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Home My WebLink About14592-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... g.1.5.953 ....... Date July 14, 1987 THIS CERTIFIES that the building .... one-family dwelling. 1075 Old Orchard Lane East Marion Location of Property ~$~s~ hid ....................... County Tax Map No. 1000 Section 31 . .Block 7 .Lot 16 Subdivision Gardiner' s B..ay E..s.t.a.t,e..s..Filed Map No. 5083 .Lot No. 183 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... · F.e.b..r.u.a.r.Y.3.,.,.1,9~86 , pursuant to which Building Permit No. 14592Z 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~.e.-: ~ ~ra.i.!y..a.w.e..z.z.in~, w.i.~.h.. 9.n.e.-: .c.a.r..sf .a.r.a.~e...a.n.a., .a.tt.a?..h?~ .a..e??.s. :.. The certificate is issued to ..... ;RQI~I~g,T..L.:, .I.!..&..C.A.R..O.L..D.:..M.!L.L..S ................... of the aforesaid building. Suffolk County Department of Health Approval .............. 8..5 7.S.0.-~3' .4 ................... UNDERWRITERS CERTIFICATE NO ....................... .N 7 9.q o..~ .9 ................... PLUMBERS CERTIFICATION DATED: 7/1/87 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, AAIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 14592 Z Permission is hereb/granted to: ~ /~ fL . _. .~.~/~1. ...."~...o....x,..~t.~ ................................................... ,..,, .~..~.~......~..:~.:....I.!..~ ........... , .., ,o ~ ...................................... ~..~ .......... ~ ........ ~ ........ .~ ............................. ?......: ................ ~... 0, premises ,,~,,,,,d,,t.~.~..~......~.~...~..........~ ...... ...~..~ Building Inspector. F~e ~.~.~.:,!.~. .... and approved by the Building Inspector 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 t'3198 G. DEPT. TOWN OF $OUTHOLD Instructions A. This application must be filled in tvpewriter OR ink, and submitted m ~ 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 '~musual 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 approva~ of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-exist'nD' 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 ),ears $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .. NewC'onstPuction . .. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ./.O. 7..~'.....~../.Z~...(~..~.~./f'.,~..~/.~.....Z..~..z~..~ ........ .~'~'~.../...~.f~.~-J.O./.O... Hou.~ No. Street Nam/er Owner or Owners of Property . .~..O.~.~-. 7-..,.-.~.. ] ]- 'i~,.. [[ ~ -~' ..Y~.' .~4...o.I...D..~.l[~ ......... County Tax Map No. 1-000 Section .... ~.~ ........ Block ..... 7. ........ Lot ..... ~.~. ........ ,Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~.c~ .~. ?.... Date of Permit .~/~./.~:~...Applicant . '~.~..F~. ?....~.,..~t~(. j l!~..~....... ~¢~.~ I .D.. ~L(,/I~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ C~C~- /c~/~-d~:97 Construction on above described buildir~andperr~i~t mjeets a~ll applicable codes and regulations. loooTo~s THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY [~ 88 JOHN STREET. NEW YORK, NEW YORK 10038 ~.,~ ~'~.~ ~, ~ ~,,,,,,i~,io.~o.o.~i,~ ,¢vz?o~ N 790029 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Robert ~lls, 01d Orch~] Lane, E~ ~,~ion.. N.Y. in the followlng location; ~ Basement ~ Ist 1~7. [] 2nd FI. 3rd, Fl. ,Section Bilk Lot u~s examined oft J~nuary ] ~ ~ '[~7 a~l fou.d to be in ¢ompllanee ~hh the require.tents ~ th~s Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE SW['~CHES OUTLETS DRYERS FLUORESCENT SYSTEMS E OTHER APPARATUS: Motors: 1--Ibp ! ¢ NO, OF CC, COND, NO. OF HI-LEG PER~ CC, COND, 1 OF HI4EG NO, OF~UTRAL$ A,W'G' OF NEUTRAL Sal PralD Wiggins Lane G~eenpo~t, N.Y. 11944 Lic. 1049E This certlfkote must notbe ahered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUSTNOT BE ALTERED IN ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~'?.