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Home My WebLink About14833-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy ~o. z..l.~.l, to. .......... Date . August 31 , 1987 THIS CERTIFIES that the building .. 9.n.e. . .f .a.m.i.! Y. fi.w?..1.1.i.n, g ....................... 625 Southern Blvd East Marion Location of Property ......................... · ...................................... House No. Street Hamlet County Tax Map No. 1000 Section 2 1 .Block . . .3 ............ Lot 2 9 S hcl' '' Map of Aquaview Park u~ws,on ............................... Filed Map No..5.6.2. !...Lot No. 4. ............ conforms substantially to the Application for Building Pem~it heretofore filed in this office dated . · .A. P .r 3.1. · 2..9 ~. · 1. 9..8.6 ..... pursuant to which Building Permit No .... 1.~ 8..3.3.z. ........... 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 ......... ...o..n.~..f.~..m.LZ.y., .~.~?.~. ~..~ .,.g.,...~.t.t.~. ~..h.~.d..2...?7...g.~y.a.g. ?: .......................... The certificate is issued to THOMAS E. WILSON, JR. & BETH D. WILSON ..................... io¥.;;,~5~/~/k k k'f ................. of the aforesaid building. Suffolk County Department of Health Approval ....8.6.--.8..07.ltl...J .u.n.e.. 2. .6.,.. ! 9. .8.7 ............. UNDERWR1TERS CERTIFICATE NO. N827738 A.ug. 18, 1987 PLUMBERS CERTIFICATION DATED: ROBERT KOWALSKI Aug. 31, I987 Building Inspector Rev. 1/81 · OEM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14833 Z Permission is hereby granted t.o: ............ ......-~.~.x...~.~.~. .............................................. .... ~.,~..~:.....~.:.~.,....!.!..~.~ ............... . ,o at premises located at .................. ~.....~ .......................................................... County Tax Map No. lO00 Section ...... ..O.....:~..,,I ..... Block ..... ..0.....~. ....... Lot No......'~....°1. ............. pursuant ,o application dated ..... .~.......~....C~. .................... , 193.~,,, and ~pprov~ by the Building Inspector. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS I~UREAU OF ELECTRICITY ,,.,,u.t ,6, THiS CEEIPIES THAT Tho~s E. Wil~on , Jr. Southern ~oul.evard 675, East ~on. N~Y. ~. thefollowinglocatlon, ~ B~$(~e.~ .~ Is, Fl. ~ 2nd Fl, Section Bl~k Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 42 67 DRYERS SYSTEMS NO. OF FEET E E R V I C OTHER APPARATUS: Motors: 1-30amp Trampler Switch 6-GoF.C.L 1-~S~oke Detector Panelboards: I-6cir. 100~ps Selected Load P~el Track Lighting 18' 10' 0 Lites FamOus Electric 18 Graham Road Mamptom Bays~ N.Y. 11946 Lie. 2347E GENERAL M~NAGER 11// This certificate must not be altered in any manner; return to the office may be identified E~y their credentials. COPY FOR [~UILD HG DEPARTMENT.~ THIS COPY OF CERTIF, CATE MU~T HOT.:BE ALTERED IH ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owne r~'~Nr~Ckf~ ~ (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 signature) Sworn to before me this ~/~ day of ~~ Notary Public, J ~ota~y Public County FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 featu res. 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 property showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: Additions $25.00 1. Certificate of occupancy New Dwelling. S25.0.0, Accessory.i$]O.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 $10.00 5.Updated C.O. $50.00 Date .............. New C ohs t, ruc t i on ...... ~-OId or'Pre-existing Building ............ Vacant Land . ./,,(;'. ,~-~'. ..... Location'ofPro ert ~'~ .~'~,.~..,,~..~.-,~/~/ 8Z' ~). ..~..~..~/.~.../~..~...,~.?.~ ../~.~,//~j~ House No. Street Ham/et Owner or Owners of Property . .-~../~P/~./~.¥..~.~...~?~.~.~?..'~..~..--~....?~....~.. ,~../~.,. Q....~. ~.'./~..~.../J~, County Tax Map No, 1000 Section ............... Block ............... Lot ................ Subdivision/~.4~.~. ?...~...~.~-/..'~ .~.'.~-.~....,~?..~./..~'...Filed Map No..~, .~..~. l..Lot No .............. Permit No/¥/. .~.~...~. ~.. Date of Permit ~.$/..~.~...Applicant~.~.,'~?. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate'. .................... Final Certificate ....................... · $ Fee Submitted ............................. Construction on above d ser bed bu,d n meets 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ '~INAL 765-1802 BUILDING DEPT. INSPECTION I- ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I/NSULATION FRAMING [,~] FINAL ~ ~//~'/~ q INSPECTOR DATE~ ~/~//~ - REMARKS: .A~/ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST ~'~"~ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION FRAMING ~ ~ FINAL REMARKS: 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: _. ~/_~/ .<~~,'~ DATE 765-1802 BUILDING DEPT. INSPECTION iOFO UNDATION 1ST [ ] ROUGH PLBG. UNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE 765-'~802 BUILDING DEPT. iNSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL RE:MARKs= ,, C/~ ~ DATE INSPECTOR ~/~ 765-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~NSULATION [ ] FRAMING FINAL DATE FIELD INS[~ECTION COMMENTS i~ ~-~ FOU__ND~TIO__N --~.(~st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE DITIONAL COMMENT{: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined,, ,~ ,o,&~,/~ .... ,19~, .