cost ....... .I~. ~.0.} 6 6 & 5. If dwelling, number of dwelling units... ( ........ If garage, number of cars .... ,~ ............... (Description) ....... Fee .......... , ........................... ' (to be ipaid on filing this application) Number of dwelling units on each floor ............... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front.. ~/a~J~-- ....... Rear ....... i ....... Depth ............... Height ............... Number of Stories ............................ i ............................ Dimensions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ...................... Height ................... Number of Stories ......... ---& Dimensions of entire new construction: Front , ..~ ~ :' .... ~' ' ........ Rear .... .~..0.,. ......Depth .~,~.~.. ~. '" Height . Number of Stories . .~. .......... : . . t ~ ..... I ............. i ........ 9. S~ze of lot: Front ...... /.O~. ........... Rear ..... J~O ............. rDepth ...~ .... : ........ 10. Date of Purchase ........ ~/.~j~.~. ............ Nam9 of Former Owner J .-w..o.S~-~°~tM£..~,og&.2,z~o.;. .... 11. Zone or use district in which premises are situated.. ~aF~JO ~C~ ........ ! ............................ 12. Does proposed constructlon violate any zoning law, ordinance or regulation: . . .AJ.Q .......................... 13. Will lot be regraded .... .... /~.t~ ................ .~V/il.1 excess fill be removeld from premises: ~ No 14. Name of Owner of premises 2md.~v~%. ~-.4,~.~,.~. t~i~i~'~ess ~'0~..).tiC..~C...f-r~q~.t~hone No..tt~2~O&6 3 .... Name of Architect ...,ik,,'q-tZ..~..Y....T, t4 ~.r..t-.~. ..... Address ... ~e-~l°.~. t~... Phone No ................ Name of Contractor .......................... Address ............... i ....Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. i~dicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ....... S.S .... /~. ~J.&.~.b... t~ 0.~d.~£~..f.' ... ...... ·..... being duly sworn, deposes and says that he is the applicant' (Name of individual signing contract) above na~ned. He is the ..... 0. ¢tJ,~J/z~.~ ............................................. ~ ............................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this application; that all statements contained in this application are true to the best ofh is 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 · 2 ........ t~.. ..... , .....dayof. ~.L.~~. ....... ,19.~.~. $ tary Public, ..... ~-,~yr.....~:i&~[ ....... County....~..~c~. ~. ~.,. · , .......... (Si~turfof applicant) Tm'pA Expires MarCh 30,19 SUFFOLK CO. HEALTh DEPT. APPROVAL H.S. NO. ~ ~ ~ ~,, ] STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DIS~SAL SUFFOLK CO. DEPT. Of HEALTH SERVICES. (si SUFFOLK COUNTY DEPT. OF HEALTH ............... ~ SERVICES ~ FOR APPROVAL j CONSTRUCTION ONLY I DATE: I i H.S. REF. NO . j SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: ~ w DEED: L.~ P. 2~,~uJ~ ~.F. TEST HOLE STAMP ~ SEAL R~DERICK VA'N TUYL, P.C.~, [/~. ~~ 1 LAND SURVEYORS GREEN~RT NEW YORK ( VAt,.' ~,C A,?.C T., '? RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT' NEW YORK 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~. D E P_~a~ H~E A_~_~SE R V ! C E S. X'~AF~=J. lC N SUFFOLK COUNTY DER~F. ~F HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY SUFFOLK CO. TAX MAP DESIGNATION: LIST SECT BLOCK PCL, OWNERS ADDRESS: DEED: L ,u/A, P. TLS, HOLE ~TAMP SEAL - - ""~'- SUFFOLK CO. HEALTH DEPT. H.S. NO. ' 7; NAP OF PI2OPEI-ZTY ' DONALD N LY qN ' N, ~8 24 4O 8. ~,0 ~ · ¢ ~ATE~NT ~ INTENT ...... ~- ~ ............ ~ ~ ' ' THE WATER BY A~'~ DI~AL I . O SY~M r~ T~II RIWKE WILL , , . ~* ~. , ~.~ ~ % SERVICES -- FOR APPROVAL OF ~ , u~ ~ ¢' / / ' .;". ,~ ,b '~ -- t L ., ~,- .. ~., .... , ......../~-~ ~ T ~7.47 ~ --' G.~8'~4o '~. ~.o '~ ~v,o ~. ~ ~~T ~ ~K ..7 ¸ '~":"' .~', :~'>CERTiFICA'TE OF OCCUPANCy · , '- - . m=cO~L~T~ FOa C.O. GREENpORT, N.Y. i Ig44 S~PPLYSYSTEMCANNO~ ~u~ ~1~ ' ' STaTECO~SrRUCT~O~ ~ ~NEROY CODES. HOT RES~NSIBLE FOR EXCEED 2110 of t% LEAD, "'~EAIGN OR CONSTRUCTION ERROR~r . Main Ri)ad-' ,; (, ! GREENPORT, N Y. 11944 Phone 4~77400 ~ Main Phone47%0480 ~ Main Road