~ --(~-~[L~'se printr~ Plumber ~,~/~O/~ (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 I day of ,~ ,' Notary Public,.~ County Notary Public 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,~NAL REMARKS: DATE ~0/,~7 ,NSPECTOR~ *~ 765-1802 ~ ~BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL DATE 1ELD INSFECTION COMMENTS ~'OUNDATION (1st) 'OUNDATION (2nd) ~OUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDI IONAL COMMENTS: BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL .,=MA.KS: ~"'/'~-" ~°~-- DATE iNSPECTOR/~f~ [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT, INSPECTION [/~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved · .~.. ~..~.. ,~. ,., 19~..{°. Permit No. ! .~..~..c],~.. ,.~.- Disapproved a/c ..................................... Received. '... (Building Inspector) ,,. ,,, ( ,APPLICATION FOR BUILDING PERi'IT ') i~': i · ' Date INSTRUCTIONS a. This application must be completely riBed in. by typewriter or in ink and submitted )o sets of plans, accurate plot plan to scale. Fee according to schedule, ' . .. /:::~ .~:' . ')/', b. Plot plan showing location o~ lot and of buildings on premises relation~p tO. adjoin~g prsmiscsor or areas, and giving a detailed description of layout of property must be.draw~l on the:dial~mm Cation. < :': ' ' C. The work covered by this application may not be commenced beforelissuance Of Building Permit,;: d. Upon approval of this application, the Building Inspector wilt issued a Building P~.r~.it to tho 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 fo~ any'plJrpose what, eVeruntil ,a Certificate of shall have been granted by the Building Inspector '" ' ' ' .. ' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building perm/t: Building Zone Ordinance of thc Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings; additions or alterations, or for removal or demolition, as herein The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations,. Sad admit authorized inspectors on premises and in building for necessaD'qn~p~rtirm~ ' ~' . ' .~ '..: .' (S~gnature of apphcant~ or name, ff a corporation) P.O. Box 211, Greenpor[, New York li944 (Mailing address of applicant) ~" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buflder, Nameofownerofpremises ~ob.ext :k Ni.lJ_,s I~ ' ' ~ ' (as on the'tax roll or lates~ 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... ~.~ i/~..[~. ~ .~.t.~.o. ..... Other Trade's License No ...................... East Marion 1'. Location of land on which proposed work will be done ........... 1075 Old Orchard Lane House Number Street Hamlet County Tax Map No. 1000 Section ....3.1 ............. Block.,...' . 7,. -.,.." Lot....1.6 , ..,...,.. Subdivision Gardiner's Bay'Estal:es Filed Map No, 5083 Sec 3 Lot 1.83 (Name) 2. State existing use and occupancy of premises and intended use andoccupancy Of proposed cohstrUction; i a. xisting use an occupancy ....................................... , Residence b. Intended use and occupancy ~ .... · .... , ~ Nature of wot check which a ca : New Building ! ,. .... Addition, i ........ Alteration ,, .... . , .... Repair Removal DemoLition i Other Work 47 E~timated ·C°st ...... ~ .,'~e,~ ,;..¢-A~. ,i', ,(, ,. :., .... ,.};, .... i'~, Fee...' ...... ~ , , ' ~,,,, ~ ', , (to be' prod on filing this apphc~tion) ' - ' ' ,- , ' ' , One ~, ' ~, ' ' ,, I¢ dwMlm~ numb,r of dwo~tng umt~ ,,. ...... . .... , .. Number.of dwelling umt~ on *ach floor ............ , ... 'If garage numberofc~ .. ¢~q ' ' ; . : , If busmess.-commerclal or mlx~d,occup~cy, speedy nature and extent of each ty~e of use ........ ! . .. }..~ 7~.' D~nsion~ 0f exist~g structures, if any. Front .... .. Rear Depth ...... . ~ HMght ;. ? ~, .".........~.. Numb*r of Stofi,s, ~ .: ~ ~. ~...... i ........... ~. .... D~enstons of same structure ~th alterahons or additions Front ,~ ,,~8.' D~ensions of entire new const~ion Front :*aZ' 6" ', ~-, 20' 0[ ~.,~ 57' 6" ' ' 20 10~ ~ , Height ....:.