{q'. Approved.....~..~__[3~.~.., 19~.~. Permit No. ! .~.~..%.~.~. ·. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG, DEPT, TOWN OF SOUTHOLD 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 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, bu~ code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~,,pec..c.c~ons. ~/ /~ ~ // (Signature of applicant, or name, if a corp rat'on) ?.s.;. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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... c?.C-'~.4~..~?.P.~... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · ............. ............. £a..s. ............ House Number Street Hamlet Connty Tax Map No. 1000 Section .... .~..! .......... Block ..... ~ ........... Lot .... .JJ~.'.2.~.. ....... Subdivision .... /g..~..C/./9..~.~.~.~....~.~..~..~. ...........Filed Map No...~.~.~: ! ...... Lot....q. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~../{..C.~..~..T. ......~.o. b. Ifitended us; ~.nd occ.upancy .... .'..~. (.1~.~..~.~. i.. ?..~..~" .~. ~./~/..~.&.~. ....... i ..... '..": .....- .......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....':.. ~.. Repair .............. Removal .............. Demolition ............ i. · Other Work ............... (Description). .? \ ~-.Q ~ ~.Qg: Fee ' 4 E tim d C . · s ate est ...................................... , ....................... - .... ~ (to be phid on filing this application) 5; If dwelling, number of dw I "'--, elling units ................ Nu/nber.of ~welling units on each floor ................ If gal'age, number of cars .......... ~..(.~ .~ .(~.~ .9~ ......... .i .......................... 6. If business, commercial or mixed occupancy specify nature and exten't°of each typ~ of use ...; ................. 7. Dimensions of existing structi~res., if any: Front ............... Rear ........ i ...... Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front .......... ~. · .i .... Rear .................. Depth ...................... Height ........... ~. .......... Number 9f Stories 8. Dimensions of entire new construction Front ....~./. ..... Rear . ~r--! : . ' ~e' 't~t' '~.'~'; '~'t> ..... Height ./ Number of Stories · ' ' '~' ................ · · I.a.¢' .......... '~ .................... 9. Slzeoflot Front Rear l:Z~'l? . n ....._. ;..~.g.?.3.~.~.l...~ff-}.~.d.'..~-. De_t, _. 10. Date of Purchase .-(q.~..~.../..Ig.~..~. .............. Name of Former Owner A~g/.C:~r .~...~..'",:~../f.q .~.g.5/.'... 11 Zone or use district in which premises are situated ~?.~3 ;~ ¢~ ~'~'~t~ - ' 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ~ ¢. ................... '.. 13. Will lot be regraded . ~..~..c; .9~f~{~r*.q*_q ~ ........... Will excess fill be rempv, edifrom ~r~mises: ~e~ No 14. ' oe' 7-~ //7.~'e/v Name of Owner of premises ......... /~ .......... Address ~...~ .... ~./.'..~.~..;~. ~S~ne No. ~??.: . .I~--~..~ ..... Name of Architect ........................... Address .................... Phone No ................ Name of Contractor .......................... Address .................i... Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& ind property lines. Give street and block number 9r description according to deed, and show interior or corner lot.' < ,, 5 a cfr~/r,~,v 8~- v D cate all set-back dimensions from mes and indicate whether STATE OF NEW YOlkK, S.S COUNTY OF ................. ........... .~.¢.ff~... ~ 3.\.~ .o.r). ................... being duly sworn, deposps and says that he is the applicant (Name of individual signing contract) ~bove named. :te is the .O (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this lpplication; that all statements contained in this application are true to the best of his mowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ~worn to before me this ............ ~,...~ ......... day of ...... ~ ....... , 19 qotary Public, ...... ,.; ~.-;.-~-~. ........... ounty ~'~ rai~'l~-~.~_a7 [ i ,(Signature of applicant) SUFFOLK CO. HEALTH DEPT. APPROVAL THE WATER SU~LY AND SEWAGE DI~SAL SYSTE~ FOR THIS RESIDENCE WILL ~~T~ CONFORM TO THE STANDARDS OF THE SUFFOL~ CO. DEPT.~ OF HEALTH SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- F'OR APPROVAL OF ~ 'DATE: ~ J J - '~ SUFFOLK CO. TAX MAP DESIGNATION: OWNERS ADDRE~: ," ' ,, TEST HOLE ~T~MP RODERICK VAN TUYL, P,C. LAND SUR~ORS GREEN~RT NEW YORK III Lo¥ 4 S.C DEPT OF HEALTH SERVICES IIIOI2ERI~,~ VAN TUYL. P.C. NEW YORK su.ou< ¢o. HtALT. ~,?. STAT~i'~T OF' THE WATER SUPPLY AND SI~WA(:i[ DISPOSAL SYSTEMS, FOR THIS RESIDENCE WILL CONFORM T(~ 'THE STANDARDS 'OF THE SUFFOLK CO. DEPT. OF HEALTH AII~LICANT ~UFFOkK COUNTY DEPT. OF HEALTH ~*ER¥1CE$ -- FOR APPROVAL OF ~'"ONSTRUCT ION ONLY CO. TAX MAP DESI~INATION: m~. S~CT. I~OCK ~. /o<2o ~ t ,9 ,~..~ G rc',r-?.~ W,, A/:..k" Lo P, (,,/ed .,ap) S~AL OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ,SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 ~f 1% LEAD. pLuMBER CERTIFICATION ON LEAD CONTENT SEFORE CERTI?ICATE OF OCCUPANCY APPROVED AS NOTED fftF<.O N T 'b,l~ E q-FE L I v 1 t--4 ic~_ / Pho.e477-0400 ~ Mai""o,*If l GRYENPORT, 1'"4 Y11't44 T o,L / ,,/ Phone 477-0400 GREENPORT Main Road N Y, t --7,