~,,.,. ......... Numbor of Stofles .... %g~.., ......... . ..... S~zeoflot Front ~QQ,., ~, 110 n~,h 226 71 ,~, gone or ds* district in wMeh pr,mhe~ are situated ..... ~ v~vo~*~ wolat, ~onm~ mw~ ordinance or regulahon: ... ~a... ............ ?~,,, Wffi IOt,bo regraded ..., ..... .,, · ...., .... .,. ..... Will excess fill betemoved from premises: Yes , ,'N~0 of~chtteet .~$9¢ Mazzaferro, PE,' ' . ........ .' r ...... /4,'~',' '.'?~' '~'~'~ - .-~,. · ; ,; aoaress ~<qq~axq, .~!..~... Phone No. k/,~.%), ,t.%%Z~. ' of Contra¢tor',. ,', ', · ' Address ~.;;,:'.,~, N~o ;;; ":; , ' ' Phone No Locate :cle~ly ~d dm~ctly ~1 buildings, ~hether eXxStmg or nro~osed and i-'d~-+~ a~ ,~, ~,~ ~r~p~ Unes. O!~e.street ~ block number or deso~phon aCcord~g to deed, ~d show street nmos and indicate whether ,~mtenor,or corner tot,- ,, , , , "~se~. attached.: surveys ~:York , ,~"No, 30-6360 0 ' Commi~slon Expires March 30', 198~ applicant) ~ .ls,~II. ~. ~ . . ', ...........,, , ................ , , , ,. eing duly sworn, dep , es and says that he is th~ apptican/'~ ii tv, [~ [1 signing contract), ,7 , , : ..: ;~contractor ~ ' ,, ':,,,, ?/,,' (Contractor~ agent, corporate officei~, 'etc.) i r and is' duly authorized tO i~erform or have performed the s~id work and to make and ill* this statement'~eofltatned ~n this application ar~ true to the best of his'knowledge and'belief; and that the ~ manner s*t forth in the application filed therewith, SUFFOLK CO. HEALTH DEPT. APPROVAL OWN OF SOUT~OLD ____ THE WATER SU~LY AND SEWAGE DIS~SAL ~ ~' ~ ~. ~ SYSTEMS FOR THIS RESIDENCE WILL ' ~ .. ,~v, ~ )F' ~ ~ '-' ~' CONFORM TO THE STANDARDS OF THE ~ ............. , SUFFOLK CO DEPT. OF HEALTH SERVICES. IS) A~LICANT x ~ SUFFOLK COUNTY DEPT. OF HEALTH X SERVICES FOR APPROVAL OF ~'0~ ~ y CONSTRUCTION ONLY / ~ DATE: V~T / H. S. REF. NO APPROVED: ' SUFFOLK CO. TAX MAP DESIGNATION: ~ DIST. SECT BL~K ~L '~ -~ // " VAST - ~ SEAL - ~DERICK VAN TUYL,~. -- ' --- LI~NSED LAND SU~VEY~S GREE~RT NEW YORK VACA ~.~ i' o 2.ELE%AF!OI'4S ,c.~F~:,~ T',) I',dEAN ,~EA ~E 226.71 / ,SINGLE, FI :~5T~f~ C&N Tt TLE INSL FeAh~(_ ...... ~CK V~ TUVL~.~. LICEN~D LAND SURVEY~S GREEN~RT 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 SUFFOLK CO DEPT OF HEALTH SERVICES. {si APPLICANT SUFFOLK COUNTY DEPT Of HEALTH SERVICES FOR APPROVAL OF CONSTRUCTIONDATE O N L Y~ ~,~....~_~.~ H. s. REF. NO %S- S,:,- ¢..~ F 3 HLY DWILLINR ONL~ ~ SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT BLOCK PCL OWNERS ADDRESS: TEL. "" - 'I'; , *.5'00 DEED: L. ~//~ TEST HOLE STAMP SEAL N. 60° 57'4D'E- ,~..-'w N ,cF 30UTI",,IOcD, Li~NSED LAND SURVEYORS GR~ENI~OR T NEW YORK SUFFOLK CO. HEALTI4,1~:tI~T. APII~OVAL H.S. NO.,., STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE OlSI~OSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS 4~-IF THE SUFFOLK CO. DE3~'r. OF HEALTH SE:RVICES, (si API~L. ICA NT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO.: APPROVED: , , SUFFOLK CO. TAX MAP DE~IGNATION: DIST. S~CT. BLOCK P~L. ~ooO ~il ? 16 OWNERS ADDRESS: I'EL. 472-.I$~0 DEED: L. N/A P. I ?iAi:; :)F !:~'"' '"-' .... ' SINGLE FAMILY DWELLING ONLY --~ ......... .. STAT~NT ~ INTENT DATE ~ I ~ ~ '~, THE WATER $U~Y AND S~A~ DI~AL ..... SYSTEM~ F~ THIS RESIDENCE WILL THE SEWAGE ~S~SAL AND WATER SUPPLY FACILITIES FOR THIS [ ['/~: ~A~I.~.N~ L~ATION HAVE BEEN INSPECTED BY THIS D~PA~ENT AND . )F- :/. )r,' _ C~M TO THE STANDARDS ~ T~ ~ '- ...... ,~,' ~-~ .2~.~ ~ ~ ~FFOLK CO. DEPT. OF HEALTH SERVICES. FOUND TOBE~'~F~T~Y. - ~ a-~ ~ ~ ............. Chief of ~astewater Ma~.,*~ment Section . -:~A A~ICANT SERVICES -- FOR APPROVAL OF ~ CO~TRUCTION ONLY , )~ DATE: / ~OVED: ,/: t / ' " ~FFOLK CO. TAX MAP ~GNATION: DIST. ~T. ~K - ~ ~ /i' .< , :,.~ .< Jo :? / ...... ' -~K VAN TUYL.~ 2,~LffVA~'~ON5 ~F E~L T0 HEAN g~EA gE-VEL, LI~D LAND SURVEY~S ~EE~T NEW